Water vapour therapy for benign prostate enlargement according to the Rezūm principle

Rezūm Therapy gently removes benign enlarged prostate tissue without medication

For the treatment of benign prostate enlargement, so-called benign prostatic hyperplasia (BPH), our clinic has recently started to use the what is called Rezūm Water Vapor Therapy, which uses the therapeutic effect of hot steam. The name Rezūm is an artificial word that originated in the USA and is pronounced “rezoom”. Comparable to the other gentle methods of BPH treatment used at our clinic (Greenlight laser, Evolvelaser), the Rezūm procedure also involves inserting a probe into the urethra. The patient is sedated with a local anaesthetic and hardly notices anything.

The urologist uses a cystoscopic camera to check that the probe is correctly positioned in the prostate. The urologist pushes a thin needle out of the tip of the probe, from which several short and well-dosed bursts of steam escape. Each steam burst lasts about nine seconds. The water vapour has a temperature of 103°C. In the excess tissue itself it works at a temperature of about 73°C. The water vapour is distributed between the tissue cells, where it releases its energy through water vapour condensation. The energy contained within the hot steam causes the excess tissue to die. These tissue cells are then gradually broken down by the body over the course of the next few weeks. After about three weeks, the patient should already feel significant relief from the symptoms. Experience has shown that the whole process takes about three months. By then, the urethra will have dilated again by itself. The excessive bladder pressure should disappear, as should the frequent urge to urinate. The treatment itself only takes between 5 and 20 minutes, is very well tolerated and there is no surgical incision through the urethra.

Additional medication is not required. Furthermore, the treatment does not seem to have any impact on the erectile function of the patient. Shortly after the treatment, the patient can return to their previous quality of life and if the prostate tissue grows back, which is not uncommon, this particularly gentle Rezūm therapy may be repeated at any time.

The top illustration shows the situation before treatment with the Rezūm therapy. The middle illustration shows the Rezūm probe inserted into the urethra and the bottom illustration shows how the hyperplastic, that is, the excess tissue shrinks back to normal size. The number of water vapour bursts varies with the size of the prostate. The schematic illustrations are intended to demonstrate how the procedure works.

Video animation of the treatment process The video is in English. (Courtesy of Boston Scientific)

FAQ – Frequently asked questions and answers about the Rezūm procedure

What is Rezūm Water Vapor Therapy?

Rezūm Water Vapor Therapy is a minimally invasive procedure that uses the energy stored in steam to treat excess prostate tissue that causes BPH symptoms.

Who is the Rezūm therapy suitable for?

Clinical studies have shown that many men living with BPH experience relief from symptoms with the Rezūm Water Vapor Therapy. The therapy is suitable for men over 50 who have a prostate volume of 30 to 80 cubic centimetres. It is an option for those who want to avoid a surgical procedure involving a hospital stay of several days or for those who wish to avoid or stop drug treatment with all its possible side effects.

Is the Rezūm Water Vapor Therapy right for me?

The first course of action should be to visit a urologist or the urologist you trust. Based on your symptoms and, if necessary, after further examinations, the urologist will determine whether you suffer from benign prostate enlargement (benign prostatic hyperplasia or BPH). If this is the case, you can discuss together which of the gentle treatment methods is the right one for you.

How much does the Rezūm therapy cost?

The costs depend on your insurance and service package. Although more and more insurers cover the Rezūm therapy, it is advisable to clarify the costs in advance with the attending physician and then contact your health insurance company for cost coverage or cost sharing.

How long do the improvements last?

Current clinical studies show a sustained improvement in symptoms for up to four years; the improvements are likely to last much longer. If the prostate tissue grows back, which is not uncommon, the Rezūm therapy can be repeated at any time.

Are there any special medical risks?

Every medical treatment is subject to certain medical risks. In the case of Rezūm therapy, however, these are considered quite low. Rezūm therapy is intended to relieve symptoms and reduce the excess prostate tissue. It is indicated for men with a prostate volume of 30 to 80 cubic centimetres.
The Rezūm procedure is also indicated for treatment of the prostate with hyperplasia of the central zone and/or a middle lobe. Potential risks include painful urination (dysuria), blood in the urine (haematuria), blood in the semen (haematospermia), decrease in ejaculatory volume, suspected urinary tract infections (UTI), and frequency, retention or urgency of urination.

Can Rezūm cause erectile dysfunction?

There are no reports of new erectile dysfunction as a result of treatment from Rezūm therapy. Based on data from clinical studies in the USA, there is evidence that ejaculatory function is maintained.

Study for download

Those who would like to delve deeper into Rezūm Water Vapor Therapy can read the English language study entitled “Rezūm Water Vapor Thermal Therapy for Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: 4-Year Results From Randomized Controlled Study" (published in UROLOGY, 21/01/2019). You can also download the study as a PDF document.