Rezūm therapy is a minimally invasive treatment that uses water vapor to reduce enlarged prostate tissue in patients with benign prostatic hyperplasia (BPH). The procedure begins with a thorough examination of the prostate using a cystoscope inserted through the urethra. During this process, the urology specialist carefully evaluates the size, location, and structural characteristics of the enlarged prostate tissue. Based on this assessment, the physician measures the prostate from the bladder neck and determines the precise treatment area.
Next, a specialized instrument equipped with a small needle delivers high-temperature, high-pressure water vapor directly into the prostate tissue. Because the prostate capsule naturally separates normal tissue from the enlarged tissue, the treatment can selectively target the hyperplastic prostate tissue while preserving surrounding healthy structures. After treatment, the damaged tissue gradually shrinks and is absorbed by the body over one to three months, leading to improvement in urinary symptoms. The actual vapor injection typically takes only one to two minutes, and the entire procedure can be completed in approximately ten minutes. Rezūm therapy is generally considered suitable for patients over the age of 50 whose prostate volume ranges from approximately 30 to 80 grams. Because recovery time is minimal, it is often considered a simpler alternative to conventional prostate surgery.
As patient interest in Rezūm therapy continues to increase, it is helpful to understand how it compares with other treatment options, including HoLEP surgery and the prostatic urethral lift (UroLift).
First, when comparing Rezūm therapy with holmium laser enucleation of the prostate (HoLEP), one major advantage of Rezūm is its ability to minimize the risk of retrograde ejaculation. HoLEP surgery can sometimes lead to retrograde ejaculation, whereas Rezūm therapy can help preserve normal ejaculation function in many cases. In addition, Rezūm is often performed under local anesthesia, making it an option for older patients or individuals with underlying medical conditions that make general anesthesia risky.
Another advantage of Rezūm therapy is the relatively fast recovery period. After the procedure, a simple catheter with a small plug is often used to help manage urination temporarily. This approach generally minimizes patient discomfort and allows for a quicker return to daily activities. In contrast, HoLEP involves more extensive removal of prostate tissue, which can result in a longer recovery period. Patients undergoing HoLEP may also need to use a urinary drainage bag temporarily and may experience irritation or discomfort related to the surgical procedure.
However, Rezūm therapy also has several limitations. One of the main disadvantages is the higher cost. Because the procedure requires specialized single-use equipment, it can be more expensive. In comparison, HoLEP surgery is typically covered by national health insurance, making it relatively more affordable. In addition, Rezūm may provide slightly less dramatic symptom improvement compared with HoLEP surgery. Another limitation is that the treatment effect is not immediate. Because the water vapor causes the enlarged tissue to undergo necrosis and gradual absorption, it may take one to three months before full symptom improvement becomes noticeable.
Rezūm therapy can also be compared with the prostatic urethral lift procedure (UroLift). Overall, Rezūm offers several advantages compared with UroLift. In terms of long-term effectiveness, Rezūm therapy has shown better durability. Clinical studies have reported that UroLift has a retreatment rate of approximately 13.6% within five years, whereas Rezūm therapy has demonstrated a lower retreatment rate of about 4.4% over the same period.
Another difference lies in the presence of permanent implants. UroLift requires the placement of metallic implants in the prostate to hold the enlarged tissue away from the urethra. Because these implants remain in the body, some patients may experience discomfort, inflammation, or irritation. In contrast, Rezūm therapy does not leave any foreign materials inside the body. Additionally, UroLift may be less effective in patients with median lobe enlargement of the prostate. Rezūm therapy, however, can target specific obstructed areas using controlled vapor injections, allowing it to treat a wider range of prostate anatomies.
Despite these advantages, no single treatment method is ideal for every patient with benign prostatic hyperplasia. Each surgical option has its own advantages and limitations. The most appropriate treatment depends on factors such as the severity of symptoms, prostate size, anatomical structure, and the specific pattern of prostate enlargement.
For this reason, it is important for physicians to provide patients with clear and objective information about available treatment options. Helping patients understand the benefits and limitations of each approach can reduce uncertainty during the decision-making process and improve overall treatment satisfaction.
As men age, various urologic conditions can gradually interfere with daily life. By providing accurate and practical information about urinary health, the goal is to help individuals maintain a healthier and more comfortable quality of life during middle age and beyond.