Decision regret and patient satisfaction after TURP and Rezūm™ for benign prostatic obstruction: a retrospective comparative cohort study.

BACKGROUND

Patient-reported outcomes are increasingly relevant in benign prostatic obstruction (BPO), particularly when comparing procedures with different trade-offs in invasiveness, recovery, durability, and preservation of sexual function. We compared decisional regret and global satisfaction between men undergoing transurethral resection of the prostate (TURP) or Rezūm™ water vapor therapy.

MATERIALS AND

METHODS

We conducted a single-center retrospective comparative cohort study. TURP patients were selected to approximate the Rezūm™ cohort according to age and prostate volume. The primary endpoint was an adapted 5-item regret-focused postoperative measure transformed to a 0-100 scale, with lower scores indicating less regret. The secondary endpoint was global satisfaction (0-10). Adjusted linear regression models accounted for residual baseline imbalance.

RESULTS

A total of 187 men were included, including 94 treated with Rezūm™ and 93 treated with TURP. Regret-focused scores were low in both groups, with median values of 0 (IQR 0-10) after TURP and 5 (IQR 0-20) after Rezūm™ (p = 0.170). Global satisfaction was higher after TURP than after Rezūm™ (median 10 [IQR 9-10] vs. 9 [IQR 8-10], p = 0.002). However, treatment type was not independently associated with satisfaction (β = +0.52; 95% CI - 0.11 to 1.15; p = 0.107) or regret (β = -1.13; 95% CI - 7.86 to 5.61; p = 0.743).

CONCLUSIONS

Both procedures were associated with favorable patient-reported perceptions. Although TURP showed higher unadjusted satisfaction, treatment type was not independently associated with satisfaction or regret after adjustment.