Dr. Tanuj Paul Bhatia, Institute of LASER and Stone Surgery (ILSS), Faridabad, Haryana
Rezum is a minimally invasive treatment for BPH that utilizes steam to target and shrink enlarged prostate tissue. Developed by NxThera, Rezum was FDA-approved in 2015.(1) The procedure involves injecting steam into the prostate tissue, causing the target cells necrosis and eventual reabsorption.(figure 5) This innovative approach aims to alleviate lower urinary tract symptoms, especially suited for high risk patients and those who want to preserve ejaculation.
The Hit:
Rezum has garnered attention for its potential to provide relief from LUTS without the need for invasive surgery. Many patients appreciate the minimally invasive nature, as it generally requires only a local anesthetic and can be performed in an outpatient setting. Studies have shown that Rezum can lead to a significant reduction in prostate size and improvement in urinary symptoms, offering a promising alternative to traditional treatments like medication, resection or enucleation.(1)
The success of Rezum lies in its ability to address BPH symptoms while minimizing the potential side effects commonly associated with other treatment options. Clinical trials have reported a low rate of sexual dysfunction and a quick recovery period, making it an attractive choice for those seeking a balance between efficacy and reduced invasiveness.
In a review of literature, preoperatively, the mean IPSS score was 19.8, the mean Qmax was 9.2 mL/s, and the mean PVR was 142 cc. At 3 months after surgery, the mean IPSS score was 1.5, mean Qmax was 13.7 mL/s, and mean PVR was 74 cc.(2)
Rezum also offers the advantage of minimal learning curve compared to other MIST or more invasive therapies.
The Miss:
While Rezum has shown promise, it is not critiques. Some critics argue that the long-term effectiveness of the treatment remains unclear, as studies with extended follow-up periods are limited. Additionally, not all patients may experience the same level of symptom relief, and the procedure may not be suitable for everyone, depending on factors such as prostate size.
Some patients may experience postoperative dysuria, urgency, bleeding, urinary retention.(1,2) Mean postoperative catheterization time was 8.8 days.(2)
Cost is another consideration, as Rezum therapy may be more expensive than traditional treatments.
Conclusion:
Rezum therapy presents a promising option for men suffering from BPH, offering a balance between effectiveness and reduced invasiveness. While it has proven successful in alleviating symptoms in many patients, the long-term efficacy and cost-effectiveness of Rezum remain areas of ongoing research and debate. As with any medical procedure, individual factors, preferences, and considerations should guide the decision-making process between patients and their Urologist.