The majority of older men will likely experience an enlarged prostate (aka, benign prostatic hyperplasia) during their lifetime. Although that is not good news, the severity of the condition varies greatly, and not all men will require or need treatment. For those who do, use of Rezum for enlarged prostate is a relatively new, minimally invasive procedure that has been demonstrating good results.
What is Rezum for enlarged prostate?
Rezum is a first-of-its-kind treatment for enlarged prostate that utilizes steam to eliminate enlarged tissue, which in turn relieves symptoms. The procedure was approved by the Food and Drug Administration (FDA) in late 2015 for BPH. It joins an arsenal of other treatment options, including medications, about a dozen nonsurgical procedures, and several surgical techniques, as well as a variety of natural remedies and lifestyle changes.
Rezum therapy is a one-time procedure that is completed on an outpatient basis in the office or outpatient clinic using minimal sedation and with no need for post-procedure therapy. Men can drive themselves home after the procedure and return to regular activities within a few days.
How Rezum works
The clinician uses a hand-held device that uses radiofrequency energy applied to water to create steam (vapor). The vapor is delivered to the prostate tissue by passing a small probe up the urethra. Once the vapor is injected into the prostate tissue, it is immediately transformed into water and releases its energy into the cell membranes in the prostate.
This gently destroys the offending cells, causing them to die off. The number of injections needed is determined by the size of the prostate. The entire procedure takes less than 20 minutes.
Over time, the body absorbs the dead cells through its natural healing process.
In as little as two weeks, men typically experience an improvement in symptoms, such as weak urine stream, incomplete emptying of the bladder, urinary urgency, urinary frequency, dribbling after urinating, straining to urinate, and starting and stopping when urinating.
Men may need to take antibiotics and have a urinary catheter for several days after the procedure. Sexual intercourse should be avoided for up to four weeks after the procedure.
What are the side effects of Rezum?
As is typical with minimally invasive procedures, Rezum may cause some temporary side effects, including:
- Blood in urine or semen
- Local discomfort
- Painful urination
- Frequent urination
- Difficulty completely emptying the bladder
If these or other side effects last more than three weeks, talk to your physician. Local discomfort can be alleviated by using a sitz bath or taking over-the-counter medication such as ibuprofen or acetaminophen. Men are also encouraged to avoid caffeine and alcohol.
Research results
The findings of a 2018 study were reported in Urology and reflected data from fifteen centers that included 197 men aged 50 years and older. After the procedure was performed, the subjects were followed annually for three years.
Maximum relief from symptoms of at least 50 percent in quality of life, International Prostate Symptom Score, and BPH Impact Index remained stable over three years. No new cases of erectile dysfunction were reported and none of the men experienced late-related adverse events.
Bottom line
Rezum is a minimally invasive treatment option for men with an enlarged prostate. Men who should consider Rezum include those who have chosen to not take medications or to discontinue them, or men who do not want to undergo other minimally invasive or surgical BPH procedures.
Rezum for enlarged prostate is indicated for men whose prostate volume is in the range of 30 cm3 to 80 cm3 and for treatment of the central zone and/or median lobe of the prostate. It is not for men who have had a urinary implant or a penile prosthesis.
References
CAMC Health Systems. Rezum. Frequently asked questions.
McVary KT, Roehrborn CG. Three-year outcomes of the prospective, randomized controlled Rezum system study: convective radiofrequency thermal therapy for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Urology 2018 Jan; 111:1-9
