Uzun Süreli Üriner Sonda Kullanan Yüksek Riskli Yaşlı Hastalarda Rezum Tedavisinin Klinik Sonuçları: Retrospektif Bir Çalışma

Year 2025, Volume: 17 Issue: 3, 164 - 169, 30.09.2025

Ali Egemen Avci , Basri Cakiroglu

https://doi.org/10.54233/endourolbull-1748348

Abstract

Amaç: Bu çalışmanın amacı, Amerikan Anesteziyologlar Derneği (ASA) skorları 3–4 olan uzun süreli üriner kateter kullanımı ve yüksek anestezi riski bulunan yaşlı erkek hastalarda Rezum su buharı tedavisinin etkinliğini ve güvenliğini değerlendirmektir.
Gereç ve Yöntemler: Ocak–Aralık 2023 tarihleri arasında Rezum tedavisi uygulanan, ASA skoru 3–4 olan ve kalıcı üriner kateter kullanan 15 yaşlı erkek hasta retrospektif olarak analiz edildi. Tedavi sonrası 1. ve 6. aylarda Uluslararası Prostat Semptom Skoru (IPSS), yaşam kalitesi (QoL), prostat hacmi (PV) ve işeme sonrası artık idrar hacmi (PVR) değerlendirildi. Sondanın çekilme süresi de kaydedildi.
Bulgular: Ortalama yaşı 83,2 yıl olan 15 yaşlı erkek hasta çalışmaya dahil edildi. Sonda çıkarma işlemi ortalama 21 ± 4,5 gün sonra denendi. On üç hasta sondasız idrar yapmayı başardı, ancak iki hastada akut üriner retansiyon gelişti ve tekrar sondalanmaları gerekti. Bu hastalarda sonda en az 14 gün daha tutuldu. Üçüncü ayın sonunda tüm hastalar sonda bağımsızlığına ulaşmıştı.
Tedavi sonrası 1. ayda ortalama IPSS skoru 20,07 ± 1,62 iken, 6. ayda 18,13 ± 1,51’e düştü. QoL skorları 1. ayda 3,33 ± 0,49’dan 6. ayda 3,67 ± 0,49’a yükseldi. PVR, başlangıçta 136,7 ± 53,7 mL iken 6. ayda 92,0 ± 33,4 mL’ye düştü. Prostat hacmi ise 91,07 ± 18,7 mL’den 65,27 ± 13,4 mL’ye geriledi. Clavien-Dindo ≥2 düzeyinde hiçbir komplikasyon gözlenmedi.
Sonuç: Rezum tedavisi, konvansiyonel cerrahi müdahalelere uygun olmayan kalıcı sondalı yüksek riskli yaşlı erkek hastalar için güvenli ve etkili bir minimal invaziv tedavi seçeneği olarak görünmektedir.

Keywords

ASA skoru , benign prostat hiperplazisi , minimal invaziv tedavi , Rezum , üriner kateter

Ethical Statement

Bu çalışma Helsinki Bildirgesi ilkelerine uygun olarak gerçekleştirilmiştir. Hisar Hospital Intercontinental Kurumsal Etik Kurulu'ndan etik onay alınmıştır (21.07.2025/25-39).

Supporting Institution

Bu araştırma, kamu, ticari veya kar amacı gütmeyen sektörlerdeki herhangi bir fon kuruluşundan özel bir hibe almamıştır.

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

Abstract

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.

Keywords

ASA score , benign prostatic hyperplasia , elderly patients , high surgical risk , minimally invasive therapy , urinary catheter , Rezum

Ethical Statement

This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Institutional Ethics Review Board of Hisar Hospital Intercontinental (21.07.2025/25-39).

Supporting Institution

This research received no specific grants from any funding agency in the public, commercial, or not-for-profit sectors.

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