{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:48:57Z","timestamp":1789998537872,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008497","name":"Boston Scientific Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008497","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["LUTS"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms (LUTS) in aging men. Patients with large prostates (\u2265\u200980\u2009mL) often experience more severe symptoms and have limited minimally invasive treatment options. Water vapor thermal therapy (Rez\u016bm) has demonstrated efficacy in moderate\u2010sized glands, and emerging evidence including multicenter cohorts and systematic reviews suggests efficacy in larger glands. However, long\u2010term real\u2010world multicenter data remain limited. This study evaluates the effectiveness of Rez\u016bm therapy in men urinary status outcomes, sexual function, and prostate size in a large, multicenter real\u2010world cohort with extended follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a retrospective analysis of a prospectively maintained multicenter registry including patients treated with Rez\u016bm therapy between April 2019 and August 2025 at two high\u2010volume centers in Canada and Italy. Eligible patients had a baseline prostate volume\u2009\u2265\u200980\u2009mL. Outcomes were assessed at baseline and follow\u2010up intervals of 6, 12, 24, and 36\u2009months. Primary outcomes included changes in International Prostate Symptom Score (IPSS), quality of life (QoL), BPH Impact Index (BPHII), maximum urinary flow rate (\n                      <jats:italic>Q<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      ), and postvoid residual (PVR). Sexual function was evaluated using the International Index of Erectile Function (IIEF\u201015) and the Male Sexual Health Questionnaire (MSHQ). Changes in prostate volume at 12\u2009months were also analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 321 patients were included with a mean age of 68.7\u2009years and median prostate volume of 107\u2009mL. Median lobe enlargement was present in 80.1% of patients. Mean IPSS improved from 21.7\u2009\u00b1\u20096.9 at baseline to 9.9\u2009\u00b1\u20096.8 at 12\u2009months and 8.4\u2009\u00b1\u20097.0 at 36\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), representing a symptom reduction of up to 62%. QoL scores improved from 4.5\u2009\u00b1\u20091.1 to 1.6\u2009\u00b1\u20091.2 at 36\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Qmax increased from 8.1\u2009\u00b1\u20096.5\u2009mL\/s at baseline to 14.6\u2009\u00b1\u20096.7\u2009mL\/s at 6\u2009months, while PVR decreased from 144\u2009\u00b1\u2009136\u2009mL to 48\u2009\u00b1\u200963\u2009mL at 12\u2009months. Erectile and ejaculatory function remained stable during follow\u2010up, with retrograde ejaculation reported in 6.2% of patients. Among 172 patients with imaging follow\u2010up, mean prostate volume decreased by 35.2\u2009mL (29.9%) at 12\u2009months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rez\u016bm therapy provides significant and durable improvements in urinary symptoms and functional outcomes in men with large prostates (\u2265\u200980\u2009mL), while preserving sexual function. These findings support Rez\u016bm as a safe and effective minimally invasive treatment option for large\u2010volume BPH in real\u2010world clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/luts.70079","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T01:51:41Z","timestamp":1783475501000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real\u2010World Long\u2010Term Outcomes of Rez\u016bm Therapy for Large\u2010Volume Benign Prostatic Hyperplasia: A Multicenter Cohort Study"],"prefix":"10.1111","volume":"18","author":[{"given":"Liberty","family":"Liu","sequence":"first","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2867-9723","authenticated-orcid":false,"given":"Mario Henrique Bitar","family":"Siqueira","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2679-2635","authenticated-orcid":false,"given":"Naeem","family":"Bhojani","sequence":"additional","affiliation":[{"name":"Division of Urology Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM)  Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Chughtai","sequence":"additional","affiliation":[{"name":"Plainview Hospital, Smith Institute of Urology Northwell Health  Syosset New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin C.","family":"Zorn","sequence":"additional","affiliation":[{"name":"BPH Canada Prostate Surgical Institute  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0712-2719","authenticated-orcid":false,"given":"Luca","family":"Cindolo","sequence":"additional","affiliation":[{"name":"Urology Department, CUrE Group Hesperia Hospital  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Urology Department, CUrE Group Hesperia Hospital  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Lajkosz","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2469-4644","authenticated-orcid":false,"given":"Eviatar","family":"Fields","sequence":"additional","affiliation":[{"name":"Faculty of Medicine McGill University  Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1507-7783","authenticated-orcid":false,"given":"Dean","family":"Elterman","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_2_11_2_1","article-title":"Comprehensive Analysis of the Global, Regional, and National Burden of Benign Prostatic Hyperplasia From 1990 to 2021","volume":"15","author":"Chen X.","year":"2025","journal-title":"Scientific Reports"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.7045"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2011.10250.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12745"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare8020158"},{"issue":"1","key":"e_1_2_11_7_1","article-title":"The Global Burden of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: A Systematic Review and Meta\u2010Analysis","volume":"7","author":"Lee S. W. H.","year":"2017","journal-title":"Scientific Reports"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1106637"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(22)00213-6"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.12.002"},{"issue":"89","key":"e_1_2_11_11_1","first-page":"96","article-title":"Urodynamic Features and Significant Predictors of Bladder Outlet Obstruction in Patients With Lower Urinary Tract Symptoms\/Benign Prostatic Hyperplasia and Small Prostate Volume","volume":"14","author":"Kang M.","year":"2015","journal-title":"Urology"},{"issue":"6","key":"e_1_2_11_12_1","first-page":"613","article-title":"Benign Prostatic Hyperplasia: Rapid Evidence Review","volume":"107","author":"Arnold M. J.","year":"2023","journal-title":"American Family Physician"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0251721"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000020356"},{"key":"e_1_2_11_15_1","volume-title":"Minimally Invasive Treatments for Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia (CADTH Issues in Emerging Health Technologies; Issue 182)","author":"CADTH","year":"2020"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-020-03548-7"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2020.0177"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.24191"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2022.0637"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15753"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/luts.70043"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-025-05793-0"},{"issue":"6","key":"e_1_2_11_23_1","first-page":"759","article-title":"Water Vapor Thermal Therapy (Rez\u016bm System) in Patients With Large Prostates: Results From a Prospective Comparative Study","volume":"76","author":"Balsamo R.","year":"2024","journal-title":"Minerva Urology and Nephrology"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-026-02050-3"},{"issue":"184","key":"e_1_2_11_25_1","first-page":"244","article-title":"Water Vapor Thermal Therapy in Men With Prostate Volume \u2265\u200980 cm3: A Systematic Review and Meta\u2010Analysis","volume":"24","author":"McVary K. T.","year":"2023","journal-title":"Urology"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/luts.12435"}],"container-title":["LUTS: Lower Urinary Tract Symptoms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/luts.70079","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/luts.70079","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/luts.70079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:59:49Z","timestamp":1785412789000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/luts.70079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/luts.70079"],"URL":"https:\/\/doi.org\/10.1111\/luts.70079","archive":["Portico"],"relation":{},"ISSN":["1757-5664","1757-5672"],"issn-type":[{"value":"1757-5664","type":"print"},{"value":"1757-5672","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-03-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70079"}}