There are instances where one frequently needs to find a restroom wherever they go, or wakes up multiple times from sleep due to the urge to urinate. These are common symptoms observed in patients with benign prostatic hyperplasia (BPH). This condition refers to a state where the prostate gland abnormally enlarges, compressing the urethra and preventing the smooth discharge of urine. It primarily occurs in men in middle age and beyond, and it is known that the prevalence rate sharply increases with age.
In the early stages of benign prostatic hyperplasia, symptoms begin with difficulty during urination or a feeling of incomplete bladder emptying (post-void dribbling). However, gradually, the urinary stream becomes weaker and thinner, the urination time lengthens, and nocturia, where one wakes up multiple times at night to urinate, accompanies these symptoms. Such symptoms not only cause inconvenience in daily life but also degrade the quality of sleep, leading to fatigue, decreased concentration, and other issues.
The treatment for benign prostatic hyperplasia varies depending on the severity of symptoms, prostate size, and overall health status. If medical therapy does not lead to improvement or causes side effects, surgical treatment is considered. Recently, the Rezūm procedure, a minimally invasive treatment, has been utilized for patients for whom general anesthesia is difficult, or for those with a prostate that is not excessively large.
The Rezūm procedure is a method that selectively necrotizes prostate tissue using the thermal energy of water vapor. Above all, its advantages include being performed through the urethra without an incision, minimal bleeding, and rapid recovery. Most patients experience an improvement in urinary symptoms within a short period after the procedure, and a quick return to daily life is a significant strength.
As such, the Rezūm procedure is emerging as a useful alternative for elderly patients, those with anesthesia risks, or patients who have not responded to medical therapy. Furthermore, due to its low incidence of retrograde ejaculation, it is also receiving significant attention from patients who wish to preserve sexual function. Moreover, despite being an interventional treatment, the re-treatment rate is extremely low.
It should be noted that the Rezūm procedure is not simply a surgery that injects water vapor. Injecting an unconditionally large amount does not necessarily guarantee better efficacy, nor can injecting a small amount be considered safe. This is because the size and shape of the prostate, the degree of enlargement, and the pattern of the obstructed area all differ from patient to patient. In other words, where, how much, and how to inject are the core aspects of the Rezūm procedure.
Ultimately, what is crucial in the Rezūm system is a customized strategy that adjusts the injection location and amount based on a precise analysis of the patient's anatomical structure and obstruction pattern, rather than the absolute number of injections. Even if symptoms appear mild, if a specific area is obstructed, delivering water vapor to the exact location alone can lead to significant improvement.
Conversely, if the prostate size is 80g or larger, other treatment methods might be more suitable. It is important to remember that a personalized treatment approach, requiring precise judgment and planning, is the key point of the Rezūm procedure.