Head-to-head comparison of Rezum vs Urolift for patient with benign prostatic hyperplasia: A systematic review

Introduction: Minimally invasive surgical therapies (MISTs) have been developed to treat Benign Prostatic hyperplasia (BPH) while minimizing adverse surgical effect. Most recent developed MIST, Rezum and Urolift, showed effective efficacy in improving, but head-to-head comparison still lacking. This study aims to compare the efficacy and safety of Urolift and Rezum in managing BPH-related LUTS. Methods:A systematic search was conducted in Cochrane, PubMed, EMBASE, SCOPUS and EBSCOhost, identifying observational studies comparing rezum and urolift in BPH patient. Data extraction included demographics, intervention protocols, follow-up duration, and outcomes International Prostate Symptom Score (IPSS) score, IPSS-QoL, sexual function, and reintervention rate. The quality of studies was assessed using the Newcastle-Ottawa Scale. Results:Two cohort with a total of 101 patients with BPH were included. At 12 months, Rezum tends to be superior in improving symptoms severity, while at 2 months of follow-up, Urolift outperformed Rezum. Both intervention preserved patient’s sexual function and does not differ significantly. Reintervention rate significantly higher in Urolift compared to Rezum group. Conclusion: Rezum offers a more effective alternative to Urolift for managing BPH in long term setting, with lower reintervention rate and preserved sexual function. In early setting, Urolift showed higher efficacy and rapid improvement compared to Rezum.