Soarawee Weerasopone, Urologist
Samitivej Sriracha hospital, Thailand
We Wellness clinic, Chonburi Thailand
Royal Phnom Penh hospital, Cambodia
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.
- Observation
- Oral medications
- 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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