4th Annual Jefferson Urology Symposium: Focus on Urinary Incontinence

© The Canadian Journal of Urology TM : International Supplement, August 2021 UroLift and Rezum: minimally invasive surgical therapies for the management of benign prostatic hyperplasia Joon Yau Leong, MD, 1 Anthony T. Tokarski, MD, 1 Claus G. Roehrborn, MD, 2 Akhil K. Das, MD 1 1 Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA 2 Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA LEONG JY, TOKARSKIAT, ROEHRBORNCG, DAS AK. UroLift and Rezum: minimally invasive surgical therapies for the management of benign prostatic hyperplasia. Can J Urol 2021;28(Suppl 2):2-5. Introduction: Minimally invasive surgical therapies for benign prostatic hyperplasia (BPH) are popular alternatives to the gold standard transurethral resection of the prostate (TURP). These procedures have fewer discernable side effects on urinary and sexual function, when compared to TURP, making it a desirable option for many patients. Materials and methods: We provide an updated literature review on the current landscape of minimally invasive modalities, specifically the prostatic urethral lift (UroLift) and water vapor thermal therapy (Rezum), for the surgical treatment of BPH. Results: Both UroLift and Rezum have demonstrated excellent efficacy and durability in relieving lower urinary tract symptoms (LUTS) in the BPH patient. When compared to TURP, these minimally invasive therapies can be performed in an outpatient setting, with decreased hospitalization, operative and catheterization times, which minimizes overall healthcare costs. Moreover, these therapies have no discernable adverse effects on sexual function (both ejaculatory and erectile) or sexual satisfaction, making it a desirable option for many patients. Conclusions: Both the UroLift and Rezum are office- based, minimally invasive techniques capable of providing durable, and significant relief of LUTS secondary to BPH. In select patients, they demonstrate comparable efficacy to TURP with the added advantage of preserving sexual function and minimizing patient morbidity and healthcare cost. An individualized, shared decision-making approach is essential in selecting the optimal treatment option for each patient. Key Words: UroLift, Rezum, minimally invasive, benign prostatic hyperplasia, BPH Address correspondence to Dr. Joon Yau Leong, Department of Urology, Thomas Jefferson University, 1025Walnut Street, Suite 1100, Philadelphia, PA 19107 USA Introduction Minimally invasive therapies are becoming a popular surgical alternative to the gold standard transurethral resection of the prostate (TURP) for the treatment of benign prostatic hyperplasia (BPH) in prostates up to 80 mL. While TURP is effective in treating patients with significant lower urinary tract symptoms (LUTS) secondary to BPH, it is also associatedwith bothersome urinary and sexual adverse effects, including urinary 2 incontinence and retrograde ejactulation. Currently, UroLift and Rezum are among the two popular office-based procedures that are approved by the American Urological Association (AUA) guidelines for the management of symptomatic BPH in patients who have failed medical management. 1 These novel therapies have shown to provide significant, and durable relief of LUTS secondary to BPH, with the added advantage of avoiding the TURP- related adverse effects. Herein, we provide an updated literature review on the current landscape of minimally invasive modalities, specifically the prostatic urethral lift (UroLift) and the water vapor thermal therapy (Rezum), for the surgical treatment of BPH.