/)
If you are waking up two or three times a night to urinate, straining to start, or feeling like your bladder never fully empties, an enlarged prostate is one of the most common reasons. The medical name is benign prostatic hyperplasia, or BPH, and it is a normal part of ageing for most men. The harder question is what to do about it once tablets stop helping or their side effects become annoying. For years the main step up from medication was transurethral resection of the prostate (TURP), an effective operation that often changes ejaculation. Rezum sits in the gap between those two options: more durable than a daily pill, far less invasive than cutting or lasering the prostate, and usually kind to sexual function.
This guide explains how Rezum (water vapor thermal therapy) actually works, who it suits and who it does not, what it costs in Bangkok with transparent THB and USD figures, how recovery unfolds week by week, what the published results show out to five years, and the risks worth understanding before you book. Rezum is a medical procedure that requires a urology consultation and assessment, so treat the figures and timelines here as a realistic starting point, not a substitute for being examined.
What Rezum therapy is
Rezum is a treatment for an enlarged prostate that uses steam rather than a blade or laser. A thin device is passed along the urethra (the channel you urinate through) to the prostate, and a retractable needle delivers short bursts of sterile water vapor directly into the overgrown tissue that is squeezing the urinary channel shut. Each injection lasts about nine seconds.
The clever part is what happens next. The vapor releases its stored thermal energy as it condenses inside the tissue, and that energy spreads evenly through the targeted zone, a process called convective heating. The treated cells die, and over the following weeks your body's own immune system clears them away. As that tissue is reabsorbed, the prostate shrinks from the inside, the urethra reopens, and urine flows more freely. Because the energy stays within the treated zone and respects natural tissue boundaries, the structures that control continence and ejaculation are usually spared.
A few features make Rezum distinctive compared with older surgery. There are no incisions anywhere on the body. It can be performed under light sedation or local anaesthesia rather than a general anaesthetic in many men. And it removes nothing in the operating room itself, so the visible improvement is gradual rather than instant. That last point matters for expectations: you do not walk out cured, you walk out with a process underway that pays off over the next one to three months.
If you want the wider picture of how an enlarged prostate develops and how all the treatment tiers compare, our overview of benign prostatic hyperplasia in men sets the context, and Rezum is one of the minimally invasive options within it.
Where Rezum fits among BPH treatments
Rezum belongs to a family of minimally invasive surgical therapies (sometimes shortened to MIST) that aim to relieve obstruction while protecting sexual function. It helps to see it alongside its neighbours.
Medication (alpha-blockers such as tamsulosin, and 5-alpha-reductase inhibitors such as finasteride or dutasteride) is usually the first step. It works for many men but has to be taken indefinitely, can cause dizziness, low blood pressure or changes in ejaculation, and tends to lose ground as the prostate keeps growing. Many men reach Rezum because they want off the tablets. Our page on BPH medication for men covers that tier in detail.
UroLift is the closest cousin to Rezum. Instead of heating tissue, it places small permanent implants that hold the prostate lobes open like tie-backs on a curtain. It often gives faster relief and may avoid a catheter, but it does not shrink the prostate and is less suited to certain anatomies. Our UroLift procedure guide compares the two in more depth.
Resective and ablative surgery removes or vaporises tissue outright: TURP, HoLEP for larger glands, and newer options such as Aquablation. These tend to give the largest, fastest improvement in flow, which is why they remain the reference standard, but they more often change ejaculation and usually need a general or spinal anaesthetic.
Prostatic implants such as the iTind device temporarily reshape the channel and are then removed. Our note on the iTind BPH implant outlines that approach.
The trade-off Rezum offers is a middle path: more lasting than medication, gentler than resective surgery, and ejaculation-sparing in most men, at the cost of a slower onset and a small chance of needing a further procedure later.
Bangkok pricing: THB, USD and how it compares
Rezum in Bangkok is usually quoted as an all-in package at a private hospital. Based on published hospital pricing and current market rates, the figures below are indicative; the exact number depends on the hospital tier, your prostate size, the type of sedation, and whether pre-operative tests are bundled or billed separately. Always confirm the final quote at consultation. USD conversions use roughly 36.5 THB to 1 USD and will move with the exchange rate.
