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Rezūm — Water-Vapor Thermal Therapy

Rezūm (Boston Scientific) is a convective water-vapor thermal therapy system for BPH-related LUTS. Sterile water is heated to ~ 103 °C and injected into the prostatic transition zone as 9-second pressurized vapor pulses; the latent heat released during vapor-to-liquid phase change causes localized tissue ablation by convection, sparing the urethral mucosa and ejaculatory apparatus.[1][2]

For procedural detail see Rezūm — Water Vapor Therapy.

Device Components​

  • Handpiece with retractable needle delivering vapor through 12 small ports.
  • Single-use generator cartridge producing thermal vapor.
  • Cystoscopic visualization (0° lens, dedicated sheath).
  • Typical case: 4–10 injections of 9 s each into the transition zone (and optionally median lobe).

Indications​

  • BPH-related LUTS, prostate volume 30–80 mL (FDA-approved 2015).
  • Patients who prioritize ejaculation preservation (~ 0% anejaculation in pivotal trial).
  • Outpatient or office setting, oral or light sedation.
  • FDA-approved 2018 for median-lobe obstruction — a key advantage vs UroLift.

Reconstructive Relevance​

  • Failure modes seen by reconstructive urology: retention requiring CIC (early postop), urinary tract infection, hematuria, persistent LUTS, rare post-Rezūm urethral or bladder-neck stricture.
  • 5-year pivotal trial follow-up: surgical re-treatment rate 4.4%; IPSS reduction sustained ~ 48% from baseline.[3]
  • Cross-link to TURP, HoLEP, UroLift, iTind, Aquablation, Optilume BPH DCB.

References​

1. McVary KT, Gange SN, Gittelman MC, et al. "Minimally invasive prostate convective water vapor energy ablation: a multicenter, randomized, controlled study for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia." J Urol. 2016;195(5):1529–38. doi:10.1016/j.juro.2015.10.181

2. Dixon C, Cedano ER, Pacik D, et al. "Efficacy and safety of Rezūm system water vapor treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia." Urology. 2015;86(5):1042–7. doi:10.1016/j.urology.2015.05.046

3. McVary KT, Gittelman MC, Goldberg KA, et al. "Final 5-year outcomes of the multicenter randomized sham-controlled trial of a water vapor thermal therapy for treatment of moderate to severe lower urinary tract symptoms secondary to benign prostatic hyperplasia." J Urol. 2021;206(3):715–24. doi:10.1097/JU.0000000000001778