Rezum for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia

Rezum is water vapour (steam) therapy for treating lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). The technology uses water vapour to destroy excess prostate tissue with the aim of relieving symptoms.

The water vapour is injected into the prostate through a single-use device attached to a urological endoscope. The process is intended to disrupt cell membranes, leading to cell death and shrinking the prostate. The intention is to relieve obstructive symptoms without interfering with surrounding tissues that might impair sexual function.

The vapour is injected for 9 seconds during treatment. The number of times this has to be done in each lobe of the prostate depends on the length of the prostatic urethra. It can be customised to the configuration of the gland. A maximum number of 15 full injections can be done with each delivery device although fewer injections are needed for most treatments. The procedure is usually done in the NHS under general anaesthesia or local anaesthesia with sedation, and lasts up to 20 minutes.

Rezum differs from other prostate treatments because it uses water vapour thermal energy. It does not use a laser and can be used to treat the median or middle lobe.

Rezum is intended for the treatment of prostates with volumes greater than 30 cm³ (equivalent to 30 g).

The instructions for use state that Rezum is contraindicated for patients:

• with a urinary sphincter implant

• who have a penile prosthesis.

The typical cost of consumables for the Rezum procedure is estimated at £1,348 (excluding VAT) per treatment. The company supplies the generator, which is loaned free of charge. The company also provides servicing including maintenance and other services (such as software updates) free of charge.