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4. Real-world experience of water vapour therapy (Rezum) in patients with benign prostatic enlargement: a retrospective single-center study

Author

Wolters, Mathias, Krastel, Martin, Winkler, Thorben, Idais, Hamza, Mazdak, Mehrdad, Tezval, Hossein, Kuczyk, Markus A., and von Klot, Christoph-A. J.

Abstract

Background: Water vapor thermal therapy (Rezum) is a minimally invasive treatment for benign prostatic enlargement (BPE). Studies reporting urodynamic results regarding the procedure are rare. Our study aimed to assess the effectiveness of Rezum on urinary outcome parameters in a consecutive series of patients and compare urodynamic data before and after treatment. Methods: We retrospectively evaluated all the patients treated with Rezum between 07/2017 and 12/2023 at our institution. Patients who had more than one Rezum intervention, those who were unable to void (i.e., catheter-dependent patients), and those with insufficient data were excluded from the data analysis. Descriptive outcomes, such as symptom scores (IPSS, IPSS-QoL), peak flow in uroflowmetry (Qmax), post-micturition residual urine volume (PVR), and prostate volume (PVol), were analyzed. If available, preoperative and postoperative urodynamic results were evaluated. Results: In total, 250 Rezum procedures were performed during the observational period. After applying the exclusion criteria, the data from 193 patients were included in the analysis. Patients achieved significant symptom relief as measured using the IPSS (46% reduction) and IPSS-QoL scores (41% reduction). Qmax improved by 4.8 ml/s, as the mean PVR significantly decreased by 50%. PVol and PSA values decreased by 30% and 27.5%, respectively. In 19/193 patients with a urodynamic evaluation, pre- and postoperative data analysis showed a significant reduction in the bladder outlet obstruction index (BOOI) by approximately 70%. Conclusions: Rezum is effective and can improve urinary symptoms. In appropriate patients, Rezum can significantly reduce the bladder outlet obstruction (BOO).

Published
2024
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6. En bloc resection of urothelium carcinoma of the bladder (EBRUC): a European multicenter study to compare safety, efficacy, and outcome of laser and electrical en bloc transurethral resection of bladder tumor

Author

Kramer, Mario W., Rassweiler, Jens J., Klein, Jan, Martov, Alexey, Baykov, Nikolay, Lusuardi, Lukas, Janetschek, Günter, Hurle, Rodolfo, Wolters, Mathias, Abbas, Mahmoud, von Klot, Christoph A., Leitenberger, Armin, Riedl, Markus, Nagele, Udo, Merseburger, Axel S., Kuczyk, Markus A., Babjuk, Marko, and Herrmann, Thomas R. W.

Published
2015
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13. MP26-04 SAFETY, EFFICACY AND 12-MONTHS RECURRENCE RATE OF LASER VS. ELECTRICAL EN BLOC RESECTION OF UROTHELIUM CARCINOMA OF THE BLADDER: RESULTS OF THE EBRUC TRIAL

Author

Kramer, Mario W., Rassweiler, Jens J., Klein, Jan, Martov, Alexey, Baykov, Nikolay, Hurle, Rodolfo, Janetschek, Guenter, Lusuardi, Lukas, Wolters, Mathias, Abbas, Mahmoud, Leitenberger, Armin, Riedl, Markus, Nagele, Udo, Merseburger, Axel S., Kuczyk, Markus A., Babjuk, Marko, and Herrmann, Thomas R.W.

Published
2015
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32. Laser versus electrical en bloc resection of bladder tumors: Results of a European multicenter study (EBRUC).

Author

Kramer, Mario W., primary, Martov, Alexey, additional, Baykov, Nikolay, additional, Klein, Jan, additional, Rassweiler, Jens J., additional, Lusuardi, Lukas, additional, Janetschek, Guenter, additional, Hurle, Rodolfo, additional, Wolters, Mathias, additional, Abbas, Mahmoud, additional, Leitenberger, Armin, additional, Riedl, Markus, additional, Nagele, Udo, additional, Merseburger, Axel S., additional, Kuczyk, Markus A., additional, Babjuk, Marek, additional, and Herrmann, Thomas R. W., additional

Published
2015
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33. Deep Surgical Site Infections after Open Radical Cystectomy and Urinary Diversion Significantly Increase Hospitalisation Time and Total Treatment Costs.

