What is Rezūm?
Rezūm is a method by which steam energy is used to ablate (or remove) the particular part of the prostate that enlarges and causes symptoms due to BPH.
Rezūm uses the natural energy stored in water vapour, or steam. It is a safe and effective treatment available to relieve symptoms associated with benign prostatic hyperplasia (BPH).
This system consists of a portable radiofrequency (RF) generator and delivery device that is introduced into the body via the urethra (transurethral approach) and guided by direct visualization through a telescopic lens placed within the delivery device.
RF energy from the generator is applied to an inductive coil in the delivery device to heat up a controlled amount of water outside of the body, converting the water into vapour or steam. The thermal energy created outside the body is delivered into the prostate tissue through a tiny needle with emitter holes to ablate the targeted obstructive prostate tissue that causes BPH.
The procedure takes approximately 3 – 7 minutes and can be performed in a Day Surgery setting.
No RF energy is delivered into the body.
Throughout the insertion of the device and during the treatment saline (salty water) is running to help ensure better views and to prevent the urethra from overheating.
The Rezūm System is intended to relieve the symptoms of obstruction and prostate tissue associated with BPH and is indicated for men with prostatic urethra lengths >2 .0 cm and prostate volumes >20 cm3. The Rezūm System also is indicated for treatment of prostates with a median lobe or elevated central zone tissue.
Advantages of Rezūm?
The major advantages of Rezūm are:
• Fast, effective and, precise BPH treatment
• Ablates targeted tissue, which is then resorbed
• Treats enlarged central zones and/or median lobes
• Clinically proven, safe and effective
• Preserves sexual and urinary functions
•A rapid return to normal activities
What type of patients may benefit from the Rezūm procedure to treat BPH?
Men who have elected to discontinue or who have chosen not to take BPH medications
Men who are not receptive to other minimally invasive or surgical BPH procedures
Men who have indicated they aren’t bothered enough by their symptoms to elect an invasive surgical procedure.
How do I know if Rezūm therapy is a good treatment for me?
Your urologist will consult with you to determine if Rezūm water vapour therapy is a good treatment option for you based on your symptoms and personal treatment goals.
The Rezūm System is indicated for men 50 years and older with a prostate volume of ≥ 30cm3 and ≤80cm3.
The Rezūm System is also indicated for treatment of prostate with hyperplasia of the central zone and/or a median lobe.
The use of the Rezūm System is contraindicated for patients with a urinary implant or who have a penile prosthesis.
A Three year randomized study comparing Rezum to TURP has now been completed and the results can be read here
What happens next?
You will be offered a date for the procedure and also for a pre-operative assessment if a general anesthetic is going to be used. If you have not already done a flow test, this will be performed as well as completing the questionnaires. If you are on blood thinners you may be asked to stop taking them for a period prior to your treatment.
You will have been given a time to attend the hospital. Even though the procedure only takes a few minutes, you will probably be at the hospital some time before and after the procedure, again depending on the anaesthetic used. It is very likely that you will be discharged home the same day.
Your consultant will see you before the procedure and ask you to sign consent forms.
About an hour before, you will be given some strong painkillers as well as some antibiotics which you will continue at home. You will then be accompanied to theatre where the procedure will take place. If you are having a general anesthetic you will be sent to sleep.
The majority of men will be awake for the procedure. Local anaesthetic will then be administered around the prostate gland with the use of an ultrasound probe via the back passage.
This may feel a bit uncomfortable, but the more relaxed you are the easier it will be. Antibiotics will be given directly into your vein.
The Rezūm equipment is then passed through the urethra using plenty of anesthetic gel, which may momentarily sting. After an inspection of the bladder, the treatment will begin.
On completion a catheter will be left within your bladder for a few days prior to voiding as the prostate readjusts to the treatment and the swelling subsides. An antibiotic and pain killing suppository will be inserted into your rectum at the end.
When can I go home?
After your procedure, your consultant will review you and discuss with you the operation, any specific requirements for you at home and a plan for your aftercare.
A date will be given to you as when to return for the catheter removal as well as the care required whilst at home.
It is normal to have some pain or discomfort after operations, and we advise you on painkillers to help keep it under control.
Return to work as you feel comfortable depending on your job. If in doubt please check with your surgeon and obtain a certificate, before you are discharged.
When you attend for catheter removal, please try to arrive with a full bladder so that your stay will be as short as possible. The tube will be removed and then when you are ready you will be asked to void into the flow machine and the bladder scanner will detect any remaining volume of urine. If the nurse is happy with the results you will be discharged.
If there are any problems you may require a further period of catheterisation or be taught intermittent self catheterisation.
Within a few days you will be able to resume normal activities and should notice improvements within 2 weeks, although it may be 3 months before the full benefit is evident. Blood may be visible in the urine and ejaculation fluid.
When can I resume sexual activity?
Once the catheter has been removed and you feel comfortable. Do not be surprised if you see blood afterwards.