Opinion
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One consideration is the setting in which the procedure is performed.
The FDA recently expanded the label for the Rezūm System, which now includes prostate volumes up to 150 cm3, In this interview, Kevin T. McVary, MD, FACS, emphasizes that beyond prostate volume, several patient-specific factors are critical when assessing candidacy for Rezūm Water Vapor Thermal Therapy. A key element he considers is the patient’s motivation and expectations. McVary highlights the importance of ensuring patients have realistic goals, as some may expect life-changing outcomes that are not supported by clinical evidence. He stresses the need to clearly communicate the benefits—such as quicker recovery, rapid symptom relief, preservation of sexual function, and reduced anesthesia requirements—while also setting appropriate boundaries about what Rezūm can and cannot achieve.
McVary also considers a patient’s overall health status, especially if they are medically complex or require anticoagulation therapy due to heart conditions or stents. Such factors may affect procedural safety and outcomes, and should be factored into the decision-making process.
Another consideration is the setting in which the procedure is performed. McVary notes that 95% of his Rezūm procedures are performed in-office, reflecting his experience and comfort level from participating as principal investigator in the pivotal trial. However, he acknowledges that less experienced urologists may prefer to begin in ambulatory surgery centers for greater support and lower pressure during initial procedures.
Finally, McVary cautions patients to understand the limitations of existing data. Although 5-year outcome data are promising, long-term effects beyond that timeframe remain unknown. Overall, McVary advocates for a comprehensive and individualized approach, considering the patient’s physical health, expectations, procedural setting, and candid communication to determine whether Rezūm is the right treatment choice.
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