REZUM WATER VAPOR THERAPY FOR ENLARGED PROSTATE - A Modern Solution for Benign Prostatic Hyperplasia (BPH)

Also known as enlarged prostate or swollen prostate gland — a condition causing difficulty passing urine in men over 50

By Dr. Rohit Dadhwal | Senior Consultant Urology | Fortis Hospital Mohali

India’s 2nd Highest-Volume Rezum Center | Proctoring Centers Nationwide | Over 100 Successful Procedures

Introduction: A New Era in Prostate Care

As a urologist at Fortis Hospital Mohali, I see men every day who are struggling with the frustrating symptoms of an enlarged prostate — also known as benign prostatic hyperplasia, or BPH (a non-cancerous growth of the prostate gland). If you’re one of them, you know the impact it has on your life: waking up multiple times each night to urinate, experiencing a weak or interrupted stream, feeling like you can never fully empty your bladder, and the constant urgency that disrupts your daily activities and sleep.

For years, men faced a difficult choice: continue suffering with medications that may lose effectiveness over time and have side effects, or undergo major surgery like TURP (transurethral resection of the prostate — a traditional surgical procedure to remove prostate tissue) with its associated risks and lengthy recovery. But there’s exciting news: Rezum water vapor therapy is revolutionizing how we treat BPH.

I’m proud to say that Fortis Hospital Mohali has been at the forefront of this innovation. We were North India’s first center to introduce Rezum therapy, and we’ve now completed over 100 successful procedures — making us the second highest-volume Rezum center in India. I’ve personally performed the second highest number of Rezum procedures in the country, and I’m regularly invited to proctor and train urologists at other hospitals who are introducing this technique.

In this comprehensive guide, I’ll explain everything you need to know about Rezum therapy: how it works, who benefits most, what to expect during and after the procedure, and how it compares to other treatment options. My goal is to give you the information you need to make an informed decision about your prostate health.

Understanding BPH: Why Your Prostate Grows and Causes Problems

Before we discuss Rezum, it’s important to understand what’s happening in your body. The prostate is a walnut-sized gland that sits just below the bladder and surrounds the urethra (the tube that carries urine from the bladder out through the penis). The prostate’s normal function is to produce fluid that nourishes and transports sperm.

As men age, the prostate naturally enlarges. This happens to most men over 50 — in fact, by age 60, more than 50% of men have BPH, and by age 85, that number rises to 90%. The problem occurs when the enlarged prostate squeezes the urethra, restricting urine flow. Across Punjab and the Chandigarh region, this is one of the most common urological complaints in men over 50.

Common Symptoms of BPH That Bring Men to My Clinic

• Frequent urination, especially at night (a symptom doctors call nocturia) — some men wake up 5–6 times per night
• Weak or interrupted urine stream — taking much longer to empty the bladder
• Difficulty starting urination — standing at the urinal waiting for the stream to begin
• Feeling of incomplete bladder emptying — always feeling like there’s more urine left
• Sudden, urgent need to urinate — rushing to find a bathroom
• Dribbling at the end of urination
• In severe cases, complete inability to urinate (called urinary retention) requiring emergency catheterization (insertion of a tube to drain the bladder)

These symptoms aren’t just inconvenient — they significantly impact quality of life. Men tell me they can’t sleep through the night, they’re afraid to go on long car trips, they avoid drinking fluids before social events, and their sexual confidence suffers.

When Conservative Treatments Aren’t Enough

In my practice, I always start with conservative management:

• Lifestyle modifications — limiting fluids before bed, reducing caffeine and alcohol, avoiding decongestants
• Medications — alpha blockers (like tamsulosin) to relax prostate muscles and improve urine flow, or 5-alpha reductase inhibitors (like finasteride) to slowly shrink the prostate over months

These work well for many men, especially in the early stages. However, medications have limitations: they don’t work for everyone, they can have side effects (including sexual dysfunction such as reduced sex drive or erectile problems), they must be taken indefinitely, and their effectiveness can diminish over time. When medications fail to provide adequate relief, or when side effects become unacceptable, it’s time to consider procedural interventions.

What Is Rezum Water Vapor Therapy?

Rezum is a minimally invasive, FDA-approved (internationally certified for safety and effectiveness) treatment that uses the natural energy of water vapor (steam) to shrink excess prostate tissue. Think of it as using controlled, precisely targeted steam to treat only the enlarged portions of the prostate that are blocking urine flow.

How Rezum Works: The Science Made Simple

Here’s what happens during a Rezum procedure:

I insert a small Rezum device through the urethra (the same path urine follows) using a cystoscope (a thin camera tube). No incisions are needed. Once the device is positioned, I deliver short bursts of steam — each lasting just 9 seconds — directly into the enlarged prostate tissue. The steam is created by heating sterile water to 103 degrees Celsius.

When the steam hits the prostate tissue, it immediately releases thermal energy. This causes the cells in the overgrown tissue to die through a process called cell necrosis (controlled cell death). The beauty of this approach is that it’s highly targeted — I can precisely treat only the areas that are causing obstruction while leaving healthy tissue untouched.

