Evidence map›Paper›PMID 42207322›Full record

ArticleWorld journal of urology2026

Water vapor thermotherapy and high-grade Clavien-Dindo complications: retrospective analysis of 10 cases.

Luca Cindolo, Antonio Minore, Iván Schwartzmann, Alba Farré Alejo, Vittorio Imperatore, Vincenzo Iossa, Jan Ebbing, Paolo Destefanis, Richard Hindley, Amr Emara and 7 more

Abstract read
PubMed Publisher
In one paragraph

Article in World journal of urology, 2026. 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. Small procedures, big complications.World journal of urology · 2026
    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

17 authors.

Luca CindoloCentro Urologico Europeo, Modena, Italy. lucacindolo@virgilio.it.
Antonio MinoreDepartment of Urology, Fondazione Campus Bio-Medico of Rome, Rome, Italy.
Iván SchwartzmannDepartment of Urology, Universidad Autonoma de Barcelona, Fundaciò Puigvert, Barcelona, Spain.
Alba Farré AlejoDepartment of Urology, Universidad Autonoma de Barcelona, Fundaciò Puigvert, Barcelona, Spain.
Vittorio ImperatoreDepartment of Urology, AORN Moscati, Avellino, Italy.
Vincenzo IossaDepartment of Urology, AORN Moscati, Avellino, Italy.
Jan EbbingDepartment of Urology, University Hospital Basel, Basel, Switzerland.
Paolo DestefanisDepartment of Surgical Sciences, A.O.U. Città della Salute e della Scienza- Molinette Hospital, Urology Clinic, University of Turin, Turin, Italy.
Richard HindleyUrology Department, Hampshire Hospitals Foundation Trust, Basingstoke, UK.
Amr EmaraUrology Department, Hampshire Hospitals Foundation Trust, Basingstoke, UK.
Antonio PastoreICOT Hospital, University Sapienza, Rome, Italy.
Manfredi Bruno SequiICOT Hospital, University Sapienza, Rome, Italy.
Raffaele BalsamoUrology Unit, Department of Surgical Sciences AORN dei Colli, Monaldi Hospital, Naples, Italy.
Radoslav KnazikUROplus, Urology Clinic, Banska Bystrica, Slovakia.
Mathieu CoscarellaH.U.B. Hopital Erasme, Brussels, Belgium.
Cosimo De NunzioDepartment of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
Silvia SeccoASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWater vapor thermal therapy (WVTT) has emerged as a widely adopted minimally invasive treatment for lower urinary tract symptoms due to benign prostatic hyperplasia/obstruction (BPH/BPO), with excellent functional outcomes and a favorable safety profile. However, life-threatening real-world complications are likely underreported. The aim of this study was to describe severe (Clavien-Dindo > = 4) complications after WVTT and discuss possible mechanisms, risk factors, and preventive strategies.

methodsDuring an international WVTT meeting (Madrid, June 2025), experienced surgeons from high-volume centers were invited to retrospectively report life-threatening complications after WVTT. Anonymized demographic, clinical, perioperative, and postoperative data were collected using a standardized template and were qualitatively analyzed.

resultsContributors reported a small multicenter series of life-threatening events occurring despite negative preoperative urine cultures and standard antibiotic prophylaxis. Most complications were infectious, including septic shock with intraprostatic abscess and bacteremia, often requiring intensive care, vasopressor support, and prolonged intravenous antibiotics. Some fatal events were recorded, mainly due to sepsis caused by multidrug-resistant pathogens. Apart from infectious events, other complications were destructive orchitis requiring orchiectomy, severe urethral stricture with extensive intraprostatic necrosis requiring endoscopic treatment, and thermal injury to a redundant sigmoid colon. Several patients had relevant comorbidities, prior catheterization, or unrecognized anatomic variants.

conclusionAlthough WVTT is generally safe, rare but dramatic life-threatening complications do occur, even in expert hands. Strict infection control, careful patient selection, adherence to recommended injection schemes, attention to bowel history and anatomy, and comprehensive counseling, particularly in frail and multimorbid patients, are essential to mitigate risk. Systematic, standardized reporting of severe adverse events is needed to refine perioperative strategies and improve patient safety.

Indexed as

Hyperthermia, InducedLower Urinary Tract SymptomsPostoperative ComplicationsProstatic HyperplasiaSteamAgedHumansMaleMiddle AgedRetrospective StudiesSeverity of Illness IndexSteamBenign prostatic hyperplasiaComplicationsDeathWater vapor thermotherapy

Identifiers

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.