The Rezum procedure is a minimally invasive treatment method that uses steam to reduce an enlarged prostate. The procedure begins with a thorough examination of the prostate area using a urethro-cystoscope. During this examination, a urology specialist evaluates the size, location, and characteristics of the benign prostatic hyperplasia (BPH) tissue. Based on this assessment, the size of the prostate is measured from the bladder neck to precisely plan the treatment area.
Subsequently, a specialized device equipped with a needle is used to inject high-temperature, high-pressure steam into the prostate. At this point, the normal tissue is separated from the hyperplastic tissue by a capsule, allowing the procedure to specifically target only the benign prostatic hyperplasia tissue while protecting the normal tissue. With this treatment method, the enlarged prostatic tissue shrinks over a period of 1 to 3 months, leading to an improvement in urinary symptoms.
The Rezum procedure itself typically 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 80 grams, characterized by its simplicity compared to traditional prostate surgeries while minimizing recovery time.
The most significant advantage of the Rezum procedure is that it minimizes the risk of retrograde ejaculation. Furthermore, the Rezum procedure is often performed under local anesthesia, offering the benefit that it can be performed on elderly patients who may have difficulty with general anesthesia due to underlying conditions such as diabetes or hypertension. In addition, the Rezum procedure utilizes a simple urinary catheter with a stopper to manage urine flow. This minimizes patient discomfort and facilitates an easier return to daily activities.
Of course, the Rezum procedure also has its disadvantages. First and foremost, there is the drawback of higher cost. The Rezum procedure incurs greater expense due to the use of specialized, single-use equipment. In contrast, another treatment method for benign prostatic hyperplasia, HoLEP surgery, 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 enlarged prostatic tissue to be absorbed.
It can also be compared with another treatment method, prostatic urethral lift (UroLift). Overall, the Rezum procedure is a treatment method with many advantages compared to UroLift. In the case of the Rezum procedure, its effectiveness is superior to UroLift. While UroLift has reported a recurrence rate of approximately 13.6% within 5 years after the procedure, the Rezum procedure recorded a low recurrence rate of about 4.4% after 5 years.
Furthermore, with UroLift, some patients complain of inflammation or pain because permanent implants (sutures) must be semi-permanently inserted into the body. In contrast, the Rezum procedure can treat benign prostatic hyperplasia without leaving foreign objects in the body. While UroLift finds it difficult to treat BPH when the median lobe is enlarged, the Rezum procedure can also treat this condition. By injecting steam, specific areas can be targeted for treatment, allowing for the treatment of a broader range of benign prostatic hyperplasia cases.
Dr. Min Seung-ki of Goldman Urology Jamsil Branch advised, “It cannot be guaranteed that the latest treatment method will yield good results for all patients with prostatic enlargement, 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 enlarged prostatic tissue.” He added, “It is also important for doctors to strive to provide objective information transparently to patients, thereby reducing their decision-making time and increasing their satisfaction with the treatment.”