At Urohealth Medical Clinic, we use Urolift and Rezum water vapor therapy to treat many patients with prostate enlargement. Why is that? Are these our only options? The answer is no, we are comprehensive in the treatments that we offer our patients. Usually, patients with prostate enlargement start with medications like alpha blockers that help to relax the prostate muscles. We also occasionally use medications such as 5 alpha reductase inhibitors that shrink the prostate. However, I am always concerned by their prolonged side effects related to testosterone inhibition. The drug has been associated with prolonged erectile dysfunction even after stopping the medication for a year. Furthermore, it can cause hot flushes and quite a few of patients complain of low energy and libido.
After trying out medications, we offer the full gamut of enlarged prostate treatments; from the more invasive therapies like Transurethral Resection of the Prostate ( TURP) to Greenlight Laser Vaporization of the Prostate (TUVP) and in the last two years, we have also adopted Urolift and Rezum for a more minimally invasive treatment of the prostate. Both Urolift and Rezum provides significant improvement in urinary issues relating to the prostate and more importantly preserve urinary continence and erectile and ejaculatory function. Both these minimally invasive procedures do not require general anesthesia, can be done as a day procedure and patients are back to normal activities in a few days.
Another very common question I am often asked is whether these minimally invasive therapies that have minimal side effects are durable. Recently, a randomized multicentre trial, which is the highest level of scientific evidence, has shown that Rezum is as durable and long-lasting at 5 years when compared to TURP which is considered the gold standard of therapy. The study shows that in patients with a prostate size of 30 to 80 grams treated with Rezum, they had a retreatment rate of 4.4% at five years. This means 95.6% of patients treated with Rezum did not need any further surgical interventions after five years. More importantly, this study also included patients with median lobe in their prostates. Even with a median lobe, the results are similar to a TURP. It also compares very favorably with other minimally invasive prostate therapies. In a similar study, Urolift had a 13.6% retreatment rate at give years.
I am now more confident in recommending men both Rezum and Urolift for the treatment of their prostate issues. I have confidence that the majority of patients will do well with minimal long term complications and will have long-lasting benefits with a small minority requiring retreatment at five years.