Rezūm: Water Vapour Therapy for the Prostate
A method in which prostate tissue is shrunk using water vapour energy, with no incision and no tissue removal. It comes into consideration for men whose priority is preserving sexual function. Who is it suitable for and when does it start to work?
Last medically reviewed: October 4, 2026 — Assoc. Prof. Dr. Müslüm Ergün
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- Procedure time
- 10–20 minutes
- Anesthesia
- Local anaesthesia or light sedation
- Hospital stay
- Day case
- Stay in Türkiye
- 4–6 days
- Return to work
- 2–4 days
- Flight clearance
- 3–5 days
About the condition
Rezūm is a water vapour thermal therapy used in benign prostate enlargement. A needle at the tip of a slim device passed along the urinary passage enters the enlarged prostate tissue and delivers sterile water vapour in bursts lasting a few seconds. The heat energy carried by the vapour causes the cells it reaches to lose their function.
The most important feature of the procedure is that tissue is not cut away and removed. The cells in the treated area are gradually reabsorbed by the body and the prostate shrinks step by step. For this reason the effect does not appear at once but over weeks. In most men improvement begins in the first few weeks and settles within a few months.
The vapour acts only in the area where it is delivered; it does not spread to the outer capsule of the prostate or to the surrounding structures. This helps to protect the bladder neck and the structures involved in sexual function. If the middle lobe of the prostate is enlarged, that area can be treated in the same session.
The procedure is carried out under local anaesthesia or light sedation, usually in 10–20 minutes, and the patient goes home the same day. A catheter stays in place for a few days afterwards, because the swelling caused by the heat can temporarily make passing urine harder.
AN IMPORTANT LIMIT: because no tissue is removed in Rezūm, no pathological examination can be carried out. If there is any suspicion of prostate cancer, that must be assessed separately first. The method is also not suitable for every prostate; in very large glands and in men whose bladder function is impaired, the expected benefit may not be achieved.
SEXUAL FUNCTION: compared with surgical methods, Rezūm is regarded as more protective with regard to semen passing backwards (retrograde ejaculation), and this is one of the reasons it is chosen. Even so, no procedure can guarantee that sexual function will be preserved exactly as it was.
Who is it suitable for?
May be suitable
- Men who gain insufficient benefit from medication or are troubled by its side effects
- Men with a small to moderately sized prostate
- Men who particularly value preserving ejaculatory function
- Men with accompanying illnesses for whom general anaesthesia would be risky
- Men who carry a bleeding risk because of blood-thinning medication and are looking for a less invasive option
- Men with an enlarged middle lobe — this area can be treated in the same session
May not be suitable
- Men with a very large prostate — enucleation or resection may be more appropriate
- Men expecting immediate, definitive relief — the effect is gradual
- Men in whom a suspicion of prostate cancer has not been resolved — no pathology is possible as no tissue is taken
- Men whose bladder muscle has lost its function — symptoms may persist even if the obstruction is reduced
- Men with an active urinary tract infection — this is treated first
- Men whose anatomy is unsuitable because of an implant in the prostate or certain previous procedures
Technology used
- Water vapour thermal therapy system (Rezūm)
- Targeted vapour delivery under cystoscopic vision
- Needle placement that allows treatment of the middle lobe
- Ultrasound measurement of prostate volume and residual urine after voiding
Surgeon's experience
Verifiable information
- Surgeon's experience
- Assoc. Prof. Dr. Müslüm Ergün121270
Step-by-step journey
- Before the procedure
Assessment
The symptom score, urinary flow rate, prostate volume on ultrasound and residual urine after voiding are measured. The presence of a middle lobe can be seen at cystoscopy. PSA is checked.
- Day of the procedure
Vapour delivery
Under local anaesthesia or light sedation, the urinary passage is entered and bursts of vapour lasting a few seconds are delivered into the enlarged tissue. This usually takes 10–20 minutes and the patient is discharged the same day.
- First days
Catheter period
A catheter stays in for a few days because of the temporary swelling caused by the heat. The length varies between patients and the catheter is removed after assessment at a check-up.
- Weeks 2–4
Transition period
Burning on passing urine, frequency and urgency can occur during this period. These are part of the healing process and lessen with time.
- Months 1–3
The effect settles
As the treated tissue is reabsorbed the prostate shrinks and urinary flow improves markedly. The outcome is measured again and assessed during this period.
