Benign prostatic hyperplasia (BPH) is a common, non-cancerous enlargement of the prostate that can gradually make urination difficult. Many men notice a weaker stream, needing to pass urine more often (especially at night), urgency, hesitancy, or a feeling that the bladder does not fully empty. Rezum is a minimally invasive treatment designed to reduce the blockage caused by an enlarged prostate and improve urinary symptoms, usually without the need for traditional surgery.

Understanding what Rezum is designed to do

Rezum is a procedure that uses controlled water vapour (steam) energy to treat the part of the prostate that is narrowing the urine channel. The steam is delivered directly into the enlarged prostate tissue. Over time, the treated tissue is naturally broken down and reabsorbed by the body, which can reduce pressure on the urethra and improve urinary flow.

Rezum does not involve external cuts and is typically performed as a day procedure. Symptom improvement is usually gradual, as the prostate changes over weeks rather than immediately.

When Rezum may be a good option

Rezum can be considered for men with bothersome lower urinary tract symptoms due to BPH, particularly when:

• Symptoms are affecting sleep, daily activities, or quality of life
• Tablets for BPH have not helped enough, or side effects are difficult to tolerate
• A minimally invasive approach is preferred over more extensive surgery
• Preserving sexual function is an important priority

It is often most suitable when the prostate size is within a treatable range (commonly up to around 80 to 100 grams, depending on anatomy and clinical judgement). Some men with a specific pattern of enlargement, such as a median lobe, may still be candidates, but this needs careful assessment.

When another approach may be better

Rezum is not the right choice for everyone. Alternative treatments may be recommended if:

• Urinary symptoms are caused by something other than BPH (for example, urethral stricture, bladder problems, infection, or neurological conditions)
• There is significant urinary retention, recurrent infections, bladder stones, or kidney strain related to obstruction, where a different intervention may be more appropriate
• The prostate is very large or anatomy makes steam treatment less effective
• There is a suspicion of prostate cancer that needs investigation first

A specialist assessment is essential to confirm the cause of symptoms and to match the treatment to your prostate size, shape, and overall health.

Specialist assessment and planning before treatment

Before Rezum is considered, an assessment at our specialist urology clinic is used to confirm that BPH is the main cause of symptoms and to rule out other conditions. This typically includes:

• A detailed symptom review, including how often you pass urine at night and whether you strain or feel incomplete emptying
• A physical examination, usually including a digital rectal examination
• Urine testing to check for infection or blood
• Blood tests when appropriate, which may include PSA depending on age, symptoms, and risk factors
• Flow rate testing and a bladder scan to measure how well the bladder empties
• Imaging or cystoscopy in selected cases to assess prostate anatomy and the urinary channel

Medication history is also important. Blood thinners and certain heart medications may need planning around the procedure, and any history of urinary retention or previous prostate procedures helps guide suitability.

What the procedure involves

Rezum is performed through the urethra (the natural urine passage), so there are no skin incisions. The procedure is usually carried out with local anaesthetic and sedation where appropriate, although the exact anaesthetic plan depends on individual needs.

A slim instrument is passed into the urethra to the level of the prostate. Short, controlled bursts of water vapour are delivered into the enlarged prostate tissue. Each application lasts only seconds, and the number of treatments depends on prostate size and the pattern of enlargement.

The total time in the procedure room is usually under an hour, although this can vary. Many patients go home the same day.

Will a catheter be needed?

A temporary urinary catheter is commonly used after Rezum. This helps the bladder drain while early swelling settles. The catheter may be needed for a few days, and occasionally longer, depending on baseline symptoms and how the bladder is functioning.

What to expect after Rezum

Rezum works gradually. It is common for urinary symptoms to fluctuate during early healing.

Early recovery (first days to 2 weeks)

In the short term, you may notice:

• Burning or stinging when passing urine
• Increased frequency and urgency
• A weaker stream temporarily due to swelling
• Small amounts of blood in the urine
• Discomfort in the pelvic area

These effects are usually temporary and improve as inflammation settles. If a catheter is in place, you will be given clear instructions on care, hygiene, and what to do if drainage stops.

Symptom improvement timeline

Many men start to notice improvement within a few weeks, with further gains over 2 to 3 months as the treated tissue shrinks and the urinary channel opens. The goal is meaningful symptom relief and better quality of life, although results vary between individuals.

Follow-up and ongoing support

Follow-up is an important part of care. Reviews typically focus on symptom scores, urine flow, bladder emptying, and any side effects. If you were taking BPH medications before the procedure, a plan will be agreed for whether and when these can be reduced or stopped.

Our medical team also provides guidance on returning to exercise, work, and sexual activity, tailored to your recovery and comfort.

Benefits and realistic expectations

Rezum is designed to reduce obstruction while avoiding more invasive surgery for suitable patients. Potential advantages include:

• Minimally invasive treatment with no external cuts
• Day-case care for many patients
• A lower risk of sexual side effects compared with some other BPH procedures, with ejaculation preserved in most men
• Durable symptom improvement for many patients, though long-term outcomes vary and some men may need further treatment in the future

It is important to understand that Rezum does not remove the entire prostate. The aim is to treat the obstructing tissue and improve urinary function.

Risks, side effects, and important considerations

All medical procedures carry risks. Your urologist will discuss these in the context of your health and prostate anatomy. Potential risks and limitations include:

• Temporary worsening of urinary symptoms during healing
• Urinary tract infection
• Urinary retention (difficulty passing urine), sometimes requiring a catheter for longer
• Blood in the urine or semen for a short period
• Pain or discomfort during urination
• Rarely, narrowing of the urethra or bladder neck (scar tissue)
• Need for repeat treatment or an alternative procedure if symptoms do not improve enough

Although sexual function is often preserved, no procedure can guarantee this for every individual. Any concerns about erections, ejaculation, fertility, or existing sexual symptoms should be discussed during the consultation.

Seek urgent medical advice if you develop fever, chills, severe pain, inability to pass urine, heavy bleeding, or if a catheter stops draining.

Your consultation and continuity of care at our urology clinic

Care is delivered through a single specialist urology clinic, with assessment, treatment planning, and follow-up coordinated by the same medical team. The consultation focuses on understanding how symptoms affect your life, confirming the diagnosis, and explaining all appropriate options, which may include lifestyle measures, medication, Rezum, or other minimally invasive and surgical treatments.

If Rezum is suitable, you will receive a clear plan covering preparation, anaesthesia options, catheter expectations, recovery guidance, and follow-up scheduling. Our team remains available after the procedure to help manage early symptoms, catheter questions, and recovery concerns, so you feel supported throughout the process.

If you are considering Rezum, the next step is a specialist assessment to confirm that BPH is the cause of your symptoms and to ensure this approach matches your prostate anatomy, health needs, and personal priorities.