Learn more about treatment options for benign prostate hyperplasia

Many men experience benign prostatic hyperplasia (BPH) as they get older. BPH is a non-cancerous growth of the prostate gland. Even though BPH doesn’t lead to cancer, it can cause uncomfortable urinary symptoms for older men.

In the past, doctors have treated BPH with medications and surgery. But now there’s another option: Rezūm™ water vapor therapy for BPH. Rezūm™ is a less-invasive procedure that can help shrink the prostate and ease BPH symptoms.

“Having BPH symptoms doesn’t have to be a part of aging,” says Sergio Giancola, MD, a fellowship-trained urologist at UPMC Hamot and UPMC Northwest. “If you’re starting to notice problems with urination, you should see a urologist. There are good, non-invasive treatments for BPH.”

Dr. Giancola was one of the first doctors in the region trained to use water vapor therapy. “Unlike many medications, Rezūm™ gets to the root of the problem instead of just masking the symptoms,” he says. “The steam actually shrinks the prostate.”

What Is Benign Prostatic Hyperplasia?

BPH happens when the prostate gland grows too big. The prostate gland is usually about the size of a walnut. It surrounds the urethra, the tube that carries urine out of the body.

When the prostate gets too big, it can press on the urethra and cause problems with urine flow.

BPH is common as men age. According to the American Urological Association, about half of all men between 51 and 60 have BPH. That number jumps to 80% after age 80.

Doctors don’t know precisely what causes BPH. Hormonal changes due to age might be a factor.

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Benign Prostatic Hyperplasia Symptoms

BPH symptoms range from mild to severe. In the worst cases, you might not be able to pass urine at all. Being unable to pass urine is a medical emergency, and you should get to the ER immediately.

More typical symptoms include:

  • A weak urine stream.
  • An urgent need to pass urine.
  • Feeling that you didn’t empty all the urine in your bladder.
  • Straining to pass urine.
  • The need to pass urine frequently, every hour or two.
  • The need to stop and start several times when passing urine.
  • Waking up more than two times a night to pass urine.

Treating Benign Prostatic Hyperplasia With Water Vapor

Traditional BPH treatments include medicines and various types of surgery. Rezūm™ water vapor therapy is a less-invasive procedure that injects steam into the prostate.

“There are no incisions or surgery per se,” says Dr. Giancola. “The injection causes cell death where there is enlargement of the prostate. In other words, it shrinks the prostate.”

UPMC has offered water vapor therapy since 2017. “It’s a fairly standard treatment now,” says Dr. Giancola. “Your primary care doctor can refer you to a urologist who does the procedure.”

Is Rezūm™ Suitable for Everyone with Benign Prostatic Hyperplasia?

Only your doctor can tell you if Rezūm™ is right for you. If your prostate is too big, other treatments may be more effective. Younger men or those with early symptoms of BPH are good candidates for Rezūm™.

Benefits of Benign Prostatic Hyperplasia Water Vapor Therapy

Rezūm™ has several benefits over traditional BPH treatments.

  • It doesn’t affect sexual function.
  • Instead of treating symptoms, it gets to the root of the problem — an enlarged prostate.
  • It’s a quick outpatient procedure. You’ll go home the same day.
  • It’s less invasive — no incisions or surgery involved.
  • You can get back to your regular activities quickly. Many men go back to work the next day.

Risks of Benign Prostatic Hyperplasia Water Vapor Therapy

The risks of water vapor therapy for BPH are like any other medical procedure.

They include:

  • Bleeding. “Even though it’s minimally invasive, there’s always a risk of bleeding from the procedure,” says Dr. Giancola. “You should expect some blood in your urine for a short time afterwards.”
  • Continuing problems with urination. For those with larger prostates, Rezūm™ may not be enough. You may need another procedure to decrease the size of the prostate.
  • Infection. There’s a slight risk of getting a urinary tract infection (UTI) after Rezūm™.

How Do You Prepare for BPH Water Vapor Therapy?

Your doctor will ask you to get routine bloodwork and possibly an EKG before the procedure. That’s to make sure you’re healthy enough for Rezūm™ treatment.

You shouldn’t eat or drink anything the morning of your procedure. If you take blood thinners, your doctor may ask you to stop taking them.

You should plan to have someone drive you home, as you’ll receive sedation during the procedure.

What Happens During the Water Vapor Therapy Procedure?

Doctors perform Rezūm™ in the office or an outpatient surgery facility.

You will get anesthesia to put you in partial sedation, or “twilight sleep.” A nurse will insert a catheter through the urethra to drain urine.

Depending on the size and shape of your prostate, doctors will give you anywhere from two to 15 steam injections. The entire procedure will take up to 30 minutes.

Once you come out of the sedation, your doctor will release you to go home. Someone will need to drive you.

What Is the Recovery from Water Vapor Therapy?

You can go home on the same day as your procedure. You will go home with a catheter to drain urine. Your doctor may prescribe antibiotics or pain medicine to take while you heal.

You will need to use the catheter for three or four days. It drains urine into an attached bag. You empty the urine from the bag directly into the toilet.

“The catheter is very discreet,” says Dr. Giancola. “Your clothes cover it, and no one will know you have it.”

After a few days, you’ll go back to the doctor’s office for a checkup. A nurse will remove the catheter. You’ll go back for another checkup four to six weeks after the procedure.

One note of caution, says Dr. Giancola — water vapor therapy isn’t an instant fix.

“It takes time to shrink down the tissue. For the first month, your symptoms may get worse instead of better. But after six weeks or so you should see improvement.”

The prostate continues to grow throughout a man’s lifetime. You may need to have the Rezūm™ procedure repeated in four or five years.

Editor's Note: This article was originally published on , and was last reviewed on .

About UPMC

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