Benign Prostatic Hypertrophy: The Advantages of Rezum Treatment with Water Vapor. Interview with Prof. Carlo Molinari.

Benign Prostatic Hypertrophy: The Advantages of Rezum Treatment with Water Vapor. Interview with Prof. Carlo Molinari. | UPMC Italy

Benign prostatic hypertrophy, commonly known as BPH, is a widespread disease, especially among men over 60 years of age. In Italy, it is estimated that more than 6 million people suffer from it, with the highest incidence among men over 65 (80%) and men over 80 (90%).

BPH causes an obstruction and enlargement of the prostate leading to symptoms similar to those caused by fibromyadenoma in the female uterus. Today, thanks to innovation, it is possible to treat this disease with minimally invasive techniques that allow a rapid functional recovery. Early diagnosis is crucial, and it is essential not to overlook the symptoms and to consult a specialist in good time.

We interviewed Prof. Carlo Molinari, a urology expert specialising in the minimally invasive Rezum treatment, which exclusively uses water vapour to treat BPH.

Professor Molinari, can you briefly explain what benign prostatic hypertrophy is?

By BPH, we refer to the increased volume of the prostate gland, caused by a benign tumour that inevitably affects all adult men. This tumour (which has nothing to do with cancer) grows on the inside of the prostate, surrounding, stretching and compressing the urethra, causing a 'mechanical-hydraulic' obstruction that prevents complete emptying of the bladder.

You are an expert in the treatment of benign prostatic hypertrophy using water vapour through an endoscopic approach. Could you explain how this technique works?

The Rezum treatment consists of injecting water vapour directly into the prostate tissue via an endoscopic approach within a few minutes. This steam causes necrosis of the prostate cells by convection. In a short time, usually within 4-8 weeks after the procedure, the treated tissue is reabsorbed, causing the adenoma to shrink. This process results in an improvement of obstructive symptoms, allowing better urinary flow.

Can Rezum definitively cure benign prostatic hypertrophy and reduce prostate size?

Certainly, Rezum makes it possible both to reduce the size of the prostate and to eliminate the obstruction.  The benefits of unblocking last for several years. Currently, in Italy, the success rate is more than 75% of cases and remains up to six years after treatment. It is important to note that no intervention, surgical or endoscopic, can completely prevent the regrowth of a new or residual adenoma, but this takes several years.

So functional recovery is complete and rapid?

Yes, functional recovery occurs within 4-16 weeks after surgery.

Compared to other treatment methods, such as surgery, what are the main advantages of Rezum?

Rezum offers numerous advantages over other treatment methods:

  1. Short duration of surgery
  2. Execution of the method in Day Surgery
  3. Absence of bleeding

And what are the contraindications of Rezum?

The only contraindications are related to the size of the prostate: very large adenomas, exceeding one hundred grams, may not be treated effectively with this technique.

In the context of prevention, what symptoms should be considered alarm bells, regardless of age, that require a visit to a specialist?

Obstructive symptoms such as the need to urinate frequently, especially at night (pollakiuria), difficulty initiating urination, and a weak urine stream should be considered alarm bells and require evaluation by a specialist.

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