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Water vapor thermal therapy for indwelling urinary catheter removal in frail patients

  • Urology - Original Paper
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Abstract

Purpose

To report the efficacy and safety of water vapor thermal therapy to achieve catheter removal in frail patients with refractory acute urinary retention.

Methods

Data from consecutive frail patients with indwelling urinary catheter undergoing the Rezūm™ therapy (Boston Scientific Corporation, Marlborough, MA) at a single center between October 2017 and June 2021 were prospectively collected. The included patients were deemed unfit or at high risk of complications for conventional benign prostatic hyperplasia (BPH) surgery. Prostate volumes up to 120 mL were considered eligible. The primary endpoint was successful cessation of catheter dependency, assessed postoperatively and up to 1 year of follow-up.

Results

A total of 24 men met our inclusion criteria. The median age, Charlson comorbidity index, and duration of preoperative catheterization were 77 years (IQR 67–86), 6 (IQR 3–7), and 113 days (IQR 87–159), respectively. Two cases (8.3%) of postoperative complications were recorded (Clavien II and Clavien IIIa). After a median postoperative catheterization time of 21 days (IQR 11–32), all patients regained spontaneous voiding. During follow-up, two patients died and a total of 22 patients completed the 1 year follow-up. All patients maintained spontaneous voiding without recurrence of urinary retention. No surgical retreatment was performed. In terms of pharmacological management, 22/24 patients (91.7%) had a BPH medication pre‐Rezūm™; this decreased to 8/22 patients (36.3%) post‐Rezūm™ (p < 0.001).

Conclusions

In this single-institution, prospective, and observational study, water vapor thermal therapy was found to be effective and safe in restoring successful spontaneous voiding in a cohort of elderly and frail patients.

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Availability of data and materials

Data are available upon request to the corresponding author.

Code availability

None.

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Funding

The study was not funded.

Author information

Authors and Affiliations

  1. Department of Urology, CH Aix-Pertuis, Aix en Provence, France

    Abel Tadrist, Michael Baboudjian, Mamadou B. Bah, Camille Alegorides, Florie Bottet, Frederic Arroua, Christophe Eghazarian & Marc Fourmarier

  2. Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France

    Michael Baboudjian

  3. Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain

    Michael Baboudjian

  4. Department of Urology, Hôpital National Ignace Deen, Conakry, Republic of Guinea

    Mamadou B. Bah

Authors
  1. Abel Tadrist
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  2. Michael Baboudjian
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  3. Mamadou B. Bah
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  4. Camille Alegorides
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  5. Florie Bottet
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  6. Frederic Arroua
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  7. Christophe Eghazarian
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  8. Marc Fourmarier
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Contributions

Study concept and design: F, T, and B. Acquisition of data: T, B, and A. Analysis and interpretation of data: F, T, and B. Drafting of the manuscript: F, T, and B. Critical revision of the manuscript for important intellectual content: A, E, and B. Statistical analysis: B.

Corresponding author

Correspondence to Michael Baboudjian.

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Conflicts of interest

The authors report no conflict of interest.

Ethics approval

All procedures performed in this study were in approval with the ethical standards of the institutional research committee (IRB 19–10-09) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent to participate

All patients provided oral and written consent to undergo Rezūm™ therapy, while it was a technique under development and knew that the data could be used for research purposes.

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All authors approve the submission.

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Tadrist, A., Baboudjian, M., Bah, M.B. et al. Water vapor thermal therapy for indwelling urinary catheter removal in frail patients. Int Urol Nephrol 55, 249–253 (2023). https://doi.org/10.1007/s11255-022-03408-w

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  • DOI: https://doi.org/10.1007/s11255-022-03408-w

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