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What is Rezum Therapy? and How Does it Treat an Enlarged Prostate?

Rezum therapy for an enlarged prostate

Benign prostatic hyperplasia (BPH), or prostate enlargement, is a common condition in ageing men. It can cause symptoms such as weak urine flow, frequent urination, urgency, hesitancy, and the sensation of incomplete bladder emptying. Traditional surgical treatments, though effective, often involve risks, longer recovery times, and potential side effects. 

Rezum Therapy offers a modern alternative. This minimally invasive procedure uses water vapor (steam) to target and reduce excess prostate tissue, relieving pressure on the urethra and restoring normal urine flow. For men seeking a safer, less invasive solution, consulting a skilled Urologist in Dhanbad can help determine if Rezum is the right treatment option. 

Here’s how it works: 

  • A urologist (like Dr. Saket Narnoli) inserts a slender probe through the urethra (so there is no external cut). 
  • That probe emits controlled bursts of steam into targeted areas of the enlarged prostate. The thermal energy from the steam destroys prostate cells in the zone pressing on the urethra. 
  • Over time (weeks to months), the body’s natural healing response reabsorbs the treated tissue, shrinking the prostate in those areas, and opening the urethral channel. 
  • Usually, the procedure is done in an outpatient or clinic setting (no hospital stay) and does not require general anaesthesia. 

Because of its minimally invasive nature, Rezum provides a middle ground between medications and more invasive surgeries. 

What are the benefits and risks of Rezum Therapy? 

Rezum Therapy Benefits 

  1. Relief of urinary symptoms
    Many patients experience an improvement in symptoms—such as reduced frequency, stronger flow, and decreased urgency—within two to four weeks, with maximum benefits typically observed by three months. 
  2. Preservation of sexual function
    One of the key advantages is that Rezum tends not to impair erectile function or ejaculatory function in most men. In clinical trials, new erectile dysfunction was not commonly observed, and ejaculatory function is generally preserved. 
  3. No incisions, no general anaesthesia
    Since the procedure is delivered through the urethra, there is no external cutting. Most patients do not require general anaesthesia; local or mild sedation is often enough. 
  4. Quick recovery, outpatient basis
    You can usually go home the same day. Many patients return to normal day-to-day activities in a few days. 
  5. Long-term symptom control and low retreatment rate
    Studies show that only about 4–5% of men need surgical retreatment within five years. Also, many men can discontinue BPH medications over time. 
  6. Suitable for many prostate sizes and median lobe
    The therapy is recommended for prostates ranging from approximately 30 cm³ to 80 cm³ and is also effective in treating hyperplasia of the median (central) lobe. 

Rezum Therapy Risks and Possible Side Effects 

While Rezum is generally well-tolerated, like any medical procedure, it has potential risks. Most are temporary and mild to moderate in nature. 

Some of the common or known risks include: 

  • Pain or burning during urination (dysuria) 
  • Urinary frequency, urgency, or discomfort 
  • Blood in urine (hematuria) or blood in semen (hematospermia) 
  • Urinary tract infection (UTI) 
  • Temporary inability to urinate fully or urinary retention 
  • Decrease in ejaculatory volume or changes in ejaculation 
  • Urethral stricture (narrowing) or scarring 
  • In rare cases: bladder neck narrowing, bladder stones, infection 
  • Rarely, sloughing (shedding) of prostatic tissue has been reported 
  • In exceptional cases, worsening erectile dysfunction or other complications 

The most reported minor side effects are dysuria and hematuria. 

A published case has described prostatic tissue sloughing following Rezum, although such events are rare. Importantly, symptoms may temporarily worsen during the healing phase before improving. The use of a urinary catheter for a few days is often necessary to ensure proper drainage while swelling subsides. Patients should always discuss their individual risk profile with their urologist to determine whether Rezum is appropriate for them. 

Recovery After the Procedure: What to Expect 

Because Rezum is a minimally invasive prostate treatment, the recovery is typically faster, and smoother compared to traditional surgery. Here’s a general timeline and tips to help you understand what to expect: 

Immediate post-procedure period 

  • After the procedure, a urinary catheter is usually left in place for 1 to 3 days, depending on individual swelling. 
  • You may experience urinary discomfort, urgency, burning sensations, or light bleeding for a few days. This is expected during the healing process. 
  • Drink plenty of fluids to help flush the bladder and reduce the concentration of irritants. Avoid bladder irritants like caffeine, spicy foods, and carbonated drinks. 

First few days to weeks 

  • Many patients resume light daily activities within a few days. Rest and avoid heavy lifting or strenuous exertion for some weeks. 
  • You might notice transient worsening of urinary symptoms initially, for example, urgency or weak stream, before gradual improvement. 
  • Sexual activity (intercourse or masturbation) is typically withheld for a few days or weeks (as per your doctor’s instructions) to allow healing. 

Weeks to months 

  • Symptom relief usually begins within two to four weeks. 
  • Gradual improvement continues over a span of three months, which is when many patients reach near-maximum benefit. 
  • Follow-up visits with your urologist will check your symptom scores, urinary flow, and residual urine volume. 

Long-term outlook 

  • In many men, the benefits last for five years or more, with a relatively low rate of needing further invasive treatment. 
  • If symptoms recur, Rezum can sometimes be repeated, or alternative therapies may be considered. 

Throughout your recovery, it is important to attend regular follow-ups, follow bladder care instructions, and promptly report any concerning symptoms—such as difficulty urinating, fever, or severe pain—to your doctor, such as Dr Saket Narnoli. 

Who is a good candidate for Rezum, and how does it compare to surgery? 

Not every patient with prostate enlargement is an ideal candidate for Rezum. Your urologist (such as Dr. Saket Narnoli) will assess based on factors including prostate size, the presence of a median lobe, symptom severity, other medical conditions, and your goals regarding sexual function. 

Rezum is especially suitable for: 

  • Men aged 50 years or older with moderate to severe lower urinary tract symptoms due to BPH 
  • Prostate volumes between 30 and 80 cm³ 
  • Patients who prefer a minimally invasive prostate treatment without open surgery 
  • Those who wish to preserve sexual/ejaculatory function and avoid risks associated with more invasive surgery 

How does Rezum compare with surgical options like TURP (transurethral resection of prostate)? 

  • TURP is more “aggressive” in removing prostate tissue and often yields very strong relief more quickly, but it has higher risks of bleeding, longer hospital stays, and more risk to sexual/ejaculatory functions. 
  • Rezum offers a trade-off: somewhat slower onset of relief, but fewer complications, quicker recovery, and preservation of function. 
  • Because Rezum can be done on an outpatient basis with minimal anaesthesia, it is especially appealing to men who cannot tolerate more extensive surgery or have comorbidities. 

In short, Rezum therapy provides a valuable middle path: more durable relief than medications, with far lower risk and downtime than traditional surgery. 

Final thoughts 

If you are experiencing bothersome urinary symptoms due to prostate enlargement and are considering treatment options without surgery, Rezum Therapy is a promising choice. This minimally invasive procedure can help relieve symptoms, maintain sexual function, and reduce dependence on lifelong medication, all while offering a quicker recovery. 

However, every patient’s situation is unique. Consulting an expert is essential, and a skilled urologist like Dr Saket Narnoli can evaluate your prostate size, overall health, and personal goals to determine if Rezum Therapy is the right option for you. Understanding the role of a urologist in men’s health ensures that you receive tailored care and make informed decisions for your well-being.