Rezum is a minimally invasive procedure that uses steam to shrink an enlarged prostate. It takes about 10 minutes, requires no general anesthesia in most cases, and preserves sexual function at rates significantly better than traditional prostate surgery. The procedure has been FDA-cleared since 2015 and is recommended by the American Urological Association for prostates between 30 and 80 grams.
How the Procedure Works
During Rezum, a urologist inserts a thin, rigid tube through the urethra to reach the prostate. A tiny needle extends from the tip of the device and delivers small bursts of steam directly into the enlarged prostate tissue. Each burst lasts about nine seconds. The steam’s thermal energy destroys the targeted cells on contact, and over the following weeks to months, your body naturally absorbs the damaged tissue. As this happens, the prostate shrinks and stops squeezing the urethra.
The number of steam injections depends on the size and shape of your prostate. A general rule used by urologists is that each injection treats roughly 10 grams of prostate tissue, and the device allows up to 15 injections per session. Most procedures involve somewhere between 4 and 10 injections. The whole thing is typically done in an office or outpatient setting with local anesthesia or light sedation.
Who Is a Good Candidate
Rezum is designed for men with benign prostatic hyperplasia (BPH), the non-cancerous prostate enlargement that causes frequent urination, weak stream, nighttime bathroom trips, and difficulty fully emptying the bladder. The AUA formally recommends it for prostates between 30 and 80 grams, which reflects the size range studied in the original clinical trials.
In practice, many urologists treat larger prostates. Data from real-world use shows that about 26% of Rezum patients had prostates larger than 80 grams, with an average size of 119 grams in that group. Some urologists consider prostates up to 120 grams reasonable candidates given the device’s 15-injection limit. Whether Rezum is right for you also depends on the specific anatomy of your enlargement. The procedure can treat a median lobe, the portion of the prostate that sometimes grows upward into the bladder, which some other minimally invasive options cannot address.
What Recovery Looks Like
You will likely go home the same day with a urinary catheter in place. On average, men keep the catheter for 3 to 4 days after the procedure. This is the most inconvenient part of recovery for most patients.
During the first few weeks, it’s common to experience some blood in the urine, burning with urination, and increased urgency or frequency. These symptoms happen because the prostate tissue is actively breaking down and being reabsorbed. They’re temporary but can be uncomfortable. Most men return to normal activities within a few days, though urinary symptoms may take several weeks to settle. The full benefit of the procedure develops gradually as the prostate continues to shrink, typically over two to three months.
Long-Term Results
Five-year data from the pivotal randomized trial shows durable results. Symptom scores improved by nearly 48% from baseline and held steady through the five-year follow-up. At that point, 61% of treated men were both free from any retreatment and still had at least a 30% improvement in their symptoms.
The surgical retreatment rate was 4.4% over five years, meaning fewer than 1 in 20 men needed another surgical procedure. An additional 11.1% went back on BPH medication during that period. Put another way, roughly 85% of men did not need any surgical redo within five years.
Sexual Function After Rezum
This is often the biggest concern for men weighing their options. Traditional prostate surgery (TURP) carries well-known risks of retrograde ejaculation, where semen flows backward into the bladder, and in some cases erectile dysfunction. Rezum performs significantly better on this front. The five-year trial reported no cases of procedure-related sexual dysfunction or sustained new-onset erectile dysfunction. The International Society for Sexual Medicine notes that Rezum preserves sexual function better than TURP and several other minimally invasive alternatives.
For many men, this is the deciding factor. If you’re sexually active and want to stay that way, Rezum offers effective symptom relief without the sexual trade-offs that come with more aggressive surgical options.
Rezum Compared to UroLift
UroLift is the other popular minimally invasive BPH procedure, and the two are frequently compared. UroLift works differently: it uses tiny implants to physically hold prostate tissue apart rather than destroying it. A real-world, single-institution analysis comparing the two found similar improvements in symptom scores and similar surgical retreatment rates.
The recovery profile differs slightly. In the first 90 days, Rezum patients experienced more blood in the urine, burning during urination, and urinary retention, while UroLift patients more frequently had blood clot retention. Neither procedure showed a clear advantage in emergency room visits or hospital readmissions. One practical difference: UroLift does not typically require a catheter, while Rezum does for several days. On the other hand, Rezum can treat a median lobe and generally handles larger prostates, giving it broader applicability.
What It Costs and Insurance Coverage
Rezum is covered by Medicare and most private insurance plans when performed for diagnosed BPH. Out-of-pocket costs depend on your plan, but because it’s done in an office or outpatient setting rather than a hospital operating room, the facility fees are typically lower than traditional surgery. If you’re considering the procedure, your urologist’s office can usually run a benefits check before scheduling.