Evidence map›Paper›PMID 41405700›Full record

SynthesisWorld journal of urology2025

Management of NOACs in patients undergoing water vapour thermal therapy (REZUM) for benign prostatic obstruction: a comprehensive review.

M Coscarella, S Secco, D S Elterman, M Baboudjian, M Al Barajraji, M Leclercq, F Gillard, I Moussa, M Pedini, S Holz and 4 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

M CoscarellaDepartment of Urology, Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme - Université Libre de Bruxelles (ULB), Brussels, Belgium. coscarellam@helora.be.
S SeccoDepartment of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
D S EltermanDivision of Urology, University Health Network, Toronto, Canada.
M BaboudjianDepartment of Urology, North Hospital, Aix-Marseille University, Marseille, France.
M Al BarajrajiDepartment of Urology, Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme - Université Libre de Bruxelles (ULB), Brussels, Belgium.
M LeclercqDepartement of Anesthesiology, CHU Helora, Mons, Belgium.
F GillardDepartement of Anesthesiology, CHU Helora, Mons, Belgium.
I MoussaDepartment of Urology, CHU Helora, Mons, Belgium.
M PediniDepartment of Urology, Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme - Université Libre de Bruxelles (ULB), Brussels, Belgium.
S HolzDepartment of Urology, CHU Helora, Mons, Belgium.
F DalatiDepartment of Urology, CHU Saint-Pierre, Brussels, Belgium.
M FourmarierDepartment of Urology, CH Aix-Pertuis, Aix-en-Provence, France.
T RoumeguèreDepartment of Urology, Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme - Université Libre de Bruxelles (ULB), Brussels, Belgium.
L CindoloCentro Urologico Europeo (CUrE), Modena, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMinimally Invasive Surgical Techniques (MIST) such as water vapor thermal therapy (WVTT, or Rezum) are increasingly adopted for treating benign prostatic obstruction (BPO), particularly in frail or elderly patients. These procedures offer a safer, less invasive alternative to conventional surgery while preserving sexual function. Frail patients often require long-term anticoagulation with non-vitamin K oral anticoagulants (NOACs), which poses challenges in balancing bleeding and thrombotic risks during urological procedures.

objectiveTo evaluate the bleeding risk profile of in patients on NOAC therapy and propose evidence-based recommendations for peri-operative NOAC management.

methodsA systematic literature review was performed using PubMed and Cochrane databases, focusing on combinations of NOACs with WVTT. Supplementary expert opinions and international clinical guidelines were also analyzed. The review compared REZUM's bleeding risk to prostate biopsy as a reference procedure which is generally categorized as low-risk.

resultsThe review revealed a paucity of direct studies on NOAC management during WVTT, with no formal recommendations from urological societies. However, data suggest that WVTT is associated with minimal bleeding, similar to prostate biopsy. It's short procedural time, targeted vapour delivery, and minimal invasiveness support this hypothesis. Existing cardiology and anesthesiology guidelines recommend against bridging in low-risk procedures. A practical protocol based on pharmacokinetics and patient co-morbidities is proposed herein.

conclusionWVTT appears to be a safe and effective treatment option for anticoagulated, including frail patients with BPO. In the absence of specific urological guidelines, adopting a standardized, evidence-based protocol-often without NOAC interruption or bridging-may improve patient outcomes and urologist autonomy. Larger, prospective studies are needed to validate this approach.

Indexed as

AnticoagulantsHyperthermia, InducedProstatic HyperplasiaHumansMaleMinimally Invasive Surgical ProceduresSteamAnticoagulantsSteamAnticoagulation managementBenign prostatic obstructionBPHFrail patientMinimally invasive surgeryMISTNOACsNon-vitamin k oral anticoagulantsREZUMWater vapour thermal therapy

Identifiers

PMID41405700

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.