(079) Predictors of Failed Trial of Void After Rezum Water Vapor Therapy for Benign Prostatic Hyperplasia
Bibliographic record
Abstract
Abstract Introduction Benign prostatic hyperplasia (BPH) is a common condition that affects a significant portion of men in mid to late adulthood. Rezum water vapor therapy, a minimally invasive intervention that utilizes convective water vapor energy to reduce prostatic tissue volume and alleviate obstruction, has demonstrated favourable safety and efficacy in treating BPH. Post-treatment, patients are discharged with a Foley catheter insertion and undergo a trial of void (TOV) at catheter removal. Failure to void at this time results in re-catheterization, prolonging patient discomfort and increasing the risk of urinary tract infection and other catheter-associated complications. Despite growing data on Rezum water vapor therapy as a treatment for BPH, there is limited data on predictors of post-operative trial of void success. Objective This study aims to identify clinical and procedural variables associated with failed TOV following Rezum therapy, aiming to contribute to the limited literature on outpatient Rezum outcomes. Methods We conducted a retrospective study of patients undergoing Rezum water vapor therapy at a Canadian ambulatory surgical centre from April 2022 to November 2024. Data was collected retrospectively from patients who were over the age of 18, receiving Rezum water vapor therapy, and were not using a Foley catheter prior to the procedure. Baseline characteristics, number of injections, and post-operative progress markers were recorded. Univariate logistic regression analysis for each collected variable was performed to determine predictive factors. Results Among 314 procedures performed from April 2022 to January 2025, the mean patient age was 68.8 ± 8.0 years with mean BMI of 29.3 ± 4.9. Of these patients, 2.9% (n = 9) failed the TOV, while 4.8% (n = 15) were initially able to void but later failed the TOV, and 92.3% (n = 290) successfully voided during the initial TOV. All TOVs were conducted during the 1-week post-operative follow-up. Univariate logistic regression analysis revealed that pre-operative post-void residual volume (PVR) was statistically significant in association with the outcome of the TOV (p = 0.0125). Age, BMI, gland size, median lobe size, total injections, and median lobe injections were not significantly associated with the TOV failure. Conclusions Our findings identify pre-operative PVR as the sole predictor of failed trial of void (TOV) following catheter removal after Rezum water vapor therapy in an outpatient setting. Recognizing patients at increased risk for re-catheterization may facilitate more personalized and effective post-operative care. Ongoing long-term follow-up is necessary to evaluate the durability of surgical outcomes. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
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".