Item | Bangkok (THB) | Bangkok (USD approx.) | Typical US / UK private | Notes |
Rezum procedure, all-in package | ฿180,000 – ฿280,000 | $4,900 – $7,700 | US hospital/surgical centre ~$8,000 – $16,000 (office cash-pay can be lower); UK ~£6,000 – £9,000 | Day case, sedation or local; published Bangkok packages cluster around ฿220,000 – ฿250,000 |
Urology consultation | ฿1,000 – ฿2,500 | $30 – $70 | $150 – $350 | Often credited toward the package |
Pre-procedure work-up (uroflow, ultrasound, PSA, urine test) | ฿4,000 – ฿12,000 | $110 – $330 | $300 – $800 | May be bundled or separate |
Follow-up visit and catheter removal | Often included | – | – | Confirm whether in package |
Indicative all-in total | ฿190,000 – ฿295,000 | $5,200 – $8,100 | UK and US facility pricing often higher | Confirm at consult |
The pricing picture for men travelling for care is more nuanced than a single savings figure. UK private Rezum commonly sits around £6,000 to £9,000, so a Bangkok package at established hospitals routinely comes in below that. The US comparison is bimodal: hospital or surgical-centre billing with anaesthesia frequently lands somewhere in the region of 8,000 to 16,000 USD once facility and anaesthesia fees are added, while some US urology practices offer office-based, cash-pay Rezum for only a few thousand dollars. So the Bangkok advantage is clearest against UK private and US facility-based pricing, and less so against the lowest US office rates. Treat all of the foreign figures as ballpark ranges rather than fixed quotes, since they vary widely by provider and insurance status, and note that Bangkok hospitals use the same Boston Scientific Rezum system and comparable facilities.
For a deeper line-item breakdown specific to Bangkok hospitals, see our companion article on Rezum treatment costs in Bangkok.
What drives the cost
A few factors move the price within those ranges:
Prostate size. Larger glands need more vapor injections and sometimes a slightly longer procedure, which can nudge the cost up.
Sedation versus local anaesthesia. Light sedation or a brief general adds anaesthetist and recovery charges compared with a local-only approach.
Hospital tier. Flagship international hospitals price above mid-tier private centres for the same procedure.
Pre-operative testing. Whether the uroflowmetry, ultrasound, PSA and urine tests are inside the package or billed on top.
Catheter and follow-up. Whether the catheter, its removal visit and the early follow-ups are included.
Travel logistics. For overseas patients, accommodation and a longer stay to clear the catheter are real costs to plan for, even when the medical fee is fixed.
Who is a good candidate
Rezum tends to suit men who have bothersome lower urinary tract symptoms from BPH and want a durable result without the higher sexual side-effect profile of resective surgery. You are more likely to be a good candidate if you:
Have moderate to severe symptoms (weak stream, frequency, urgency, nocturia, incomplete emptying) that affect daily life
Have a prostate volume roughly in the 30 to 80 gram range, the size band where the strongest evidence sits, with selected use up to about 100 grams at experienced centres
Have tried medication and found it insufficient, or want to stop taking it
Place a high value on preserving ejaculation
Prefer a minimally invasive, mostly outpatient option over a hospital operation
Are fit enough for light sedation or local anaesthesia
Prostate size is assessed by ultrasound at your work-up, which is why an in-person evaluation matters. The published trials enrolled men with glands of 30 to 80 cm³, and professional guidance generally frames Rezum as an option below about 80 grams, with counselling about retreatment for larger glands. Newer data suggest selected larger prostates can be treated, but with longer catheter times and a higher complication risk, so this is a decision to make with your urologist.
