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.
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.
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).
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.
World journal of urology. 2026 Jul 31*** epublish ***
Horst Emanuel Lagos-Beitz, Guillermo H Martínez-Delgado, Samantha Sanchez-Torres, Gabriela Neri-Moguel, Francisco Rafael Valencia-Álvarez, Guillermo Trujillo-Martínez, Rodrigo Escalante-Armenta, Jorge Augusto Alcacio-Mendoza, Ricardo Alonso Castillejos-Molina, Carlos Enrique Mendez-Probst
Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga No. 15, Tlalpan, Mexico City, 14080, Mexico., Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga No. 15, Tlalpan, Mexico City, 14080, Mexico. .