Non-Surgical Solution for Enlarged Prostate: Water Vapor (Rezum) Therapy

For men, benign prostatic hyperplasia (BPH)—commonly known as an enlarged prostate—is a frequent companion of advancing age. Today, an innovative, non-surgical approach called water vapor therapy (Rezum) is standing out as a highly effective treatment. By accessing the prostate through the urinary tract and injecting sterile water vapor, this method shrinks the enlarged tissue while significantly improving the patient's quality of life. Because it requires no incisions or tissue removal, this minimally invasive technology offers a safe and reassuring alternative for patients who feel anxious about traditional surgery.

At a glance:

• The procedure takes only a short time, averaging 10 to 15 minutes.
• There are no incisions, and patients are typically discharged on the same day.
• The preservation rate of sexual functions (both erection and ejaculation) is exceptionally high.
• It is an ideal option for patients with a prostate volume between 30 and 80 ml.
• According to clinical studies, 95 percent of patients do not require additional treatment during a 5-year follow-up.

What is Rezum (Water Vapor) Therapy?

Benign prostatic hyperplasia (BPH) is a widespread health issue that affects about half of men over the age of 50, and up to 80 percent of those over 80. As the prostate gland, which surrounds the urinary tract, enlarges with age, it makes the flow of urine increasingly difficult, severely diminishing a man's quality of life. While this condition was historically managed with daily medications or invasive surgeries, the development of water vapor therapy is widely regarded as a revolutionary step in the medical world.

The clearest answer to "what is Rezum therapy?" is that it is an FDA-approved procedure using sterile water vapor heated with radiofrequency energy to shrink the overgrown prostate tissue. This method essentially triggers the body's natural healing mechanisms. The excess prostate cells, destroyed by the thermal energy, are gradually absorbed and cleared away by the body over time. As a result, the pressure on the urinary tract is lifted, and the patient's symptoms recede. The greatest feature of this procedure is that it targets only the specific area, without harming the surrounding healthy nerves and tissues.

Causes and Risk Factors of Prostate Enlargement

The enlargement of the prostate gland is considered a natural part of male aging. Although the exact cause is not fully understood, it is believed that hormonal changes occurring during the aging process lead to this condition. In particular, the interaction of testosterone and dihydrotestosterone (DHT) hormones on prostate cells sets the stage for these cells to multiply.

Alongside age, genetic predisposition plays a significant role. Men with a family history of prostate enlargement are more likely to experience it themselves. Systemic issues such as obesity, a sedentary lifestyle, diabetes, and heart disease are also among the factors that can increase the risk of BPH. It is comforting to know that benign prostatic hyperplasia is not a type of cancer. However, because the symptoms can be quite similar, regular doctor check-ups and prostate cancer screening tests should never be neglected.

What Are the Symptoms of an Enlarged Prostate?

As the prostate gland squeezes the urinary tract, the bladder cannot empty completely, and over time, its muscle structure weakens. This leads to various complaints that negatively affect a patient's daily life, whether it's enjoying a long walk along the Bosphorus or simply getting a good night's sleep. Symptoms usually start mild and, if left untreated, intensify over the years.

The most common BPH symptoms include:

• The need to urinate frequently during the night (nocturia)
• Difficulty or hesitation when starting to urinate
• A decrease in urine pressure, resulting in a weak or interrupted stream
• The feeling that the bladder is not completely empty after urination
• A sudden, urgent need to urinate
• Dribbling at the end of urination

When these symptoms are mild, they can often be managed with lifestyle changes and medications. However, when symptoms worsen or when medications cause unwanted side effects, it becomes necessary to seek more permanent methods for treating benign prostatic hyperplasia.

How is it Diagnosed at the Hospital?

For patients presenting with suspected prostate enlargement, diagnosis begins with a specialist doctor taking a detailed medical history. To measure the severity of the complaints, a questionnaire called the International Prostate Symptom Score (IPSS) is applied. Following this, a physical examination is performed to evaluate the size and structure of the prostate.

To confirm the diagnosis and rule out other possible diseases, various tests are requested. A blood PSA (Prostate-Specific Antigen) test is done to assess the risk of prostate cancer. A urinalysis checks for the presence of infection or bleeding. Through urinary ultrasonography, the volume of the prostate (in ml) and the amount of urine left in the bladder are clearly measured. Additionally, a urine flow test called uroflowmetry objectively records the speed and pressure of the urine. Based on all this data, a decision is made as to whether the patient is a suitable candidate for non-surgical prostate treatment.

Non-Surgical Prostate Treatment: How is Rezum Performed?

Rezum therapy is performed in a hospital setting, usually under mild sedation or local anesthesia. Using a specially designed thin device (cystoscope), the doctor reaches the prostate by entering through the urinary tract (urethra). No incisions are made during the procedure.

Once the device is correctly positioned, sterile water vapor is injected into the enlarged tissue of the prostate in short, 9-second bursts. Depending on the size of the prostate, this process may be repeated at several different points. The total procedure time is just 10 to 15 minutes. The thermal energy carried by the vapor breaks down the cell membranes, neutralizing the overgrown tissue. Over the following weeks, the body naturally clears away these dead cells.

Pre-Procedure Preparation

Before the procedure, the patient's general health status is evaluated, and necessary blood tests are conducted. Patients taking blood thinners may need to pause these medications a few days prior to the procedure, strictly under their doctor's supervision. On the day of the procedure, the patient will be asked to fast from food and water for a certain period. To minimize the risk of infection, a course of preventive antibiotics is started beforehand.

