From the Guidelines
A prostatic tissue volume of approximately 37cc is indeed suitable for Rezum therapy for benign prostatic hyperplasia (BPH), as it falls within the recommended range of 30-80cc. According to the provided evidence, Rezum is a minimally invasive water vapor thermal therapy that is FDA-approved for treating prostates of this size 1. The procedure involves delivering targeted steam injections to the transition zone of the prostate, causing cell death in the hyperplastic tissue which is then reabsorbed by the body over time, reducing prostate volume and relieving urinary symptoms.
Key considerations for Rezum therapy include:
- Prostate volume: The recommended range for Rezum is between 30-80cc, making a 37cc prostate a suitable candidate 1.
- Symptom severity: Rezum is particularly effective for patients with moderate to severe lower urinary tract symptoms who wish to avoid more invasive surgical options or the side effects of long-term medication.
- Treatment outcomes: The procedure typically takes less than 15 minutes, requires minimal anesthesia, and most patients can return to regular activities within a few days, though some urinary symptoms may temporarily worsen before improving 1.
- Sexual function: Rezum offers the advantage of preserving sexual function, including ejaculation, which is often affected by other BPH treatments.
It's essential to note that the effectiveness of Rezum therapy may vary depending on individual patient factors, such as the severity of symptoms and overall health. However, based on the provided evidence, a prostatic tissue volume of approximately 37cc is a suitable indication for Rezum therapy 1.
From the Research
Prostatic Tissue Volume and Rezum Therapy for BPH
- The Rezum therapy is a minimally invasive treatment for Benign Prostatic Hyperplasia (BPH) that has been recommended for prostate volumes of ≤80 cc 2.
- A study published in 2021 found that Rezum therapy can be effective for patients with larger prostates, with a mean prostate size of 106.8 cc 3.
- Another study published in 2024 reviewed ablative minimally invasive surgical therapies for BPH, including Rezum, and found that they can be safe and effective while preserving sexual function 4.
- A single office experience with convective radiofrequency water vapor thermal therapy using the Rezum system found that the treatment was effective in improving symptoms and flow rate, with a 17% prostate volume reduction based on TRUS and 14% based on PSA 5.
Indications for Rezum Therapy
- The current guidelines recommend Rezum for prostates <80 cc, but there is evidence to suggest that it can be effective for larger prostates as well 2, 3.
- A prostate volume of 37cc is within the recommended range for Rezum therapy.
- The decision to use Rezum therapy should be based on individual patient factors, including symptom severity, prostate size, and patient preference 6.
Efficacy and Safety of Rezum Therapy
- Rezum therapy has been shown to improve symptoms and flow rate in patients with BPH, with significant improvements in IPSS and Qmax 3, 5.
- The treatment has been found to be safe, with common adverse events including urinary tract infections and transient urinary retention 5.
- Rezum therapy can be performed in an office setting, and has been found to be effective in reducing prostate volume and improving symptoms 5.