Medical Articles · 6 min read
Rezūm vs TURP: Understanding the Differences
In brief
Rezūm and TURP both relieve urinary symptoms caused by an enlarged prostate. Rezūm is a minimally invasive steam treatment that usually preserves ejaculation, with improvement developing over weeks; TURP surgically removes obstructing tissue and generally gives a larger, faster improvement in flow, but commonly causes dry ejaculation.
Medically reviewed by Dr. Atip Chatsudthipong, MD on
Written by Editorial teamPublished Updated
How do Rezūm and TURP compare?
| Rezūm | TURP | |
|---|---|---|
| Approach | Water vapour injected into the prostate; tissue reabsorbed over time | Tissue removed through the urethra with an electrical loop |
| Anaesthesia | Local, with sedation if needed | Spinal or general |
| Hospital stay | Usually none | Usually 1–2 nights |
| Catheter | Usually a few days | Usually 1–3 days |
| Speed of improvement | Gradual, over about 2–12 weeks | Within a few weeks |
| Size of improvement | Meaningful; generally smaller than TURP | Typically the largest improvement in flow |
| Ejaculation | Preserved in most men | Dry (retrograde) ejaculation in most men |
| Erections | Preserved | Usually unaffected |
| Typical prostate size | About 30–80 g | About 30–80 g |
| Durability | Low retreatment rates over 5 years in trials | Long-term track record |
Who might prefer Rezūm?
- Men who want to avoid a general anaesthetic or a hospital stay
- Men for whom preserving ejaculation is a high priority
- Men with moderate symptoms who would like to stop medication
Who might prefer TURP?
- Men with severe obstruction, urinary retention or complications such as bladder stones
- Men who want the largest and most immediate improvement in urine flow
- Men for whom ejaculation changes are less of a concern
Are there other options?
Yes. Medication remains the first step for many men, UroLift offers a further minimally invasive option for suitable prostates, and laser enucleation or simple prostatectomy may be preferred for very large glands. The prostate treatments overview compares the main procedures.
How should I decide?
The right choice depends on your prostate's size and shape (measured by ultrasound and sometimes cystoscopy), how severe your symptoms are, your general health, and what matters most to you. A urologist can explain the realistic benefits and trade-offs for your situation. Read more on Rezūm and TURP.
Frequently asked questions
Is Rezūm safer than TURP?
Both are established treatments with different risk profiles. Rezūm avoids general anaesthesia and tissue removal and rarely affects ejaculation; TURP has a slightly higher risk of bleeding and commonly causes dry ejaculation, but provides a larger improvement. Neither is risk-free.
References
- 1.Lerner LB, et al. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline Part II — Surgical Evaluation and Treatment. J Urol. 2021;206(4):818–826. (opens in a new tab)
- 2.Sandhu JS, et al. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline Amendment 2023. J Urol. 2024;211(1):11–19. (opens in a new tab)
- 3.McVary KT, et al. Final 5-Year Outcomes of the Multicenter Randomized Sham-Controlled Trial of a Water Vapor Thermal Therapy for Treatment of Moderate to Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. J Urol. 2021;206(3):715–724. (opens in a new tab)
- 4.European Association of Urology. EAU Guidelines on Management of Non-neurogenic Male LUTS. (opens in a new tab)
This information is for general education and does not replace a consultation with a qualified doctor. If you have severe symptoms, seek emergency care (in Thailand, call 1669). See our medical disclaimer.