Rezum Therapy for Enlarged Prostate
What is Rezum Therapy for Enlarged Prostate?
Rezum is an FDA-approved minimally invasive procedure for the treatment of enlarged prostate. The procedure involves the application of steam energy to ablate or remove a specific section of the prostate that has enlarged and is causing symptoms associated with an enlarged prostate.
Enlarged prostate, also known as benign prostatic hyperplasia or BPH, is the most common prostate problem in men. Almost all men develop some degree of prostate enlargement as they age. The prostate is a small, walnut-sized gland situated between the bladder and the penis, just in front of the rectum. The prostate gland encircles the urethra (the tube through which urine passes from your bladder and your body). When the gland enlarges, it presses against the urethra, restricting urine flow through the tube and causing problems with urination and other associated symptoms. The exact cause of prostate enlargement is unknown. However, it is believed that factors connected to ageing and changes in the cells of the testes may play a part in the enlargement of the gland, in addition to testosterone levels. Also, a family history of prostate issues or any abnormalities with your testes may increase your risk of prostate enlargement.
Rezum therapy works by delivering very small amounts of steam to the enlarged prostate. This process damages the prostate cells causing enlargement, thus reducing the overall size of the prostate and the symptoms associated with BPH.
Indications for Rezum Therapy
Your physician may recommend Rezum therapy when medication and other nonsurgical treatments have not been able to effectively treat prostate enlargement and its associated symptoms, such as:
- Urinary frequency (frequent urination)
- Urinary hesitancy (straining to urinate)
- Urinary urgency (Strong and sudden urge to urinate)
- Urinary retention (inability to urinate)
- Haematuria (blood in the urine)
- Dysuria (pain with urination)
- Incomplete bladder emptying
- Dribbling at the end of urination
- Delayed or slowed start to urination
- Weak urine stream
Who is a Good Candidate for Rezum Therapy?
You may be a good candidate for Rezum therapy if:
- You do not wish to take BPH medications or have elected to discontinue BPH medications
- Are not receptive to other minimally invasive or surgical BPH procedures
- You are 50 years and older with a prostate volume of ≥ 30 cm3 and ≤80 cm3
- You have prostate hyperplasia of the central zone and/or a median lobe
Preparation for Rezum Therapy
Pre-procedure preparation for Rezum therapy may involve the following steps:
- A review of your medical history and a physical examination are performed by your doctor to check for any medical issues that need to be addressed prior to the procedure.
- Diagnostic tests such as bloodwork, flow rate bladder scan to see how well the patient is emptying, and a prostate ultrasound to evaluate prostate condition
- You should inform your doctor about:
- Your current medication list
- Allergies to any medications
- Supplements or herbal products you are taking
- Any conditions you have such as heart or lung disease
- You may be asked to refrain from certain medications such as blood thinners or vitamin/herbal supplements for a week or two prior to the procedure.
- You are advised to have a light meal and plenty of fluids on the day of the procedure.
- An informed consent form will be obtained from you after the pros and cons of the procedure have been explained.
Procedure for Rezum Therapy
Rezum therapy is a minimally invasive procedure performed in-office that does not require general anaesthesia. The procedure itself is simple and quick and takes approximately 3 to 7 minutes. The Rezum therapy system consists of a portable radiofrequency (RF) generator and a delivery device that is introduced into the body through the urethra and guided by direct visualisation through a telescopic lens placed within the delivery device. Both the prostate and the penis are numbed prior to placement of the Rezum 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 (destroy) the targeted obstructive prostate tissue that causes prostate enlargement. The prostate is divided into 4 anatomical zones and enlargement typically occurs in the central and transitional zones of the prostate. Throughout the treatment, saline is delivered through the device to allow visualisation and keep the urethra cool and protect it from the thermal effects of the vapour during treatments.
Post-Procedure Care and Recovery
Post procedure you will be transferred to the recovery room where you will be observed for a few hours. You will be discharged home once you are deemed stable. Patients are usually able to drive themselves home and may return to regular activities within a few days. BPH symptoms may improve in as little as two weeks.
Benefits of Rezum Therapy
Some of the benefits of Rezum therapy include:
- Ablates targeted tissue, which is then resorbed
- Preserves sexual and urinary functions
- Clinically proven, safe, quick, and effective
- Rapid return to normal activities
- Few complications
- Treats enlarged central zones and/or median lobes of the prostate
- Can be performed under sedation without incisions or general anesthetic
Risks and Complications
All treatments have inherent and associated risks. Potential risks and complications of Rezum therapy include:
- Dysuria
- Haematuria
- Hematospermia (blood in the sperm)
- Reduction in ejaculatory volume
- Urinary tract infection
- Urinary frequency, urgency, or retention