Rezum

For patients with benign prostatic hyperplasia (BPH), UT Southwestern Medical Center’s expert urologists offer Rezum, a minimally invasive procedure that uses steam to shrink an enlarged prostate.

Innovative Treatment for Enlarged Prostate

Benign prostatic hyperplasia (BPH), also known as enlarged prostate, can cause frustrating symptoms for men, including frequent urination, hesitancy in urination, urgency to urinate, and a weak urinary stream.

Rezum works by inserting sterile water vapor (steam) into the prostate gland during nine-second treatments. The therapy is targeted to a defined area because steam will travel only between cells until it encounters natural collagen barriers or the prostate capsule itself.

UT Southwestern Medical Center’s Kenneth Goldberg, M.D., was the first urologist in North Texas certified to perform the Rezum treatment, and he has performed more than 350 of the procedures. Dr. Goldberg is also the first doctor in the Greater Dallas area to receive a Rezum Center of Excellence Designation.

Clinical trials on Rezum were conducted at UT Southwestern. Dr. Goldberg has published his results in Prostate Cancer and Prostatic Diseases, and he presented at the annual American Urologic Association meeting in May 2019.

When medication and other nonsurgical treatments aren’t able to effectively reduce the symptoms of BPH, Rezum can make a significant difference in a patient’s quality of life, Dr. Goldberg says. He adds that after having the procedure done, more than 90 percent of his patients have been able to get off medication.

What to Expect Before Rezum

To help assess whether a patient is a good candidate for Rezum, the doctor will use a flow rate bladder scan to see how well the patient is emptying. The patient may also be asked to keep track of the amounts of fluids that he drinks and voids. After this evaluation, the doctor will perform a prostate ultrasound and take a telescopic look at the prostate.

At the pre-procedure visit, the patient receives detailed instructions on pre- and postoperative care. He will also receive an antibiotic prescription that should be started the night before the procedure, as well as an anti-anxiety prescription. Anti-inflammatories are given the day before and after the procedure. An alpha blocker prescription is usually given to improve the flow of urine after the procedure.

What to Expect During Rezum

On the day of the procedure, a light meal and lots of fluids are recommended.

The procedure itself is quick and simple, taking only a single one- to two-hour office visit. Depending on the size of the prostate, the procedure consists of two to seven injections, each nine seconds long.

Upon arriving, the patient will be instructed to eliminate urine, and the bladder is then checked. If there is still more urine in the bladder, it’s drained to avoid having to drain it during the procedure.

Both the prostate and the penis are numbed. The Rezum device is inserted, a needle is deployed, and vapor is injected into the prostate for nine seconds. This vapor disperses between cells, then cools, releases heat, and gently disrupts the prostate’s cells.

Because of the initial swelling, a catheter is then inserted, which will remain for two to five days. The catheter is hooked to a bag that stays on the leg and is covered by pants. A driver is required to take the patient home.

What to Expect After Rezum 

After the Rezum procedure, the body creates an inflammatory response, which takes two to four months to completely resolve. Initially, there will be swelling in the prostate, which can cause restriction of flow and cause more difficulty and frequency of urination.

Symptoms will get worse before they get better. Generally, at two weeks symptoms begin to stabilize. At four weeks, patients are back where they were before the procedure, and at six weeks patients start to get off medication.

Erections are not affected by the Rezum procedure. There is a one to two percent chance of retrograde ejaculation, which occurs when semen enters the bladder instead of the penis, causing very little to no semen to be ejaculated. This is a significantly lower percentage than in other prostate procedures.