With advances in medical technology, treatment options for benign prostatic hyperplasia (BPH) have become increasingly diverse. Commonly used approaches include UroLift, Holmium Laser Enucleation of the Prostate (HoLEP), robotic waterjet surgery (Aquablation), Rezūm therapy, and the iTind procedure.
Among these, Rezūm therapy is widely recognized as a treatment that can help improve prostate-related symptoms within a relatively short period of time. It is considered a minimally invasive treatment that uses steam to reduce enlarged prostate tissue.
The Rezūm procedure begins with a thorough examination of the prostate using a cystoscope inserted through the urethra and bladder. A urology specialist evaluates the size, location, and pattern of the enlarged prostate tissue. Based on this assessment, the physician measures the prostate starting from the bladder neck and plans the precise treatment area.
A specialized device equipped with a needle is then used to inject high-temperature, high-pressure steam into the prostate tissue. One notable characteristic of this procedure is that the prostate capsule separates normal tissue from enlarged tissue. As a result, the treatment targets only the enlarged prostate tissue while preserving surrounding normal structures. After treatment, the enlarged prostate tissue gradually shrinks over a period of one to three months, which may lead to improvement in urinary symptoms.
The entire Rezūm procedure typically takes less than 10 minutes to complete. It is generally considered suitable for patients over the age of 50 whose prostate size ranges between approximately 30 and 80 grams. One of its key advantages is that it is relatively simple compared with conventional prostate surgery and can minimize recovery time.
However, it is important for patients to understand both the advantages and limitations of Rezūm therapy. For example, when comparing Rezūm therapy with HoLEP surgery, one of the main advantages of Rezūm is the reduced risk of retrograde ejaculation. HoLEP surgery, which uses a holmium laser to remove enlarged prostate tissue, may carry a higher likelihood of retrograde ejaculation. Rezūm therapy can help address this concern. In addition, Rezūm therapy is often performed under local anesthesia, making it a potential option for elderly patients who may have difficulty undergoing general anesthesia due to underlying health conditions.
Recovery following Rezūm therapy is also typically faster than after HoLEP surgery. Patients usually require a simple urinary catheter with a plug to help manage urination temporarily. This approach can reduce discomfort and make it easier for patients to return to normal daily activities. In contrast, HoLEP surgery involves more invasive removal of prostate tissue, which may require a longer recovery period. Patients may also need a urine collection bag and may experience discomfort due to bleeding or irritation.
Nevertheless, Rezūm therapy also has certain limitations. One consideration is cost, as the procedure uses specialized disposable equipment that can make it more expensive. In comparison, HoLEP surgery is generally covered by national health insurance in many cases, which may reduce the financial burden. Additionally, the therapeutic effect of Rezūm may be somewhat less pronounced than that of HoLEP surgery. Because the treatment works by causing enlarged prostate tissue to undergo necrosis and gradual absorption, it may take one to three months for the full effect to appear.
Dr. Ryu Kyungho of the Gangnam branch of Goldman Urology Clinic explained that even though a treatment method is considered advanced or newly introduced, it does not guarantee the best outcome for every patient with benign prostatic hyperplasia. Each surgical technique has its own advantages and limitations, and the most appropriate treatment can vary depending on factors such as the patient’s symptoms, the size and location of the enlarged prostate tissue, and its anatomical characteristics. He emphasized that providing patients with transparent and objective information about available treatment options is essential for helping them make informed decisions, reducing uncertainty during the decision-making process, and ultimately improving satisfaction with treatment outcomes.