Cadmore media player playing video Water Vapor Thermal Therapy
Video Player
Accessibility
Using forms mode, you can utilize keyboard shortcuts to make usability more efficient.
Space bar will play and pause the video. Pressing escape will close all displays and pressing it again will jump to the end of the player.
You can press A to open the Keyboard Shortcut Dialog which also provides an audio description of the player and all of its features.
Language
1x
Play Speed
Adjust Volume
Transcript
Search
Result Count
of
Click to jump to result
Search
Re-center
Segments
Result Count
of
Click to jump to result
Search
Name:
Water Vapor Thermal Therapy
Description:
Water Vapor Thermal Therapy
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/f2ff12cc-ba82-4ebc-9a08-34e37857b07f/videoscrubberimages/Scrubber_1.jpg?sv=2019-02-02&sr=c&sig=em2GX9UgiCnGhrXmVVGuKIqKhlkFxtRXav5B2PIi1RY%3D&st=2025-05-22T06%3A34%3A54Z&se=2025-05-22T10%3A39%3A54Z&sp=r
Duration:
T00H19M00S
Embed URL:
https://stream.cadmore.media/player/f2ff12cc-ba82-4ebc-9a08-34e37857b07f
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/f2ff12cc-ba82-4ebc-9a08-34e37857b07f/Water Vapor Thermal Therapy video.mov?sv=2019-02-02&sr=c&sig=xHxACJYgjXCV28wn3wajHWJmZxgQbaDEXTPxYKVjH6w%3D&st=2025-05-22T06%3A34%3A55Z&se=2025-05-22T08%3A39%3A55Z&sp=r
Upload Date:
2023-12-06T00:00:00.0000000
Transcript:
Language: EN.
Segment:1 Introduction.
SPEAKER: This video presentation will discuss water vapor thermal therapy, a minimally invasive treatment for benign prostatic hyperplasia. Water vapor therapy comes with a set of unique advantages and disadvantages. We'll cover its mechanism of action, indications, limitations, procedural steps, and clinical outcomes.
Segment:2 How It Works.
SPEAKER: Let's start with the physiology behind how this therapy works. First, steam is rapidly and uniformly injected into the prostatic tissue.
SPEAKER: The vapor condenses and releases thermal energy that denatures cell membranes. This leads to tissue coagulation and necrosis, vasculature closure, and adrenergic denervation followed by cellular apoptosis and tissue contraction, which eventually opens the prostatic urethra. So depicted here is the one-week and three-month post-MRI results. You can see the initial defect and edema seen one week after surgery and then followed by scarring and contraction and a reduction in prostatic tissue three months after the procedure.
SPEAKER: Here's an example of the ureteroscopic views before treatment and six months after treatment from a 51-gram prostate. You can see the increased luminal caliber and reduced prostatic adenoma. Here's another example of pre- and post-treatment in a 31-gram prostate, where it's again, apparent the reduction in obstructing tissue with an adequate treatment of a median lobe.
Segment:3 Advantages.
SPEAKER: Water vapor therapy comes with some specific advantages. It does not require leaving any long-term foreign bodies. It can be done under local anesthesia as an in-office procedure. It allows for treatment of median lobes and patients with bladder neck elevation. It has minimal sexual side effects like retrograde ejaculation or erectile dysfunction.
SPEAKER: It appears to be durable with consistent outcomes in relieving lower urinary tract symptoms, improving flow, and improving quality of life in well-selected patients. We'll discuss the details of the four-year data from the pivotal study later in this presentation. It also has a short learning curve.
Segment:4 Disadvantages.
SPEAKER: There are also some important disadvantages that need to be discussed.
SPEAKER: Patients who undergo water vapor therapy may potentially need longer catheterization times and experience increased duration of dysuria. Risks and outcomes of X-ray therapy and brachytherapy are unknown. Not all patients are good candidates for this procedure, and as such, it requires a careful selection process. It's only an option for those with prostates between 30 and 80 grams.
SPEAKER: Its durability is still a concern since data is only limited to four years.
Segment:5 Indications.
