Transurethral water vapour ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia

To inform the committee, NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 10 sources, which was discussed by the committee. The evidence included 1 randomised controlled trial (RCT) reported with 1, 2 and 3 years of follow-up in 4 publications, 1 comparative study (also including patients from the RCT) and 3 case series (1 of which was reported in 3 publications), and is presented in table 2 of the interventional procedures overview.

The specialist advisers and the committee considered the key efficacy outcomes to be: improvement of lower urinary tract symptoms, urinary flow rate, and quality of life.

The specialist advisers and the committee considered the key safety outcomes to be: bleeding, infection, disorders of sexual function, and need for re-intervention.

Fifteen commentaries from patients who had experience of this procedure were received, which were discussed by the committee.

The committee was advised that the procedure may also be effective for patients with an enlarged median prostatic lobe.

Patients may need a urinary catheter for several days after the procedure.

The committee noted that this procedure is also known as transurethral water vapour thermal ablation or transurethral steam ablation.

Patient commentaries were all supportive of the procedure, and most people reported improvement in symptoms.