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Rezum Water Vapor Therapy for BPH

Minimally Invasive Convective Steam Treatment for Enlarged Prostate

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Rezum Water Vapor Therapy for BPH?

Convective water vapor thermal therapy (Rezum) is a minimally invasive procedure for symptomatic BPH using sterile water vapor (103°C) to ablate prostatic adenoma.

Energy delivery: 9-second steam injections through transurethral needle electrode into transition zone tissue (typical 4-6 injections per lobe, plus median lobe if enlarged).

Mechanism: convective heat transfer causes selective coagulation necrosis of treated tissue while sparing the surrounding capsule and urethra.

Performed under local anesthesia (prostatic block) plus oral sedation, no general anesthesia required.

Procedure duration approximately 15-20 minutes; outpatient or in-office setting.

FDA approved for prostate volumes 30-80 mL (some operators extend to 80-150 mL); also approved for median lobe.

Symptoms

Indication: moderate to severe lower urinary tract symptoms (LUTS) due to BPH (IPSS over 13).
Failure of medical therapy (alpha-blockers and/or 5-ARI) or unwillingness to take long-term medications.
Desire to preserve antegrade ejaculation and erectile function (sexual function preservation rate over 95%).
Avoidance of major surgery (TURP) due to comorbidities or patient preference.
Recurrent urinary retention with documented BPH etiology.
Recurrent UTIs, hematuria, or bladder stones secondary to BPH.
Pre-procedure: IPSS, uroflow, post-void residual, prostate volume by TRUS or MRI.

Risk Factors

Active urinary tract infection (must be treated first).
Severe urethral stricture preventing scope passage.
Bladder stones requiring concurrent management.
Significant median lobe protrusion (relative; technique-dependent).
Anticoagulation therapy (relative; multidisciplinary management).
Prior prostate radiation or pelvic surgery (relative).

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent urinary frequency, urgency, weak stream, nocturia, or incomplete emptying.
  • Inadequate symptom control on alpha-blockers and 5-ARIs.
  • Side effects from BPH medications (dizziness, sexual dysfunction, retrograde ejaculation).
  • Recurrent urinary retention requiring catheterization.
  • Hematuria attributable to enlarged prostate.
  • Patient preference for less invasive alternative to TURP.

Treatment Methods

01
Pre-procedure assessment: IPSS, uroflow, post-void residual, prostate volume, urinalysis, PSA.
02
Cystoscopy with Rezum delivery system; treatment planning based on lobe anatomy and median lobe presence.
03
Steam injections (9 seconds each) at 1 cm intervals along transition zone of lateral lobes; additional 1-3 in median lobe if present.
04
Foley catheter placement post-procedure for 3-7 days during initial inflammatory edema phase.
05
Postoperative antibiotics, analgesics (NSAIDs), and continued alpha-blocker temporarily.
06
Symptom improvement begins at 2-4 weeks; maximal benefit at 3-6 months as treated tissue is reabsorbed.
07
Outcomes: 50% reduction in IPSS, durable to 5-year follow-up, retreatment rate approximately 4% at 5 years.
08
Sexual function preservation: erectile function preserved, ejaculatory function preserved in over 95%.
09
Follow-up: IPSS, uroflow, PSA at 3, 6, 12 months, then annually.
10
Consider second Rezum, TURP, or other surgical option if symptoms recur.

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Üroloji Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.