PCRI's resident moderator Mark Moyad, MD, MPH, talks with urologist Steven Gange, MD, FACS, about the Rezum procedure for treating enlarged prostates, also known as benign prostatic hyperplasia (BPH).

Dr. Steven Gange graduated from the UCLA School of Medicine in 1986. After his Urology residency training at the University of Kentucky in 1991, he entered the US Army as an academic urologist, teaching, and training residents. He joined Western Urological Clinic (now Summit Urology Group) in Salt Lake City, UT, in 1996. With over 25 years of clinical and research experience, he has developed an expertise in Men’s Health Urology, emphasizing minimally invasive procedures. He continues to be active as a Clinical Researcher and as such was the first Urologist in North America to perform the NeoTract UroLift for BPH, and the first in the world to perform UroLift under local anesthesia.

0:43 Dr. Gange explains that Rezum treats BPH by means of delivering heat to destroy excess prostate cells. Rezum takes advantage of the concept of convection by using steam to achieve consistent heat transfer. This contrasts with two older heat-based therapies for BPH, transurethral microwave therapy (TUMT) and transurethral needle ablation (TUNA), which both use conductive heat.

1:52 Dr. Gange says that the Rezum procedure can be completed in about five minutes, which is slightly faster than the contemporary Urolift procedure. He goes on to say, however, that the Rezum procedure is usually more painful for patients than Urolift. Also, the heat from Rezum causes tissue swelling that prolongs urinary blockage symptoms until the swelling subsides. Therefore, it is routine for Rezum patients to temporarily use a catheter. Urolift patients, then, usually have a better immediate experience. However, Dr. Gange defers judgment about which procedure is superior until the time when studies about the two are completed.

3:30 Dr. Gange says that it is possible to perform the Rezum procedure more than once if it fails after the first attempt. However, he goes on to add that he does have concerns about multiple retreatments because of changes to tissue architecture.

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