Rezum vs. HoLEP

Rezum (Water Vapor Therapy) and Holmium laser enucleation of the prostate (HoLEP) are two different procedures that are used to treat benign prostatic hyperplasia (BPH). While both procedures are effective at reducing BPH symptoms, there are some key differences between them.

Rezum is a minimally invasive procedure that uses steam to shrink the prostate gland and relieve symptoms. During the procedure, a small device is inserted into the urethra and guided to the prostate gland. The device then releases steam that is absorbed by the prostate tissue, causing it to shrink. Rezum is typically performed on an OUTPATIENT basis and DOES NOT require any incisions or cutting of tissue.

HoLEP, on the other hand, is a more invasive surgical procedure that involves removing part of the prostate gland using a laser. During the procedure, a small tube is inserted into the urethra and guided to the prostate gland. The laser is then used to remove the excess prostate tissue, which is then suctioned out of the body. HoLEP is typically performed under spinal or general anesthesia and requires one-day hospital stay.

Some of the key differences between Rezum and HoLEP include:

1. Invasiveness: Rezum is a minimally invasive procedure that uses steam to shrink the prostate gland, while HoLEP is a more invasive surgical procedure that involves removing part of the prostate gland using a laser. Rezum does not require any incisions or cutting of tissue, while HoLEP involves making small incisions in the prostate gland to remove the excess tissue.

1. Anesthesia: Rezum is typically performed under local anesthesia or sedation, which numbs the area being treated, while HoLEP is typically performed under spinal or general anesthesia, which puts the patient to sleep during the procedure.

1. Procedure time: Rezum typically takes about 10-15 minutes to complete, while HoLEP can take up to 2 hours.

1. Recovery time: Recovery time after Rezum is typically quicker than HoLEP. Patients who undergo Rezum can usually resume normal activities within a few days, while patients who undergo HoLEP may need to avoid strenuous activity for 3-4 weeks. Patients who undergo HoLEP may also experience disuria and bleeding during the recovery period.

1. Sexual side effects: While both procedures have a low risk of sexual side effects, HoLEP may have a slightly higher risk of retrograde ejaculation (when semen flows into the bladder instead of out of the body during ejaculation) compared to Rezum. This is because HoLEP involves removing part of the prostate gland, which can affect the function of the bladder neck and the muscles that control ejaculation.

1. Efficacy: Both Rezum and HoLEP are effective at reducing BPH symptoms, but studies have shown that HoLEP may provide more significant and longer-lasting symptom relief compared to Rezum. HoLEP has also been shown to be more effective at reducing the size of the prostate gland compared to Rezum.

It is important for patients to discuss all treatment options with their healthcare provider to determine the best course of action for their individual needs, taking into consideration factors such as the severity of their BPH symptoms, the size of their prostate gland, and their overall health.