Presented by: Belén Giménez MD
Urology Department, Universidad de Chile, Hospital Clínico San Borja Arriarán

Introduction

Water Vapor Thermal Therapy (WVTT) is an effective minimally invasive surgical treatment of bladder outflow obstruction. We aimed to identify pre and perioperative factors associated with health-related quality of life (HRQoL) positive changes after 12-months of WVTT.

Materials

Patients who underwent WVTT between 2020-2022 in a Chilean clinical center were eligible for inclusion. Changes in urinary symptoms and HRQoL were assessed using the International Prostate Symptom Score (IPSS) questionnaire, and only patients with IPSS-QoL ≥ 3 at baseline were included. Demographics, perioperative, and clinical outcomes data were obtained at baseline. The patients were assessed at 6 weeks and 3, 6, and 12 months after procedure. An improvement greater than 50% in IPSS score or an IPSS-QoL score less than or equal to 2 points after procedure, was considered as a satisfactory treatment. Logistic regression analysis was used to determine potential predictors of a satisfactory treatment.

 

Results

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A total of 130 men were treated and followed for a median of 13.1 months. The median age of included patients was 61.9 years (50-87) with a mean prostate volume of 52.3cc (35-81). Regarding the severity of the symptoms, 65.4% of patients reported moderate (IPSS 12-23), 28.8% severe (IPSS 24-35) and 5.4% mild lower urinary tract symptoms (IPSS 0-11). At 12 months follow-up, IPSS improved by 22.1%, 65%, 66.5% and 65.5% at 6 weeks, and 3, 6 and 12 months, respectively (P < 0.03). IPSS Quality of Life (QoL) scores improved by 55.5%, 61%, 63.2% and 66.6% % at these same time points (P < 0.001). Maximum flow rate (Qmax) improved by 6.9 mL/s at 12 months (p=0.01). According to the definition of satisfactory procedure, 61.5% of patients improved their IPSS score, and 86.2% their quality-of-life score. Age ≤60 years-old, expected prostate volume ≤ 60cc and a total number of injections ≤5, were independently associated on logistic regression analysis with improvement on IPSS-QoL (OR 1.25, 1.87 and 1.55 respectively).

Conclusion

The WVTT was effective in improving the quality of life of the patients one year after the intervention. In this study, we demonstrated that age (≤60 years-old), prostate volume (≤60cc) and a small number of treatments during WVTT (≤5 injections) were predictors of a significant 12-month improvement of HRQoL in patients undergoing WVTT.

Funding

None

Lead Authors

Juan Fulla, MD, MsC
Universidad de Chile

Co-Authors

Ragheb Massouh, MD
Universidad de Chile

Diego González, MD
Universidad de Chile

Sebastián Arroyo, Medical Intern
Universidad de Chile

Tomás Gatica, MD
Universidad Finis Terrae

Sofía Astorga, MD
Universidad de Chile

Catherine sanchez, PhD, MVD
Clinica las Condes