Incidence and prevention of postprocedural bacteraemia and complications following water vapour therapy of the prostate: a retrospective review and quality improvement initiative at a tertiary care centre.

BACKGROUND

Water vapour therapy of the prostate is a minimally invasive treatment for benign prostatic hyperplasia. While generally safe, rare but clinically significant complications, such as postprocedural bacteraemia, have been reported. Differentiating true complications from expected side-effects is essential for accurate risk communication and quality improvement.

OBJECTIVE

The aim of this study was to evaluate the incidence of bacteraemia and other adverse events following these treatments and assess the impact of targeted interventions on patient safety.

METHODS

A retrospective review was conducted of all procedures performed at Cleveland Clinic Abu Dhabi between January 2021 and December 2025. The pre-intervention cohort included 82 cases, and the postintervention cohort included 46 cases. Outcomes were classified as complications or side-effects. Interventions initiated in Q3 2023 included standardized operating procedures, revised antibiotic prophylaxis, and enhanced patient education. Risk differences, relative risks, and P-values were calculated using Fisher's exact test.

RESULTS

Before the intervention, bacteraemia occurred in 6.1% of cases and urinary tract infections (UTIs) in 6.1%. Following implementation, no cases of bacteraemia or UTIs were observed in the postintervention cohort (0/46), representing a reduction compared with the pre-intervention period. A single case of candiduria emerged in the postintervention cohort (1/46; 2.2%), with no evidence of a sustained increase in fungal complications. Urinary retention decreased from 6.1% to 0. Haematuria remained relatively stable, increasing from 13.4% to 15.2%. Dysuria decreased from 19.5% to 8.7%. Although statistical significance was not achieved, these findings indicate clinically meaningful improvement.

CONCLUSION

Protocolized antimicrobial prophylaxis, standardized workflows, and patient education were associated with reduced infectious complications and improved safety.