What is Rezum therapy?
Rezum (manufactured by Boston Scientific) is a minimally invasive treatment for benign prostatic hyperplasia — the common, non-cancerous enlargement of the prostate that affects over half of men in their sixties. The procedure uses convective water vapour thermal therapy (WVTT): a small cystoscope is passed through the urethra and a retractable needle delivers brief bursts of steam (water vapour at 103°C) directly into the obstructing prostate tissue.
The thermal energy from the steam destroys the targeted cells. Over 3–6 months, the immune system absorbs this treated tissue, the prostate shrinks in volume (typically by approximately 30–34%), and urinary symptoms progressively improve. Because the procedure targets only the obstructing tissue — not the ejaculatory ducts — sexual function is preserved far better than with TURP.
Who is suited to Rezum?
Rezum is an excellent option for men who:
- Have moderate to severe BPH symptoms (IPSS ≥ 8) not controlled by medication
- Want to avoid general anaesthetic and overnight hospital admission
- Wish to preserve ejaculatory and erectile function
- Have a prostate volume of 30–80 ml (ideal range)
- Have a prostate with or without a small median lobe (Rezum can treat median lobes, unlike Urolift)
- Have confirmed BPH — cancer must be excluded before any BPH procedure
Rezum is generally less suited to men with very large prostates (above 80 ml), large median lobes, or those in urinary retention — where Aquablation or TURP produce more reliable results.
How Rezum is performed
Recovery after Rezum
| Timeframe | What to expect |
|---|---|
| Day 0 | Day case — home the same day. Catheter in situ. Some burning or discomfort on the day is normal. Rest advised. |
| Day 3–7 | Catheter removed in clinic or by district nurse. Urgency and frequency common initially. Drink plenty of fluids. |
| Week 1–2 | Return to desk work and light activity for most men. Avoid strenuous exercise, alcohol and spicy food. Urinary symptoms may fluctuate. |
| Month 1–3 | Progressive improvement in flow rate and symptoms as treated tissue is absorbed. Bladder urgency usually settles. Most men notice meaningful improvement by week 6–12. |
| Month 3–6 | Full benefit established. IPSS symptom scores typically 50% lower than before treatment. Three-month outpatient review with urine flow assessment. |
| Year 1–5 | Durable results confirmed in pivotal trial at 5 years. Retreatment rate approximately 4–11%. Annual review recommended. |
Risks and side effects
Rezum has an excellent safety profile — one of its main advantages over TURP and Aquablation.
Very common (temporary)
Urgency and frequency
Irritative urinary symptoms are common in the first 4–6 weeks as the prostate heals. These typically resolve completely as the tissue is absorbed. Alpha-blocker medication can help during this period.
Common
Short-term urinary retention
Due to post-operative swelling. Managed with the short-term catheter (3–7 days). Rarely, a longer catheterisation period or repeat procedure is needed.
Uncommon
Urinary tract infection
Prophylactic antibiotics are routinely given. UTI in the post-operative period is treated with a course of oral antibiotics.
Rare (<2%)
Retrograde ejaculation
Significantly rarer with Rezum than with TURP or Aquablation. Published data confirms ejaculatory function is preserved in the large majority of men — a key advantage for sexually active patients.
Very rare
Haematuria (blood in urine)
Some blood-staining of urine is normal and expected for a short period after catheter removal. Significant bleeding requiring intervention is very uncommon with Rezum.
Rare
Retreatment needed
Approximately 4–11% of men require further treatment within 5 years. All BPH treatments carry some retreatment risk, particularly as the prostate continues to grow with age.
Frequently asked questions
Rezum does not produce immediate symptom relief. As treated tissue is absorbed over 3–6 months, symptoms progressively improve. Most men notice meaningful improvement at 3 months, with full benefit by 6 months. IPSS symptom scores typically improve by approximately 50% from baseline; urine flow (Qmax) improves by an average of 7 ml/s.
This depends on your specific anticoagulant and why you are taking it. For many patients on warfarin, rivaroxaban, apixaban or similar, a short pause (typically 5–7 days) before Rezum is all that is needed — and because Rezum has a very low bleeding risk, the interruption period is shorter than for TURP or Aquablation. This will be reviewed carefully at your pre-operative assessment.
Both are day-case, sexual-function-preserving treatments for BPH, but they work differently. Urolift uses small permanent implants to hold the prostate lobes apart — producing immediate symptom improvement. Rezum destroys tissue with steam, which is then absorbed — so improvement is gradual over 3–6 months but the prostate genuinely reduces in size. Rezum can treat a median lobe; Urolift cannot. Your anatomy and personal preferences guide the choice.
Yes. If symptoms return — which occurs in approximately 4–11% of men within 5 years — Rezum can be repeated, or alternative treatments including Aquablation or TURP can be considered. Because Rezum does not alter the urethral anatomy, all subsequent treatment options remain available.
Yes. Because Rezum is performed under local anaesthetic or light sedation, it is well tolerated by older men and those with medical comorbidities including diabetes, heart conditions or chronic lung disease — groups who may not be fit for general anaesthetic. Published Italian data confirms Rezum is safe and feasible in frail and elderly men.