DIAGNOSTIC & MINIMALLY INVASIVE THERAPY

Rezūm Water Vapor Therapy for BPH

Medical Review & Verification: Dr. Niti Navanimitkul, M.D.

Board-Certified Urological Surgeon | Advanced Prostate Diagnostics Specialist | M-Trust Urology Clinic

Last Reviewed: July 2026

The innovative, minimally invasive BPH treatment. No surgery, no general anesthesia, same-day discharge, and outstanding preservation of sexual function. FDA Approved.

✓ FDA Approved (2015)

✓ Preserves Sexual Function

✓ Outpatient Procedure

✓ 5+ Years Durability

What is Rezūm?

Rezūm is an advanced medical technology FDA-cleared in 2015 for treating Benign Prostatic Hyperplasia (BPH). It utilizes the principles of **Convective Water Vapor Energy**—injecting sterile steam directly into the obstructive prostate tissue.

This method represents a paradigm shift in BPH treatment, as it effectively destroys the cells causing urinary obstruction without the need for surgical cutting, general anesthesia, or risking damage to the delicate nerves controlling sexual function.

Deep Dive: Mechanism of Action

The science behind Rezūm relies on the phase change of water and the rapid transfer of thermal energy:

1. Vapor Delivery

A slender transurethral device is inserted, and a tiny needle delivers 103°C (217°F) sterile water vapor into the transition zone of the prostate.

2. Convective Energy Transfer

As the steam contacts the tissue, it condenses back into liquid water. This phase change instantaneously releases stored thermal energy, which disperses through the tissue interstices.

3. Apoptosis (Cell Death)

The thermal energy denatures cell membranes, causing immediate cell death (apoptosis) in the targeted hyperplastic tissue without charring or damaging adjacent structures.

4. Natural Reabsorption

Over the next 3 to 6 months, the body's natural healing response absorbs the ablated tissue, shrinking the prostate volume and opening the urethra.

Pros and Cons of Rezūm Therapy

⊕ ข้อดี (Pros)

✓No general anesthesia required (local anesthesia is sufficient).
✓No surgical incisions, no cutting of tissue.
✓Fast procedure (15-30 minutes) with same-day discharge.
✓Nearly 100% preservation of erectile and ejaculatory function.
✓Very low complication rate and minimal bleeding risk.
✓Effective even for patients with a prominent median lobe.

⊖ ข้อจำกัด (Cons)

✗Requires temporary urinary catheterization at home (usually 3-7 days).
✗Temporary dysuria (burning sensation) or frequency for the first 1-2 weeks.
✗Trace hematuria (blood in urine or semen) during the initial healing phase.
✗Results are not instantaneous; it takes 2-4 weeks for significant symptom relief as the tissue is absorbed.
✗Not recommended for extremely large (>150cc) or very small (<30cc) prostates.

Who is a Candidate for Rezūm?

According to clinical guidelines and FDA indications, Rezūm Therapy is ideal for:

▹Men aged 50 and older suffering from Lower Urinary Tract Symptoms (LUTS) due to BPH.
▹Patients with a prostate volume ranging from 30 to 150 cm³.
▹Patients with an obstructive median lobe (historically difficult to treat non-surgically).
▹Men seeking to avoid the daily side effects of BPH medications (e.g., dizziness, fatigue).
▹Men who want to preserve sexual function (erectile and ejaculatory function).
▹High-risk surgical patients (e.g., those with cardiovascular disease) who cannot undergo general anesthesia.

Comparison: Rezūm vs. Traditional TURP vs. BPH Medications

An academic comparison of efficacy, safety profiles, and impact on long-term quality of life.

Comparison Metric	Rezūm Water Vapor Therapy	Traditional TURP Surgery	BPH Medications (Lifelong Pills)
Mechanism of Action	Convective steam thermal energy induces natural cell apoptosis without cutting	Mechanical cutting and scraping of prostate tissue using an electrified wire loop	Relaxes prostate smooth muscle (Alpha-blockers) or shrinks volume hormonally (5-ARIs)
Anesthesia & Admission	Local nerve block or light sedation; outpatient procedure (no hospital stay)	Spinal block or general anesthesia; requires 2-3 days hospital admission	None required; self-administered oral medication at home
Urinary Catheterization	Temporary catheter for 3-7 days at home due to transient tissue swelling	Indwelling catheter in hospital for 2-3 days to monitor bleeding and flush clots	None required
Sexual Function Preservation	Excellent (>99% preserve normal ejaculation and erectile function)	High risk of retrograde ejaculation (50-75% 'dry orgasm'); small risk of ED	Risk of decreased libido, ED, or ejaculatory disorders in 5-10% of patients
5-Year Durability	Sustained relief; very low surgical retreatment rate of 4.4% at 5 years	Excellent, highly durable with the lowest rate of recurrence	Low; symptoms return immediately upon discontinuation of daily pills

Clinical Outcomes & Durability

Data from the 5-Year Pivotal Trial confirm the long-term efficacy and safety profile of Rezūm:

4.4%

Surgical Retreatment Rate

Over 5 years, a very low percentage of patients required additional surgical intervention.

48%

LUTS Improvement

Significant reduction in International Prostate Symptom Score (IPSS) sustained over 5 years.

0%

De Novo Erectile Dysfunction

No reports of new-onset erectile dysfunction directly attributed to the Rezūm procedure.

Recovery & Temporary Side Effects

As an outpatient procedure taking only 15-30 minutes, most patients go home the same day. However, temporary short-term side effects may occur:

•Catheterization: Due to temporary tissue swelling, most patients go home with a urinary catheter for 3 to 7 days.
•Dysuria: Mild burning during urination or pelvic discomfort is common for the first 1-2 weeks.
•Hematuria: Trace amounts of blood in the urine or semen can be expected in the early recovery phase.
•Results Timeline: Noticeable symptom relief typically begins within 2 weeks, with maximum benefits achieved by 3 months.

Clinical References

McVary KT, et al. 'Final 5-Year Outcomes of the Multicenter Randomized Sham-Controlled Trial of a Water Vapor Thermal Therapy for Treatment of Moderate to Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia.' Journal of Urology, 2021.
FDA Approval Letter for Rezūm System (K150786).
Boston Scientific Clinical Data on Rezūm Water Vapor Therapy.

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