MINIMALLY INVASIVE SURGICAL TREATMENT WITH WATER VAPOR ENERGY THERAPY FOR LOWER URINARY TRACT SYMPTOMS SECONDARY TO BENIGN PROSTATIC HYPERPLASIA: A PROSPECTIVE STUDY

(Introduction and objective) Water vapor energy therapy (WAVE) received insurance approval in Japan in September 2022 for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. Here we report a prospective trial of WAVE. (Patients and methods) This study included 16 patients who underwent WAVE between November 2022 and December 2023. International Prostate Symptom Score (IPSS), IPSS Quality of Life (QOL) score, overactive bladder symptom score, post-void residual urine volume (PVR), prostate volume (PV) measured using transrectal ultrasonography, postoperative catheter removal rate, surgical duration, and adverse events were recorded preoperatively and at 1, 3, 6, and 12 months postoperative. (Results) The median age was 76.5 years, and 11 of 16 patients (69%) received antiplatelets and/or anticoagulants. The median preoperative PV was 43.5 ml, while the median postoperative follow-up period was 6.9 months. Comparison of the baseline and 6-month postoperative follow-up values showed that the median IPSS and IPSS-QOL scores decreased significantly (by 48% and 55%, respectively), while the median PV was significantly reduced by 36%. The median PVR was reduced by 51%; however, the difference was not significant. Catheter removal was successful in 80% of patients. The median surgical duration was 8.5 min (range, 4.0-26.0 min). Complications (grade ≤ II) according to the Common Terminology Criteria for Adverse Events v5.0 occurred in 12 patients. (Conclusion) WAVE is a useful minimally invasive surgical approach in elderly patients and patients receiving antiplatelets and/or anticoagulants, featuring a short surgical duration, improved micturition, and no serious adverse events.