Method comparison
| Criterion | Rezūm | TURP |
|---|---|---|
| Tissue removal | No, shrunk by vapour | Yes, shaved away |
| Anaesthesia | Local or light sedation | Spinal or general |
| Hospital stay | Day case | 1–2 nights |
| Onset of effect | Gradual, over weeks | Immediate |
| Catheter time | A few days | 1–2 days |
| Retrograde ejaculation | Less common | Common |
| Pathological examination | Not possible | Carried out |
| Likelihood of further treatment | Higher | Lower |
| Suitable prostate volume | Small to moderate | Moderate |
Rezūm is not a method that replaces surgery; it is a different option for men with different priorities. Where faster recovery and preserving sexual function come first, Rezūm stands out; where a more lasting and immediate opening comes first, surgery does.
Risks
- Burning on passing urine and frequency — expected, temporary findings in the first weeks
- Blood in the urine — usually slight and settles on its own
- Temporary inability to pass urine — this is why a catheter is placed for a few days afterwards, and the period can sometimes be longer
- Urinary tract infection
- The gradual onset of the effect — expecting immediate relief is a mistaken expectation
- THE NEED FOR FURTHER TREATMENT: symptoms can return over time and medication, a repeat Rezūm or surgery may be needed; this possibility is higher than with surgical methods
- No pathological examination is possible — because no tissue is removed, a hidden cancer cannot be detected by this procedure
- A change in sexual function — regarded as more protective than surgery with regard to retrograde ejaculation, but it cannot be guaranteed
Alternatives
- Medication (alpha blockers, 5-alpha reductase inhibitors or a combination)
- TURP — the reference surgical method for moderately sized prostates
- HoLEP or ThuLEP enucleation — particularly for large prostates
- Prostatic urethral lift systems — in selected anatomies
- Open adenomectomy — for very large prostates
- Lifestyle adjustment and surveillance where symptoms are mild
Recovery
First 48 hours
The catheter is in place. Mild discomfort and a pink tinge to the urine may be seen. Plenty of fluids are advised.
Days 3–7
The catheter is removed at a check-up. Burning and urgency may be felt on the first few voids; this is expected.
Weeks 2–4
This is the period when urinary symptoms are most marked, and they steadily lessen. Normal daily life has resumed.
Months 1–3
As the prostate shrinks, urinary flow improves. The symptom score and flow rate are measured again to assess the outcome.
Frequently asked questions
How does Rezūm work?
A needle on a device passed along the urinary passage delivers bursts of sterile water vapour lasting a few seconds into the enlarged prostate tissue. The heat carried by the vapour causes the cells it reaches to lose their function. Those cells are gradually reabsorbed by the body and the prostate shrinks.
When does it start to work?
Not immediately. Improvement is gradual as the tissue is reabsorbed; in most men it begins in the first few weeks and settles within a few months. It is not a suitable method for men who come expecting the instant opening that surgery provides.
Will a catheter be placed after the procedure?
Yes, usually for a few days. A catheter is placed because the temporary swelling caused by the heat can make passing urine harder. The length varies from patient to patient and the catheter is removed after assessment at a follow-up visit.
Will my ejaculation be affected?
Compared with surgical methods, Rezūm is regarded as more protective with regard to semen passing backwards, and this is one of the reasons it is chosen. Even so, no procedure can guarantee that sexual function will be preserved exactly as it was.
Can Rezūm take the place of surgery?
No, it is a different option. Surgery provides a faster and generally more lasting opening; Rezūm stands out because it is less invasive, can be done as a day case and better preserves ejaculatory function. Which suits you is determined by prostate volume, bladder function and your expectations.
Might further treatment be needed afterwards?
Yes, and this possibility is higher than with surgical methods. If symptoms return over time, medication, a repeat Rezūm or surgery may come into consideration. Knowing this from the outset matters when making the decision.
My prostate is very large — can I have Rezūm?
In very large glands the expected benefit may not be achieved; enucleation (HoLEP, ThuLEP) or resection is then more appropriate. The volume is measured by ultrasound and the decision made accordingly.
Will it show whether I have prostate cancer?
No. Because no tissue is removed in Rezūm, no pathological examination can be carried out. If there is a suspicion of cancer because of a raised PSA or an examination finding, that must be assessed separately before Rezūm.
Is the procedure painful, and how long does it take?
It is carried out under local anaesthesia or light sedation and usually takes 10–20 minutes. There may be a sensation of pressure but most men tolerate it well. You can go home the same day.
When can I fly?
Flying is usually permitted after 3–5 days. A stay of 4–6 days is planned for patients travelling from abroad; this also covers the check-up at which the catheter is removed.
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This page is for general information only and is not a substitute for medical advice.
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