Rezum therapy is a minimally invasive treatment that reduces enlarged prostate tissue using water vapor. The procedure begins with a thorough examination of the prostate using a cystoscope inserted through the urethra into the bladder. During this stage, a urology specialist evaluates the size, location, and characteristics of the enlarged prostate tissue. Based on this assessment, the physician measures the prostate starting from the bladder neck and plans the exact treatment areas.
A specialized device equipped with a small needle is then used to inject high-temperature, high-pressure water vapor into the prostate tissue. The prostate capsule naturally separates normal tissue from enlarged tissue, allowing the treatment to target only the hyperplastic tissue while preserving surrounding healthy structures. As a result, the treated prostate tissue gradually shrinks over the course of one to three months, leading to improvement in urinary symptoms.
The vapor injection itself usually takes about one to two minutes, while the entire procedure is typically completed within about ten minutes. Rezum therapy is generally considered suitable for patients over the age of 50 with prostate sizes between 30 and 80 grams. Compared with traditional prostate surgery, the procedure is relatively simple and allows for a shorter recovery period.
One of the most significant advantages of Rezum therapy is that it minimizes the risk of retrograde ejaculation. In addition, the procedure is often performed under local anesthesia, which makes it a viable option for elderly patients who may have underlying conditions such as diabetes or hypertension that make general anesthesia difficult. Another advantage is that only a simple catheter with a valve is typically used after the procedure, which helps reduce patient discomfort and allows for an easier return to daily activities.
However, Rezum therapy also has certain limitations. One disadvantage is cost, as the procedure requires specialized single-use devices that can increase the overall expense. In comparison, another treatment for benign prostatic hyperplasia, holmium laser enucleation of the prostate (HoLEP), is covered by national health insurance in Korea and is therefore relatively more affordable. Another limitation is that the treated prostate tissue gradually undergoes necrosis and absorption, which can take one to three months before the full therapeutic effect becomes noticeable.
Rezum therapy can also be compared with the prostatic urethral lift procedure (UroLift). Overall, Rezum therapy offers several advantages over UroLift. Clinical data suggest that Rezum may provide better long-term outcomes. While UroLift has been reported to have a recurrence rate of about 13.6% within five years after treatment, Rezum therapy has shown a lower recurrence rate of approximately 4.4% at five years.
Another difference is that UroLift requires permanent implants to be placed inside the body, which can sometimes cause inflammation or discomfort in certain patients. In contrast, Rezum therapy treats benign prostatic hyperplasia without leaving foreign materials in the body. Additionally, UroLift is generally less effective in cases where the median lobe of the prostate is enlarged, whereas Rezum can treat this condition because the water vapor can be injected precisely into specific areas of the prostate.
Dr. Min Seung-gi of Goldman Urology Clinic’s Jamsil branch explained that even though a treatment may be considered advanced or modern, it does not guarantee the best outcome for every patient. Each surgical technique 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 physicians should provide patients with transparent and objective information so that they can make informed decisions and ultimately achieve higher satisfaction with their treatment outcomes.