Over the next 1 to 3 months, your body naturally absorbs the dead tissue through a process called apoptosis (the body’s natural process of clearing away damaged cells). As this tissue is removed, the urethra gradually opens up, urine flow improves, and symptoms resolve. Most patients notice improvements within weeks, with full benefits realized by 3 months.

The number of steam injections depends on the size and shape of your prostate — typically 4 to 10 injections. Each injection takes only 9 seconds. The entire treatment usually takes just 5 to 15 minutes.

The Rezum Procedure at Fortis Mohali: What to Expect

One of the things my patients appreciate most about Rezum is how straightforward and minimally disruptive it is compared to traditional surgery. Let me walk you through the process step by step.

Pre-Procedure Consultation and Assessment

When you come to my clinic, I conduct a thorough evaluation:

• Detailed symptom assessment using standardized questionnaires (IPSS — International Prostate Symptom Score, a scoring system that rates how much your urinary symptoms affect your daily life)
• Physical examination including digital rectal exam to assess prostate size
• Uroflow study (a simple test that measures how fast your urine flows) to measure your urine flow rate
• Ultrasound to measure prostate size and post-void residual urine (how much urine is left in the bladder after urination)
• Blood tests including PSA (Prostate-Specific Antigen — a blood marker used to rule out prostate cancer)
• Sometimes cystoscopy (a camera examination of the inside of the bladder and prostate) to visualize the prostate and urethra

Based on these findings, I determine whether you’re a good candidate for Rezum. The ideal prostate size for Rezum is typically 30 to 80 grams, though we can sometimes treat slightly larger prostates.

The Day of Your Procedure

Rezum is performed as a day-care procedure — you come in the morning and go home the same day. Here’s what happens:

Preparation:

• You’ll have fasted for 6 hours before the procedure
• We administer local anesthesia to numb the urethra — some patients also receive light sedation if they prefer
• Importantly, you do NOT need to stop blood thinners like aspirin or clopidogrel — this is a major advantage over surgical procedures

The Treatment:

I position you comfortably on the procedure table. Using a cystoscope, I visualize your prostate through the urethra on a monitor. Then I systematically deliver steam injections to the enlarged areas. You’ll feel some pressure but the local anesthetic prevents significant pain. The actual steam delivery takes 5 to 15 minutes.

Immediate Aftermath:

After the treatment, we monitor you for a few hours. Some patients are able to urinate on their own right away. Others may experience temporary swelling that makes urination difficult — in these cases, I place a small catheter (a thin tube to drain urine) that you’ll take home for 3 to 7 days. Don’t worry — this is temporary and expected.

Most patients are discharged the same day, usually within 2 to 4 hours.

Recovery and What to Expect in the Weeks Ahead

Week 1:

• You may experience some burning with urination, urgency, frequency, or blood in the urine — these are normal and temporary
• Pain is usually mild and managed with over-the-counter medications
• Most men can return to light activities within a few days
• Avoid heavy lifting, strenuous exercise, and sexual activity for 2 weeks

Weeks 2–4:

• Symptoms gradually begin to improve
• If you had a catheter, you’ll notice significant relief once it’s removed
• You can return to work, especially if you have a desk job

1–3 Months:

• This is when the real improvement happens — your body is actively absorbing the treated tissue
• Urine flow steadily improves
• Nighttime urination decreases
• You’ll notice progressive symptom relief

3 Months and Beyond:

• Maximum benefit achieved
• Studies show sustained improvement for 5+ years
• Most men experience 40–50% reduction in symptom scores
• Quality of life significantly improved

Why Choose Rezum ? The Key Advantages

In my experience performing over a hundred Rezum procedures, here’s why this treatment stands out:

1. Preserves Sexual Function

This is often my patients’ top concern. Traditional surgical treatments like TURP have a 40–60% risk of retrograde ejaculation (where semen goes into the bladder instead of out through the penis during orgasm, also known as “dry orgasm”). Rezum has only a 4–5% risk of this complication. Erectile function is preserved in the vast majority of patients. For younger men and those still sexually active, this is a game-changer.

2. Minimally Invasive with Fast Recovery

No incisions. No general anesthesia. No hospital stay. Most of my patients are back to light activities within days and fully recovered within 2–3 weeks. Compare this to TURP, which often requires 2–3 days in the hospital and 4–6 weeks of recovery.

3. Safe for High-Risk Patients

I can perform Rezum on patients who would be too high-risk for traditional surgery:

• Patients on blood thinners (no need to stop medications)
• Elderly patients with multiple medical conditions
• Patients who cannot tolerate general or spinal anesthesia
• Patients with pacemakers or defibrillators

4. Long-Lasting Results

The 5-year data is excellent. Studies show sustained symptom improvement with very low retreatment rates (around 4–10%). This is comparable to surgical outcomes but with far fewer risks and faster recovery.

5. No Permanent Implants

Unlike UroLift (which places permanent implants), Rezum doesn’t leave anything foreign in your body. The treatment uses only steam and relies on your body’s natural healing processes.

Rezum vs. TURP: How Do They Compare?

