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Use of the Schelin Catheter for transurethral intraprostatic anesthesia prior to Rezūm treatment
Hamouda Aalya, Ibrahim Ahmed, Corsi Nicholas, Siena Giampaolo, Elterman S. Dean, Chughtai Bilal, Bhojani Naeem, Sessa Francesco, Rivetti Anna, Secco Silvia, Zorn C. Kevin Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada

Minimally invasive surgery techniques (MIST) have become newly adopted in urological care. Given this, new analgesic techniques are important in optimizing patient outcomes and resource management. Rezūm treatment (RT) for BPH has emerged as a new MIST with excellent patient outcomes, including improving quality of life (QoL) and International Prostate Symptom Scores (IPSSs), while also preserving sexual function. Currently, the standard analgesic approach for RT involves a peri-prostatic nerve block (PNB) using a transrectal ultrasound (TRUS) or systemic sedation anesthesia. The TRUS approach is invasive, uncomfortable, and holds a risk of infection. Additionally, alternative methods such as, inhaled methoxyflurane (Penthrox), nitric oxide, general anesthesia, as well as intravenous (IV) sedation pose safety risks or mandate the presence of an anesthesiology team. Transurethral intraprostatic anesthesia (TUIA) using the Schelin Catheter (ProstaLund, Lund, Sweden) (SC) provides a new, non-invasive, and efficient technique for out-patient, office based Rezūm procedures. Through local administration of an analgesic around the prostate base, the SC has been shown to reduce pain, procedure times, and bleeding during MISTs. Herein, we evaluated the analgesic efficacy of TUIA via the SC in a cohort of 10 patients undergoing in-patient RT for BPH.

Keywords: BPH, Rezum, TRUS, PNB, Schelin Catheter, TUIA,
Feb 2024 (Vol. 31, Issue 1 , Page 11802)
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The Rezūm system - a minimally invasive water vapor thermal therapy for obstructive benign prostatic hyperplasia
Cantrill H. Christopher, Zorn C. Kevin, Elterman S. Dean, Gonzalez R. Ricardo, MD Urology San Antonio, San Antonio, Texas, USA

Benign prostatic hyperplasia (BPH) and accompanying lower urinary tract symptoms (LUTS) sits in the top ten prominent and costly disease conditions in men over 50 years of age. In the United States it is the most common diagnosis made by urologists for men 45 to 74 years of age. Twenty percent of the population will reach 65 years of age or older by 2030, and those over 85 years will represent the fastest growing segment of our population. The prevalence of symptomatic BPH increases proportionally with the aging population. It is estimated that BPH now affects 6% of the male population worldwide. Moreover, in Canada, the estimated BPH prevalence is more than 1 million men aged 50 years and older. Among the various surgical treatments, Rezūm water vapor thermal therapy has been developed as a unique, rapid and reproducible minimally invasive surgical treatment exhibiting safe and early effective relief of LUTS/BPH. The targeted prostate tissue ablation is amenable to all zones of the prostate including intravesical median lobes. We present our experiences with this technique, which can be quickly performed under local anesthesia in an office setting.

Keywords: benign prostatic hyperplasia, prostate, LUTS, water vapor thermal therapy, Rezum system, minimally invasive surgical treatment,
Jun 2019 (Vol. 26, Issue 3 , Page 9787)
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