Author

Wolters, Mathias, Oelke, Matthias, Lutze, Bettina, Weingart, Markus, Kuczyk, Markus a., Chaberny, Iris F., and Graf, Karolin

Subjects
*SURGICAL site, *CYSTECTOMY, *URINARY diversion, *INTENSIVE care units
Abstract

Introduction: Deep surgical site infections (DSSI) usually require secondary treatments. The aim of this study was to compare the total length of hospitalisation (LOH), intensive care unit (ICU) duration, and total treatment costs in patients with DSSI versus without DSSI after open radical cystectomy (ORC) and urinary diversion. Material and Methods: Prospective case-control study in a tertiary care hospital in patients after ORC with urinary diversion during April 2008 to July 2012. DSSI was defined based on Centers for Disease Control and Prevention criteria. Matched-pair analysis for patients with versus without DSSI was done in 1: 2 ratios. Patients with superficial surgical site infections (SSI) were excluded from analysis. Results: In total, 189 operations were performed. Thirty-eight patients (20.1%) developed SSI of which 28 patients (14.8%) had DSSI. Out of 28 patients, 27 (96.4%) were with DSSI and required surgical re-intervention. Due to insufficient matching criteria, 11 patients with DSSI were excluded from analyses. Consequently, 17 patients with DSSI were matched with 34 patients without DSSI. Significant differences were seen for median overall LOH (30 vs. 18 days, p < 0.001), median ICU duration (p = 0.024), and median overall treatment costs (€17,030 vs. €11,402, p = 0.011). Conclusions: DSSI significantly increases LOH (67%) and treatment costs (49%), adding up to a financial loss for the hospital of approximately €5,500 in patients with DSSI. [ABSTRACT FROM AUTHOR]

Published
2017
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41. [Pressure study of two miniaturised amplatz sheaths of 9.5 F and 12 F outer diameter for minimal invasive percutaneous nephrolithotomy (MIP): An ex vivo organ model measurement].

Author

Huusmann S, Wolters M, Schilling D, Kruck S, Bader M, Tokas T, Herrmann TR, and Nagele U

Subjects
Animals, Equipment Design, Humans, Miniaturization, Pressure, Swine, Therapeutic Irrigation, Materials Testing, Nephrolithotomy, Percutaneous instrumentation, Urodynamics
Abstract

Over the last decade, several devices for percutaneous nephrolithotomy with smaller diameters have been introduced in order to reduce renal trauma. Recent studies have found comparable stone free rates but also exhibit the same rate of postoperative fever and septicaemia. One possible cause is the influence of irrigation fluid during stone treatment procedures. The purpose of this ex vivo study was to compare two new miniaturised PNL nephroscopy sheaths with an outer sheath diameter of 9.5 F and 12 F to the well-established MIP M Set (17.5 F) by Karl Storz., Material and Methods: The new devices were tested in a perfused organ model of fresh porcine kidneys with different irrigation pressures, applied either by gravitation or the use of a pressure pump (Uromat E.A.S.I. Pump, Karl Storz, Tuttlingen, Germany).In addition, the 9.5 F sheath was examined for active irrigation evacuation, i. e. suction of irrigation fluid through a mono-J-catheter. An urodynamic pressure probe measured intrapelvic pressure levels throughout the procedures., Results: Regardless of the sheath diameters used, the intrapelvic pressure did not exceed 40 cmH 2 O (30 mmHg) when applying moderate irrigation pressure levels, either by pump or gravitation. The active suction of irrigation fluid from the kidney basin via the mono-J-catheter had no measurable impact on the detected intrarenal pressures. A crucial increase in the intrapelvic pressure was detected only when using the 9.5 F sheath in combination with applying high irrigation pressures., Conclusion:  The newly designed miniaturised MIP sets maintain the favourable pressure features of the earlier 17.5 MIP sheath. Although the diameter has been reduced to 12F or 9.5 F, the intrapelvic pressures remained below 40 cmH 2 O when regular irrigation settings by gravitation or pump irrigation were used., Competing Interests: Thomas Herrmann und Udo Nagele sind als Berater für die Firma Karl Storz tätig. Beide sind Patentinhaber von Karl Storz-Produkten und erhalten Honorare der Firma., (© Georg Thieme Verlag KG Stuttgart · New York.)

Published
2019
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