As medical technology continues to advance, treatment options for benign prostatic hyperplasia (BPH) are expanding. In the past, surgical treatment for BPH was often perceived as burdensome. Today, however, a wider range of treatment approaches is being considered based on a patient’s overall health, lifestyle, and prostate condition.
In clinical practice, several treatment methods are currently used to manage BPH. These include UroLift, HoLEP surgery, robotic waterjet surgery (Aquablation), and the iTind procedure. Among these options, Rezūm therapy has also emerged as one of the minimally invasive treatment methods used for BPH.
Rezūm therapy is a minimally invasive procedure that delivers thermal energy to enlarged prostate tissue using high-temperature, high-pressure water vapor. The treatment is performed through the urethra without surgical incisions. During the procedure, controlled thermal stimulation is applied to the affected prostate tissue through a specialized device.
The procedure typically takes about 10 minutes. Before treatment, a cystoscopic examination of the urethra and bladder is performed to evaluate the size, location, and pattern of prostate enlargement. Based on these findings, the treatment area is determined, usually beginning near the bladder neck. Steam is then injected into the enlarged tissue using a specialized instrument. The heat generated by the steam causes targeted tissue damage, and gradual tissue changes occur as the body absorbs the treated area over time.
This approach is designed to minimize damage to surrounding healthy tissue. In some patients, improvements in urinary symptoms have been reported following the procedure. Rezūm therapy has often been introduced as a treatment option for middle-aged and older patients with prostate sizes ranging approximately from 30 to 80 grams.
In addition, the procedure may be performed under local anesthesia, which makes it a potential option for patients who may have difficulty undergoing general anesthesia. After treatment, patients typically use a urinary catheter for a short period before returning to daily activities.
Some clinicians compare Rezūm therapy with HoLEP surgery when discussing treatment options. HoLEP (Holmium Laser Enucleation of the Prostate) removes prostate tissue directly and is often performed to improve urinary flow and relieve obstruction. Rezūm therapy, on the other hand, induces structural changes in prostate tissue using thermal energy. Because of these differences, the two treatments may vary in procedure technique, recovery process, and potential side effects.
As with any medical treatment, certain considerations are associated with Rezūm therapy. The procedure requires specialized single-use equipment, which may increase treatment costs. In addition, because tissue changes and absorption occur gradually after the steam injection, symptom improvement may not be immediate. In patients with very severe symptoms or significantly enlarged prostates, other surgical treatments may be considered.
Ultimately, the treatment of benign prostatic hyperplasia requires a comprehensive evaluation of each patient’s symptoms, prostate condition, and overall health. Because the clinical presentation of BPH varies widely among individuals, physicians typically explain the characteristics and limitations of each treatment option and develop a personalized treatment plan accordingly.
Written by
Dr. Ryu Jeman
Goldman Urology Clinic, Seoul Station Center