Comparing Water Vapour Thermal Therapy (Rezūm) and TURP

A Randomized Controlled Trial Comparing Water Vapour Thermal Therapy (Rezūm) and TURP in Men With Benign Prostatic Hyperplasia in Refractory Urinary Retention

This is a randomized controlled trial using a non-inferiority design with the subjects randomized 1:1 to either water vapour thermal treatment (REZUM) arm or transurethral resection of prostate (TURP) arm.

Inclusion Criteria:

• Men 50-80 years
• Refractory urinary retention related to benign prostatic hyperplasia (BPH)
• On urethral Foley's catheter before treatment
• Prostate size 30-80ml on ultrasound

Exclusion Criteria:

• Prior prostate operation
• Past or current history of prostate cancer
• Strong suspicion of prostate cancer (e.g. Elevated PSA before urinary retention or abnormal prostate on DRE without workup for prostate cancer)
• Known Urethral stricture / Bladder stone / Hypocontractile bladder
• Known neurological diseases which may affect bladder function (e.g. Parkinsonism, stroke)
• Contraindicated to undergo TURP or REZUM (e.g. not fit for GA/SA, active urinary tract infection, fail to be placed in lithotomy position, uncorrectable coagulopathy, antiplatelet or anticoagulant which cannot be stopped)