Impact of convective water vapor thermal therapy (Rezum) on male sexual function: a systematic review and meta-analysis

Resumo original em inglês

O que aconteceu

Benign prostatic hyperplasia (BPH) is highly prevalent among aging men, with management often requiring a balance between symptom relief and preservation of sexual function. Convective water vapor thermal therapy (Rezūm) has emerged as a minimally invasive treatment; however, its effects on sexual function remain incompletely defined. This systematic review and meta-analysis evaluated the impact of Rezūm therapy on erectile and ejaculatory function.

A systematic search of PubMed, Web of Science, and Scopus was conducted from inception to October 2025 in accordance with PRISMA guidelines. Studies reporting pre- and postoperative sexual function outcomes using validated instruments were included. To prevent metric mixing, the International Index of Erectile Function (IIEF) data were stratified into 3 distinct instrument frameworks: Group A (True IIEF-5; 0-25 scale), Group B (IIEF-15 Total Score; 0-75 scale), and Group C (IIEF-Erectile Function Domain; 0-30 scale), alongside the Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD) score and bother domains. Pooled mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models, stratified by follow-up duration.

O que encontraram

Fourteen unique studies comprising 1306 patients were included. Group A (True IIEF-5) scores demonstrated stable erectile function postoperatively, with a significant improvement observed only at 12 months (MD = 1.09; 95% CI, 0.02-2.15; P = .046; I2 = 77.2%); however, this finding did not persist under risk-of-bias-restricted (MD = 0.08; P = .85; I2 = 0%) or r = 0.5 sensitivity analyses (P = .056). Group B (IIEF-15 Total Score) showed no significant change from baseline in the primary pooled analyses at any follow-up interval. However, sensitivity analyses excluding a heterogeneity-driving outlier revealed significant improvements at 3 months (MD = 2.58; 95% CI, 0.01-5.15; P = .049; I2 = 15.7%), 6 months (MD = 5.21; 95% CI, 2.50-7.93; P = .0002; I2 = 0%), and 12 months (MD = 3.09; 95% CI, 0.56-5.61; P = .017; I2 = 0%). Group C (IIEF-Erectile Function domain) scores demonstrated preservation of erectile function through 24 months (all P > .05), despite a transient decline observed in a single cohort at 1 month. Male Sexual Health Questionnaire for Ejaculatory Dysfunction Bother scores demonstrated a significant and sustained reduction in ejaculatory distress from 1 month (MD = -0.35; P = .016) through 12 months (MD = -0.78; P = .0018), while MSHQ-EjD Score outcomes remained largely stable over time.

Por que isso importa

Rezūm therapy demonstrates a favorable sexual safety profile, with preservation of erectile and ejaculatory function. These findings support its role as an effective minimally invasive treatment for BPH, particularly in patients prioritizing sexual function preservation.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.