SPEAKER: The indications for water vapor therapy are similar to other minimally-invasive BPH treatments. It should be considered once a patient has failed medical therapy or wants to reduce their use of medical therapy.
SPEAKER: It may be an option for those wanting to avoid other more invasive procedures with potential sexual side effects. It may also be a way to avoid the need for general or spinal anesthesia and may offer quicker recovery times and reduce catheter times compared to some more invasive hospital-based procedures. Here's the AUA surgical management guidelines for LUTS associated with BPH.
SPEAKER: You can see that water vapor therapy is one option to be considered for average- to small-size prostates, less than 80 grams.
Segment:6 Contraindications.
SPEAKER: Contraindications include patients with inflatable penile prostheses and artificial urinary bladders. Relative contraindications include gross hematuria, which should be evaluated before undergoing surgery.
SPEAKER: An important note, large obstructing medium lobes and severely elevated bladder necks are not contraindications for water vapor therapy and they can be successfully treated.
Segment:7 Preoperative Preparation.
SPEAKER: So in discussing water vapor therapy as an option for patients with appropriate-sized prostates, it's important to ask about goals and set reasonable expectations. Patients should be fully informed regarding the risks to sexual function, the plan regarding any anticoagulant medications, the timeline for expected symptom relief, the need for a catheter after surgery, the expected durability of the results, and how pain and anxiety will be managed during and after the procedure.
SPEAKER: In addition, to the AUA symptom score, post-void residual, and urinary flow rate, patients should also undergo cystoscopy and transurethral ultrasound of the prostate prior to surgery to evaluate if the patient is a candidate for water vapor therapy. It's important to assess the prostate length and volume, the prostatic urethral angle, the presence of a median lobe or elevated central zone, and intravesical protrusion.
SPEAKER: And this may also be a good time to gauge the patient's pain tolerance and bleeding tendency to further inform the operative plan. To reduce risks of infection and bleeding, we recommend antibiotic treatment for 48 hours prior to surgery and cessation of anticoagulation medications. Now, let's discuss setup and pain management during the procedure.
Segment:8 Instruments.
SPEAKER: Water vapor therapy systems like Rezum, which is the only FDA-approved system in the United States, come with a delivery device that includes a scope with an injection system, a light, and irrigation. Additional materials to have prepared include a preparation tray, some topical antiseptic, a drape, underpads, lidocaine gel, an IV pole for the saline, a 4-millimeter 30-degree, 30-centimeter rigid cystoscope lens, and a monitor and light source.
Segment:9 Patient Positioning.
SPEAKER: Patients can be placed in the dorsal and low dorsal lithotomy position for both OR and in-office procedures. Make sure the buttocks are just off the edge of the table with no obstructions that would limit the movement of the device.
Segment:10 Anesthesia.
SPEAKER: Water vapor therapy is amenable to in-office treatment under local and oral pain control. It can also be performed under IV sedation like any other common BPH treatment.
SPEAKER: As with any in-office procedure, the methods for pain and anxiety control should take into consideration, both the skills of the physician and the values of the patient. Here are some options to consider as part of the anesthesia plan. Antianxiety medication like alprazolam may be utilized to make the patient more comfortable. Oral pain medication, like hydrocodone-acetaminophen or oxycodone-acetaminophen can be given one hour prior to the procedure.
SPEAKER: Local administration of 1% lidocaine to numb the region can be done via two different methods, a simple pudendal block or a traditional prostatic block, both will be discussed in detail on the following slides. And other considerations include oral muscle relaxants, NSAIDs or narcotics as needed for postoperative pain, and a belladonna and opium suppository. Local analgesia aims to anesthetize the inferior hypogastric nerve plexus, which includes the prostatic plexus.
SPEAKER: The pudendal block and the traditional block use similar supplies. They're both going to utilize a 22-gauge spinal needle, 20 cc's of lidocaine, 1%, both of which are in our standard tray. And then they might also use an ultrasound machine for guidance. A pudendal block consists of administering 4 to 5 cc's lateral to the seminal vesicles between the prostate and the bladder neck on both sides.
