The Rezum procedure is a minimally invasive treatment method that utilizes water vapor to improve benign prostatic hyperplasia (BPH). The procedure begins with a thorough examination of the prostate area using a urethro-cystoscope. During this examination, a urology specialist evaluates the size, location, and pattern of the enlarged prostate tissue. Based on this assessment, the prostate size is measured from the bladder neck to plan the precise treatment area.
Subsequently, a special device equipped with a needle is used to inject high-temperature, high-pressure water vapor into the prostate. At this point, the capsule distinguishes between normal tissue and hypertrophic tissue. This allows the procedure to target only the enlarged prostate tissue while protecting normal tissue. Using this treatment method, the enlarged prostate tissue shrinks over 1 to 3 months, leading to an improvement in urinary symptoms.
The Rezum procedure typically takes about 1 to 2 minutes, with the entire process completed within approximately 10 minutes. It is suitable for patients aged 50 and older with a prostate size between 30g and 80g. A key characteristic is its simplicity compared to traditional prostate surgeries, as it minimizes recovery time.
The characteristics of the Rezum procedure can be compared with Holmium Laser Enucleation of the Prostate (HoLEP) surgery. One of the main advantages of the Rezum procedure is that it minimizes the risk of retrograde ejaculation. HoLEP surgery has the disadvantage of potentially causing retrograde ejaculation, which the Rezum procedure can mitigate. Furthermore, the Rezum procedure is often performed under local anesthesia, offering the advantage that it can be performed on elderly patients with underlying conditions who may have difficulty with general anesthesia.
The Rezum procedure also boasts a faster recovery than HoLEP surgery. Rezum uses a simple catheter with a stopper to manage urine, thereby minimizing patient discomfort and facilitating an easier 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 a possibility of experiencing discomfort due to bleeding or irritation.
Of course, the Rezum procedure also has its disadvantages. First and foremost, it comes with a higher cost. The Rezum procedure utilizes specialized disposable equipment, which contributes to its higher expense. In contrast, HoLEP surgery is covered by national health insurance, making it relatively more affordable. Another point is that the Rezum procedure tends to be less effective than HoLEP surgery. Furthermore, there is the disadvantage that it can take 1 to 3 months for the high-temperature water vapor to necrotize and for the enlarged prostate tissue to be absorbed.
Moreover, the Rezum procedure offers numerous advantages compared to UroLift. While UroLift has reported a recurrence rate of approximately 13.6% within 5 years post-procedure, the Rezum procedure recorded a low recurrence rate of about 4.4% after 5 years, demonstrating its sustained effectiveness over time.
In the case of UroLift, some patients complain of inflammation or pain because permanent or semi-permanent sutures (implants) must be inserted into the body. In contrast, the Rezum procedure can treat BPH without leaving foreign material inside the body. While UroLift finds it difficult to treat BPH where the median lobe is enlarged, the Rezum procedure can also treat this condition. Because water vapor injection allows for targeted treatment of specific areas, it can treat a broader range of benign prostatic hyperplasia.
Director Lee Chang-ki of Goldman Urology Clinic Incheon Branch stated, "It cannot be guaranteed that the latest treatment methods will yield good results for all BPH patients, as each surgical method clearly has its pros and cons, and the appropriate surgery varies for each individual patient depending on their symptoms, the size, location, and pattern of the enlarged prostate tissue." He added, "The efforts of medical staff are also crucial in transparently providing objective information to patients, thereby reducing their decision-making time and further increasing treatment satisfaction."