Due to the advancement of medical technology, treatment methods for benign prostatic hyperplasia (BPH) are becoming increasingly diverse. Representative examples include the existing UroLift alongside HoLEP surgery, Waterjet robotic surgery, Rezūm procedure, and iTind surgery.
Among these, the Rezūm procedure is widely known as a treatment method for benign prostatic hyperplasia that contributes to improving the lesion within a short period. It is gaining attention as a minimally invasive treatment method that uses steam to reduce the enlarged prostate. The Rezūm procedure begins with a thorough examination of the prostate area using a urethrocystoscope. Subsequently, a urology specialist evaluates the size, location, and characteristics of the enlarged prostate tissue. Based on this, the prostate size is measured from the bladder neck to plan the precise treatment area.
Next, a special device equipped with a needle is used to inject high-temperature, high-pressure steam into the prostate. A distinctive feature at this stage is the separation of normal tissue from hypertrophic tissue by a capsule. This ensures that only the enlarged prostatic tissue is targeted while protecting the normal tissue. When this treatment method is used, the enlarged prostatic tissue is expected to shrink over 1 to 3 months, leading to an improvement in urinary symptoms.
The entire process of this Rezūm procedure is completed within approximately 10 minutes. It is suitable for patients aged 50 and older with a prostate size between 30 and 80g, and is particularly characterized by being simpler than traditional prostate surgeries while minimizing recovery time.
However, it is important to be aware of both the advantages and disadvantages of the Rezūm procedure. Let's first compare HoLEP surgery (Holmium Laser Enucleation of the Prostate) with the Rezūm procedure. One of the main advantages of the Rezūm procedure compared to HoLEP surgery is that it minimizes the risk of retrograde ejaculation. HoLEP surgery has the disadvantage of potentially causing retrograde ejaculation, which can be compensated for by the Rezūm procedure. Furthermore, the Rezūm procedure is often performed under local anesthesia, offering the advantage that it can be performed on elderly patients with underlying conditions for whom general anesthesia is difficult.
The Rezūm procedure also offers faster recovery than HoLEP surgery. The Rezūm procedure uses a simple catheter with a stopper to manage urine. This minimizes patient discomfort and makes it easier to return to daily activities. HoLEP surgery, involving more invasive tissue removal, generally entails a longer recovery period. It often requires the use of a urine bag, and there is also a possibility of experiencing discomfort due to bleeding or irritation.
Of course, the Rezūm procedure also has its disadvantages. Firstly, there is the disadvantage of higher cost. The Rezūm procedure uses specialized disposable equipment, which contributes to higher expenses. In contrast, HoLEP surgery is covered by national health insurance, making it relatively more affordable. The Rezūm procedure is also generally less effective than HoLEP surgery. Furthermore, there is the disadvantage that it can take approximately 1 to 3 months for the high-temperature steam to necrotize and for the enlarged prostatic tissue to be absorbed.
It cannot be guaranteed that the latest treatment method will yield good results for all benign prostatic hyperplasia patients, as each surgical method clearly has its advantages and disadvantages, and the appropriate surgery varies for each individual patient depending on their symptoms, and the size, location, and characteristics of the enlarged prostatic tissue. Therefore, the efforts of medical staff are also crucial to transparently provide objective information to patients, thereby reducing their decision-making time and increasing treatment satisfaction.
Director Ryu Kyung-ho, Goldman Urology Clinic, Gangnam Branch