REZUM for BPH vs Urolift for Treatment of Enlarged Prostate Symptoms

by Alex Shteynshlyuger MD

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Everything You Want to Know About Rezum and Urolift

Technology: Urolift vs Rezum

Urolift mechanically displaces the prostate by compressing it without destroying tissue.   The REZUM procedure destroys prostate tissue using heat energy in the form of water vapor produced by the conversion of radiofrequency energy (RF) into heat.

Rezum vs Urolift: What is More Effective

dralex banner Copy 300x258 - Urolift vs REZUM for Treatment of Enlarged Prostate Symptoms and Slow Urine StreamWhile no studies have been done to compare the effectiveness of Rezum and Urolift directly against each other, we can draw some conclusions based on the mechanism of action of each procedure, studies that have been published and clinical experience.

Most men experience improvement in urinary symptoms after Urolift surgery within 1-2 weeks. Improvement in symptoms after treatment with the REZUM procedure takes about 1 month as destroyed tissue needs to be resorbed by the body.

For men with pliable lateral lobe hypertrophy of the prostate, Urolift is very effective. For men with a component of the median lobe, REZUM surgery may be more effective as it is capable of destroying the median lobe.

Men whose obstruction by the lateral lobe of the prostate is predominantly at the bladder neck may be better off with REZUM as Urolift is not very effective at treating lateral lobe obstruction in proximity to the bladder neck.

Men with predominantly distal lateral lobe obstruction, may benefit more from the Urolift procedure as the placement of Urolift stents is very controlled and there is no concern about injury to the urethral sphincter with the Urolift procedure for BPH.

Recovery after Urolift procedure vs REZUM procedure for BPH

Both Urolift procedure and REZUM procedure allow most men to return to work the same or next day.  Men are advised to refrain from sexual activity for 2 weeks to allow healing time. 

Most men experience fairly fast improvement in urinary symptoms within 1-2 weeks after the Urolift procedure.   Noticeable improvement after the REZUM procedure requires more patience and typically benefits start to appear after 1 month to 6 weeks after the procedure.  It is important to understand that most men will not see any benefit from the REZUM procedure until a month after the procedure; one should NOT expect immediate benefit and there is no need to be frustrated.

At New York Urology Specialists, we advise men that they can return to their usual activity within a few days after REZUM and Urolift procedure.  We also advise avoiding any activity that involves stress on perineum and prostate:  biking, having sex and masturbation (ejaculation).

Side Effects of Treatment: Urolift vs REZUM

Both Urolift and REZUM prostate procedures for the treatment of enlarged prostate (BPH) can be performed under local anesthesia in under 15 minutes.  IV Sedation or general anesthesia is not necessary but can be administered to patients with severe anxiety and a history of panic attacks. 

At New York Urology Specialists, most men are able to urinate spontaneously after Urolift procedures and fewer than 10% require a catheter for 1-3 days.  With the REZUM procedure, more inflammation and swelling occurs because it destroys prostate tissue and there is a more frequent need for temporary catheterization after the REZUM procedure than after Urolift.

Men may experience a small amount of bleeding in urine for a few days after both Urolift and REZUM procedures.  Bleeding typically stops spontaneously after a few days to 1 week after the procedure. 

Because of the manipulation, a small amount of irritation with frequent urination, mild burning with urination and urinary urgency can occur immediately after the Urolift procedure for BPH as well as after REZUM treatment for enlarged prostate.  The frequency of these side effects is similar and they are typically mild and resolve within 3-10 days after REZUM and Urolift procedures.

Insurances Coverage for Rezum procedure vs Urolift Insurance Coverage

Many insurances including CIGNA, AETNA, UnitedHealthcare, GHI, EmblemHealth as well as 1199 cover the cost of treatment with REZUM procedure or Urolift for enlarged prostate. Some insurances may cover Urolift and not REZUM and vice versa – in these circumstances we are usually able to work with insurance companies to get approval.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: (646) 663-4044

Dr. Alex Shteynshlyuger is an experienced urologist who has treated hundreds of men with an enlarged prostate.  He is one of the few urologists who offers a full range of treatment options for BPH including REZUM procedure, Urolift for BPH, and laser prostate enucleation.  Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for urinary problems in men including BPH, frequent urination, slow urine stream, enlarged prostate, and urinary tract infections.