Abstract：
BACKGROUND: Rezum alleviates lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH) while preserving sexual function, but long-term sexual function outcomes are lacking in patients with baseline erectile dysfunction (ED).
OBJECTIVE: The study sought to analyze 4 years of real-world sexual function outcomes of Rezum using the International Index of Erectile Function (IIEF) questionnaire, stratified by baseline ED status.
METHODS: Participants included multiethnic Rezum-treated patients from a single outpatient office. IIEF domains and BPH medication usage were compared at baseline and 6, 12, and 48 months using t tests, Mann-Whitney U tests, chi-square tests, and Wilcoxon signed rank tests.
RESULTS: Primary outcomes over 4 years included the IIEF functional domains (erectile function [EF], orgasmic function [OF], sexual desire [SD], intercourse satisfaction [IS], overall satisfaction [OS]) and BPH medication usage.
RESULTS: A total of 91 patients were included: 40 (44%) in the ED cohort and 51 (56%) in the no ED cohort. History of diabetes was more prevalent in the ED cohort (35% vs 15.7%; P = .048). Baseline scores in the EF, OF, IS, and OS domains were lower in the ED cohort. Compared with baseline, there were no significant changes in any IIEF domains in either cohort at 6 months. At 12 months, the ED cohort had significant percent decreases in OF (-25%; P = .02), SD (-22.2%; P = .04), and OS (-33.3%; P = .004); the no ED cohort had a significant percent increase in EF (5%; P = .04). At 48 months, the no ED cohort had no significant changes in any IIEF domains, while the ED cohort had significant percent increases in EF (30%; P = .01), SD (22.5%; P = .02), IS (20%; P = .01), and OS (58.3%; P = .008). Both cohorts significantly discontinued BPH medications at all follow-ups. At 48 months, there were no cases of de novo ED in the no ED cohort.
CONCLUSIONS: As modern BPH therapies continue to demonstrate efficacy in alleviating lower urinary tract symptoms, the preservation or improvement of sexual function emerges as an increasingly important consideration for patients, with our study suggesting Rezum as a compelling option.
UNASSIGNED: Our study has the strength of long-term Rezum outcomes in an ethnically diverse patient population, stratified by the presence of baseline ED, but is limited by retrospective design, single-center nature, and small sample sizes at long-term follow-ups.
CONCLUSIONS: Rezum preserved long-term sexual function in patients without baseline ED and improved sexual function in those with baseline ED; however, individuals with ED may experience temporary decreases in sexual function at 12 months.
OBJECTIVE: The study sought to analyze 4 years of real-world sexual function outcomes of Rezum using the International Index of Erectile Function (IIEF) questionnaire, stratified by baseline ED status.
METHODS: Participants included multiethnic Rezum-treated patients from a single outpatient office. IIEF domains and BPH medication usage were compared at baseline and 6, 12, and 48 months using t tests, Mann-Whitney U tests, chi-square tests, and Wilcoxon signed rank tests.
RESULTS: Primary outcomes over 4 years included the IIEF functional domains (erectile function [EF], orgasmic function [OF], sexual desire [SD], intercourse satisfaction [IS], overall satisfaction [OS]) and BPH medication usage.
RESULTS: A total of 91 patients were included: 40 (44%) in the ED cohort and 51 (56%) in the no ED cohort. History of diabetes was more prevalent in the ED cohort (35% vs 15.7%; P = .048). Baseline scores in the EF, OF, IS, and OS domains were lower in the ED cohort. Compared with baseline, there were no significant changes in any IIEF domains in either cohort at 6 months. At 12 months, the ED cohort had significant percent decreases in OF (-25%; P = .02), SD (-22.2%; P = .04), and OS (-33.3%; P = .004); the no ED cohort had a significant percent increase in EF (5%; P = .04). At 48 months, the no ED cohort had no significant changes in any IIEF domains, while the ED cohort had significant percent increases in EF (30%; P = .01), SD (22.5%; P = .02), IS (20%; P = .01), and OS (58.3%; P = .008). Both cohorts significantly discontinued BPH medications at all follow-ups. At 48 months, there were no cases of de novo ED in the no ED cohort.
CONCLUSIONS: As modern BPH therapies continue to demonstrate efficacy in alleviating lower urinary tract symptoms, the preservation or improvement of sexual function emerges as an increasingly important consideration for patients, with our study suggesting Rezum as a compelling option.
UNASSIGNED: Our study has the strength of long-term Rezum outcomes in an ethnically diverse patient population, stratified by the presence of baseline ED, but is limited by retrospective design, single-center nature, and small sample sizes at long-term follow-ups.