SPEAKER: So here's an example of this being done without an ultrasound machine at our institution. [VIDEO PLAYBACK] And of course, both sides are treated.
SPEAKER: [END PLAYBACK] Another method to consider is the traditional block, which consists of 3 to 4 cc's of lidocaine between the seminal vesicles and prostate on both sides, 1 to 2 cc's between the rectum and the prostate, and another 1 to 2 cc's under the prostate from the vascular pedicle to the apex.
Segment:11 Surgical Steps.
SPEAKER: Now, we'll cover some of the procedural steps and cover some anatomical considerations.
SPEAKER: Successful water vapor therapy treatment aims to create overlapping ablation of the prostate adenoma parallel to the slope of the urethra. Unique patient anatomy may alter how this is achieved, and sound judgment should always be used when treating each patient. Once the patient is comfortable and appropriate anesthesia has been administered, pass the scope into the bladder and then retract to assess the prostatic urethral length.
SPEAKER: [VIDEO PLAYBACK] Then begin the first treatment 1-centimeter distal to the bladder neck, starting at either the right or left lateral lobe. To treat, we deploy the needle, we eject vapor for nine seconds, and then wait one to two seconds after treatment before retracting the needle.
SPEAKER: If you're under local anesthesia, remind the patient to remain still during the procedure to avoid vapor leaks that could reduce efficacy. For vapor leaks, which are noted by bursts of bubbles during the treatment, remove the device towards the leak, and it should seal. If it's a large vapor leak longer than three to nine seconds of the treatment, then retreat the area.
SPEAKER: Proceed distally from the bladder neck to the verumontanum in 1-centimeter increments on the same side, moving parallel the urethra and focusing on the bulk of the adenoma. And the number of treatments will depend on the length of the prostatic urethra. And then retreat the contralateral side. [END PLAYBACK] [VIDEO PLAYBACK] Here's the same procedure but with simultaneous transmitter ultrasound being utilized.
SPEAKER: Here, we can visualize the device in the urethra when the needle is going to be injected into the lateral lobe. And we can see the steam as it enters the prostatic tissue. [END PLAYBACK]
Segment:12 Anatomical Considerations.
SPEAKER: So when encountered, medium lobes should be treated for optimal results.
SPEAKER: This is done by deploying the needle from a midweight point between the base and the apex, approaching at a 45-degree angle. And two treatments are typically sufficient for most medium lobes. However, those median lobes of a wide base may utilize an additional treatment at the apex. Whenever there's difficulty entering the bladder, it's important to not force the device.
SPEAKER: This can cause prostatic injury and unnecessary bleeding. In the case of increased urethral angle, 40 degrees, enlargement of the central tissue is likely the culprit. When unable to enter the bladder, treatment can be initiated at the central elevation, which will reduce and then allow passage into the bladder. Then it's possible to continue in 1-centemeter increments from the bladder neck to the verumontanum as described earlier.
SPEAKER: Tips for treating and evaluating the central tissue and taller prostatic urethra. Use a Z-like pattern, or two parallel stacked lines is recommended. Begin at the top of the elevated tissue rather than the bladder neck. And then it's advisable to tell the patient they may see passage of some necrotic tissue postoperatively.
SPEAKER: When intraprostatic protrusion of lateral lobes is present, you can treat similar two protruding medium lobes by measuring from the tip of the intravesical protrusion instead of the bladder neck and then using stacked Z lines in order
Segment:13 Postoperative Care.
SPEAKER: to treat the tissue. Here are some important postoperative care steps for water vapor therapy patients. They should be sent home with a 16 French Foley catheter for three to seven days.
SPEAKER: Patients should be informed that they may experience two to three weeks of urgency, frequency, and dysuria. The follow up should include a trial of void when the catheter is removed after three to seven days, a return visit in one to three months. And it's recommended to wean patients from alpha blockers three to four weeks after the procedure. Here's a full procedure at our institution. [VIDEO PLAYBACK] [END PLAYBACK]
Segment:14 Outcomes Data.
SPEAKER: So let's discuss the outcomes for water vapor therapy.
