Some men find themselves searching for a restroom wherever they go and waking up several times during the night to urinate. These are common symptoms experienced by patients with benign prostatic hyperplasia (BPH). The condition occurs when the prostate gland enlarges abnormally and compresses the urethra, making it difficult for urine to flow normally. It primarily affects middle-aged and older men, and the prevalence increases significantly with age.
In the early stages of BPH, symptoms may begin with difficulty urinating or a feeling of incomplete bladder emptying. Over time, the urine stream may become weaker, urination may take longer, and nocturia—waking up multiple times during the night to urinate—may develop. These symptoms not only cause inconvenience in daily life but can also reduce sleep quality, leading to fatigue and decreased concentration.
Treatment for BPH depends on the severity of symptoms, the size of the prostate, and the patient’s overall health condition. When medication fails to improve symptoms or causes side effects, surgical treatment may be considered. Recently, a minimally invasive treatment known as Rezūm therapy has been increasingly used, particularly for patients who cannot undergo general anesthesia or those whose prostate size is not excessively large.
Rezūm therapy uses the thermal energy of water vapor to selectively destroy enlarged prostate tissue. The procedure is performed through the urethra without any incision, which means minimal bleeding and a relatively quick recovery. Most patients experience improvement in urinary symptoms within a short period after the procedure and can return to their daily activities quickly.
For these reasons, Rezūm therapy has emerged as a useful alternative for elderly patients, individuals with anesthesia-related risks, or those who do not respond well to medication. It has also gained attention among patients who wish to preserve sexual function, as the rate of retrograde ejaculation is relatively low. In addition, despite being a procedural treatment, the rate of retreatment has been reported to be very low.
However, it is important to understand that Rezūm therapy is not simply a matter of injecting steam into the prostate. Injecting more steam does not necessarily produce better results, and using less steam does not automatically guarantee safety. This is because the size, shape, degree of enlargement, and location of obstruction vary from patient to patient. In other words, where, how much, and how the steam is injected are the key factors that determine the outcome of the procedure.
Ultimately, the most important aspect of the Rezūm system is not the absolute number of injections but a customized strategy based on precise anatomical analysis of the patient’s prostate and the pattern of obstruction. Even when symptoms appear mild, significant improvement can be achieved if steam is accurately delivered to the specific area causing obstruction.
On the other hand, when the prostate size exceeds approximately 80 grams, other treatment options may be more appropriate. This highlights that Rezūm therapy is a personalized treatment approach that requires careful evaluation and planning for each individual patient. (Dr. Ryu Kyung-ho, Goldman Urology Clinic, Gangnam Branch)