Predictors of achieving a minimal clinically important difference in lower urinary tract symptoms 3 month safter Rezum therapy

Abstract

Introduction

Gaining insight into patient characteristics to predict the success of procedures is crucial for improving outcomes and for preoperative counselling. We identified predictors of achieving a minimal clinically important difference (MCID) in lower urinary tract symptoms (LUTS) 3 months after Rezūm.

Material and methods

A retrospective study was conducted on patients treated with Rezūm. Patients with moderate or severe LUTS and a recorded International Prostate Symptom Score (IPSS) at 3 months were included and categorised into 2 cohorts based on experiencing a MCID at 3 months (≥ 25% improvement in IPSS). Predictors were identified through multivariate logistic regression analysis.

Results

Out of 174 patients, 134 (77%) achieved a MCID at 3 months, and those who did had a higher median baseline IPSS (20 [16–26] vs 15 [10–21], P <0.001) and were more likely to have severe LUTS at baseline (53.0% vs 35.0%, P = 0.046) when compared to those who did not experience a MCID at 3 months. Higher baseline IPSS (OR: 1.10, 95% CI 1.04–1.17) and larger baseline prostate volumes (OR: 1.03, 95% CI 1.0–1.05) were predictors of achieving a MCID at 3 months. More specifically, a significantly greater proportion of patients with severe LUTS (83.5 vs 70.8%, P = 0.046) and prostate volume ≥60 cc (94.6 vs 71.4%, P = 0.003) achieved MCID at 3 months when compared to patients with moderate LUTS and prostate volumes <60 cc, respectively.

Conclusions

More than three-quarters of patients treated with Rezūm achieved a MCID at 3 months. Patients with severe LUTS and prostate volumes ≥ 60 cc may be optimal candidates for experiencing early relief in LUTS following Rezūm.

Babar M, Abramson M, Labagnara K, et al. Predictors of achieving a minimal clinically important difference in lower urinary tract symptoms 3 months after Rezum therapy. Cent European J Urol. 2024; 77: 262-272.