REZUM Water Vapor BPH Therapy

Dr. Engel has been and continues to be a big proponent of heat-based, minimally invasive in-office BPH therapies. Many of these procedures have come and gone over the years, and Dr. Engel has trialed most of them – some very effective and some with mixed results. While microwave-based therapies and TUNA or transurethral needle ablation (that uses RF waves to heat and destroy prostatic tissue) were once the standard for in-office BPH treatment, very few urologists use them anymore, and they are no longer included in the latest AUA guidelines. Even insurance companies have begun to question coverage because they often don’t consider these procedures mainstream treatments.

You may have also seen the heavily marketed procedure known as Urolift on the internet, radio, or via TV commercials. This uses implanted permanent sutures to pull back prostatic tissue and eliminate some narrowing of the urethra, thus reducing lower urinary tract symptoms. However, this procedure has drawbacks that make it less palatable to Dr. Engel than Rezum or Tuna/Prostiva. Urolift is designed as an office procedure and can be performed very simply. However, serious risks such as bleeding and pelvic hematoma formation raise the specter of subsequent hospitalization, which should not be part of an office-based procedure. Just as important is the idea that permanent foreign bodies that can cause irritation, infection, and distort subsequent imaging like prostate MRI are considerations. Lastly, Urolift is not well applied to all anatomies, such as Rezumor Tuna/Prostiva can be, so it is not as versatile a procedure.

Rezum water vapor therapy is an evolution of prior heat-based therapies, using heated water vapor therapy instead of microwave or RF waves to destroy the overgrowth of prostatic tissue. This water vapor application retains the precision and flexibility that was the hallmark of previous heat-based office BPH procedures but dramatically reduces treatment time.