The Rezūm procedure is a minimally invasive treatment method that uses steam to reduce the enlarged prostate. The procedure begins with a thorough examination of the prostate area using a urethro-cystoscope. During this, a urology specialist evaluates the size, location, and characteristics of the benign prostatic hypertrophic tissue. Based on this, the size of the prostate is measured from the bladder neck to plan the precise treatment area.
Subsequently, high-temperature, high-pressure steam is injected into the prostate using a special device equipped with a needle. At this time, because the normal tissue and hypertrophic tissue are separated by a capsule, the normal tissue is protected while only the benign prostatic hypertrophic tissue is targeted. Using this treatment method, the benign prostatic hypertrophic tissue shrinks over 1 to 3 months, leading to an improvement in urinary symptoms.
The Rezūm procedure itself generally 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 30 and 80g, characterized by its simplicity compared to traditional prostate surgery while minimizing recovery time.
The biggest advantage of the Rezūm procedure is that it minimizes the risk of retrograde ejaculation. Furthermore, the Rezūm procedure is often performed under local anesthesia, offering the advantage that it can be performed on elderly patients with underlying conditions such as diabetes or high blood pressure, for whom general anesthesia might be challenging. In addition, the Rezūm procedure uses a simple urinary catheter with a stopper to manage urine flow. This minimizes patient discomfort and makes returning to daily activities easier.
Of course, the Rezūm procedure also has its disadvantages. Firstly, there is the disadvantage of higher cost. The Rezūm procedure incurs higher costs because it utilizes specialized disposable equipment. In contrast, HoLEP surgery, another treatment method for benign prostatic hyperplasia, is covered by national health insurance, making it relatively more affordable. Another disadvantage is that it can take approximately 1 to 3 months for the high-temperature steam to necrotize and for the hypertrophic prostatic tissue to be absorbed.
It can also be compared with another treatment method, prostatic urethral lift (UroLift). Overall, the Rezūm procedure is a treatment method with many advantages compared to UroLift. In the case of the Rezūm procedure, its efficacy is superior to UroLift. While UroLift has reported a recurrence rate of approximately 13.6% within 5 years post-procedure, the Rezūm procedure recorded a lower recurrence rate of about 4.4% after 5 years.
Furthermore, with UroLift, since ligatures must be semi-permanently inserted into the body, some patients complain of inflammation or pain. In contrast, the Rezūm procedure can treat benign prostatic hyperplasia without leaving foreign materials inside the body. While UroLift is difficult to use for benign prostatic hyperplasia where the median lobe is enlarged, the Rezūm procedure can also treat this condition. Because it can target specific areas through steam injection, it can treat a wider range of benign prostatic hyperplasia cases.
Dr. Min Seung-gi of Goldman Urology Jamsil Branch advised, “It cannot be guaranteed that the latest treatment method will yield good results for all patients with hyperplasia, as 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 hypertrophic prostatic tissue.” He added, “The efforts of doctors are also crucial in transparently providing objective information to patients, thereby reducing their deliberation time and increasing treatment satisfaction.”