Boston Scientific and BPH treatment with Rezūm™ Water Vapour Therapy

The UK has just seen the first case of treatment for benign prostatic hyperplasia (BPH) with Rezūm™ Water Vapour Therapy using the newly launched Rezūm™ EVO Console at Basingstoke and North Hampshire Hospital.

BPH is a non-malignant condition which causes an urgent need to urinate, difficulty starting and stopping urination, inability to completely empty the bladder and that affects from 50% up to 75% of men aged 50 years and over.[1] In the UK around 1.4 million men are affected by BPH and the burden of BPH is increasing and putting pressure on health systems to manage by scaling capacity (resources, infrastructure, workforce).[2] BPH can progress developing more severe symptoms such as bladder dysfunction, acute urinary retention, or urinary tract infections[3] and damage to the kidneys and bladder.[4]

When symptoms of BPH cannot, or can no longer be treated adequately by lifestyle modifications, medications are the standard first-line treatment for lower urinary tract symptoms (LUTS). However, medication side effects often impact sexual function.[5] In addition, long-term adherence to medical therapies is often poor. [6]

After medication, various surgical treatment options are available, from more invasive to less invasive. Transurethral resection of the prostate (TURP) is considered the standard surgical approach by the European Association of Urology (EAU).[7] TURP requires general or spinal anaesthesia, access to an operating room and one or more days of hospital stay. Some of the potential complications include bleeding, strictures and sexual side effects, sometimes requiring a further procedure.[8]

Among minimally invasive options, Rezūm™ Water Vapour Therapy is an effective and safe minimally invasive therapy for BPH[9] intended to relieve lower urinary tract symptoms (LUTS), obstructions, and reduce prostate tissue. It uses the energy stored in water vapour, or steam, to remove excess prostate tissue that is pressing on the urethra: water vapour is released into the prostate.

The Rezūm™ EVO Water Vapour Therapy Console is the next-generation device intended to be used alongside the current Rezūm delivery device to perform the Rezūm Water Vapour Therapy procedure and is designed for improved mobility and greater ease of use, making it practical for various medical settings.

Compared to the previous generation, the newly-launched Rezūm™ EVO Console has been designed to take up less space with improved mobility, making it more practical for use in different clinical environments. It supports healthcare staff regardless of experience level in performing procedure efficiently and autonomously.

The Console has further benefits for staff as there is a shorter learning curve with a guided interface and 3D animations, allows staff at various experience levels to set it up it quickly and easily.

Rezūm is a minimally invasive option usually performed as a day-case procedure lasting on average less than 10 minutes,[10] with most patients being discharged the same day.[11] This means procedures can be performed in an ambulatory or outpatient setting with shorter inpatient stays, quicker recovery time and potential cost savings.[12]

NICE estimates that Rezūm is cost saving compared with standard treatments such as transurethral resection of the prostate (TURP) by more than £550 per person over four years.[13]

The cost of managing related conditions such as urinary tract infections (UTIs), which are a significant complication and driver of health care resource use for BPH patients, was estimated at £604 million for 2023-2024 in NHS hospitals alone. [14] Rezūm™ has been positively evaluated by NICE Guidance.[15]

Leading consultant urologist, Prof. Richard Hindley is the clinical lead in Urology at the North Hampshire Hospital. He has nearly two decades’ expertise in prostate cancer diagnostics, BPH and minimally invasive treatments.

He said: “Today many BPH patients are delayed from specialist consultations due to current medications prescribing practices. I do see potential to reduce waiting lists by offering quicker, minimally invasive options. Moreover, Rezūm EVO portable design could make delivery of care more flexible across hospital and outpatient settings, from the theatre area to the day unit or in outpatient setting or at urology treatment centre, increasing versatility of secondary care.”

[1] GBD 2019 Benign Prostatic Hyperplasia Collaborators. The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Healthy Longev. 2022 Nov;3(11):e754-e776. doi: 10.1016/S2666-7568(22)00213-6. Epub 2022 Oct 20. PMID: 36273485; PMCID: PMC9640930.

