Rezum therapy is a minimally invasive treatment that improves benign prostatic hyperplasia (BPH) by using water vapor. The procedure begins with a thorough examination of the prostate through a urethral cystoscope. During this stage, a urologist carefully 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 areas.
A specialized device equipped with a needle is then used to inject high-temperature, high-pressure steam into the prostate. During the procedure, the prostate capsule helps distinguish between normal tissue and enlarged tissue, allowing the treatment to target only the hyperplastic prostate tissue while preserving normal structures. After treatment, the enlarged prostate tissue gradually shrinks over a period of one to three months, leading to improvement in urinary symptoms.
The Rezum procedure itself typically takes about one to two minutes, and the entire process is usually completed within approximately ten minutes. It is generally suitable for patients over the age of 50 whose prostate size ranges between 30 g and 80 g. Because it minimizes recovery time, the procedure is considered simpler compared with conventional prostate surgery.
The characteristics of Rezum therapy can also be compared with holmium laser enucleation of the prostate (HoLEP). One of the key advantages of Rezum is that it minimizes the risk of retrograde ejaculation. In contrast, HoLEP can sometimes result in retrograde ejaculation. Another advantage is that Rezum is often performed under local anesthesia, making it a potential option for elderly patients or those with underlying medical conditions who may not tolerate general anesthesia well.
Rezum therapy also tends to involve a faster recovery process than HoLEP. The procedure usually requires only a simple urinary catheter with a valve to regulate urination, which helps minimize patient discomfort and allows a quicker return to daily activities. HoLEP, on the other hand, involves more invasive tissue removal, which may lead to a longer recovery period. Patients may need to use a urine collection bag and may experience discomfort due to irritation or changes in blood flow.
Despite these advantages, Rezum therapy also has limitations. One of the main disadvantages is the cost. Because Rezum uses specialized single-use equipment, the procedure can be more expensive. In contrast, HoLEP is typically covered by national health insurance, making it relatively more affordable. In addition, the overall treatment effect of Rezum may be somewhat lower than that of HoLEP. Another limitation is that the high-temperature steam causes the enlarged prostate tissue to undergo necrosis and gradual absorption, a process that can take one to three months before full symptom improvement is achieved.
Rezum therapy also offers several advantages compared with the UroLift procedure. Studies have reported that UroLift has a recurrence rate of approximately 13.6 percent within five years after treatment, whereas Rezum shows a lower recurrence rate of about 4.4 percent at five years, indicating more durable results over time.
Another difference is that UroLift requires the permanent placement of implants to hold prostate tissue apart. Some patients may experience inflammation or discomfort due to these implanted materials. In contrast, Rezum therapy does not leave any foreign material inside the body. Additionally, UroLift may be less suitable for patients with median lobe enlargement of the prostate, whereas Rezum can treat this condition because steam injections can be directed precisely to specific areas of the prostate.
Dr. Lee Chang-gi of Goldman Urology Clinic Incheon Branch explained that even the latest treatment methods cannot guarantee the best results for every patient. Each surgical option has its own advantages and limitations, and the most appropriate treatment depends on the patient’s symptoms, as well as the size, location, and pattern of prostate enlargement. He emphasized that providing patients with transparent and objective information is essential to help them make informed decisions and ultimately improve their satisfaction with treatment outcomes.