Mr Sonpreet Rai
Consultant Urological and Robotic Surgeon
Specialist expertise: Men's Health, Urology, Prostate Cancer Diagnostics, Kidney Stones, BPH Treatment and Surgery, Urinary Infection.
Water Vapour Ablation of the Prostate or Rezum, is a minimally invasive surgical treatment employed in the management of men suffering with bothersome lower urinary tract symptoms secondary to benign (non cancerous) enlargement of the prostate whilst protecting all aspects of sexual function, including both ejaculation and erectile function
Water Vapour Ablation of the Prostate or Rezum, is a minimally invasive surgical treatment (MIST) employed in the management of men suffering with bothersome lower urinary tract symptoms secondary to benign (non cancerous) enlargement of the prostate whilst protecting all aspects of sexual function, including both ejaculation and erectile function
The procedure involves the delivery of steam into the occlusive parts of the prostate, causing the tissue to shrink away over time, relieving obstruction and leading to an improvement in the strength of the flow of urine and urinary symptoms.
The procedure may be delivered with local anaesthesia or with the patient asleep, under sedation or a light general anaesthetic. It is a very quick procedure, each injection of steam taking only 9 seconds and with an average of 4 to 6 injections, the operation is completed in a matter of minutes. As there will initially be some swelling of the prostate, all patients will need a catheter (drainage tube from the bladder) inserted at the end of the procedure. Discharge from the hospital is thereafter in a matter of a few hours and arrangements are made to return a few days later (3 to 7 days depending on the prostate volume and number of treatment injections required) for removal of the catheter.
Patients undergoing Rezum, can resume normal activities very quickly, even with a catheter in place. After removal of the catheter, some patients may suffer from visible blood in the urine, burning on passing urine, frequency and urgency of urination which will settle slowly over time, but may limit confidence in the level of activity during this process.
Not all men presenting with symptoms relating to their prostate may be suitable for Rezum. Those with very severe symptoms or a very large prostate may not predictably achieve the level of symptom improvement hoped for. Careful discussion with an expert urologist is needed to understand whether Rezum is an appropriate option.
Following the procedure, the rate of complications beyond infection are low and commonly men will be discharged with a course of prophylactic antibiotics.
The risk of negative impact upon sexual function is low, with no risk to erectile function identified in the clinical trials and a very low risk, some 3 % of permanent dry ejaculation
High quality data from a trial in the US, suggests reasonable longevity of benefit for those undergoing Rezum - with a 3 - 4 % risk of undergoing further treatment over a 5 year period.
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