SPEAKER: McVety and Rory Bourne's pivotal study of water vapor therapy demonstrated a favorable postoperative profile with 57% of patients reporting no adverse events. Of those that reported adverse events, they were mild to moderate and resolved within three weeks. The most common adverse events were dysuria in 17%, gross hematuria in 11.6%, hematospermia in 6.3%, urinary frequency in 5.8%, and urinary urgency in 4.8%. The four-year data from the pivotal study has demonstrated durability with significant sustained reduction in the AUA symptom score and a net increase in maximum net duration flow or Q max.
SPEAKER: They also demonstrated a better quality of life scores after surgery, sustained up to four years, as well as a reduced BPH Impact Index score which was also sustained for the four years. Regarding sexual function, they demonstrated no significant change in erectile function over four years.
SPEAKER: They also showed no significant change in ejaculatory function. One important note, the five-year data on this study are available and anticipate to publish soon. An important point regarding medial lobes. They found that when a medial lobe was present, prostate symptom scores were better and maximum net duration flow rate was higher if the median lobe was treated.
SPEAKER: You can see the blue lines on both of these graphs, which represent those whose median lobe was retreated. And the green line represents those of median lobes that were not treated. Lastly-- well, these are not head-to-head studies-- here are some comparisons of the reported outcome data from the pivotal studies for water vapor therapy, conductive TUNA, TUMT, and UroLift.
SPEAKER: And you can see that water vapor therapy has a comparatively lower repeat procedure and further need for BPH medications.
Segment:15 Conclusion.
SPEAKER: In conclusion, water vapor therapy is a minimally-invasive treatment that is effective and durable. It is a simple procedure that can be done in-office under local anesthesia.
SPEAKER: Patients must be carefully selected for best results. And for those that are candidates, it may be helpful to avoid sexual dysfunction and complications seen in other BPH treatments. Thank you.
Segment:1 Introduction.
SPEAKER: This video presentation will discuss water vapor thermal therapy, a minimally invasive treatment for benign prostatic hyperplasia. Water vapor therapy comes with a set of unique advantages and disadvantages. We'll cover its mechanism of action, indications, limitations, procedural steps, and clinical outcomes.
Segment:2 How It Works.
SPEAKER: Let's start with the physiology behind how this therapy works. First, steam is rapidly and uniformly injected into the prostatic tissue.
SPEAKER: The vapor condenses and releases thermal energy that denatures cell membranes. This leads to tissue coagulation and necrosis, vasculature closure, and adrenergic denervation followed by cellular apoptosis and tissue contraction, which eventually opens the prostatic urethra. So depicted here is the one-week and three-month post-MRI results. You can see the initial defect and edema seen one week after surgery and then followed by scarring and contraction and a reduction in prostatic tissue three months after the procedure.
SPEAKER: Here's an example of the ureteroscopic views before treatment and six months after treatment from a 51-gram prostate. You can see the increased luminal caliber and reduced prostatic adenoma. Here's another example of pre- and post-treatment in a 31-gram prostate, where it's again, apparent the reduction in obstructing tissue with an adequate treatment of a median lobe.
Segment:3 Advantages.
SPEAKER: Water vapor therapy comes with some specific advantages. It does not require leaving any long-term foreign bodies. It can be done under local anesthesia as an in-office procedure. It allows for treatment of median lobes and patients with bladder neck elevation. It has minimal sexual side effects like retrograde ejaculation or erectile dysfunction.
SPEAKER: It appears to be durable with consistent outcomes in relieving lower urinary tract symptoms, improving flow, and improving quality of life in well-selected patients. We'll discuss the details of the four-year data from the pivotal study later in this presentation. It also has a short learning curve.
Segment:4 Disadvantages.
SPEAKER: There are also some important disadvantages that need to be discussed.
SPEAKER: Patients who undergo water vapor therapy may potentially need longer catheterization times and experience increased duration of dysuria. Risks and outcomes of X-ray therapy and brachytherapy are unknown. Not all patients are good candidates for this procedure, and as such, it requires a careful selection process. It's only an option for those with prostates between 30 and 80 grams.
