Is Rezum better than TURP?

Neither is better in every case. TURP and ThuLEP give a bigger improvement in urinary flow, but retrograde ejaculation after them is common and permanent. Rezum gives a smaller flow gain while usually preserving ejaculation, and is done under sedation as a day care procedure.

Rezūm Water Vapor Therapy: Treating Enlarged Prostate Without Major Surgery

Q: Is Rezum a permanent cure for an enlarged prostate?

Rezum is a durable treatment rather than a cure. In the five year trial data, 4.4 per cent of men needed a further surgical procedure over five years, which means the great majority kept the benefit without another operation. The prostate can still grow with age, so long term follow up matters.

Q: Is Rezum Water Vapor Therapy available in Kottayam?

Yes. Rezum Water Vapor Therapy is performed at the Department of Urology, Mar Sleeva Medicity Palai, Cherpunkal, Kottayam, along with ThuLEP and TURP for an enlarged prostate. Appointments can be booked online or by calling 04822 359 900.

Rezūm Water Vapor Therapy: Treating Enlarged Prostate Without Major Surgery

2 September 2026

Prepared and medically reviewed by Dr. Vijay Radhakrishnan, Senior Consultant and Head, Centre of Excellence in Urology, Mar Sleeva Medicity Palai. Last updated: 2 September 2026

Rezūm Water Vapor Therapy is a minimally invasive day care treatment for an enlarged prostate. Sterile water vapour is injected into the prostate tissue through the urethra in nine second bursts, and the treated tissue shrinks over the following weeks, opening the urinary channel. It is done under sedation, needs a catheter for about a week, and at five years it preserves ejaculation in most men, which is the trade off that brings most patients to it instead of TURP.

In this article

How Rezūm Water Vapor Therapy works

Rezūm Water Vapor Therapy uses sterile water vapour to shrink the part of the prostate that is squeezing the urethra. A thin scope goes in through the urethra, and a retractable needle delivers vapour into the prostate tissue itself, nine seconds at a time. The vapour spreads through the tissue and releases its stored energy as it condenses back into water. That energy destroys the treated cells. Over the following weeks the body clears them and the prostate shrinks from the inside, opening the channel.

The vapour stays inside the zone it is injected into. It does not travel past the natural tissue boundaries of the prostate, which is why the nerves and structures that matter for continence and ejaculation are usually left alone.

What happens on the day of the procedure

The treatment itself takes a few minutes. Most men have it under local anaesthesia with sedation, and go home the same day. How many vapour injections you need depends on the size and shape of your prostate, which I assess on cystoscopy before treating. A prostate with a large middle lobe pushing up into the bladder needs a different plan from one that is enlarged only on the sides, and both can be treated.

You go home with a catheter. I usually keep it in for about a week. Men are often surprised by this, because they expect a minimally invasive procedure to mean no catheter at all, but the prostate swells before it shrinks and the catheter carries you through that phase.

What recovery after Rezūm is really like

Symptoms get worse before they get better. This is the part I spend the most time on in clinic, because it is where expectations break. For the first few weeks you can expect burning, urgency, going more often and some blood in the urine. That is the treated tissue breaking down, and it settles.

Real improvement starts around two weeks and keeps building. Most men see the full result by three months. If you need to be back at work and symptom free in a week, this is not the right operation for you and I will say so.

How well Rezūm works at five years

The randomised sham controlled trial of water vapour thermal therapy followed 197 men and reported final five year outcomes in the Journal of Urology in 2021. At five years:

Symptom scoreImproved by 11.3 points on the IPSS, about 48 per cent below the starting score of 22.

Peak urinary flowRose from 9.9 mL per second to 14.0 mL per second.

Quality of life scoreFell from 4.4 to 2.2.

Surgical retreatment4.4 per cent of men needed a further surgical procedure over the five years.

Sexual functionThere were no cases of sustained new erectile dysfunction attributed to the device or the procedure.

