The Rezum procedure is a treatment method for benign prostatic hyperplasia (BPH) that contributes to improving the condition within a short period. It is gaining attention as a minimally invasive treatment method that reduces the enlarged prostate using water vapor. The Rezum procedure begins with a thorough examination of the prostate area using a urethro-cystoscope. Subsequently, a urology specialist evaluates the size, location, and characteristics of the enlarged prostatic tissue. Based on this, the prostate size is measured from the bladder neck to plan the precise treatment area.
Next, a specialized device equipped with a needle is used to inject high-temperature, high-pressure water vapor into the prostate. A distinctive feature at this stage is the separation of normal tissue from the hypertrophied tissue by a capsule. This allows the procedure to target only the enlarged prostatic tissue while protecting the normal tissue. When this treatment method is employed, the enlarged prostatic tissue is expected to shrink over a period of 1 to 3 months, leading to an improvement in urinary symptoms.
The entire Rezum procedure is completed in approximately 10 minutes. It is suitable for patients aged 50 and above with a prostate size between 30 and 80 grams, and is particularly characterized by being simpler than conventional prostate surgeries while minimizing recovery time.
The advantages and disadvantages of the Rezum procedure are clear. First, let's compare the Rezum procedure with HoLEP surgery (Holmium Laser Enucleation of the Prostate). One of the main advantages of the Rezum 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 Rezum procedure. Furthermore, the Rezum 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 Rezum procedure also boasts a faster recovery than HoLEP surgery. The Rezum 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 involves more invasive tissue removal, and therefore generally has 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 Rezum procedure also has its disadvantages. First, there is the disadvantage of higher cost. The Rezum procedure uses specialized disposable equipment, which contributes to its higher cost. In contrast, HoLEP surgery is covered by national health insurance, making it relatively more affordable. The Rezum procedure is also generally less effective than HoLEP surgery. Another disadvantage is that it can take 1 to 3 months for the high-temperature water vapor to necrotize and for the enlarged prostatic tissue to be absorbed.
Let's also compare it with prostatic urethral lift (UroLift). Overall, the Rezum procedure is a treatment method with more advantages than UroLift. In the case of the Rezum procedure, its effectiveness is superior to UroLift. UroLift has reported a recurrence rate of approximately 13.6% within 5 years after surgery, whereas the Rezum procedure recorded a lower recurrence rate of about 4.4% after 5 years. This demonstrates its sustained efficacy over time.
In the case of UroLift, some patients complain of inflammation or pain because permanent implants (sutures) must be semi-permanently inserted into the body. In contrast, the Rezum procedure can treat benign prostatic hyperplasia without leaving foreign materials inside the body. UroLift finds it difficult to treat BPH where the median lobe is enlarged, but the Rezum procedure can also treat this condition. By injecting water vapor, specific areas can be targeted for treatment, allowing for the treatment of a broader range of benign prostatic hyperplasia cases.
Dr. Ryu Je-man, director of Goldman Urology Clinic, Seoul Station Branch, stated, "It cannot be guaranteed that the latest treatment methods will yield good results for all patients with benign prostatic hyperplasia, because each surgical method clearly has its advantages and disadvantages, and the appropriate surgery varies for each individual patient depending on their symptoms, the size, location, and characteristics of the enlarged prostatic tissue." He added, "It is also crucial for medical staff to strive to provide objective information transparently to patients, thereby reducing their deliberation time and increasing their satisfaction with the treatment."