SPEAKER: Its durability is still a concern since data is only limited to four years.
Segment:5 Indications.
SPEAKER: The indications for water vapor therapy are similar to other minimally-invasive BPH treatments. It should be considered once a patient has failed medical therapy or wants to reduce their use of medical therapy.
SPEAKER: It may be an option for those wanting to avoid other more invasive procedures with potential sexual side effects. It may also be a way to avoid the need for general or spinal anesthesia and may offer quicker recovery times and reduce catheter times compared to some more invasive hospital-based procedures. Here's the AUA surgical management guidelines for LUTS associated with BPH.
SPEAKER: You can see that water vapor therapy is one option to be considered for average- to small-size prostates, less than 80 grams.
Segment:6 Contraindications.
SPEAKER: Contraindications include patients with inflatable penile prostheses and artificial urinary bladders. Relative contraindications include gross hematuria, which should be evaluated before undergoing surgery.
SPEAKER: An important note, large obstructing medium lobes and severely elevated bladder necks are not contraindications for water vapor therapy and they can be successfully treated.
Segment:7 Preoperative Preparation.
SPEAKER: So in discussing water vapor therapy as an option for patients with appropriate-sized prostates, it's important to ask about goals and set reasonable expectations. Patients should be fully informed regarding the risks to sexual function, the plan regarding any anticoagulant medications, the timeline for expected symptom relief, the need for a catheter after surgery, the expected durability of the results, and how pain and anxiety will be managed during and after the procedure.
SPEAKER: In addition, to the AUA symptom score, post-void residual, and urinary flow rate, patients should also undergo cystoscopy and transurethral ultrasound of the prostate prior to surgery to evaluate if the patient is a candidate for water vapor therapy. It's important to assess the prostate length and volume, the prostatic urethral angle, the presence of a median lobe or elevated central zone, and intravesical protrusion.
SPEAKER: And this may also be a good time to gauge the patient's pain tolerance and bleeding tendency to further inform the operative plan. To reduce risks of infection and bleeding, we recommend antibiotic treatment for 48 hours prior to surgery and cessation of anticoagulation medications. Now, let's discuss setup and pain management during the procedure.
Segment:8 Instruments.
SPEAKER: Water vapor therapy systems like Rezum, which is the only FDA-approved system in the United States, come with a delivery device that includes a scope with an injection system, a light, and irrigation. Additional materials to have prepared include a preparation tray, some topical antiseptic, a drape, underpads, lidocaine gel, an IV pole for the saline, a 4-millimeter 30-degree, 30-centimeter rigid cystoscope lens, and a monitor and light source.
Segment:9 Patient Positioning.
SPEAKER: Patients can be placed in the dorsal and low dorsal lithotomy position for both OR and in-office procedures. Make sure the buttocks are just off the edge of the table with no obstructions that would limit the movement of the device.
Segment:10 Anesthesia.
SPEAKER: Water vapor therapy is amenable to in-office treatment under local and oral pain control. It can also be performed under IV sedation like any other common BPH treatment.
SPEAKER: As with any in-office procedure, the methods for pain and anxiety control should take into consideration, both the skills of the physician and the values of the patient. Here are some options to consider as part of the anesthesia plan. Antianxiety medication like alprazolam may be utilized to make the patient more comfortable. Oral pain medication, like hydrocodone-acetaminophen or oxycodone-acetaminophen can be given one hour prior to the procedure.
SPEAKER: Local administration of 1% lidocaine to numb the region can be done via two different methods, a simple pudendal block or a traditional prostatic block, both will be discussed in detail on the following slides. And other considerations include oral muscle relaxants, NSAIDs or narcotics as needed for postoperative pain, and a belladonna and opium suppository. Local analgesia aims to anesthetize the inferior hypogastric nerve plexus, which includes the prostatic plexus.
SPEAKER: The pudendal block and the traditional block use similar supplies. They're both going to utilize a 22-gauge spinal needle, 20 cc's of lidocaine, 1%, both of which are in our standard tray. And then they might also use an ultrasound machine for guidance. A pudendal block consists of administering 4 to 5 cc's lateral to the seminal vesicles between the prostate and the bladder neck on both sides.
