We aim to report the short-term outcomes of patients undergoing Rezum as a re-treatment intervention for recurrent lower urinary tract symptoms after prior surgical treatment for benign prostate enlargement. Data from two institutions for baseline International Prostatic Symptom Score with Quality of life item, prostate size, and maximum flow-rate was acquired. Patients were assessed 3-month post-treatment. Outcomes were compared with unpaired t-tests and Fisher's exact tests. Nineteen patients were included. Prior surgical interventions included transurethral resection of the prostate (31.6%, n = 6), Urolift (26.3%, n = 5), transurethral bladder neck incision (15.8%, n = 3), prostate artery embolization (10.5%, n = 2), transurethral needle ablation, greenlight photovaporization of prostate and Rezum (5.3%, n = 1 each). Median age was 69.0 years (IQR 14; range 59-87 years) with a median prostate volume of 65.0 ml (IQR 63; range 22-160 ml). The median time to Rezum treatment was 48 months (IQR 78; range 9-240 months). 63.1% (n = 12) were re-started on benign prostatic enlargement medication and 36.8% (n = 7) had recurrent bothersome symptoms before re-treatment with Rezum. At 3-month follow up, median International Prostatic Symptom Score decreased from 23 to 9 (p < 0.001) and Quality of life from 4 to 2 (p < 0.001). Median maximum flow-rate improved after treatment from 8.6 to 14.8 ml/s (p < 0.001). None of the patients were required to restart medication for benign prostate enlargement.

Purpose: Transurethral needle ablation (TUNA) is a minimally invasive procedure for the treatment of symptomatic benign prostatic hyperplasia (BPH). Compared to transurethral resection of the prostate (TURP), office-based TUNA is an attractive alternative as it is minimally invasive and avoids general anaesthesia. The aim of this study is to evaluate the efficacy of single session office-based TUNA. Materials and Methods: Data of 121 patients who had undergone TUNA was retrieved from June 2008 to March 2017. Patients were followed-up with visits at 1, 3, 6, and 12-months with the International Prostate Symptom Score (IPSS), quality of life (QoL) scoring and uroflowmetry. Results: Patients were 39 to 85 years old. The prostate volumes were 20.00 to 96.90 mL with a median of 26.95 mL. The median IPSS score pre-TUNA was 19, median QOL score pre TUNA was 4 and median maximum urinary flow (Qmax) pre-TUNA was 10.3 mUs. There is 65% improvement of IPSS post-TUNA (p<0.001). There is 75% improvement of QOL post-TUNA QOL (p<0.001). There is 35% improvement of Qmax post-TUNA Qmax (p<0.001). The mean relapse-free survival for TUNA is 6.123 years. The 1st, 3rd, and 5th year relapse-free survival rate were 91.7%, 76.6% and 63.7% respectively. Conclusions: Our study is the first to investigate the use of a single-setting office-based TUNA requiring minimal sedation in the Asian community. Complication rates were low in our series, with no associated mortality. When applied to selected patients, TUNA is an effective and reasonably safe alternative for the treatment of symptomatic BPH.