Comparing Water Vapor Therapy, Needle Ablation, and Microwave Therapy for Enlarged Prostate

What is it about?

This study aimed to compare the efficacy and safety of water vapor therapy (Rezūm), transurethral needle ablation (TUNA), and transurethral microwave therapy (TUMT) for treating men with moderate to severe benign prostatic hyperplasia (BPH) symptoms. The authors conducted a network meta-analysis (NMA) of randomized clinical trials (RCTs) and found that Rezūm had similar outcomes to TUNA and TUMT in terms of improvement in International Prostate Symptom Score, maximum peak-flow rate (Qmax), and post-void residual volume (PVR). However, Rezūm had a higher rate of serious adverse events (Clavien-Dindo ≥ Grade 3) than TUMT and TUNA. The authors concluded that the widespread use of Rezūm in clinical practice is based on limited evidence, and the evidence suggests that Rezūm is not significantly better than TUNA and TUMT in any clinically relevant domain.

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Why is it important?

This research is important because it compares the efficacy and safety of water vapor therapy (Rezūm), transurethral needle ablation (TUNA), and transurethral microwave therapy (TUMT) for treating men with moderate to severe benign prostatic hyperplasia (BPH) symptoms. It provides valuable insights into the effectiveness of these therapies and can help urologists make informed decisions about the best treatment options for their patients. Key Takeaways: 1. Rezūm, TUNA, and TUMT have similar efficacy in improving International Prostate Symptom Score (IPSS) and Maximum Peak-Flow Rate (Qmax). 2. Rezūm has similar or inferior outcomes to TUNA and TUMT in terms of Post-void Residual Volume (PVR) and Serious Adverse Events (SAE) rates. 3. The difference in SAE rates between Rezūm, TUNA, and TUMT was not statistically significant. 4. Based on the findings, justifying the use of Rezūm over TUNA and/or TUMT would be difficult due to the similar efficacy outcomes and lower SAE rates of the latter two techniques. 5. The evidence suggests that Rezūm is not significantly better than TUNA and TUMT in any clinically relevant domain.