Convective water vapor thermal therapy may be a viable treatment for men with benign prostatic hyperplasia (BPH) who suffer from lower urinary tract symptoms (LUTS), new research suggests.
BPH – an enlarged prostate – and related urinary problems are often treated with medication, such as alpha-blockers, or surgery. While these treatments can improve urinary symptoms, they also often result in sexual side effects, including erectile dysfunction (ED) and ejaculatory disorders.
This study, published this month in the Journal of Sexual Medicine, examined the effects of convective water vapor therapy on ejaculatory and erectile function in relation to LUTS and BPH.
The therapy uses the heat of water vapor ablate prostate tissue cells. The treatment device involves a retractable needle that delivers water vapor in 9-second increments. The needle can be repositioned as necessary. One hundred ninety-seven men (average age 63) were randomly assigned to receive water therapy or a placebo control that mimicked treatment. The two groups were compared at a 3-month follow-up point. Those who received treatment were then followed for a total of 12 months.
The researchers assessed the men’s prostate systems, urinary flow rate, and sexual function using questionnaires, including the International Prostate Symptom Score (IPSS), the International Index of Erectile Function (IIEF), and the Male Sexual Health Questionnaire for Ejaculatory Function.
At the three-month follow-up, LUTS symptoms had improved for the therapy group. Prostate symptoms, as measured by the IPSS, had improved for 51% of the therapy group and 19% for the control group. About a third of the men in the treatment group had better erectile function.
After 12 months, 30% percent of the men in the treatment group had improved ejaculation, and 27% of the men had increased scores for the erectile function domain of the IIEF, indicating improved erections. Scores on other IIEF domains – orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction – did not change significantly from baseline for either the treatment or control group.
“Based on the conservation of sexual function and efficacy in treating BPH-related LUTS, the water vapor thermal therapy could be offered as first-line treatment in lieu of drugs for patients with moderate to severe LUTS,” the authors concluded.
In an editorial comment published in the Journal of Sexual Medicine, Dr. Giovanni Corona expressed concerns that this study did not compare water vapor therapy to other non-invasive treatments and that other factors that could affect sexual function, such as metabolic syndrome and lifestyle, were not addressed. Dr. Corona recommended confirming the data in larger studies.
In response, the study authors wrote that “one must start at the beginning,” and that this work “lays the ground for confirmatory studies.”
Resources
The Journal of Sexual Medicine
Corona, Giovanni, MD, PhD
“Editorial Comment on ‘Erectile and Ejaculatory Function Preserved With Convective Water Vapor Energy Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Randomized Controlled Study’”
(Full-text. June 2016)
http://www.jsm.jsexmed.org/article/S1743-6095(16)30178-3/fulltext
McVary, Kevin T., MD, et al.
“Erectile and Ejaculatory Function Preserved With Convective Water Vapor Energy Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Randomized Controlled Study”
(Full-text. June 2016)
http://www.jsm.jsexmed.org/article/S1743-6095(16)30087-X/fulltext
McVary, Kevin T., MD, et al.
“Response and Rebuttal to Editorial Commentary on ‘Erectile and Ejaculatory Function Preserved With Convective Water Vapor Energy Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Randomized Controlled Study’”
(Full-text. June 2016)
http://www.jsm.jsexmed.org/article/S1743-6095(16)30192-8/fulltext
Renal and Urology News
Charnow, Jody A.
“Water Vapor Ablation Eases BPH/LUTS, Preserves Sexual Function”
(May 8, 2016)
http://www.renalandurologynews.com/aua-2016-bphluts/water-vapor-ablation-eases-bphluts-preserves-sexual-function/article/495025/