What is the Rezum procedure?
Millions of men suffer from benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate, and many seek relief from its frustrating urinary symptoms. The Rezum procedure is a minimally invasive, non-surgical option available that uses steam to reduce the prostate tissue and help ease the symptoms of BPH.
What is BPH?
BPH occurs when the prostate gland, which is located below the bladder and surrounds the urethra, becomes enlarged and begins to compress this vital urinary passageway, causing symptoms of varying degrees. This natural aging process affects approximately 50% of men by age 60 and up to 90% by age 85, creating a progressive condition that can significantly impact their quality of life.
What are the symptoms of BPH?
BPH symptoms typically include frequent urination (especially at night — known as nocturia), urgency to urinate, hesitancy in starting urination, weak urine flow, the sensation of incomplete bladder emptying, and urinary incontinence. These symptoms occur because the enlarged prostate tissue creates a partial blockage of the urethra, making it difficult for urine to flow freely from the bladder.
Medications are available to help manage these symptoms, but they often come with side effects. And some medications may lose effectiveness over time, leading many men to seek alternative treatments like the Rezum procedure.
The Rezum procedure explained
Rezum (pronounced “ruh-ZOOM”) is a minimally invasive, non-surgical treatment for BPH that was approved by the U.S. Food and Drug Administration (FDA) in 2015. Also known as Rezum Water Vapor Therapy, uses the natural energy stored in water vapor or steam to reduce excess prostate tissue pressing on the urethra.
Unlike traditional surgical approaches that require cutting away prostate tissue, Rezum delivers targeted thermal energy in the form of water vapor, causing the problematic cells to die and eventually be reabsorbed by the body through its natural healing processes.
One of our urologists can perform this innovative approach in-office. It does not require general anesthesia and typically takes approximately 30 minutes to complete.
How does the Rezum procedure work?
The Rezum system works through a remarkably elegant mechanism that uses convective heat transfer and harnesses the fundamental properties of water vapor. During each nine-second treatment, a precise amount (0.42 milliliters) of sterile water is heated using radiofrequency energy and converted into vapor.
This vapor is then injected into specific areas of the enlarged prostate through a specialized device inserted via the urethra.
This approach is efficient because steam behaves once inside the prostate tissue — it rapidly disperses through the spaces between cells until it encounters natural barriers such as collagen or the prostate capsule itself.
When the vapor contacts the prostate tissue cells, it instantly condenses back to water, releasing all its stored thermal energy directly into the targeted tissue.
This energy transfer process causes immediate cell death by denaturing cell membranes while closing off small blood vessels in the treatment zone. Furthermore, the entire procedure is virtually bloodless.
The precise delivery system ensures that only the intended areas of the prostate receive treatment, leaving surrounding tissues unaffected.
Most patients receive between two and six nine-second treatments during a single session. Your Tower Urology physician determines the optimal number of treatments based on your specific anatomy.
Who is a good candidate for Rezum?
The ideal candidate for Rezum therapy is typically a man with bothersome urinary symptoms caused by BPH who has either found medications ineffective, experienced unacceptable side effects from medications, or prefers a more definitive treatment approach.
At Tower Urology, our urologists frequently utilize various diagnostic tests, including flow rate measurements and bladder scans, to determine whether a patient would benefit from the procedure.
What happens during the Rezum procedure?
Before the procedure, patients are typically asked to urinate, after which a local anesthetic will be administered to numb the urethra and prostate area, ensuring comfort during the treatment.
Once numbing is achieved, the urologist carefully inserts the Rezum delivery device, which consists of a narrow tube with specialized instruments, through the urethra until it reaches the prostate’s enlarged areas.
Our urologist precisely positions the device and deploys a tiny needle that delivers the water vapor in controlled nine-second bursts to predetermined zones of the prostate.
Throughout the procedure, the patient remains awake but comfortable. While they may feel some sensations of warmth or pressure, the local anesthesia prevents significant discomfort.
The entire process, including preparation and treatment, typically takes around 30 minutes. After that, a temporary urinary catheter is typically placed to help manage urination during the initial swelling phase.
Most patients can undergo treatment as an outpatient and return home the same day with simple instructions for catheter care and activity limitations during the healing period.
The catheter is usually removed after several days once post-procedure swelling has subsided sufficiently to allow for normal urination.
What is recovery like after the Rezum procedure?
The recovery process following Rezum therapy is relatively straightforward; however, patients should be aware of what to expect in the weeks following the treatment.
Most patients can resume normal daily activities within a few days of the procedure, making Rezum an attractive option for those who cannot afford extended downtime.
However, it’s important to note that during the initial healing period, some BPH symptoms may temporarily worsen before improvement begins. This occurs because the treated prostate tissue initially swells in response to the thermal therapy before starting to shrink and be reabsorbed by the body.
How long does it take before patients begin to see results after the Rezum procedure?
Most patients experience improvement in their urinary symptoms within two to four weeks after the procedure, and the benefits continue to increase as the body reabsorbs the treated prostate tissue.
The maximum therapeutic benefit typically happens within three months post-procedure. However, with almost all medical procedures, individual responses can vary based on factors such as prostate size, symptom severity before treatment, and personal healing patterns.
Patients are typically scheduled for follow-up appointments at regular intervals to monitor their progress. Our urologists recommend an initial check approximately two to three weeks after the procedure, followed by additional visits at three, six, and twelve months to ensure optimal outcomes and address any concerns that may arise during recovery.
What are Rezum’s long-term success rates?
Since receiving FDA approval in 2015, the Rezum procedure has accumulated impressive clinical evidence supporting its effectiveness and durability in treating lower urinary tract symptoms.
