TOPLINE:

Transurethral ablation of Gleason grade group 2 (GG2) lesions using water vapor therapy cleared the area of prostate cancer in 75% of men and 91% had no GG2 or higher-grade cancer remaining at 6 months.

METHODOLOGY:

• Researchers conducted a subset analysis of data from an ongoing prospective study at 19 sites to assess the 12-month efficacy and safety of water vapor therapy for intermediate-risk prostate cancer.
• They included 110 men (median age, 65 years) with GG2 lesions and a life expectancy of at least 10 years. Participants had prostate-specific antigen (PSA) levels ≤ 15 ng/mL and T2c or lower clinical stage.
• Prior to enrolment, all participants were required to have undergone an MRI-ultrasound fusion biopsy that showed a single suspicious lesion.
• Outpatient treatment involved transurethral water vapor ablation targeting the region of interest along with a small margin of surrounding tissue.
• The primary endpoint was the efficacy of ablation, determined using the proportion of men with a negative in-field biopsy at 6 months.

TAKEAWAY:

• At the 6-month MRI-targeted biopsy, 75% of men had benign tissue in the ablated area; GG2 prostate cancer was absent in the ablated area of 91% of men.
• Prostate volume decreased by 21%, with a median reduction of 8 cm at 6 months; PSA levels fell from a median of 5.6 ng/mL at baseline to 2.3 ng/mL at 12 months (P < .001); most men reached their lowest PSA level by 6 months.
• Sexual dysfunction initially worsened after treatment but gradually recovered over time, with 61.3% of men not experiencing a categorical worsening in sexual function; urinary incontinence events were generally mild to moderate.
• No rectal injuries, rectourethral fistulae, or osteitis pubis were reported.

IN PRACTICE:

“The current report is not intended to, and does not, validate water vapor therapy for the management of prostate cancer. We have not reported out-of-field cancer detection or management yet, to avoid introduction of bias in the final analysis of the trial,” the authors wrote.

SOURCE:

The study was led by Arvin George of the Johns Hopkins University in Baltimore. It was published online on June 10, 2026, in The Journal of Urology.

LIMITATIONS:

The study did not include a comparison group and enrolled a relatively uniform patient population that may not reflect routine clinical practice.

DISCLOSURES:

The study was funded by Francis Medical Inc. Two authors disclosed serving on the editorial board of The Journal of Urology and were recused from the editorial and peer review processes.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.