Rezūm Water Vapor Therapy for Benign Prostatic Hyperplasia at Asklepios Hospital Barmbek

At Asklepios Clinic Barmbek, Rezūm is positioned as a minimally invasive option for benign prostatic hyperplasia (BPH/BPS) within the department’s endourology offering, alongside laser surgery for BPH, and is presented to patients as part of a structured pathway for symptom assessment, diagnostics, and therapy selection. Before treatment, the BPH course is typically built around a standardized work-up to confirm that symptoms are caused by bladder outlet obstruction from BPH and to rule out competing causes; this generally includes detailed history and symptom scoring (IPSS), targeted physical examination, lab testing (e. g. , urine, PSA as appropriate), ultrasound evaluation (prostate/bladder and residual urine), and functional tests such as uroflowmetry, with cystoscopy or pressure-flow studies used when clarification is needed. This diagnostic staging matters because Rezūm is most useful when the obstructing tissue pattern is well mapped, and the expected benefit outweighs conservative/medication options. On the procedure day, Rezūm is performed transurethrally (through the urethra) without skin incisions: a cystoscopic instrument is guided under direct visualization to the prostatic urethra, and a fine treatment needle is deployed into the obstructing adenoma. The core mechanism, water vapor, is injected directly into the prostate, where it ablates excess tissue, thereby relieving symptoms. The approach is generally planned to treat the zones responsible for narrowing while keeping surrounding structures as untouched as possible. Technically, the therapy is delivered as a series of short steam applications: each application is a 9-second dose of sterile water vapor, and the urologist chooses the number and placement of applications based on prostate size and anatomy (including whether a median lobe contributes to obstruction). The steam is delivered at approximately 103°C in small, controlled volumes for each injection, with the intent of achieving convection-based heat transfer within the targeted tissue rather than cutting tissue during the session. Immediately after treatment, brief monitoring is performed, followed by a temporary urinary catheter to protect bladder emptying while the prostate is swollen from the thermal effect; the exact catheter duration is individualized but commonly ranges over multiple days in real-world urology practice. Over the following weeks, the treated tissue undergoes necrosis and is gradually resorbed by the body, which is why symptom improvement typically builds over time rather than being instantaneous, with the full remodeling phase often around three months.