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Rezum & Greenlight for BPH

Minimally Invasive Treatments for BPH

Rezūm™ Water Vapor Therapy & Greenlight Laser Therapy

As men age they many have enlargement of the prostate gland.  When this happens, it can squeeze the urethra and obstruct the flow of urine. Benign prostatic hyperplasia (BPH), as it is known, is a condition in which a man’s prostate enlarges and squeezes the urethra, causing frustrating symptoms such as frequent or urgent urination, a weak or interrupted urine stream, and the need to get up several times a night to urinate. This is because as you age, the bladder muscle breaks down and it becomes difficult for the muscle to contract and push urine past the prostate.

BPH happens to almost all men and symptoms usually begin at about age 50.  By that age, nearly half of all men will experience some of the common signs of BPH. By 80 years old, 90% of men will have symptoms. Most guys think it is normal getting up in the night to go to the bathroom, but it is a hallmark sign that this process is beginning and a reminder to seek help from your doctor.

Common signs of BPH

    • Slower urine flow
    • Getting up at night to urinate
    • Urinary frequency
    • Urinary urgency
    • Incomplete bladder emptying


Normal Prostate

Enlarged Prostate

Risk factors for BPH include: a family history of BPH, obesity, heart disease and diabetes. It is important to address BPH, as left unaddressed it can lead to an Inability to urinate requiring a catheter, urinary tract infections or even kidney damage from not emptying the bladder adequately.

Treatment Options

Fortunately, there are many treatment options are available for BPH – watching and waiting, behavioral modification therapies, medication, minimally invasive treatments and surgery.


Medication such as Flomax is the most common first-line treatment for mild to moderate symptoms of enlarged prostate. Most men initially manage BPH through their primary care doctor and are prescribed medication. They seek the help of a urologist when the medicine is not working or if they are experiencing undesirable side effects from the medicines.

Minimally invasive or surgical treatment might be recommended if symptoms are moderate to severe and medication doesn’t relieve the symptoms, relieve the underlying condition or if the patient has other health issues.

Rezūm™ Water Vapor Therapy

As symptoms progress, Rezūm™ Water Vapor Therapy is a minimally invasive in-office procedure for men looking to treat their BPH and relieve the problem at the source not just treat the symptoms. It uses natural water vapor to reduce the size of the prostate and provide lasting symptom relief from BPH without surgery. For many men, Rezūm Therapy relieves BPH symptoms safely and effectively and most men see improvement in their symptoms within a few weeks and are able to return to regular activities within a fewdays after treatment.

Rezūm™ Water Vapor Therapy may be an option for those who have moved beyond watchful waiting and lifestyle changes or men who are dissatisfied with the side effects of medication, have stopped, or don’t want to start taking BPH medications, and men not interested in other minimally invasive or not ready for surgicalBPH procedures. Rezūm Therapy removes excess prostate tissue with water vapor, thereby treating thedisease while also relieving symptoms while preserving sexual function. Rezum is a newer procedure and is used for smaller prostates. When the prostate is larger usually, we turn to the Greenlight Laser Therapy as a treatment option.

Rezum Frequently Asked Questions

Greenlight Laser Therapy


Greenlight Laser therapy is another option for the treatment of BPH and is usually employed when the prostate is larger.  It has been around for more than 15 years. It was developed as a minimally invasive alternative to a TURP Procedure, that cut out pieces of the prostate using an electrical loop to make it smaller.  This surgery required an overnight hospital stay and put people at risk for bleeding and impotence and incontinence in some rare cases.  Because of these risks, most urologists have moved away from TURP to more minimally invasive methods to treat BPH, such as the Greenlight laser.

The laser works by vaporizering tissue on contact, so it removes the excess prostate tissues where it is obstructing urinary flow. The Greenlight laser can achieve the same results as traditional surgery, but withless bleeding, shorter time in surgery, no overnight stay. Patients experience very rapid relief of symptoms and a dramatic improvement in urine flow. This can be noticeable as quickly as 24 hours after the procedure. Most see dramatic improvement in the first 3 – 4 weeks, as swelling goes down and healing begins.  Patients can expect improvement to peak at 3 – 4 months and usually see sustained improvement through the first year.  This procedure is usually a one- time procedure – with 88% of men who have undergone Greenlight Laser Therapy needing no additional treatment within 15 years.   It is an excellent option for men who have progressive BPH.

The procedure itself takes only between 30 – 45 minutes and patients go home that same day. We usually recommend they wear a catheter for 48 hours after the procedure.  It is normal to have small amounts of blood in the urine initially, but most resume normal activities about a week after surgery.

In the hands of an expert, the risk of incontinence and sexual side effects is extremely small, and patients are generally very happy with the results. With the right candidate, Greenlight Laser Therapy is an excellent way to get a surgical result with a minimally invasive procedure.


At Urology Associates our philosophy is to medically manage conditions with the least invasive methods possible.  It is important when you are considering more invasive methods of treatment that you are familiar with your surgeons’ level of expertise. Dr. Fagelson has been using the Greenlight Laser since 2001. He has achieved a high degree of experience with GreenLight Laser Therapy and Dr. Fagelson’s practice at Urology Associates has been designated as a GreenLight Center of Excellence.