Rezum is a minimally invasive transurethral water vapour therapy for benign prostatic enlargement (BPH). The device uses steam as a thermal energy to “cook” the prostate.

Water vapour is delivered through a retractable needle in the device which is passed down the penile urethra [Fig 1].

Image of the Rezum device
Fig 1. Rezum device

The water vapour is injected into the prostate, each burst lasting 9-seconds to melt the hyperplastic tissue [Fig 2].

Fig 2. Rezum treatment

How Rezum works

After the Rezum procedure, there will be swelling in the prostate, which can cause difficulty and frequency of urination. Should acute retention occur, a small foley catheter can be inserted and removed after a week. The BPH medication should be continued until the slow stream and irritation resolve, usually in about 1 month depending on how big is the BPH. Most patients should be able to get off their medication by 6 weeks.

Erections are not affected by the Rezum procedure.

Dr Chin doing Rezum

Complications include:

  • Bloody urine. This should resolve by 1 week. Many patients may also experience frequent urination, urgency but they usually subside by 1 month.
  • Acute retention of urine. This occurs due to the prostate swelling caused by the steam. The risk is more likely for big prostates. If this occurs, a foley catheter can be inserted at the end of the procedure.
  • Dry ejaculation. This occurs in 3% of patients.
  • Infection. This can still occur despite antibiotics because the prostate may harbour bacteria. The bacteria can infect the urine in the bladder and occasionally travel down to the testes to cause an infection there.

Desired outcomes:

  • Low UTI rate ( < 5% occurrence )
  • No acute retention ( < 3% rate )
  • No re-treatment ( < 5% chance )