[2] GBD 2019 Benign Prostatic Hyperplasia Collaborators. The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Healthy Longev. 2022 Nov;3(11):e754-e776. doi: 10.1016/S2666-7568(22)00213-6. Epub 2022 Oct 20. PMID: 36273485; PMCID: PMC9640930.

[3] Lepor H. Pathophysiology, epidemiology, and natural history of benign prostatic hyperplasia. Rev Urol. 2004;6 Suppl 9: S3–S10. Available: http://www.ncbi.nlm.nih.gov/pubmed/16985923

[4] Tubaro A, Carter S, Trucchi A, Punzo G, Petta S, Miano L. Early treatment of benign prostatic hyperplasia: implications for reducing the risk of permanent bladder damage. Drugs Aging. 2003;20:185–195. Carter HB. Prostate Disorders: the Johns Hopkins White Papers. Baltimore, MD: Johns Hopkins Medicine. 2010:1-24.

[5] Abdulghafour Halawani, Ryan Paterson, Tianshuang Zhong, Katie Du, Runhan Ren, Connor M. Forbes, Risks and side effects in the medical management of benign prostatic hyperplasia, Prostate International, 2024. https://doi.org/10.1016/j.prnil.2023.11.004

[6] Long, B., Cheema, A., Copelan, Ol., Joyce, C., Feffer, M., K.T. McVary. Five-Year Outcomes of Water Vapor Therapy versus Doxazosin, Finasteride, and Combination Therapy for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Cohort Data from the Medical Therapy of Prostatic Symptoms (MTOPS) Trial. Urology, 2025; Article in Press, from: Five-Year Outcomes of Water Vapor Therapy vs Doxazosin, Finasteride, and Combination Therapy for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Cohort Data From the Medical Therapy of Prostatic Symptoms Trial - Urology

[7] https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts

[8] Cornu JN, Gacci M, Hashim H, et al. EAU guidelines on the management of non-neurogenic male LUTS. European Association of Urology; 2025

[9] McVary KT, Gange SN, Gittelman MC, Goldberg KA, Patel K, Shore ND, et al. Minimally invasive prostate convective water vapor energy ablation: A multicenter, randomized, controlled study for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol. Elsevier Ltd; 2016b;195: 1529–1538. doi:10.1016/j.juro.2015.10.181​

McVary KT, Roehrborn CG. Three-Year Outcomes of the Prospective, Randomized Controlled Rezūm System Study: Convective Radiofrequency Thermal Therapy for Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia. Urology. 2018 Jan;111:1-9. doi: 10.1016/j.urology.2017.10.023. Epub 2017 Nov 6. PMID: 29122620

[10] McVary KT, Gittelman MC, Goldberg KA, Patel K, Shore ND, Levin RM, Pliskin M, Beahrs JR, Prall D, Kaminetsky J, Cowan BE, Cantrill CH, Mynderse LA, Ulchaker JC, Tadros NN, Gange SN, Roehrborn CG. Final 5-Year Outcomes of the Multicenter Randomized Sham-Controlled Trial of a Water Vapor Thermal Therapy for Treatment of Moderate to Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. J Urol. 2021 Sep;206(3):715-724. doi: 10.1097/JU.0000000000001778. Epub 2021 Apr 19. PMID: 33872051.

[11]  NICE Guidance on Rezūm https://www.nice.org.uk/guidance/mtg49/chapter/1-Recommendations

[12] https://www.eu-focus.europeanurology.com/article/S2405-4569(25)00101-4/abstract

[13] https://www.nice.org.uk/guidance/mtg49 

[14] https://www.gov.uk/government/news/utis-cost-nhs-hospitals-over-600m-last-year 

[15] NICE (National Institute for Health and Clinical Excellence). Rezūm for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia. 2020