Name of the Procedure:

Transurethral destruction of prostate tissue by radiofrequency generated water vapor thermotherapy
Common Names: Rezūm Procedure, Water Vapor Therapy for BPH

Summary

The transurethral destruction of prostate tissue using radiofrequency-generated water vapor thermotherapy is a minimally invasive procedure that involves using steam to eliminate excess prostate tissue. This helps relieve urinary symptoms caused by an enlarged prostate.

Purpose

This procedure addresses Benign Prostatic Hyperplasia (BPH), a common condition in older men characterized by an enlarged prostate gland. The goal is to reduce urinary symptoms such as frequent urination, urgency, weak stream, and incomplete bladder emptying by shrinking excess prostate tissue.

Indications

• Frequent need to urinate, especially at night.
• Difficulty starting urination.
• Weak or interrupted urine stream.
• Feeling of incomplete bladder emptying.
• Recurrent urinary tract infections due to obstructed urine flow.
• Patients who prefer a minimally invasive option over traditional surgery.

Preparation

• Patients may be advised to avoid eating and drinking several hours before the procedure.
• Certain medications, especially blood thinners, may need to be adjusted or stopped prior to the procedure.
• A pre-procedural assessment might include urinary flow studies and imaging tests like an ultrasound.

Procedure Description

1. The patient is positioned comfortably, usually in a reclining position.
2. A local anesthesia or mild sedation is administered for comfort.
3. A specialized device is inserted through the urethra to reach the prostate.
4. Radiofrequency energy is used to generate steam.
5. The steam is injected into the prostate tissue in short, controlled bursts.
6. The steam causes the targeted prostate tissue to die and eventually get absorbed by the body.

Duration

The procedure typically takes about 30 minutes.

Setting

The procedure is generally performed in an outpatient clinic or surgical center.

Personnel

• Urologist (a specialist in urinary and male reproductive organs)
• Nurses for support and patient comfort
• Anesthesiologist or nurse anesthetist if sedation is used

Risks and Complications

• Temporary urinary retention
• Urinary tract infections
• Painful or frequent urination for a short period post-procedure
• Rarely, erectile dysfunction or retrograde ejaculation
• Bleeding or infection at the site

Benefits

• Minimally invasive with a quick recovery time.
• Symptomatic relief often starts to become noticeable within a few weeks.
• Long-term results with significant reduction in symptoms and improvement in quality of life.

Recovery

• Patients can typically return home the same day.
• Avoid strenuous activities for a few days.
• Follow-up appointments to monitor progress.
• Temporary use of a urinary catheter may be required.

Alternatives

• Medication: Alpha-blockers or 5-alpha-reductase inhibitors.
• Surgical procedures: Transurethral resection of the prostate (TURP), laser therapies.
• Watchful waiting: Monitoring the condition without active intervention.

Pros and Cons of Alternatives

• Medications: Non-invasive but may need to be taken long-term.
• Surgical procedures: More invasive, possibly greater risk but might be needed for severe cases.
• Watchful waiting: No immediate risks of treatment but symptoms could potentially worsen.

Patient Experience

• During the procedure, a numbing agent helps minimize discomfort.
• Mild discomfort or urgency might be experienced during the process.
• Post-procedure, patients might feel urinary urgency or slight discomfort that typically improves within a few days.
• Pain management includes over-the-counter medication and plenty of fluid intake to aid healing.