SPEAKER: So here's an example of this being done without an ultrasound machine at our institution. [VIDEO PLAYBACK] And of course, both sides are treated.
SPEAKER: [END PLAYBACK] Another method to consider is the traditional block, which consists of 3 to 4 cc's of lidocaine between the seminal vesicles and prostate on both sides, 1 to 2 cc's between the rectum and the prostate, and another 1 to 2 cc's under the prostate from the vascular pedicle to the apex.
Segment:11 Surgical Steps.
SPEAKER: Now, we'll cover some of the procedural steps and cover some anatomical considerations.
SPEAKER: Successful water vapor therapy treatment aims to create overlapping ablation of the prostate adenoma parallel to the slope of the urethra. Unique patient anatomy may alter how this is achieved, and sound judgment should always be used when treating each patient. Once the patient is comfortable and appropriate anesthesia has been administered, pass the scope into the bladder and then retract to assess the prostatic urethral length.
SPEAKER: [VIDEO PLAYBACK] Then begin the first treatment 1-centimeter distal to the bladder neck, starting at either the right or left lateral lobe. To treat, we deploy the needle, we eject vapor for nine seconds, and then wait one to two seconds after treatment before retracting the needle.
SPEAKER: If you're under local anesthesia, remind the patient to remain still during the procedure to avoid vapor leaks that could reduce efficacy. For vapor leaks, which are noted by bursts of bubbles during the treatment, remove the device towards the leak, and it should seal. If it's a large vapor leak longer than three to nine seconds of the treatment, then retreat the area.
SPEAKER: Proceed distally from the bladder neck to the verumontanum in 1-centimeter increments on the same side, moving parallel the urethra and focusing on the bulk of the adenoma. And the number of treatments will depend on the length of the prostatic urethra. And then retreat the contralateral side. [END PLAYBACK] [VIDEO PLAYBACK] Here's the same procedure but with simultaneous transmitter ultrasound being utilized.
SPEAKER: Here, we can visualize the device in the urethra when the needle is going to be injected into the lateral lobe. And we can see the steam as it enters the prostatic tissue. [END PLAYBACK]
Segment:12 Anatomical Considerations.
SPEAKER: So when encountered, medium lobes should be treated for optimal results.
SPEAKER: This is done by deploying the needle from a midweight point between the base and the apex, approaching at a 45-degree angle. And two treatments are typically sufficient for most medium lobes. However, those median lobes of a wide base may utilize an additional treatment at the apex. Whenever there's difficulty entering the bladder, it's important to not force the device.
SPEAKER: This can cause prostatic injury and unnecessary bleeding. In the case of increased urethral angle, 40 degrees, enlargement of the central tissue is likely the culprit. When unable to enter the bladder, treatment can be initiated at the central elevation, which will reduce and then allow passage into the bladder. Then it's possible to continue in 1-centemeter increments from the bladder neck to the verumontanum as described earlier.
SPEAKER: Tips for treating and evaluating the central tissue and taller prostatic urethra. Use a Z-like pattern, or two parallel stacked lines is recommended. Begin at the top of the elevated tissue rather than the bladder neck. And then it's advisable to tell the patient they may see passage of some necrotic tissue postoperatively.
SPEAKER: When intraprostatic protrusion of lateral lobes is present, you can treat similar two protruding medium lobes by measuring from the tip of the intravesical protrusion instead of the bladder neck and then using stacked Z lines in order
Segment:13 Postoperative Care.
SPEAKER: to treat the tissue. Here are some important postoperative care steps for water vapor therapy patients. They should be sent home with a 16 French Foley catheter for three to seven days.
SPEAKER: Patients should be informed that they may experience two to three weeks of urgency, frequency, and dysuria. The follow up should include a trial of void when the catheter is removed after three to seven days, a return visit in one to three months. And it's recommended to wean patients from alpha blockers three to four weeks after the procedure. Here's a full procedure at our institution. [VIDEO PLAYBACK] [END PLAYBACK]
Segment:14 Outcomes Data.
