Benign Prostatic Hyperplasia (BPH) is a common urological disease that frequently affects middle-aged and elderly men, causing urination difficulties and significantly degrading the quality of life. If left untreated in a timely manner, it can lead to complications such as bladder dysfunction, increased residual urine, and infections. Recently, a new medical technology, the 'Rezum procedure,' which complements the shortcomings of existing BPH surgeries while offering safety and improved efficacy, is being widely utilized.
The Rezum procedure received approval from the U.S. Food and Drug Administration (FDA) in 2015, followed by approval from the Korean Ministry of Food and Drug Safety (MFDS) in 2022, and was designated as a new medical technology by the Ministry of Health and Welfare in 2023, making it a verified treatment method. This procedure operates on the principle of directly injecting 103-degree Celsius hot steam into the enlarged prostatic tissue, causing tissue necrosis. Over time, this tissue is then naturally induced to shrink.
Above all, unlike conventional prostatectomy, the fact that it is a minimally invasive procedure performed without incision, and that it can be performed with only local anesthesia instead of general anesthesia, are considered major advantages.
The Rezum procedure involves inserting an endoscope through the urethra, then puncturing the prostatic tissue with a small needle to inject steam. This steam remains localized within the enlarged prostatic tissue, minimizing the possibility of damage to normal tissue. Furthermore, because the urethral mucosa can be preserved, the risk of complications such as bleeding or infection is relatively low. The procedure time is short, approximately 10 to 20 minutes, and a 'one-day system' allowing for examination, procedure, and discharge on the same day reduces the patient's time burden.
Particularly, the Rezum procedure is suitable for elderly patients or those with underlying cardiovascular diseases who find general anesthesia burdensome, as well as patients with a high concern for recurrence. It can also be applied to patients with large benign prostatic hyperplasia, up to 80 cm³ in size.
Another characteristic is that it minimizes the possibility of benign prostatic hyperplasia recurrence. According to a 5-year follow-up study, key indicators such as the International Prostate Symptom Score (IPSS), quality of life, and maximum urinary flow rate all showed improvement after the Rezum procedure. Notably, the retreatment rate was merely 4.4%. This signifies that it is a treatment method with a low risk of recurrence and sufficiently proven long-term efficacy.
However, the Rezum procedure is only completed after the steam-induced tissue necrosis is fully absorbed by the body. Due to the nature of this principle, the symptom improvement effect does not appear immediately after the procedure. In reality, the effects of the procedure gradually manifest over several weeks to several months following treatment. Furthermore, it is important to remember that a urinary catheter must be worn for a certain period after the procedure.
Dr. Kim Byung-hoon, director of Goldman Urology Clinic Incheon branch, stated, "The treatment approach for benign prostatic hyperplasia should vary depending on various factors such as the severity of symptoms, prostate size, and the patient's overall health, and the Rezum procedure is evaluated as an option with relatively less burden and faster recovery." He added, "If you are experiencing discomfort in daily life due to urination difficulties, it is advisable to seek a urology specialist early for a precise diagnosis and choose the most suitable method for you among various treatment options, including the Rezum procedure, HoLEP surgery, and Aquablation."