The double-decking method for rezūm water vapor therapy in benign prostatic hyperplasia: volumetric, functional, and dosimetric outcomes
Abstract
Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) significantly impact quality of life in aging men. Conventional Rezūm water vapor therapy consistently achieves only a modest 25–30% prostate volume reduction, leaving a clinically meaningful therapeutic gap—particularly for larger glands where single-plane periurethral injection fails to achieve adequate thermal coverage of the entire transition zone.
To evaluate the efficacy and safety of a dual-layered injection strategy (“Double-decking method”) for Rezūm water vapor therapy, targeting a treatment cycles per unit prostate volume (CPV) > 0.15, in patients with symptomatic BPH.
Retrospective analysis of a prospectively maintained database of consecutive patients treated at a single institution.
We enrolled 26 consecutive patients with symptomatic BPH (April 2025–December 2025) who underwent Rezūm therapy using the “Double-decking method,” in which two sequential injections were performed within each field-of-view—one targeting the anterior and one the posterior aspect of the transition zone—targeting a CPV > 0.15. The primary endpoint was prostate volume (PV) reduction at 3 months; secondary endpoints included IPSS, Qmax, post-void residual (PVR), ejaculatory function assessed by the MSHQ-EjD, and erectile function assessed by the IIEF-5.
The mean CPV was 0.19. Total prostate volume decreased by 50.7% (
p
< 0.001). Qmax improved by + 203.5% (
p
< 0.001), PVR decreased by 95.2% (
p
< 0.001),…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 26 participants or records.
Read the paper
Related studies
- Treatment of non-metastatic castration-resistant prostate cancer: facing age-related comorbidities and drug–drug interactions
- The Efficacy of Flogofilm® in the Treatment of Chronic Bacterial Prostatitis as an Adjuvant to Antibiotic Therapy: A Randomized Prospective Trial
- Inhibition of growth and contraction in human prostate stromal cells by silencing of NUAK1 and -2, and by the presumed NUAK inhibitors HTH01-015 and WZ4003
- Effectiveness and Safety of a New Nutrient Fixed Combination Containing Pollen Extract Plus Teupolioside, in the Management of LUTS in Patients with Benign Prostatic Hypertrophy: A Pilot Study
- Extract from Cucurbita pepo improves BPH symptoms without affecting sexual function: a 24-month noninterventional study
- Aquablation vs. holmium laser enucleation of the prostate for benign prostatic hyperplasia: a 150-patients prospective comparative multicenter study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.