What is the Rezum water-vapour ablation of the prostate?

Rezum is a minimally-invasive therapy for benign prostate enlargement. Sterile water vapour is injected into the prostate tissue to be treated under endoscopic control. The inner zone of the prostate is treated, that is, the zone that causes the prostate enlargement and thus the symptoms. On contact with the tissue, the vapour then returns to its liquid state and releases the stored thermal energy.

This energy directly acts on the cell in the treatment area. The heat energy released by this method damages and and breaks down the cells in the treatment area. This causes the prostate to shrink, so that – depending on the size of the prostate – the urine flow will once again be unimpeded after a few weeks. Following the treatment, patients receive an urethral catheter, which can be removed after a few days

Who is the procedure suitable for?

This procedure is particularly suitable for patients with small or medium-sized prostate volumes up to about 80 ml. As no tissue is ablated, the procedure can be performed under local anaesthetic or sedation. Therefore, a spinal or general anaesthetic is not absolutely necessary. As this allows, in most cases, to spare ejaculation and is minimally invasive, the procedure is also suitable for younger patients as it represents a middle way between medication and tissue-removing procedures.

What are the advantages of this procedure?

As there is no heat spreading beyond the prostate, post-surgical incontinence is almost excluded. Ejaculation will also be virtually unaffected. Besides, this is a very brief procedure, lasting in most cases no longer than 10-15 minutes. As no tissue is removed, the risk of post-surgical bleeding or impairments due to wound healing is minimal.

What are the known risks and disadvantages?

For Rezum, there are now long-term data on its effectiveness covering 5 years. These show that the rate of patients requiring a follow-up operation was around 5%. The number of patients again requiring medication is about 11%. Unlike other techniques, the effect of this operation is not immediate and it will take up to several weeks until the improvement can be felt. Besides, depending on the size of the prostate, the use of a transurethral catheter will be required for a few days.