SPEAKER: So let's discuss the outcomes for water vapor therapy.
SPEAKER: McVety and Rory Bourne's pivotal study of water vapor therapy demonstrated a favorable postoperative profile with 57% of patients reporting no adverse events. Of those that reported adverse events, they were mild to moderate and resolved within three weeks. The most common adverse events were dysuria in 17%, gross hematuria in 11.6%, hematospermia in 6.3%, urinary frequency in 5.8%, and urinary urgency in 4.8%. The four-year data from the pivotal study has demonstrated durability with significant sustained reduction in the AUA symptom score and a net increase in maximum net duration flow or Q max.
SPEAKER: They also demonstrated a better quality of life scores after surgery, sustained up to four years, as well as a reduced BPH Impact Index score which was also sustained for the four years. Regarding sexual function, they demonstrated no significant change in erectile function over four years.
SPEAKER: They also showed no significant change in ejaculatory function. One important note, the five-year data on this study are available and anticipate to publish soon. An important point regarding medial lobes. They found that when a medial lobe was present, prostate symptom scores were better and maximum net duration flow rate was higher if the median lobe was treated.
SPEAKER: You can see the blue lines on both of these graphs, which represent those whose median lobe was retreated. And the green line represents those of median lobes that were not treated. Lastly-- well, these are not head-to-head studies-- here are some comparisons of the reported outcome data from the pivotal studies for water vapor therapy, conductive TUNA, TUMT, and UroLift.
SPEAKER: And you can see that water vapor therapy has a comparatively lower repeat procedure and further need for BPH medications.
Segment:15 Conclusion.
SPEAKER: In conclusion, water vapor therapy is a minimally-invasive treatment that is effective and durable. It is a simple procedure that can be done in-office under local anesthesia.
SPEAKER: Patients must be carefully selected for best results. And for those that are candidates, it may be helpful to avoid sexual dysfunction and complications seen in other BPH treatments. Thank you.
Form Title Download
Transcript
Form Title Bookmark
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Form Title Share
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Form Title Accessibility and Keyboard Shortcuts
The cadmore media player is a professional video and audio player experience designed to deliver media as well as relevant transcript, segmentation, and metadata. On the screen is a traditional html video player with buttons such as play, pause, forward, captioning, language and play speed selection and more. Adjacent to the video player are generally tabs, one of which shows a scrolling transcript of the video and the other shows any segmentation of the media, sometimes referred to as chapters. At the top of the video is a menu bar containing an Explore button and Tools button. The Explore button allows you to dig deeper into the video by opening up an explore dialog which contains tabs for a visual navigation of the video using thumbnails, an about tab which contains rich metadata about the media, a segments tab which contains further information about the video, and a related tab which contains links to other media related to this media. The tools button opens a menu with options for sharing the media on social media, creating bookmarking links, creating embed codes for your website, generating citations, and more.
Keyboard Shortcuts
Keyboard shortcuts only work while you are in forms mode. By entering forms mode, you will be able to quickly access portions of the media player with single key commands.
Spacebar: Play/Pause Toggle
I: Info Menu,
O: Tools Menu
T: Transcript Tab,
S: Segments Tab
F: Forward 15,
R: Rewind 15
L: Languages,
P: Playspeed
M: Mute Toggle,
V: Volume Bar
N: Video Only Toggle,
B: Full Screen Toggle
C: Captions Toggle
Escape: Closes dialogs and menus / Exits Player
Z: Next Transcript Chapter
X: Previous Transcript Chapter
Q: Next Transcript Paragraph
W: Previous Transcript Paragraph
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Embed Size
-
You Size - Responsive
-
We Size - Responsive
-
Picture Overlay Popup
-
400 x 225
-
512 x 288
-
400 x 700
-
768 x 1024
-
1024 x 512
-
1280 x 608
Form Title Cite
No citation provided.
Info
Segments
Related
Thumbnails
Exit Clip Mode
You have requested to see a portion of the video outside of the clip.
Click OK to switch to the full video or click if you would like to stay inside the clip. You can always go back to the clip with Tools and Clip Mode