Who it is not for, and contraindications
Rezum is not the right choice for everyone. It is generally avoided or needs careful rethinking if you:
Have a very large prostate (well above 80 to 100 grams), where resective options such as HoLEP usually give a more complete result
Are in complete urinary retention or have a markedly weak (underactive) bladder, since Rezum relieves obstruction but cannot make a failing bladder muscle squeeze
Have an active urinary tract infection (this must be treated first)
Have a confirmed or suspected prostate or bladder cancer that has not been evaluated
Have a penile implant or an artificial urinary sphincter, or certain other implanted devices, where the manufacturer advises against use
Need an immediate, definitive result and cannot accept the gradual onset over weeks
A prominent median lobe (a third lobe bulging into the bladder) does not rule out Rezum, but it does change the treatment plan, and very calcified or stone-laden prostates are poor targets. These are exactly the details a urologist checks before recommending the procedure, which is why Rezum always follows a consultation and cannot be prescribed sight unseen.
The procedure, step by step
Rezum is typically completed in well under half an hour of treatment time, though you should plan for several hours at the hospital across check-in, the procedure and recovery.
Assessment and consent. Before the day itself you will have a consultation, a symptom score (often the IPSS questionnaire), a urine flow test, an ultrasound to measure prostate size and check for retained urine, a PSA blood test and a urine test. This is where candidacy is confirmed. A urology consultation is the entry point.
Anaesthesia. On the day, you are given light sedation, a prostate nerve block, or a short general anaesthetic depending on the centre and your preference. Many men have it under sedation rather than full anaesthesia.
Insertion. The urologist passes the Rezum delivery device along the urethra using a small camera (cystoscope) to see the prostate from the inside. No skin incision is made.
Vapor delivery. A fine needle extends into the prostate tissue and delivers a roughly nine-second burst of sterile water vapor. The urologist repeats this in a planned pattern, usually several injections per side, mapping the treatment to your prostate's size and shape, including the median lobe if present.
Catheter placement. Because the treated tissue swells before it shrinks, a urinary catheter is placed to keep you draining comfortably while the early swelling settles.
Recovery and discharge. After a short observation period most men go home the same day with the catheter in place and a short course of medication, often including something to ease bladder irritation and sometimes an antibiotic.
Staged recovery, week by week
Recovery from Rezum is generally straightforward, but it is gradual, and the first couple of weeks can feel worse before they feel better. A realistic timeline looks like this:
Days 1 to 3. A catheter is in place. Expect burning on urination once it is out, some urgency and frequency, and possibly a little blood in the urine. Mild pelvic discomfort is normal.
Catheter removal (around days 3 to 7). Most men have the catheter for a few days; published series describe roughly three to five days for average-sized prostates and longer (around a week or more) for larger glands. Your team will confirm timing.
Weeks 1 to 2. Urinary symptoms can temporarily feel heightened as the prostate is still swollen and the treated tissue has not yet been cleared. Stinging, urgency and frequency are common and usually settle.
Weeks 3 to 6. Most men notice flow improving and night-time trips reducing as the body reabsorbs the treated tissue and the channel opens.
Weeks 6 to 12. Improvement typically reaches its peak as tissue resorption completes. This is when you and your urologist judge the final result.
Light activity can usually resume quickly, while strenuous exercise, cycling and heavy lifting are generally deferred for a week or two. Your own instructions take precedence over any general timeline.
Results: what the evidence shows
Rezum has reasonably mature data behind it, including a multicentre randomised controlled trial with follow-up out to five years. The quantified figures below come from that body of evidence and give a fair sense of what to expect, recognising individual results vary.
Symptom relief. In the key trial, urinary symptom scores (IPSS) improved by roughly 48 percent, with meaningful gains usually visible within three months and sustained through five years.
Flow and quality of life. Peak urine flow rate (Qmax) improved by around 4.4 mL per second (roughly a 45 to 50 percent improvement), and quality-of-life scores improved substantially over the same period.
Durability. There was no significant loss of benefit between one year and five years in the trial population, which is the key reason Rezum is positioned as a durable rather than temporary fix.
Retreatment. The surgical retreatment rate was about 4.4 percent over five years, and around 11 percent of men started or restarted BPH medication. In other words, roughly 95 percent avoided needing another invasive procedure within five years.
