Rezum: Minimally invasive water vapor therapy for BPH

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Rezum system, a novel ablative procedure in benign prostatic hyperplasia (BPH) was approved by US FDA since 2015. Currently, there are lots of scientific papers confirmed its pros on improving urinary symptom. We will discuss in detail about this cutting-edge technology.

As we all know that benign prostatic hyperplasia or BPH is one of the most common issues in elderly gentlemen. The treatment option is varied depend on the severity of urinary tract symptom.

1. Observation
2. Oral medications
3. Endoscopic transurethral interventions

I will jump over the Observation and oral medications options and moving on toward the interventions only. Normally, the gold standard in prostate intervention is TURP or transurethral resection of the prostate gland which can be done by electrical knife, the way we have done the operation is scooping a small prostatic tissue one by one (Like scooping the ice-cream in ice-cream bucket). Diff from TURP, the Rezum technology is completely different.

The Rezum procedure will not conduct any scooping technique or even cut any tissue from the prostate gland. There is a special needle which design specifically which we can pass inside the endoscopic instrument (We can say that Rezum is not a surgery because it is only needle puncture by its technique). Then, the surgeon will do a prostatic puncture by this special needle, after that we will infuse water heat at temperature 70 degree Celsius. The water heat will target the prostatic tissue and it becomes necrosis and shrinkage naturally over times. Patient can notice significant clinical improvement within 1 month post-Rezum.

I will make a comparison between the pros and cons of the Rezum and conventional BPH interventions for better understanding.

Rezum – Pros and Cons

Pros of Rezum	Cons of Rezum
Can be done under sedation only	Need long term follow up data
No hospitalization needed	Not suitable with urinary retention history
No erectile dysfunction complication	Not suitable with recurrent urinary tract infection history
Short procedure time	Not suitable with > 120 mL prostate size
Significant urinary symptom improvement	Not suitable with prostate radiation history
	Most of patients required urethral catheterization post procedure

It would be a great news for Cambodian and Expat who were her in Cambodia that this technology will be available soon in Royal Phnom Penh. If you have any questions on Rezum, please talk to your trusted Urologist or it would be my honor if you text me. See ya!

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