Local anesthesia for Rezūm™: a narrative review of the literature.

introductionThis narrative review analyzed current practices and protocols for local anesthesia in Rezūm™ and evaluated the feasibility, pain management, and patient comfort associated with this approach. EVIDENCE ACQUISITION: We included studies reporting the use of local anesthesia in Rezūm™, focusing on patient comfort and pain levels during the procedure. The literature search was performed in June 2024 using Medline, Cochrane, and Embase databases to identify relevant studies published from January 2015 to June 2024. Searches were restricted to publications in English. Owing the heterogeneity of study outcomes and the non-standardized quality appraisal, a narrative synthesis rather than a quantified meta-analysis of data was performed. EVIDENCE SYNTHESIS: Four studies were included. Various local anesthesia methods, including transurethral intraprostatic anesthesia with the Schelin catheter and prostatic nerve block associated with cold anesthetic gel, are effective in managing pain and can facilitate the performance of Rezūm™ in outpatient settings. Functional outcomes, including improved Qmax, reduced IPSS and QoL scores, and high catheter independence rates, were reported, with minor complications.

conclusionsRezūm™ performed under local anesthesia is feasible, offering significant advantages in terms of patient comfort and potential for outpatient application. However, the lack of standardized protocols and the need for further research on long-term outcomes and comparative efficacy are critical areas for future investigation. Addressing these challenges could optimize Rezūm™, making them more accessible and cost-effective and potentially shifting BPH management toward more office-based procedures.