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Rezum for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia

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1 Recommendations

1.1 Evidence supports the case for adopting Rezum for treating lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) in the NHS. Rezum relieves LUTS and improves quality of life.

1.2 Rezum is a minimally invasive procedure and can be done under local anaesthesia or light sedation. It should be considered as a treatment option for people with:

  • moderate to severe LUTS (International Prostate Symptoms Score [IPSS] typically 13 or over) and

  • a moderately enlarged prostate (typically between 30 cm3 and 80 cm3).

1.3 Cost modelling estimates that, per person over 4 years, Rezum is cost saving compared with:

  • UroLift by £497

  • transurethral resection of the prostate (TURP) by £569

  • holmium laser enucleation of the prostate (HoLEP) by £651.

Why the committee made these recommendations

Rezum is a minimally invasive procedure that involves injecting steam to destroy excess prostate tissue. Clinical evidence shows that using the Rezum procedure relieves LUTS caused by BPH in men with moderate to severe symptoms who have a moderately enlarged prostate. Evidence also shows that using Rezum is associated with improved quality of life and preserved sexual function. Cost analyses suggest that when Rezum is used as an alternative to standard treatment options such as TURP, it is likely to lead to cost savings because it is done as day surgery with reduced operating and recovery costs. Rezum is also cost saving compared with UroLift because of low consumable costs.