What is Rezum therapy?
Rezum therapy is a new treatment for men with BPH (benign prostatic hyperplasia) symptoms, such as slow urinary stream, urinary frequency, urinary urgency, nocturia (voiding at night), and sensations of incomplete emptying of the bladder. Rezum was recently approved by the US FDA in late 2015 and became commercially available in the US in mid-2016.
How does Rezum Therapy work?
As men get older, the prostate enlarges and the prostate tissue restricts the flow of the urine going through the prostate, causing symptoms of BPH. Rezum works by delivering heat energy in the form of heated water vapor (steam) to the enlarged prostate tissue, causing shrinkage of the prostate tissue and enlarging the opening inside the prostate for the urine to flow through.
Video was retrieved from Rezum
How effective is Rezum therapy?
Rezum therapy has been shown to be very effective in helping men with BPH symptoms. During the early trials prior to FDA approval, men have shown to have improvements in their urinary symptoms as early as 2 weeks after the procedure and maintained those improvements for 1 year after.
What kind of anesthesia is required for Rezum therapy?
Rezum therapy can be done under local or general anesthesia. However, it is more commonly done under local anesthesia.
Pain medications can also be prescribed to help you feel more comfortable during the procedure
How long does it take?
Though the procedure itself takes several minutes, the preparation may take longer so you should prepare to spend 1 hour or longer in the office.
What are the possible risks of Rezum therapy?
The possible risks of Rezum therapy may include but are not limited to minor bleeding, pain or discomfort during the procedure, and irritating voiding symptoms transiently after the procedure.
During the study prior FDA approval, Rezum therapy has been shown not to cause adverse effects on sexual function or ejaculation.
Alternative treatment options for BPH
Alternative treatment options include...
Observation
Medical therapy with alpha blockers and 5-alpha reductase inhibitor medication and or phosphodiesterase inhibitor medication
Radiofrequency treatment, microwave treatment, laser vaporization or laser enucleation of the prostate, transurethral incision of the prostate, transurethral resection of the prostate, or open prostatectomy (open surgery to remove the prostate).
What are the advantages of Rezum therapy compared to the alternative treatments?
Rezum therapy should be considered over oral medication if the patient has not achieved the desired relief from the medications, or if the medications are causing side effects.
Rezum therapy can also be individualized to the particular shape and figuration of the prostate, making it a good alternative to microwave therapy that does not.
Compared to radiofrequency ablation (TUNA or transurethral needle ablation of the prostate), the Rezum treatment is shorter in duration, lasting just a few minutes, and can potentially cause less pain and discomfort.
Unlike the Urolift procedure, the Rezum therapy can treat the median lobe of the prostate.
Urolift also requires patients to permanently have a metal clip on the outside and inside of the prostate, causing potential interference if the patient needs magnetic resonance imaging (MRI) of the prostate.
Compared to other surgical procedures of the prostate, such as laser treatment, transurethral incision of the prostate, TURP, or open surgery, Rezum therapy is less invasive and has shown not to have adverse effects on sexual function and ejaculation.
Rezum therapy can cause less bleeding and can be done in the doctor’s office under local anesthesia without the need of general or spinal anesthesia.
What do I need to prepare before the procedure?
To best prepare for the procedure, follow your doctor’s instructions, including taking pain or calming medications and possible fleet enema to clear the stool from the rectum.
You should arrange to have someone drive you home after the procedure due to the drowsy effects of pain medications.
What happens during the procedure?
Your doctor will administer local anesthesia through the rectum to the barrier around the prostate.
After that, the area in your lower abdomen and the genital area will be cleaned with an anti-septic solution.
You will be given numbing medication or gel into the urethra inside the penis.
Your doctor will then gently insert a small scope into the urethra inside the penis, going through the prostate to inspect the bladder and the prostate.
Your doctor will identify the appropriate site for the Rezum therapy.
Your doctor will insert a very small tube into the tissue of the prostate and heated water vapor (steam) will be released into that area of the prostate for 9 seconds.
After that, your doctor will move to another area of the prostate and release the steam for another 9 seconds.
Depending on the size and figuration of your prostate, your doctor will determine the appropriate number of treatments.
For each treatment, steam is targeted onto the desired prostatic tissue for 9 seconds.
Within one session/appointment, the average number treatments can be between 2-8 vapor treatments.
After treatment
After the treatment, your doctor will insert a small tube called a Foley catheter into your bladder.
The Foley catheter is anchored to your bladder by an inflated balloon so you won’t have to worry about the catheter slipping out.
The catheter can be connected to a small leg bag that can be strapped to your upper thigh.
Your doctor may give you a larger bag if needed.
Your doctor may recommend that you keep the catheter in for a few days to ease urination during healing.
What do I need to do after the procedure at home?
You need to continue antibiotic pills for 3-5 days as instructed by your doctor. Please consult your doctor for further instructions
You need to follow your doctor’s instructions on how to empty the urine from the urine bag.
You can take a shower as usual, but do not put soap in the tip of the penis – this may cause irritation.
To avoid discomfort and aid speedy recovery
Avoid any activity that may cause irritation to your prostate area, including sexual activity or riding a bicycle for up to 4 weeks.
If you experience pain or discomfort, you can take mild pain medications such as Tylenol, or pain medications prescribed by your doctor.
You can also try sitting in a warm bath or on a hot water bottle
Avoid consuming caffeine, chocolates, and alcoholic beverages
Within a few days, you will be able to resume normal activity and may experience an improvement of symptoms as soon as 2 weeks after the procedure.
Unexpected complications
Call your doctor if you experience heavy bleeding, blood in your urine that is thick like ketchup
Go to the emergency room immediately if you have fevers ( and or chills) equal or greater than 101 degrees.
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Reviewed by a Board Certified Urologist