Abstract / Summary
Summary: Background: Water vapour therapy of the prostate is a minimally invasive treatment for benign prostatic hyperplasia. While generally safe, rare but clinically significant complications, such as postprocedural bacteraemia, have been reported. Differentiating true complications from expected side-effects is essential for accurate risk communication and quality improvement. Objective: The aim of this study was to evaluate the incidence of bacteraemia and other adverse events following these treatments and assess the impact of targeted interventions on patient safety. Methods: A retrospective review was conducted of all procedures performed at Cleveland Clinic Abu Dhabi between January 2021 and December 2025. The pre-intervention cohort included 82 cases, and the postintervention cohort included 46 cases. Outcomes were classified as complications or side-effects. Interventions initiated in Q3 2023 included standardized operating procedures, revised antibiotic prophylaxis, and enhanced patient education. Risk differences, relative risks, and P-values were calculated using Fisher's exact test. Results: Before the intervention, bacteraemia occurred in 6.1% of cases and urinary tract infections (UTIs) in 6.1%. Following implementation, no cases of bacteraemia or UTIs were observed in the postintervention cohort (0/46), representing a reduction compared with the pre-intervention period. A single case of candiduria emerged in the postintervention cohort (1/46; 2.2%), with no evidence of a sustained increase in fungal complications. Urinary retention decreased from 6.1% to 0. Haematuria remained relatively stable, increasing from 13.4% to 15.2%. Dysuria decreased from 19.5% to 8.7%. Although statistical significance was not achieved, these findings indicate clinically meaningful improvement. Conclusion: Protocolized antimicrobial prophylaxis, standardized workflows, and patient education were associated with reduced infectious complications and improved safety.