Sexual function. Ejaculation was preserved in the large majority of men. The five-year trial data showed no clinically meaningful decline in erectile or ejaculatory function, and pooled series report retrograde ejaculation in roughly 2 to 3 percent of men.
That last point is usually the deciding factor for men weighing Rezum against TURP. Effective obstruction relief without routinely sacrificing ejaculation is the trade Rezum is built around. It will not always match the sheer flow improvement of a full resection, but for many men the balance of benefit and preserved function is exactly what they are looking for.
Have a question about your treatment?
Message our Bangkok clinic on WhatsApp and a doctor replies within minutes during clinic hours.
Risks and side effects
Rezum has a favourable safety profile, and serious complications are uncommon, but it is still a procedure and side effects are real. Knowing what is expected versus what needs attention helps you recover with less anxiety.
Common and usually temporary (typically settling within the first few weeks):
Burning or stinging when urinating
Increased urinary frequency and urgency
Blood in the urine or semen
Mild pelvic or perineal discomfort
Catheter-related irritation while it is in place
A temporary feeling that symptoms are worse before they improve
Less common:
Urinary tract infection
Temporary difficulty urinating or short-term retention after the catheter comes out, occasionally needing the catheter replaced for a few more days
Retrograde ejaculation (semen passing back into the bladder) in a minority of men
Seek urgent medical care if you develop any of the following after the procedure:
Inability to urinate at all after the catheter is removed (acute retention)
Fever, chills or feeling generally unwell, which can signal infection
Heavy or persistent bleeding, or passing large clots
Severe or worsening pain not controlled by your prescribed medication
Most men never experience the red-flag events, but you should know them and have a clear contact route to your clinic before you go home. Do not wait out a fever or a full, painful bladder.
Choosing a clinic safely
Rezum is only as good as the urologist planning and delivering it, and the assessment beforehand is as important as the procedure itself. A few signals separate a safe, well-run service from a risky one.
What good looks like:
A board-certified urologist who performs prostate and BPH procedures regularly, not occasionally
A proper work-up before any procedure is offered: symptom score, flow test, ultrasound for prostate size, PSA and urine test, so the recommendation is based on your actual anatomy
An honest conversation about alternatives, including medication, UroLift and resective surgery, rather than a single product being pushed
Transparent, itemised pricing with a clear statement of what the package does and does not include
A documented plan for the catheter, follow-up and what to do if problems arise
Use of the genuine Rezum (Boston Scientific) system and a clean, accredited facility
Red flags worth walking away from:
A quote or a booking offered before anyone has measured your prostate
Pressure to decide immediately, or vague pricing that keeps changing
A promise of instant results (Rezum works gradually, and any clinic claiming otherwise is misleading you)
No clear answer on who manages complications, or no after-hours contact
Dismissiveness about ruling out prostate cancer when symptoms or PSA warrant it
For men travelling to Bangkok, also confirm how long you are expected to stay for catheter removal and follow-up, so your trip is planned around the recovery rather than against it.
Rezum compared with other BPH procedures
No single treatment is best for every man. The table below summarises the practical trade-offs to discuss with your urologist. Figures are general and individual cases vary.
Feature | Rezum (steam) | UroLift (implants) | TURP (resection) | HoLEP (laser enucleation) |
How it works | Steam ablates tissue, body reabsorbs it | Implants hold lobes open | Tissue cut away electrically | Tissue lasered out and removed |
Anaesthesia | Sedation or local, often | Sedation or local, often | Spinal or general | Spinal or general |
Hospital stay | Usually day case | Usually day case | Often 1 to 2 nights | Often 1 to 2 nights |
Catheter | A few days typical | Often none or brief | Several days | Several days |
Onset of relief | Gradual, 4 to 12 weeks | Often faster | Fast | Fast |
Shrinks prostate | Yes, over weeks | No | Removes tissue | Removes tissue |
Ejaculation preserved | Usually (around 2 to 3% retrograde) | Usually | Often affected | Often affected |
Best-suited prostate size | ~30 to 80 g (selected larger) | Smaller, specific anatomy | Moderate | Large |
Durability | Durable to 5 years; ~4 to 5% retreatment | Good; some retreatment | Long-established, robust | Long-established, robust |
In broad terms: if preserving ejaculation and avoiding a hospital operation matter most, Rezum and UroLift lead the conversation. If your prostate is large or you want the most complete, immediate flow improvement and are comfortable with the sexual trade-off, resective options such as HoLEP or TURP come into focus.