Patients from Mohali, Chandigarh, and Panchkula often ask me how Rezum compares to TURP (transurethral resection of the prostate — the traditional “gold standard” prostate surgery), which has been the surgical standard for decades. Let me give you an honest comparison:

Who Should Choose Which?

In my practice, I recommend:

• Rezum for: Moderate BPH (30–80g prostate), men wanting to preserve sexual function, high-risk surgical candidates, men wanting minimal downtime
• TURP for: Very large prostates (>80–100g), severe symptoms not responsive to Rezum, patients where maximum flow improvement is critical

Who Is an Ideal Candidate for Rezum?

Based on my experience, Rezum works best for:

Men with Moderate to Severe BPH Symptoms Who:

• Have tried medications without adequate relief or experienced intolerable side effects
• Have moderate prostate enlargement (typically 30–80 grams)
• Want to preserve sexual function
• Prefer a minimally invasive option with quick recovery
• Are on blood thinners and cannot safely stop them for surgery
• Have medical conditions making traditional surgery too risky

Who May Not Be Ideal for Rezum:

• Men with very large prostates (>100g) — though we can sometimes still offer it
• Men with a prominent median lobe (a type of prostate growth that blocks the bladder outlet) obstructing the bladder neck — though newer techniques are addressing this
• Men with suspected prostate cancer (must be ruled out first)
• Men who need immediate symptom relief (Rezum takes 1–3 months for full benefit)

Fortis Mohali’s Leadership in Rezum Therapy

Why Our Experience Matters

When Rezum first came to India, we recognized its potential immediately. Fortis Hospital Mohali became North India’s first center to offer this treatment. Since then, we’ve built one of India’s most extensive Rezum programs.

Our achievements include:

• Over 200 successful Rezum procedures — second highest volume in India
• Individually, I have performed the second highest number of Rezum procedures in the country
• We regularly proctor urologists from other hospitals across India who are introducing Rezum to their practices
• In August 2025, we hosted India’s first national conference on Rezum and RIRS, bringing together urologists from across the country

This volume and experience matter tremendously. Every procedure I perform adds to my expertise. I’ve seen and successfully managed every type of prostate anatomy and every potential challenge. This translates directly to better outcomes and fewer complications for you.

Our Comprehensive Approach

At Fortis Mohali, Rezum is part of our comprehensive BPH treatment program. Men from across the Tricity region — Mohali, Chandigarh, and Panchkula — as well as patients from across Punjab, Haryana, and Himachal Pradesh benefit from our full range of options:

• Conservative management with medications
• Rezum water vapor therapy
• Robotic UroLift (for patients who prefer permanent implants)
• Laser prostate surgery (HoLEP, Greenlight)
• Traditional TURP when needed
• Robotic simple prostatectomy for very large glands

This means I can honestly recommend the best treatment for YOUR specific situation — not just push one technology. Your prostate is unique, and your treatment should be too.

Lifestyle and Natural Approaches to Complement Treatment

While Rezum can dramatically improve your symptoms, I always encourage patients to adopt healthy lifestyle habits that support prostate health:

Diet Recommendations:

• Eat plenty of fruits and vegetables, especially tomatoes (lycopene), berries, and leafy greens
• Include omega-3 fatty acids from fish
• Limit red meat, processed foods, and excessive dairy
• Avoid spicy foods if they irritate your bladder
• Reduce caffeine and alcohol, especially in the evening

Fluid Management:

• Drink adequate fluids throughout the day (about 2 liters total)
• Limit fluids 2-3 hours before bedtime to reduce nighttime urination
• Avoid drinking large amounts at once

Exercise and Weight Management:

• Regular physical activity reduces BPH symptoms
• Aim for 150 minutes of moderate exercise per week
• Maintain healthy body weight — obesity worsens BPH
• Include pelvic floor exercises (Kegels) to improve bladder control

Bladder Habits:

• Urinate when you feel the urge — don't hold it too long
• Practice double voiding: urinate, wait 30 seconds, try again
• Take your time — don't rush

Conclusion: Taking Control of Your Prostate Health

Living with BPH symptoms doesn't have to be your reality. The days when men had to choose between ineffective medications and major surgery are over. Rezum water vapor therapy offers a true middle ground — effective, minimally invasive, quick recovery, and preservation of sexual function.

At Fortis Hospital Mohali, we've made Rezum therapy accessible to men across North India. Our experience — second highest volume in India — means you benefit from refined techniques, expert care, and proven results. I've personally performed the second highest number of Rezum procedures in the country, and I regularly train other urologists in this technique.

But more important than our credentials is our commitment to you. When you come to my clinic, I take the time to understand your unique situation, explain all your options honestly, and recommend the treatment that's truly best for YOU — not just the latest technology.

If you're tired of waking up multiple times each night, if you're avoiding social situations because of bathroom urgency, if medications aren't working or are causing side effects, it's time to explore your options. Rezum may be the solution you've been looking for.

Don't let BPH control your life. Modern solutions like Rezum can restore your quality of life with minimal disruption. Schedule a consultation to discuss whether Rezum is right for you.