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Steam Treatment (Rezum) for Enlarged Prostates

Steam treatment, or Rezum, involves injecting steam into the prostate to destroy enlarged tissue which is causing blockage to urine flow and bothersome symptoms. It is an effective treatment with fewer side-effects.

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What is steam treatment for enlarged prostates?

Steam treatment for enlarged prostates is an innovative approach for patients suffering with an enlarged prostate that is causing urinary symptoms. It is set to be made more widely available after being given approval for routine use by the health watchdog, NICE. Professor Hashim Ahmed, Consultant Urological Surgeon at Cromwell Hospital and Imperial was one of the first two consultants in the UK to perform the new steam (Rezum) treatment. He performs the steam (Rezum) procedure routinely at Cromwell Hospital, Imperial Private Healthcare and in Imperial NHS Trust at Charing Cross Hospital. The initial results have been impressive and in most cases aims to replace the traditional operation, called a transurethral resection of the prostrate (TURP). Steam (Rezum) for treating enlarged prostates is NICE (UK) approved.

prostate cancer treatment newspaper article


What sort of symptoms do patients have from an enlarged prostate?

Symptoms of an enlarged prostate or often a ‘tight’ prostate can include poor urine flow, a feeling of incomplete emptying of the bladder, and needing the toilet more frequently and with more urgency. The condition, also known as benign prostatic hyperplasia (BPH), or bladder outlet obstruction, is very common in men over the age of 50, affecting around one in three. Men usually have medication as well as modifying their life-style. In those men where the symptoms continue or get worse or when men don’t want to take medication long-term, or when the medication itself causes side-effects, an operation called a TURP is often used to treat BPH. TURP is performed on thousands of men every year. It takes approximately 1-2 hours and requires two to three days in hospital with a catheter. It can cause urine leakage in 1-2% and erectile problems in 5-10% with most men having dry orgasm. Laser TURP helps reduce inpatient stay and catheter times as well as recovery and reduced blood loss with slightly lower risk of incontinence and erectile dysfunction. Professor Ahmed offers standard TURP, laser TURP and steam (Rezum) treatment for enlarged prostate glands. many men will be able to choose between all of these options and others like prostate artery embolisation or Urolift. Some men will not be suitable for all options and Professor Ahmed will advise which are optimal in your case.

How does the steam treatment for enlarged prostates work?

The new steam procedure, called Rezum, avoids the need for surgery and reduces the risk of associated complications such as bleeding, incontinence and sexual dysfunction. Small amounts of steam are injected into the prostate which destroys some of the prostate tissue, reducing its size.

steam treatment for enlarged prostate diagram
An enlarged prostate can block the urethra which runs through the middle of the prostate, making it difficult to pass urine from the bladder.

steam treatment for enlarged prostate diagram 2
With each 9-second Rezum injection, steam is released into the prostate to shrink the excess tissue that is pressing on the urethra

steam treatment for enlarged prostate diagram 3
The blockage caused by the excess growth of tissue slowly diminishes as the body absorbs the dead tissue that is created by the steam injections. The urethra opens open and urine can flow more freely.

The procedure takes about 30 minutes in total under local, sedation or general anaesthetic with patients able to go home the same day. A catheter is needed for about a week in most men due to the swelling that is initially caused by the steam. Some men will need the catheter for 10-14 days and Professor Ahmed will advise before or after the procedure. The dead prostate tissue is absorbed by the body slowly over a number of weeks. 90% of men at 5 years after the procedure have a satisfactory outcome with 5% going back on medication and another 5% having steam (Rezum) treatment again or choosing a different type of procedure. Steam (Rezum) treatment is used in prostates that are 80-90ml (or 80-90grams) in size or less. Larger prostates can be reduced in size by medication scubas finasteride or dutasteride for 3-6 months in order to then carry out the steam (Rezum) treatment for those men who still wish to have the procedure. The risk of incontinence is virtually zero and erectile dysfunction virtually zero in men who have good baseline function. Of those men who are able to ejaculate fluid during intercourse, 85-90% will retain this after steam (Rezum) treatment. Whilst this is lower than standard TURP or laser TURP, it is still not a zero risk.

Is Professor Ahmed experienced in steam (Rezum) treatment?

Professor Ahmed was one of two surgeons in the UK to first perform this procedure and performed the first Rezum procedure in London three years ago. He was also one of the lead surgeons involved in last year’s study from the UK which confirmed that we were able to achieve similar results to the USA study. So it is great that we can now offer this treatment more widely as a huge group of men could benefit. He now has the largest Rezum practice in London and one of the two highest volume surgeons offering this in the UK. He is an approved international trainer of other surgeons in the technique and regularly lectures on the procedure at national and international conference and meetings. The equipment for delivering steam treatment for enlarged prostate is fully available at the Cromwell Hospital and Imperial College, and were the two hospitals to first get them into London.

steam treatment medical equipment

Why is steam (Rezum) treatment so ground-breaking?

Men often worry about the side effects of an operation which means they suffer without seeking treatment. While the results of the treatment are not instant, it might take 8-12 weeks to see the full benefits, the impressive results show that men needing traditional surgery or those who don’t want to take tablets long-term are likely to benefit from steam (Rezum) for enlarged prostates. It is less invasive, carries fewer side effects for our patients, and patients have a quicker recovery meaning they can get on with their life.

Rezum for enlarged prostates is available in the NHS and privately.

For NHS referrals, Professor Ahmed works at Imperial College Healthcare NHS Trust. You are entitled to ask for a referral for an opinion about whether you might be suitable on the NHS. Your GP can make the referral through the choose and book electronic referral system and choose the ‘Prostate – Rezum’ folder. Your consultant team can also make the referral directly to Imperial using the email: or letter (addressed to Professor Ahmed at Charing Cross Hospital, Fulham Palace Road, London W6 8RF).

For private referrals, Professor Ahmed works at Cromwell Hospital and Imperial Private Healthcare. Self-pay patients do not need a referral to consult Professor Ahmed and there are competitive self-pay packages offered. Insured patients should check with their insurer.
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