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Water Vapor Treatment for Benign Prostatic Hyperplasia

Prostatic_HyperplasiaBenign prostatic hyperplasia commonly occurs in older men and consists of an enlargement of the prostate, a walnut-shaped gland that surrounds the urethra at the neck of the bladder. This abnormal growth may compress or completely block the urethra, causing a wide range of lower urinary tract symptoms that can lead to bladder outlet obstruction and eventually injury to the kidneys.

The Rezūm System is one of the therapeutic options developed for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia. This minimally invasive therapy uses sterile water vapor (steam) for the delivery of targeted, controlled doses of convective thermal energy directly to the transition zone of the prostate gland, the middle area of the prostate which surrounds the urethra.

Scientists from the Department of Urology at Mayo Clinic recently evaluated the physical effects of this procedure in 45 men. Patients were treated with an intraprostatic injection of water vapor and subsequently underwent a series of MRI scans over a 6 month period allowing the team to visualize and monitor the treated lesions.

From multiparametric gadolinium-enhanced MRI images of the prostate, Analyze software was used to perform segmentation, processing, registration, multimodality fusion, and measurements. The visualization and analysis tool was also used to process segmented MRI volumes into 3D volume renderings of the whole prostate, transition zone, and treatment lesions. Results showed that total prostate volumes were reduced by 28% at 6 months after treatment compared to baseline 1-week MRI images. The team also saw a significant resorption of the lesions after 3 months and nearly complete resolution after 6 months.

This study indicates that the Rezūm System can be considered an effective strategy for the treatment of prostatic hyperplasia. Also, convective thermal energy transfer did not compromise the integrity of structures surrounding the prostate such as the bladder, urinary sphincter, and rectum as the lesions generated by the water vapor treatment specifically correlated with the targeted locations of the injections.

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