Urology · 2025
Five-Year Outcomes of Water Vapor Therapy vs Doxazosin, Finasteride, and Combination Therapy for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Cohort Data From the Medical Therapy of Prostatic Symptoms Trial.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Long Bronwyn, Cheema Amandip, Copelan Olivia, Joyce Cara, Feffer Marina, McVary Kevin T
Аннотация
OBJECTIVE: To compare 5-year clinical and subjective treatment outcomes of water vapor thermal therapy to Medical Therapy of Prostatic Symptoms (MTOPS) trial cohorts receiving doxazosin, finasteride, or combination therapy.
METHODS: MTOPS subjects who received doxazosin, finasteride, combination therapy, or placebo (ClinicalTrials.gov NCT00021814) were compared to the treatment arm of a randomized controlled trial of thermal therapy using the Rezūm System (NCT01912339). Only MTOPS subjects who met criteria for the Rezūm trial were included (prostate volume 30-80 cc, International Prostate Symptom Score [IPSS] ≥ 13). Inverse probability weighting by the propensity score was used to adjust for potential confounding variables. Subjective, objective, and clinical progression outcomes were compared over 5-year.
RESULTS: Symptom scores improved from baseline after thermal therapy throughout the study (∆ IPSS = -11.1 at 3months to -9.5 at 5years). By 5 years, thermal therapy had the lowest rate of clinical progression at 4.6% while thermal therapy symptom improvement was similar to finasteride (P = .10) and combination therapy (0.77) but remained superior to doxazosin (P = .004) and placebo groups (P = .035). Objective outcomes after Rezūm were more variable throughout follow-up, with peak flow showing benefit through year 3 only, and no benefit over placebo with respect to postvoid residual.
CONCLUSION: Water vapor thermal therapy patients experienced lower rates of clinical progression at 5-year post-treatment and thus may represent a benefit compared to pharmaceutical therapy for appropriately selected patients. Additionally, a single Rezūm treatment produces symptom score improvements that are initially superior to daily long-term medication, however, this advantage wanes over time.
METHODS: MTOPS subjects who received doxazosin, finasteride, combination therapy, or placebo (ClinicalTrials.gov NCT00021814) were compared to the treatment arm of a randomized controlled trial of thermal therapy using the Rezūm System (NCT01912339). Only MTOPS subjects who met criteria for the Rezūm trial were included (prostate volume 30-80 cc, International Prostate Symptom Score [IPSS] ≥ 13). Inverse probability weighting by the propensity score was used to adjust for potential confounding variables. Subjective, objective, and clinical progression outcomes were compared over 5-year.
RESULTS: Symptom scores improved from baseline after thermal therapy throughout the study (∆ IPSS = -11.1 at 3months to -9.5 at 5years). By 5 years, thermal therapy had the lowest rate of clinical progression at 4.6% while thermal therapy symptom improvement was similar to finasteride (P = .10) and combination therapy (0.77) but remained superior to doxazosin (P = .004) and placebo groups (P = .035). Objective outcomes after Rezūm were more variable throughout follow-up, with peak flow showing benefit through year 3 only, and no benefit over placebo with respect to postvoid residual.
CONCLUSION: Water vapor thermal therapy patients experienced lower rates of clinical progression at 5-year post-treatment and thus may represent a benefit compared to pharmaceutical therapy for appropriately selected patients. Additionally, a single Rezūm treatment produces symptom score improvements that are initially superior to daily long-term medication, however, this advantage wanes over time.