Rezum steam therapy for prostate adenoma
Benign prostatic hyperplasia (BPH) is one of the most common causes of urinary dysfunction in middle-aged and older men: a weak urinary stream, frequent nocturnal urination, and a feeling of incomplete bladder emptying significantly reduce quality of life. Rezum steam therapy is a modern, minimally invasive technique that uses sterile steam to specifically destroy excess prostate tissue without incisions or traditional surgery, preserving sexual function in most patients. At the K+31 Clinic, Rezum is performed by urologists specializing in minimally invasive prostate surgery, which allows for lasting results with minimal risk of urinary incontinence and retrograde ejaculation.
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Indications for the Rezum procedure
The Rezum method is considered in patients with:
- symptoms of urinary dysfunction due to BPH: weak urine stream, frequent daytime and nighttime urges, a feeling of incomplete bladder emptying, episodes of sudden "uncontrollable" urges
- confirmed prostate enlargement by ultrasound/MRI and a corresponding clinical picture
- prostate volume up to 150 cm³, with the best results, according to experts, expected at a volume of up to 80 cm³
- insufficient effect or dissatisfaction with long-term drug therapy
- desire to preserve erectile function and ejaculation if surgical treatment is necessary
The final decision on the possibility Rezum is prescribed by urologist K+31 after a complete preoperative examination in accordance with clinical guidelines.
Advantages of Rezum compared to pills and traditional surgeries
Compared to drug therapy
- No need for lifelong medication. Maintaining the effect often requires continuous medication use, and symptoms may recur even with short-term discontinuation.
- Fewer medication side effects. Sexual dysfunction, including retrograde ejaculation, is possible with medication. Rezum acts locally on prostate tissue and is not associated with systemic effects.
- More stable results. According to studies, the need for repeat Rezum treatments in the medium term does not exceed approximately 5%, which is comparable to or better than some medication strategies.
Compared with TUR and other resection methods
- Comparable clinical efficacy. According to recent reviews, Rezum is virtually equal to TURP in improving symptoms, urine flow rate, and quality of life.
- Fewer intra- and postoperative complications. The risk of bleeding, perforation, urethral strictures, and severe urinary incontinence is significantly lower compared to traditional resection methods.
- Minimal risk of retrograde ejaculation. With Rezum, the anatomy of the bladder neck and prostatic urethra is virtually intact, so the risk of retrograde ejaculation is minimal, especially in young patients.
Features of the K+31 approach to Rezum treatment
- Specialized urologists regularly perform Rezum. The procedure is performed by surgeons specializing in minimally invasive prostate procedures, taking into account international recommendations and their own experience.
- Individualized method selection. At K+31, Rezum is considered among a range of options (medication therapy, TUR, laser enucleation, and other minimally invasive techniques), and the choice of approach is made strictly individually, based on diagnostic results.
- Treatment options for patients with comorbidities. For properly controlled diabetes and other chronic conditions, Rezum can be safely performed with prior therapy adjustments and risk assessment.
- The comfort of a premium clinic. Modern operating rooms and wards, anesthesiology support, early postoperative monitoring, and detailed written recovery recommendations.
Appointment to the doctor
Preparation for the Rezum procedure
A standard preoperative examination includes:
- Blood and urine tests, coagulation profile as indicated
- ECG, chest X-ray/CT scan (depending on age and comorbidities)
- Ultrasound of the veins of the lower extremities if necessary
- Consultations with a physician and anesthesiologist
- Additional tests (ultrasound/MRI of the prostate, flowmetry, PSA) as indicated by a urologist
The doctor discusses with the patient the use of antithrombotic medications, diabetes management, allergies, and other risk factors separately.
Stages of the procedure
- Urologist consultation and planning The doctor clarifies the patient's complaints, evaluates the examination results, prostate volume and anatomical features, discusses indications and alternatives, and develops an individual treatment plan.
- Hospitalization and anesthesia In a hospital setting, the optimal anesthesia option is selected (usually spinal or short-term intravenous anesthesia) with the participation of an anesthesiologist K+31.
- Transurethral insertion of the Rezum instrument A thin instrument, similar to a cystoscope, is inserted through the urethra; under visual control, the doctor guides it to the area of enlarged prostate tissue.
