Treatment guide
Rezūm Water Vapour Therapy
Also known as: Rezum, Water vapour thermal therapy (WVTT), Convective radiofrequency water vapour therapy
In brief
Rezūm is a minimally invasive treatment for an enlarged prostate (BPH). Small amounts of sterile water vapour (steam) are injected into the obstructing prostate tissue; the heat causes the treated cells to die and be gradually reabsorbed by the body, relieving urinary symptoms over the following weeks to months.
Medically reviewed by Dr. Atip Chatsudthipong, MD on
Written by Editorial teamPublished Updated
What is Rezūm water vapour therapy?
Rezūm uses the stored heat energy in water vapour. Each injection lasts about nine seconds and releases steam into the prostate tissue that is pressing on the urethra. As the vapour turns back into water it releases heat, which destroys the targeted cells. Over the following weeks the body reabsorbs the treated tissue, the prostate becomes smaller, and the urinary channel opens.
Unlike TURP, no tissue is cut away during the procedure. Unlike UroLift, Rezūm reduces the amount of prostate tissue, and it can treat an enlarged middle lobe.
What conditions does Rezūm treat?
Rezūm treats lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH) — a weak stream, frequency, urgency, getting up at night and incomplete emptying. It does not treat prostate cancer.
Who may be suitable for Rezūm?
- Men with moderate to severe BPH symptoms, including those who prefer not to take long-term medication
- Prostate volume generally of about 30–80 g, as reflected in AUA guidance, including some men with an enlarged middle lobe
- Men who place a high priority on preserving erectile and ejaculatory function
Rezūm may be less suitable for very large prostates, for men who cannot tolerate a temporary catheter, or where another cause of symptoms (such as a bladder problem, stricture or active infection) needs different treatment.
How is the Rezūm procedure performed?
- Local anaesthetic, sometimes with oral or light intravenous sedation, is used to keep you comfortable.
- A slim device with a camera is passed through the urethra to the prostate.
- A fine needle delivers short pulses of water vapour into each area of enlarged tissue — the number depends on prostate size and shape.
- A urinary catheter is usually placed for a few days while initial swelling settles.
The treatment itself usually takes only minutes, and most men go home the same day.
What are the potential benefits?
- Minimally invasive, with no incisions and usually no hospital stay
- Preservation of erectile function, and ejaculation in most men
- Durable symptom improvement: in the five-year randomised trial, the surgical retreatment rate was low
- May allow men to stop BPH medication
What are the risks and side effects?
- Temporary urgency, frequency, burning and discomfort while passing urine — common in the first weeks as the treated tissue is reabsorbed
- Blood in the urine or semen for a short period
- Temporary difficulty passing urine, sometimes requiring a catheter for longer
- Urinary tract infection
- Reduced ejaculate volume in a small proportion of men
- Symptom improvement that is usually less than with TURP, particularly in larger prostates
What are the alternatives to Rezūm?
Alternatives include medication, UroLift, TURP and laser procedures. See the balanced comparison in Rezūm vs TURP and the prostate treatments overview.
How long does recovery take after Rezūm?
- The catheter is usually removed after a few days
- Irritative urinary symptoms are common for the first few weeks
- Improvement typically begins within about two weeks, with the full effect usually reached by around three months
- Most men return to normal light activities within a few days
Contact the hospital promptly if you develop:
- Inability to pass urine or a blocked catheter
- Fever or chills
- Heavy bleeding or clots
When should you consult a urologist?
Arrange a consultation if urinary symptoms affect your sleep, work or quality of life, if medication is not helping or causes side effects, or if you would like to understand whether a minimally invasive option is suitable for you. Read When does an enlarged prostate need treatment?
Dr. Atip performs Rezūm water vapour therapy at the Urology Center of Bumrungrad International Hospital. At a consultation he will assess your prostate size and shape, explain whether Rezūm is suitable, and compare it honestly with alternatives such as UroLift and TURP.
Frequently asked questions
How long does it take for Rezūm to work?
Most men notice improvement within about two weeks, with the full benefit usually reached around three months after treatment, once the treated tissue has been reabsorbed.
Will I need a catheter after Rezūm?
Usually yes, for a few days, while the initial swelling settles. Your urologist will advise on the timing of removal.
Does Rezūm affect sexual function?
Rezūm is designed to preserve erectile function, and in clinical trials erectile function was maintained. Most men keep normal ejaculation, although a small proportion notice reduced ejaculate volume.
Is Rezūm better than TURP?
Neither is better for everyone. Rezūm is less invasive and better at preserving ejaculation; TURP generally gives a larger improvement in urine flow and is suitable for a wider range of prostate sizes. The right choice depends on your prostate and priorities.
References
- 1.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)
- 2.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)
- 3.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)
- 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.