The  transurethral Convective WAter Vapour Energy (WAVE) ablation therapy of the prostate (Rezūm procedure)
of the prostate is a relatively novel minimally invasive treatment for the management of lower urinary tract
symptoms (LUTS) secondary to Benign Prostatic Enlargement (BPE).  A radiofrequency generator provides the
thermal energy needed for treatment by converting water to vapour (steam).  Short term outcome studies have demonstrated an improvement in International Prostate Symptom Scores (IPSS) following the procedure. The aim of this study is to objectively
demonstrate outcome measures from the patient’s perspective.

The RezūmTM procedure was carried out as a daycase procedure by a single surgeon in a single centre in the UK. This was offered to patients with symptomatic BPE as a minimally invasive procedure. The first 65 consecutive patients with symptomatic LUTS secondary to BPE who underwent the RezūmTM procedure over a 21-month period (July 2018 – March 2020) were sent a questionnaire. Data on IPSS scores, Quality of Life (QoL) scores, Post procedure Retrograde Ejaculation (RE), Erectile Dysfunction (ED) and Urinary Incontinence (UI),  Need for retreatment, Current medication use and Level of satisfaction was recorded and analysed.

Of the 65 questionnaires distributed, 38 (58.4%) responded. Follow up period ranged from 10 – 28 months post procedure with a mean of 18.1 months. The mean age was 68 years (51-91) with a mean post procedure IPSS score of 8.6 (1-29). A higher impact appeared to be noticed in the voiding domain scores of the IPSS. Most (88.9%) patients reported being medication free. Twenty-nine (76.3%) patients would recommend the procedure to others. Some comments included “amazing change in quality of life”, “delighted” and “absolute success”. Twenty-five (65.7%) respondents had QoL scores ≤ 2 while 3 (7.8%) reported being unhappy (QoL score 5). ED, RE and UI were reported in 10%, 10% and 0% respectively. Two (5.3%) had undergone further procedures (1 TURP, 1 repeat RezūmTM).

These results demonstrate the outcomes as reported from the patients' perspective. It was not surprising to see a higher impact noticed in voiding domains as storage symptoms are notoriously difficult to treat. This study therefore gives a rare insight into the Quality of Life which the RezūmTM procedure offers as perceived by the patient.

PROMs are an objective way of assessing patients’ perspectives. In this ‘real world’ assessment, RezūmTM has largely been perceived positively by our cohort.There is insufficient pre-procedure information about ED which may call into question the ED rates reported here. However, the reported rates of ED and RE in this study need to be investigated further.