Rezum – a minimally-invasive treatment for benign prostate enlargement

Written by: Mr Andrew Ballaro
Published:
Edited by: Bronwen Griffiths

Leading urologist, Mr Andrew Ballaro, talks to us about an exciting new treatment for benign prostate enlargement, a condition that affects many men in their older age. Rezum presents a minimally-invasive approach that has shown to produce good results, without the risk of invasive surgery or the complications associated with it.

How would I recognise the symptoms of BPH?

The prostate gland is an organ, normally the size of a walnut, which encircles the urethra (the tube that drains the urine from the bladder to the penis). Benign prostatic hyperplasia (BPH) is the medical term for an enlarged prostate and is characterised by lower urinary tract symptoms (LUTS) caused by the enlarged prostate blocking the flow of urine from the bladder.

LUTS include:

  • Urinary frequency (i.e. passing urine more often than normal)
  • Urinary hesitancy (i.e. finding it difficult to start passing urine or finding there is a longer than normal wait for the stream of urine to begin)
  • Poor urinary flow and dribbling at the end of the stream, or a stop-start stream
  • Getting up at night to pass urine
  • Feeling an urgent need to pass urine that is difficult to defer

Tell us about the new Rezum treatment for benign prostate hyperplasia

Rezum is a new minimally-invasive treatment recently approved for the treatment of BPH. It involves a short general anaesthetic and can also be performed under local anaesthetic, during which steam is injected into the obstructing prostate from inside the urethra. The steam causes shrinkage of the prostate and this significantly reduces the obstruction and improves urinary symptoms.

What are the advantages of Rezum over other treatments (UroLift or TURP)?

The major advantage of Rezum over conventional techniques, such as TURP and HoLEP, is that it does not involve surgical removal of large amounts of prostate tissue. This can be associated with heavy blood loss and complications, and also routinely causes loss of ejaculation (dry orgasm and infertility). The procedure is also much shorter than TURP or HoLEP and is usually a performed as a day-case. The results appear to be better than UroLift, another minimally-invasive operation for BPH, and, unlike UroLift, it does not involve implanting a plastic foreign-body into the prostate; the long term outcome of which is not yet known.

How well does Rezum preserve sexual and urinary function?

Rezum treatment significantly improves urinary symptoms resulting in, on average, a fifteen point improvement in symptoms scores. It preserves sexual function with only 4% of patients reporting an adverse effect on ejaculation.

How much does the Rezum treatment cost?

Rezum is approved by insurance companies and is at a competitive price to alternative procedures.

 

If you are male and experiencing urinary symptoms, as described above, make an appointment with an expert to investigate and treat these symptoms.

By Mr Andrew Ballaro
Urology

Mr Andrew Ballaro is a highly experienced NHS and private consultant urologist, specialising in the diagnosis and treatment of all urology problems, including kidney stones, blood in urine, urinary infections, prostatitis, prostate and bladder problems, and urological cancers. He has a particular interest in the comprehensive management of urinary stone disease and benign prostate hyperplasia (BPH). He consistently publishes leading results for complex stone operations and offers all treatments including mini and ultra-mini PCNL for kidney stones. He also offers a choice of surgical procedures for benign prostatic disease including Holmium Laser prostatectomy (HOLEP) the new Rezum steam treatment and MRI targeted template prostate biopsy. He has a doctoral research degree in the overactive bladder and sees many patients with this condition. He holds clinics on Wednesdays and Fridays at The Wellington Hospital and The Hospital of St John and Elizabeth in North London and also consults at locations in Essex.

Mr Ballaro's extensive training began after graduating from The Royal Free Hospital Medical School in London, and undertaking his basic surgical training at Oxford. He was awarded a Fellowship from the Royal College of Surgeons of London and went on to complete higher urological training on the North London Training Scheme. This was followed by advanced training in laparoscopy and complex stone surgery from national and international experts in his field.

Mr Ballaro has a strong interest in education, currently teaching trainees at the London Deanery across many levels, in addition to being awarded a Hunterian Professorship from the Royal College of Surgeons of England. He holds a Masters degree in Urology and an MD in Clinical Sciences from the Institute of Urology and has published extensively on the subject of minimally invasive urological surgery. He is the co-author of the latest edition of the popular medical student textbook 'Lecture Notes in Urology'.

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