Clinical Outcomes of Rezum Treatment in High-Risk Elderly Patients with Long-Term Urinary Catheters: A Retrospective Study

Objective: This study aimed to evaluate the efficacy and safety of Rezum water vapor therapy in elderly male patients with long-term urinary catheterization and high anesthetic risk, as indicated by American Society of Anesthesiologists (ASA) scores of 3–4. Material and Methods: We retrospectively analyzed 15 elderly male patients with ASA scores of 3–4 who had been using indwelling urinary catheters and underwent Rezum therapy between January and December 2023. Outcomes assessed at 1 and 6 months post-treatment included the International Prostate Symptom Score (IPSS), quality of life (QoL), prostate volume (PV), and post-void residual urine (PVR) volume. Time to catheter removal was also recorded. Results: The study cohort consisted of 15 elderly male patients with a mean age of 83.2 years (73-90 years old). Catheter removal was attempted at an average of 21 ± 4.5 days post-procedure. While 13 patients tolerated catheter removal successfully, two patients developed acute urinary retention and required re-catheterization. In these patients, the catheter was maintained for at least an additional 14 days. By the third postoperative month, all patients had achieved catheter independence. At 1 month post-treatment, the mean IPSS was 20.07 ± 1.62, improving to 18.13 ± 1.51 at 6 months. QoL scores increased from a baseline of 1.60 ± 0.51 to 3.33 ± 0.49 at 1 month and further to 3.67 ± 0.49 at 6 months PVR decreased from 136.7 ± 53.7 mL at 1 month to 92.0 ± 33.4 mL at 6 months. PV reduced from 91.07 ± 18.7 mL to 65.27 ± 13.4 mL. No Clavien-Dindo grade ≥2 complications were observed. Conclusions: Rezum therapy appears to be a safe and effective minimally invasive alternative for high-risk elderly male patients with indwelling catheters who are not suitable candidates for conventional surgical interventions.