Rezūm: a minimally invasive BPH treatment—effective when anatomy and expectations are aligned
Rezūm is often described as a 'minimally invasive alternative' to prostate surgery. A more accurate way to think about Rezūm is: It is a targeted therapy for selected prostate patterns. It works through controlled tissue injury and gradual shrinkage. It can produce very meaningful symptom improvement, but timelines and recovery feel different than tissue-removing surgeries.
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What Rezūm is
Rezūm is a treatment that uses water vapour (steam) energy delivered through a device placed via the urine passage. The aim is to treat obstructing prostate tissue in a controlled way. Steam is applied to selected areas of prostate tissue, treated tissue is gradually resorbed over time, the prostate channel opens up progressively, symptoms improve as healing completes.
Who is a good candidate (and who is not)
Often a good fit when:
You have BPH symptoms that are affecting quality of life. Your prostate anatomy is suitable for targeted therapy. You want to avoid more invasive endoscopic surgery where reasonable. You understand and accept that improvement is gradual and healing involves a temporary symptom phase. You can adhere to follow-up and catheter instructions if needed.
Might be less suitable when:
There is significant urinary retention and urgent rapid relief is required. Your anatomy suggests Rezūm may not deliver predictable results. Symptoms are driven primarily by bladder dysfunction rather than obstruction. You have complicating factors that make an alternate approach safer/more definitive.
What evaluation is typically needed before deciding
1) Symptom pattern assessment
Weak stream, straining, incomplete emptying, nocturia and sleep disruption, urgency/frequency (and whether this is secondary to obstruction).
2) Urine test
To rule out infection and evaluate hematuria concerns.
3) Ultrasound with post-void residual
This is important because: high residual urine changes the risk profile, bladder/kidney impact must be assessed, prostate size estimation helps guide options.
4) PSA in context
Not to 'diagnose cancer,' but to interpret the prostate environment responsibly.
5) Anatomy review (as needed)
Some specialists in certain cases use additional evaluation to confirm suitability.
What happens during the procedure
In general: The device is placed via the urinary passage. Water vapour therapy is delivered to targeted areas. You are monitored afterward. A catheter may be placed for a short period depending on swelling risk and baseline voiding function. Rezūm aims to avoid major surgical tissue removal, but it still causes a planned inflammatory/healing response.
Catheter: when it is needed and what to expect
Why a catheter is sometimes needed
After Rezūm, the prostate tissue can swell temporarily. A catheter: maintains drainage during the early healing window, prevents painful retention, allows safer recovery.
How long is it needed?
Duration varies based on: baseline symptoms and residual urine, prostate anatomy and amount treated, clinician judgment. Your team should tell you the expected range before discharge. Catheter experience can be uncomfortable, but it is temporary and manageable with proper guidance.
Expected benefits and timelines
Early phase (first days to 2 weeks)
Urinary frequency/burning can increase temporarily. Weak stream may persist or feel worse before it improves. Catheter may be present for part of this period.
Improvement window (weeks to a few months)
Many men notice: improved stream, reduced straining, reduced nocturia, improved quality of life.
Longer-term stabilization
Symptoms often continue to improve as healing completes. A good team sets the expectation that Rezūm is not 'overnight relief,' but can be meaningful improvement.
Risks and side effects
Potential side effects include: temporary urinary irritation (burning, frequency), temporary worsening of LUTS during healing, urinary retention requiring catheter, infection risk (managed with protocols), blood in urine for a short period, rarely, incomplete response requiring additional treatment. Warning signs requiring urgent evaluation: fever/chills, inability to pass urine, severe pain or uncontrolled symptoms, heavy bleeding with clots.
Rezūm vs PAE vs TURP vs HoLEP/ThuLEP: how to think
Rezūm
Minimally invasive—but approach via the penis/urethra, and is painful post surgery. Healing involves temporary symptom phase. Needs catheterization tube after surgery. Gradual improvement.
PAE
Minimally invasive—no pain, no cuts, no scar, no anesthesia. Gradual improvement over weeks to months. Candidacy depends on artery anatomy.
TURP
Oldest procedure, major surgery with general anesthesia, approach via penis/urethra. Needs catheterization tube after surgery. Most effective surgery but also highest side effects.
HoLEP/ThuLEP
Laser prostate center removal—needs general anesthesia, approach via the penis/urethra. Needs catheterization tube after surgery. Often chosen for durable relief.
Recovery and follow-up
A good recovery plan includes: clear guidance on fluids and activity, symptom expectations by week, catheter care instructions, follow-up schedule, when to restart or stop BPH medicines during transition, warning signs and emergency contact pathway.
FAQs
Talk to a doctor / know if it fits you
For a Rezūm review to see if it can work for you, send us: ultrasound report, urine report, PSA history, your symptom pattern. We will tell you plainly: whether Rezūm is appropriate for your anatomy and goals, whether PAE or endoscopic surgery would be a better fit, what recovery timeline is realistic, and how to plan a smooth post-procedure course.
