REZUM

What is involved in the Rezūm procedure?

Your prostate gland surrounds your urethra as it exits the bladder. When it enlarges (BPH), it can obstruct the urine flow. The Rezūm procedure utilizes steam injections into the prostate, with the number of injections depending on the size of your prostate.A/Prof Homi Zargar performs this procedure at Melbourne's western suburbs (Western private hospital) and at Epworth, Richmond.
Steam injections target both the prostate tissue surrounding the urethra (lateral lobes) and any tissue extending into the bladder (median lobe). After the procedure, a temporary catheter is typically inserted into the bladder to mitigate the risk of retention, and it is removed after a few days. Over the weeks, the prostate undergoes resorption (shrinking) due to the steam injection, facilitating improved urinary flow and bladder emptying.

Main Benefits of the Procedure:

  • Brief hospital stay, often as a day-case.

  • Earlier return to normal activities.

  • Minimally-invasive procedure.

  • Rare sexual side-effects, such as retrograde (dry) ejaculation or erectile dysfunction (impotence).

A/Prof Homi Zargar will assess whether the size and shape of your prostate make you a suitable candidate for this procedure. However, it may not be suitable for all men with prostate enlargement. The images below illustrate the resorption of obstructing prostate tissue after the procedure.

After treatment urinary flow improves 40-50%

One drawback of this approach is the requirement for urinary catheterization for a week following the procedure.


REZUM main points

Key Points:

  • The Rezūm procedure involves inserting a telescope through your urethra and introducing steam into the obstructing prostate tissue surrounding it.

    • Over the subsequent 3-6 months, the prostate tissue gradually contracts.

    • The aim is to enhance urinary symptoms without resorting to the burning or removal of any prostate tissue.

    • Typically performed as a day-case procedure, a bladder catheter is required for seven days post-operation.

    • Sexual side-effects such as erectile dysfunction (impotence) are exceptionally rare, and retrograde (dry) ejaculation is also infrequent.

    • In a small number of men, additional treatment may be necessary later.

surgery

What occurs on the day of the procedure?

A/Prof Homi Zargar will discuss the surgery once again to ensure your understanding and obtain your consent. An anesthetist will meet with you to explore the options of a general or spinal anesthetic and discuss post-procedure pain relief.

Details of the procedure:

  • Depending on individual circumstances, the procedure is typically conducted under either general or local anesthesia.

  • Before the procedure, antibiotics are administered after confirming the absence of allergies.

  • A telescope is inserted into your bladder through the urethra.

  • Steam is injected into the prostate under direct vision through the telescope, utilizing a special applicator (pictured right).

  • The procedure typically takes 10-15 minutes to complete.

  • A bladder catheter is usually required for a few days post-procedure.

  • A course of antibiotics is prescribed for a few days afterward to reduce the risk of infection.

  • Initial pain and increased frequency of urination may be experienced, and urine may appear bloody for four to six weeks.

  • Blood in semen (ejaculate) is likely and may persist for up to three months.

After-Effects and Risks of the Procedure:

  • Temporary burning & stinging when passing urine (lasting 5-7 days)

    • Risk: 1 in 3 patients (33%)

  • Temporary bleeding in urine (lasting 5-7 days)

    • Risk: 1 in 4 patients (25%)

  • Temporary pain or discomfort in pelvic area

    • Risk: Between 1 in 5 & 1 in 6 patients (16-20%)

  • Infection in urine requiring antibiotic treatment

    • Risk: 1 in 15 patients (6-7%)

  • Procedure may not relieve all symptoms, requiring further treatment within 4 years

    • Risk: 1 in 25 patients (approx 4%)

  • Anaesthetic or cardiovascular problems possibly requiring intensive care (e.g., chest infection, pulmonary embolus, stroke, deep vein thrombosis, heart attack, and death) if under general anaesthetic

    • Risk: Between 1 in 50 & 1 in 250 patients (individual risk estimation by anaesthetist)