- A series of steam injections A needle is activated in the targeted areas of the prostate, delivering a measured amount of sterile steam over 9 seconds; the number of injections depends on the size and shape of the gland.
- Completion of the procedure and catheterization At the end of the procedure, the instrument is removed, and a temporary urinary catheter is usually installed to control urine flow and restore postoperative swelling.
- Observation and discharge After a short observation period, the patient receives detailed recommendations and is discharged as soon as the patient's condition and urinary parameters allow.
Results and Recovery Time
Improvement in urinary symptoms develops gradually:
- Many patients notice the first changes within a few weeks.
- The maximum effect is assessed after approximately 3 months, when the steam treatment area has completely healed and urine flow rates have stabilized.
Urinary flow rate (Qmax) increases as prostate volume decreases and the urethral lumen widens; significant improvement is usually observed within the first 3 months. Clinical studies demonstrate a sustained reduction in symptoms and an improvement in quality of life for at least 4–5 years in most patients.
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FAQ
What symptoms might prompt consideration of Rezum?
Resume is considered in patients with complaints of a weak urinary stream, frequent daytime and nighttime urination, a feeling of incomplete bladder emptying, and other signs of urinary dysfunction associated with BPH after consultation with a urologist.
At what prostate size is Rezum most effective?
The method can be used for prostate volumes up to approximately 150 cm³; however, in the experience of specialists, the most predictable and pronounced results are expected in patients with a volume of up to 80 cm³.
Is Rezum suitable for young patients (over 40 years old)?
Yes, if surgical intervention is indicated, this technology is often preferred in relatively young patients due to the minimal risk of urinary incontinence and retrograde ejaculation and the preservation of sexual function.
What examinations are needed before the procedure?
The standard workflow includes blood and urine tests, an ECG, a chest X-ray if indicated, an ultrasound of the veins of the lower extremities, and consultations with a physician and anesthesiologist. Additional tests are prescribed if necessary (ultrasound/MRI of the prostate, flowmetry, PSA, etc.).
Can Rezum be taken if you have diabetes?
Diabetes mellitus itself is not an absolute contraindication: it is important to assess blood glucose levels, adjust therapy if necessary, and perform the procedure when blood glucose levels are stable, which reduces the risk of complications.
When does relief occur after Rezum, and when does urinary flow rate return to normal? Symptom improvement develops gradually and increases over 3 months, by which time complete restoration of urinary flow and improvement in urinary flow rate are usually observed.
Can acute urinary retention develop after the procedure?
Yes, as with other treatments, a severe delay is possible due to postoperative prostate swelling. However, the likelihood is low—on the order of a few percent. Following your doctor's recommendations and prescribed therapy is key to prevention.
When can I return to sexual activity and sports?
As a rule, sexual and physical abstinence are recommended for approximately one month after the procedure. Then, if there are no complaints, you can gradually return to your normal activities in consultation with your urologist.
Can symptoms return after a few years?
The risk of symptom recurrence exists after any surgical procedure, but in the case of Rezum, it is estimated at approximately 5%; if necessary, the procedure can be safely and minimally invasively repeated.
How is Rezum better than tablets or TUR for me personally?
Medications require continuous use and do not prevent disease progression. TUR, although effective, is associated with higher morbidity and risk of complications. Rezum occupies an intermediate position, providing a comparable effect with less morbidity and a better profile for preserving sexual function. The final choice of method is made individually after an in-person consultation.
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What is steam therapy? Rezum
Rezum is a transurethral water-steam thermotherapy, which involves introducing sterile water vapor into the enlarged prostate tissue through a thin endoscopic instrument. Steam, at a temperature of approximately 103–110°C, transfers thermal energy to the adenoma cells, causing their coagulation and a gradual reduction in the gland's volume. Over the course of several weeks and months, the destroyed tissue is naturally reabsorbed and eliminated by the body, the urethra widens, and lower urinary tract symptoms gradually decrease.
The procedure is performed through the urethra, requires no incisions, can be performed under spinal, local, or short-term intravenous anesthesia, and typically does not require a lengthy hospital stay.