Booking a consultation at Menscape
If an enlarged prostate is interrupting your sleep, your travel or your confidence, the practical next step is an assessment rather than a guess. At Menscape in Bangkok, a urology consultation covers a symptom review, the flow and ultrasound measurements that determine whether Rezum suits your prostate, and a frank discussion of the alternatives, so any recommendation is built around your anatomy and your priorities. You can read more about the procedure itself on our Rezum service page.
Rezum is a medical procedure that requires a consultation, prescription and pre-procedure assessment by a qualified urologist; it cannot be arranged without one. The pricing and timelines in this article are indicative and should be confirmed in person. Book a private, discreet consultation to find out whether water vapor therapy is the right move for you.
Frequently Asked Questions
Does Rezum affect ejaculation or erections?
For most men, no. The key five-year trial found no clinically meaningful decline in erectile or ejaculatory function over that period, and pooled published series report retrograde ejaculation in only about 2 to 3 percent of men. This ejaculation-sparing profile is the main reason many men choose Rezum over TURP. Individual results vary, so discuss your own risk with your urologist.
How much does Rezum cost in Bangkok?
All-in Rezum packages at Bangkok private hospitals commonly run about 180,000 to 280,000 THB (roughly 4,900 to 7,700 USD), with published hospital prices clustering near 220,000 to 250,000 THB. The exact figure depends on the hospital tier, your prostate size, the sedation used and whether pre-operative tests are bundled. These are indicative figures to confirm at consultation. They sit clearly below UK private pricing (around £6,000 to £9,000) and US hospital or surgical-centre billing (around 8,000 to 16,000 USD), though some US practices offer office-based cash-pay Rezum for less, so compare like for like.
Will I need a catheter after Rezum, and for how long?
Yes, a urinary catheter is standard because the treated prostate swells before it shrinks. Most men keep it for only a few days; published series describe roughly three to five days for average-sized prostates, and longer (about a week or more) for larger glands. Your urologist will confirm the timing and arrange removal.
How long until Rezum works?
Relief is gradual, not immediate. The first one to two weeks can feel worse as the prostate is still swollen, then most men notice flow improving from around weeks three to six, with the peak benefit usually reached by weeks six to twelve as the body reabsorbs the treated tissue. Anyone promising instant results is misleading you.
How long do Rezum results last?
The key randomised trial followed men to five years and found durable symptom relief with no significant loss of benefit between one and five years. The surgical retreatment rate was about 4 to 5 percent over five years, meaning roughly 95 percent of men avoided another invasive procedure in that window. Longer-term outcomes beyond five years are still being studied.
Is Rezum painful?
Most men report mild discomfort rather than significant pain. The procedure is done under light sedation, a prostate nerve block or a short general anaesthetic, so it is generally well tolerated. Afterward, burning on urination, urgency and mild pelvic discomfort are common for a couple of weeks and usually settle with simple measures and prescribed medication.
Am I a candidate if my prostate is very large?
Possibly, but with caveats. The strongest evidence is for prostates of about 30 to 80 grams, and guidance generally frames Rezum as an option below roughly 80 grams. Selected larger glands up to around 100 grams can be treated at experienced centres, but with longer catheter times and higher complication risk. For very large prostates, resective options such as HoLEP often give a more complete result. An ultrasound at your work-up settles this.
How is Rezum different from UroLift?
Both are minimally invasive and usually preserve ejaculation, but the mechanism differs. Rezum uses steam to ablate tissue, which the body then reabsorbs so the prostate physically shrinks over weeks. UroLift places small permanent implants that hold the prostate lobes open without removing or shrinking tissue, often with faster relief and sometimes no catheter. The best choice depends on your prostate's size and shape, which your urologist will assess.
/)
/)
/)
/)
/)