Comparison with Traditional Surgery (TUR-P) and Its Advantages

In traditional prostate surgeries (TUR-P), prostate tissue is cut and removed using electrical energy or a laser. The prominent advantages of water vapor therapy over traditional methods include:

• Preservation of Sexual Functions: While retrograde ejaculation and erectile dysfunction are common after TUR-P, these risks are almost non-existent with water vapor therapy.
• Short Procedure Time: Traditional surgery takes 1 to 2 hours, whereas this method is completed in 10 to 15 minutes.
• No Hospital Stay Required: After TUR-P, patients stay in the hospital for a few days, but with water vapor therapy, it is possible to return home the very same day.
• Low Anesthesia Risk: It is a safe option for elderly individuals or those with additional illnesses who cannot undergo general anesthesia.

Who is it Suitable For?

Patients with a prostate volume between 30 and 80 ml are the most suitable group for this treatment. It is ideal for men who do not benefit from medication, are bothered by the side effects of drugs (such as low blood pressure or chronic fatigue), or are hesitant about surgical operations. Furthermore, it is frequently preferred by younger patients experiencing prostate enlargement who wish to maintain an active sexual life.

The Recovery Process and Things to Consider

After the procedure, patients are kept under observation for a few hours and then discharged. Due to swelling in the urinary tract, a temporary catheter is placed for a few days so the patient can urinate comfortably. The catheter is usually removed painlessly in the outpatient clinic within 3 to 7 days.

Patients can return to their normal daily routines within 2 to 3 days. Drinking plenty of water during the recovery process helps flush out the urinary tract. You may notice slight changes in your urine color during this period; adequate fluid intake is critical for your urinary tract health. For the first few weeks, heavy physical activities, prolonged sitting, and cycling should be avoided. It typically takes 1 to 3 months for the prostate tissue to shrink and for complaints to resolve completely.

Possible Side Effects and Complications

As with any medical intervention, water vapor therapy can have some temporary side effects. After the procedure, you may experience a slight burning sensation, soreness, or a frequent urge to urinate. Additionally, mild bleeding in the urine or semen is an expected occurrence.

These complaints are a normal part of the body's healing process and usually disappear on their own within a few weeks. The risk of infection is very low, but taking the antibiotics prescribed by your doctor regularly will eliminate this risk entirely. Serious complications such as permanent urinary incontinence or permanent sexual dysfunction are extremely rare with this method.

When Should You See a Doctor?

During the recovery process, certain symptoms may require immediate medical attention. If you experience any of the following conditions, you should apply to the nearest emergency room without delay or call 112:

• Inability to urinate at all after the catheter is removed (acute urinary retention)
• Heavy, continuous fresh bleeding with clots in the urine
• A high fever exceeding 38 degrees Celsius and severe shivering fits
• Unbearable pain and swelling in the lower abdomen
• Nausea, vomiting, and a general deterioration in your physical condition

These symptoms can be harbingers of situations requiring urgent intervention, such as an infection or severe bleeding. Early intervention swiftly eliminates potential risks.

The Prostate Treatment Process at BHT CLINIC

At our hospital, the diagnosis and treatment of prostate diseases are carried out meticulously in the light of current medical technologies. In our Urology clinic, personalized treatment plans are created with the goal of improving our patients' quality of life. Our expert medical staff determines the most suitable treatment option for you through detailed examinations and advanced imaging methods.

Our hospital stands by you in all kinds of urological emergencies with its 24/7 emergency service. Throughout your treatment process, your comfort and safety are kept at the forefront. When coming to your appointment, bringing your previous test results, a list of the medications you use, and your ultrasound reports will speed up the process.

Frequently Asked Questions

How long does water vapor therapy take?

The procedure itself takes an average of 10 to 15 minutes, depending on the size of the prostate. Including the preparation and post-procedure resting times, our patients can usually leave the hospital and return to their hotel or home within half a day.

Does Rezum prostate surgery affect sexual functions?

One of the greatest advantages of this method is that it preserves sexual functions. Problems commonly seen in traditional methods, such as loss of erection or semen escaping into the bladder (retrograde ejaculation), are very rarely seen in water vapor therapy. Patients can continue their normal sexual lives after treatment.

When does the treatment take effect?

Because swelling occurs in the prostate tissue immediately after the procedure, an instant improvement in complaints is not expected. As the body clears away the dead cells, a noticeable relief in urine flow begins within 2 to 4 weeks. Maximum benefit and full recovery are generally seen within 1 to 3 months.

Do I need to stay in the hospital after the procedure?

No, water vapor therapy is an outpatient procedure. Patients are kept under observation for a few hours after the procedure and, if no problems are observed, are discharged on the same day. This increases the psychological comfort of patients and reduces the risk of hospital-acquired infections.

Is the treatment permanent, or will it recur?

According to clinical studies, water vapor therapy offers long-term and permanent results. Five-year follow-up studies have proven that 95 percent of patients do not need an additional surgical intervention or prostate medication. Because prostate tissue grows very slowly, its effectiveness lasts for years.

For a healthy life and personalized treatment options, you can consult our expert physicians by booking an appointment.

This article is for informational purposes only; please be sure to consult your doctor for diagnosis and treatment.