That last point is the one most men in my clinic care about, and it is why they ask for this by name. TURP and laser enucleation give a bigger flow improvement, but retrograde ejaculation after them is common and permanent. If preserving ejaculation matters to you, that trade off is the whole conversation.

Who Rezūm is suitable for

Rezūm works best for men with moderate to severe urinary symptoms from a prostate in the small to moderate range. It also has a place for men who are on blood thinners or who are not fit for a spinal or general anaesthetic, because it is quick and done under sedation.

It is not for everyone. A very large prostate, urinary retention that has already damaged the bladder, bladder stones, or any suspicion of prostate cancer that needs tissue for diagnosis all point towards a different operation.

A man who wants the largest possible improvement in flow and does not mind losing ejaculation is better served by ThuLEP or TURP, both of which we also perform at the Centre of Excellence in Urology, Mar Sleeva Medicity Palai.

How to choose between Rezūm, ThuLEP and TURP

Bring your symptom score, your uroflow and your ultrasound, or come and we will do them. The decision comes down to three things: how big the prostate is, what shape it is, and what you personally are and are not willing to trade. There is no single best operation for an enlarged prostate. There is a best operation for you.

Frequently asked questions

Is Rezūm a permanent cure for an enlarged prostate?

Rezūm is a durable treatment rather than a cure. In the five year trial data, 4.4 per cent of men needed a further surgical procedure over five years, which means the great majority kept the benefit without another operation. The prostate can still grow with age, so long term follow up matters.

Will I need a catheter after Rezūm?

Yes. The prostate swells before it shrinks, so a catheter is placed at the end of the procedure and usually stays for about a week. Men often expect a minimally invasive treatment to mean no catheter, so it is worth planning for.

Does Rezūm affect erections or ejaculation?

The vapour stays within the treated zone of the prostate, so the structures involved in continence and ejaculation are usually spared. In the five year trial there were no cases of sustained new erectile dysfunction attributed to the device or the procedure. This is the main reason men choose Rezūm over TURP or laser enucleation, where retrograde ejaculation is common and permanent.

How long does it take to feel better after Rezūm?

Symptoms usually get worse before they get better. Burning, urgency, frequency and some blood in the urine are expected in the first few weeks. Real improvement starts around two weeks and keeps building, with most men seeing the full result by three months.

Is Rezūm better than TURP?

Neither is better in every case. TURP and ThuLEP give a bigger improvement in urinary flow, but retrograde ejaculation after them is common and permanent. Rezūm gives a smaller flow gain while usually preserving ejaculation, and is done under sedation as a day care procedure. The right choice depends on the size and shape of the prostate and on what the patient is willing to trade.

Can Rezūm be done if I am on blood thinners?

It is often possible. Because the procedure is quick and done under local anaesthesia with sedation, Rezūm has a place for men on blood thinners and for men who are not fit for spinal or general anaesthesia. The decision is made after a cystoscopy and a review of your medication with your urologist and physician.

Is Rezūm Water Vapor Therapy available in Kottayam?

Yes. Rezūm Water Vapor Therapy is performed at the Centre of Excellence in Urology, Mar Sleeva Medicity Palai, Cherpunkal, Kottayam, along with ThuLEP and TURP for an enlarged prostate. Appointments can be booked online or by calling 04822 359 900.

Consult the Centre of Excellence in Urology

To consult Dr. Vijay Radhakrishnan at the Centre of Excellence in Urology, Mar Sleeva Medicity Palai, call 04822 359 900, 354 900 or 269 700.

References

Final five 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. Journal of Urology. 2021. pubmed.ncbi.nlm.nih.gov/33872051
Water vapor thermal therapy for BPH sustains efficacy at 5 years. Urology Times. urologytimes.com
Alcina A, et al. Expert consensus on Rezūm: indications, surgical technique and postoperative care. BJUI Compass. 2025. bjui-journals.onlinelibrary.wiley.com

This article is for general information and patient education. It does not replace an individual consultation, examination and investigation. Treatment decisions for an enlarged prostate must be made with a qualified urologist.