The Rezum system in the treatment of male lower urinary tract symptoms (LUTSs) due to benign prostatic obstruction (BPO)

The classical algorithm of the management of male lower urinary tract symptoms (LUTSs) due to benign prostatic hyperplasia (BPH) includes a surgical approach in case pharmacological therapy has failed. Emerging minimally-invasive treatments (MITs) offer potential for rapid symptomatic relief, reducing the morbidity of invasive BPH surgery. Convective interstitial radiofrequency water vapour thermal ablation of the prostate with the Rezum (R) system is a novel MIT for the treatment of bothersome moderate-to-severe lower urinary tract symptoms associated with BPH. It provides early effective and durable relief of storage and voiding LUTSs, preserving both erectile and ejaculatory function and improving quality of life. The procedure allows the treatment of a wide spectrum of prostate gland morphologies including intravesical prostatic protrusion, median lobe protrusion or elevated bladder neck. In selected patients, this procedure can also be offered for first-line treatment to prevent symptom progression and may thus be used as an alternative to long-term pharmaceutical treatment in order to avoid potential side-effects of drugs. This review describes this new technology and its clinical application and presents the current clinical evidence that supports the efficacy, safety and prospects of the Rezum procedure to date.