Benign Prostatic Hyperplasia (BPH) is a common condition in aging men, characterized by an enlarged prostate gland. Normally, the prostate weighs around 20–25 grams, but with BPH, the inner part of the gland grows and compresses the urethra. This narrowing of the urinary tract can lead to urinary difficulties and other symptoms, including
- Frequent urination or sudden urge to urinate
- Prolonged urination, weak urine stream, or interrupted flow
- Dribbling at the end of urination
- Pain or discomfort during urination
- Frequent nighttime urination
- Blood in the urine
- Sudden inability to urinate
Only 40–50% of patients with BPH exhibit symptoms. However, in those who do, the severity can vary from mild to severe and may lead to complications if left untreated.
Current Treatment Options for Benign Prostatic Hyperplasia (BPH)
There are now several effective treatment options for BPH, depending on the severity of the symptoms. For patients with mild symptoms, medication is often the first-line treatment. These include:
- Alpha-blockers, which help relax the muscles of the prostate and bladder neck
- 5-alpha-reductase inhibitors, which reduce the production of DHT (dihydrotestosterone), a hormone that contributes to prostate growth
For patients with more severe symptoms, surgical intervention may be recommended. Several modern surgical techniques are currently available, including:
- Transurethral Resection of the Prostate (TURP)
- Transurethral Incision of the Prostate (TUIP)
- Transurethral Microwave Thermotherapy (TUMT)
- Laser Therapy
- Robot-Assisted Prostate Surgery
- Water Vapor Therapy for Benign Prostatic Hyperplasia (REZUM)
However, choosing the most appropriate treatment method depends on several key factors, such as:
- The size of the prostate
- The patient’s age
- The overall health condition of the patient
- The frequency and severity of urinary symptoms, such as pain or difficulty urinating
Physicians will discuss with the patient to assess the severity of symptoms and recommend the most suitable treatment approach based on the prostate size, symptom profile, and overall health status.
This article will focus on a newer treatment technique known as Water Vapor Therapy for Benign Prostatic Hyperplasia (REZUM).
Water Vapor Therapy for Benign Prostatic Hyperplasia (REZUM)
Water vapor therapy is a simple and safe treatment option for benign prostatic hyperplasia (BPH). It uses only steam to treat the enlarged prostate and typically takes about 10–15 minutes to perform. This minimally invasive procedure does not require major surgery and is often done on an outpatient basis. Recovery time is relatively short, and the risk of complications is significantly lower compared to traditional open surgery.
Who Is a Suitable Candidate for Water Vapor Therapy?
- Men aged 50 years and older with a prostate size between 30–80 grams (some international reports show successful treatment in prostates up to 120 grams)
- Patients who do not respond well to medication
- Patients who experience side effects from medication
- Individuals who prefer not to take long-term medication
- Patients with underlying health conditions that make them unsuitable for surgery under general anesthesia
- Those who wish to avoid sexual side effects commonly associated with surgery or long-term medication use
Benefits of Water Vapor Therapy
- No surgery required – The treatment is performed using a small scope inserted through the urethra, following the body’s natural pathway
- No general anesthesia needed – Only local anesthesia or mild sedation is used
- Quick procedure – The treatment typically takes only 10 to 15 minutes
- Fast recovery – Patients can usually go home the same day without hospital admission
- Reduced risk of erectile dysfunction – Compared to traditional surgical methods
- Long-lasting results – Most patients do not require retreatment within 5 years
Limitations of Water Vapor Therapy
This treatment may not be suitable for certain patients, including:
- Individuals with a urinary sphincter implant
- Individuals with a penile prosthesis
- Patients who currently have a urinary tract infection (UTI)
- Patients with a high risk of prostate cancer
Procedure Steps
The physician will insert a specialized instrument equipped with a camera through the urethra to access the prostate gland. Once in position, sterile water vapor heated to approximately 103°C is injected into the prostate 4 to 6 times, depending on the size of the gland. Each injection lasts only 9 seconds.
The steam disperses between the prostate cells, causing the obstructive cells to undergo apoptosis (natural cell death). The body then gradually eliminates these dead cells through its natural processes. As a result, the prostate shrinks, the urethral passage widens, and urinary flow returns to normal.
Post-Procedure Care
After the treatment, the doctor will insert a Foley catheter to help drain urine from the bladder. The catheter is typically left in place for about 3 to 5 days. This allows the urinary tract to rest, reduces swelling, and supports a faster recovery process.
Possible Complications
Water vapor therapy may carry some short-term risks, though most side effects are mild and temporary. These may include:
- Difficulty urinating
- Blood in the urine or semen
- Frequent urination
- Urinary retention (inability to urinate)
- Reduced semen volume during ejaculation
- Urinary tract infection (UTI)
In general, symptoms tend to improve within 2 weeks and most patients recover completely within 6 weeks.
Water vapor therapy is a modern treatment backed by clinical research, proven to be both effective and safe. It offers an excellent alternative for patients with benign prostatic hyperplasia (BPH), a condition that men should not overlook. If left untreated or if complications arise, the condition can become more difficult to manage. Therefore, men are encouraged to monitor their symptoms closely and seek medical advice as soon as early signs appear, in order to receive a proper diagnosis and a treatment plan tailored to their individual condition.
For patients experiencing symptoms of an enlarged prostate, it is recommended to consult with a urology specialist for a full evaluation and diagnosis. At the
Urology Center, Phyathai 2 Hospital, we offer a wide range of treatment options — from medication and standard surgical procedures to advanced, minimally invasive technologies such as REZUM Water Vapor Therapy. This innovative approach provides effective results with fewer risks compared to traditional treatments.