CONCLUSIONS: Rezum preserved long-term sexual function in patients without baseline ED and improved sexual function in those with baseline ED; however, individuals with ED may experience temporary decreases in sexual function at 12 months.
摘要：
背景：Rezum缓解良性前列腺增生（BPH）继发的下尿路症状，同时保留性功能，但基线勃起功能障碍(ED)患者缺乏长期性功能结局.
目的：该研究试图使用国际勃起功能指数（IIEF）问卷分析Rezum的4年真实世界性功能结果，按基线ED状态分层。
方法：参与者包括来自单一门诊的多种族Rezum治疗患者。使用t检验在基线和6、12和48个月比较IIEF域和BPH药物使用情况。Mann-WhitneyU测试,卡方检验,和Wilcoxon签署等级测试.
结果：超过4年的主要结果包括IIEF功能域（勃起功能[EF]，高潮功能[OF]，性欲[SD]，性交满意度[是]，总体满意度[OS])和BPH药物使用情况。
结果：共纳入91例患者：40例（44%）在ED队列中，51例（56%）在非ED队列中。糖尿病病史在ED队列中更为普遍（35％vs15.7％；P=0.048）。EF的基线得分，OF,IS,在ED队列中，OS域较低。与基线相比，在6个月时,任一队列的IIEF域均无显著变化.12个月时,ED队列中OF的百分比显着下降（-25%；P=0.02），SD（-22.2%；P=.04），和OS（-33.3％；P=.004）；无ED队列的EF显着增加（5％；P=.04）。48个月时,无ED队列在任何IIEF域均无显著变化，而ED队列的EF显着增加（30％；P=0.01），SD（22.5%；P=0.02），IS（20%；P=0.01），和OS（58.3%；P=0.008）。在所有随访中，两个队列均显着停止了BPH药物治疗。48个月时,无ED队列中没有从头ED病例。
结论：随着现代BPH治疗继续证明在缓解下尿路症状方面的疗效，保护或改善性功能成为患者日益重要的考虑因素，我们的研究表明Rezum是一个令人信服的选择。
■我们的研究在不同种族的患者群体中具有长期Rezum结果的优势，根据基线ED的存在进行分层，但受到回顾性设计的限制，单中心性质，和小样本量在长期随访。
结论：Rezum保留了无基线ED患者的长期性功能，改善了基线ED患者的性功能；然而，ED患者在12个月时可能会出现暂时性性功能下降.
目的：该研究试图使用国际勃起功能指数（IIEF）问卷分析Rezum的4年真实世界性功能结果，按基线ED状态分层。
方法：参与者包括来自单一门诊的多种族Rezum治疗患者。使用t检验在基线和6、12和48个月比较IIEF域和BPH药物使用情况。Mann-WhitneyU测试,卡方检验,和Wilcoxon签署等级测试.
结果：超过4年的主要结果包括IIEF功能域（勃起功能[EF]，高潮功能[OF]，性欲[SD]，性交满意度[是]，总体满意度[OS])和BPH药物使用情况。
结果：共纳入91例患者：40例（44%）在ED队列中，51例（56%）在非ED队列中。糖尿病病史在ED队列中更为普遍（35％vs15.7％；P=0.048）。EF的基线得分，OF,IS,在ED队列中，OS域较低。与基线相比，在6个月时,任一队列的IIEF域均无显著变化.12个月时,ED队列中OF的百分比显着下降（-25%；P=0.02），SD（-22.2%；P=.04），和OS（-33.3％；P=.004）；无ED队列的EF显着增加（5％；P=.04）。48个月时,无ED队列在任何IIEF域均无显著变化，而ED队列的EF显着增加（30％；P=0.01），SD（22.5%；P=0.02），IS（20%；P=0.01），和OS（58.3%；P=0.008）。在所有随访中，两个队列均显着停止了BPH药物治疗。48个月时,无ED队列中没有从头ED病例。
结论：随着现代BPH治疗继续证明在缓解下尿路症状方面的疗效，保护或改善性功能成为患者日益重要的考虑因素，我们的研究表明Rezum是一个令人信服的选择。
■我们的研究在不同种族的患者群体中具有长期Rezum结果的优势，根据基线ED的存在进行分层，但受到回顾性设计的限制，单中心性质，和小样本量在长期随访。
结论：Rezum保留了无基线ED患者的长期性功能，改善了基线ED患者的性功能；然而，ED患者在12个月时可能会出现暂时性性功能下降.