The definitive five-year clinical trial, published in the Journal of Urology in September 2021, demonstrated that Rezum therapy relieves lower urinary tract symptoms while preserving sexual function throughout the follow-up period.
Perhaps most impressive is the procedure’s low retreatment rate—only 4.4% of patients required surgical intervention within five years of receiving Rezum therapy.
Additionally, the medication retreatment rate was approximately 10% during the same timeframe, indicating that most patients could avoid or discontinue BPH medications after the procedure.
These outcomes have led to the widespread adoption of Rezum therapy by urologists throughout the United States and Europe. Medical organizations, including the American Urological Association, recognize its value in treating BPH.
How does Rezum compare to other BPH treatments?
The Rezum system offers several distinct advantages compared to alternative treatments for benign prostatic hyperplasia (BPH).
Perhaps most compelling for many patients is the potential to discontinue BPH medications after successful Rezum therapy.
One of the most significant benefits is the preservation of sexual function, with clinical studies demonstrating that Rezum therapy does not negatively impact erectile function or ejaculation. Rezum does not cause erectile dysfunction (ED).
This preservation of sexual wellness, combined with effective symptom relief, makes Rezum particularly attractive to sexually active men seeking BPH treatment.
Another significant advantage is the convenience factor — Rezum is typically performed in an outpatient setting in the office, rather than requiring a hospital operating room, which reduces cost and complexity.
The relatively brief treatment option (approximately 30 minutes) and short recovery period further enhance patient convenience and minimize disruption to daily life.
What are the risks of the Rezum procedure?
While the Rezum procedure is generally well-tolerated with fewer risks than more invasive surgery, patients should be informed about potential side effects and considerations before treatment.
For example, patients should be aware that temporary worsening of BPH symptoms is typical during the initial recovery period. This is because the prostate tissue’s natural healing response to the treatment is to swell temporarily before beginning to shrink. However, once the swelling goes down, the patient should notice improvements.
During this healing phase, patients may experience blood in the urine, painful urination, or urinary urgency; however, these symptoms typically resolve during recovery.
There is also a small risk of urinary tract infection associated with the procedure and subsequent catheterization, which is why many urologists prescribe prophylactic antibiotics as a preventive measure.
While rare, there is also a possibility that the initial procedure may not provide sufficient symptom relief, potentially necessitating additional treatments or alternative interventions.
Every patient is unique, and it’s essential to maintain realistic expectations regarding the timeline for improvement. While some patients may experience rapid symptom resolution, others may need to wait several months to achieve maximum benefit from the procedure.
A thorough discussion of individual risk factors and expectations with your urologist at Tower Urology is crucial for selecting the most suitable patient and ensuring satisfaction.
Is Rezum right for you?
The Rezum Water Vapor Therapy ablation procedure significantly advances the treatment of BPH, offering men an effective, minimally invasive option with demonstrated long-term durability.
For many men suffering from moderate to severe BPH symptoms who wish to avoid major surgery or ongoing medication use, Rezum offers an appealing middle-ground approach that balances effectiveness with convenience and safety.
What makes Tower Urology unique for the Rezum procedure in Los Angeles?
Tower Urology’s board-certified urological team has been a leader in successfully treating BPH for over two decades, with specialists trained in all aspects of prostate health. All our professionals at Tower Urology are dedicated to providing you with expert, compassionate care. We take the time to understand you so that we can personalize your treatment plan to your specific needs.
Tower Urology’s advantage lies in our unwavering commitment to providing world-class urologic care through advanced technology, personalized treatment plans, and a patient-centered approach. With a reputation for excellence and innovation, we deliver superior outcomes that set us apart as a leader in urologic health.
Tower Urology is a proud affiliate of Cedars-Sinai Medical Center, ranked #1 in California and #2 in the nation by U.S. News & World Report. This partnership reflects our commitment to delivering the highest standard of urologic care with the best urologists in Los Angeles. Our years of experience and access to Cedars-Sinai’s world-class facilities, as well as our exceptional, innovative, and state-of-the-art urological care, make Tower Urology a leader in Southern California.
We invite you to establish care with Tower Urology.
Tower Urology is conveniently located for patients throughout Southern California and Los Angeles, including Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Burbank, Glendale, and Downtown Los Angeles.
Services include treatment for enlarged prostate (BPH), prostate cancer, and elevated PSA.
Rezum Procedure FAQs
Rezum Water Vapor Therapy is considered a covered benefit by Medicare and most private insurance companies. However, coverage depends on your specific insurance plan and meeting certain eligibility requirements. We recommend you check with your healthcare insurance provider.
Sources
Rezum Therapy 5-Year Clinical Data
https://www.bostonscientific.com/en-US/medical-specialties/urology/products/rezum/rezum-5-year-data.html
Rezum Procedure
https://my.clevelandclinic.org/health/treatments/rezum
Real-world Early Outcomes and Retreatment Rates Following Water Vapour Ablative Therapy for Symptomatic Benign Prostatic Hyperplasia
https://pmc.ncbi.nlm.nih.gov/articles/PMC9068731/
What is Rezum Therapy?
https://www.rezum.com/what-is-rezum.html
Real-world experience of water vapour therapy (Rezum) in patients with benign prostatic enlargement: a retrospective single-center study
https://www.nature.com/articles/s41391-024-00836-w
Rezum Water Vapor Therapy
https://www.rezum.com/what-is-rezum/how-does-it-work.html
Rezum: a new transurethral water vapour therapy for benign prostatic hyperplasia
https://pmc.ncbi.nlm.nih.gov/articles/PMC6180381/
5-year Rezum study results show low rates of erectile and ejaculatory dysfunction
https://www.urologytimes.com/view/5-year-rezum-study-results-show-low-rates-of-erectile-and-ejaculatory-dysfunction
