MP27-17 EFFECTIVENESS OF REZŪM FOR CATHETER-DEPENDENT URINARY RETENTION: 12 MONTHS OUTCOMES OF A REAL-WORLD DATABASE
Bibliographic record
Abstract
You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II (MP27)1 May 2024MP27-17 EFFECTIVENESS OF REZŪM FOR CATHETER-DEPENDENT URINARY RETENTION: 12 MONTHS OUTCOMES OF A REAL-WORLD DATABASE Roseanne Ferreira, Naeem Bhojani, Bilal Chughtai, Kevin C. Zorn, and Dean Elterman Roseanne FerreiraRoseanne Ferreira , Naeem BhojaniNaeem Bhojani , Bilal ChughtaiBilal Chughtai , Kevin C. ZornKevin C. Zorn , and Dean EltermanDean Elterman View All Author Informationhttps://doi.org/10.1097/01.JU.0001009400.86696.a2.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Managing catheter-dependent urinary retention typically involves medical therapies and when these are ineffective, transurethral surgery. Rezūm, a minimally invasive procedure utilizing convective water vapor to ablate benign prostatic tissue, presents an alternative treatment paradigm. This study aims to evaluate the clinical outcomes of treating catheter-dependent urinary retention using Rezūm therapy. METHODS: We analyzed data from the Canadian Rezūm registry database, which prospectively collated information from two high-volume centers between April 2019 and June 2023. Eligible patients were those with catheter-dependent urinary retention at the time of treatment. Variables such as patient demographics, operative characteristics, and functional outcomes were assessed at baseline, as well as 3, 6, and 12 months post-procedure. Descriptive statistics and logistic regression analyses were employed for data interpretation. RESULTS: Out of 95 patients with a history of urinary retention, 44 were catheter-dependent at the time of undergoing Rezūm therapy. The mean age of the patients was 69.6±10.3 years, and 70.5% presented with at least one comorbidity. Average prostate volume was 87.3 ml (range 29-195 ml), with 11% of prostates exceeding 150 ml. 82% of patients had a median lobe. 4.5% (2/44) had received prior surgical intervention. All patients had recently failed at least one trial without catheter (TWOC), and 52.3% were under oral BPH medical therapy at the time of the procedure. Median vapor injections numbered 14.5 (range 7-21), and mean procedure duration was 5.0±1.7 minutes. Median scores for visibility and bleeding during the procedure were both 1 out of 5 (range 1-3). Anesthesia comprised IV propofol sedation in 57%, spinal block in 36%, and self-administered methoxyflurane in 7% of patients. The trial of void (TOV) was attempted at a median of 30 days (range 7-30), with 38% (15/44) failing their initial TOV. No significant associations were found between failed initial TOV and variables such as prostate volume, number of treatments, comorbidities, or presence of a median lobe. Urinary tract infections were noted in 6 of 10 cases, and hematuria in 2 of 3 cases among those who failed their initial TOV. The rates of spontaneous voiding and catheter independence were 43/44, 39/40, 30/31, and 24/25 at 1, 3, 6, and 12 months, respectively. By the 12-month mark, reoperation was required in 4% (1/25), while 96% (24/25) remained catheter-independent. CONCLUSIONS: Rezūm water vapor therapy offers a promising and effective treatment alternative for catheter-dependent urinary retention patients who have failed initial TWOC, high rate of spontaneous voiding at 12 months post-procedure. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e430 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Roseanne Ferreira More articles by this author Naeem Bhojani More articles by this author Bilal Chughtai More articles by this author Kevin C. Zorn More articles by this author Dean Elterman More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".