When talking about the disease that occurs only in men, most people will think about benign prostatic hyperplasia which is more common and tend to be increasingly found. The age range when it first occurs is normally in men aged 40-45 years. The main symptoms include decreased force of urination, taking a long time to urinate, incomplete emptying bladder, and urinary incontinence. These symptoms significantly affect daily lives.

Cause of Benign Prostatic Hyperplasia or Enlarged Prostate 
Benign prostatic hyperplasia is caused by abnormal growth and division of prostate cells which makes prostate gland grow bigger. The growth of prostate gland develops gradually; therefore, patients get used to decreased force of urination and a weak urine steam, and when the disease is detected, the patient is already old. Annual check-up is then essential that men should not overlook because the earlier benign prostatic hyperplasia, the easier the treatment.

The Treatment of Benign Prostatic Hyperplasia
There are many treatment options for benign prostatic hyperplasia. If the disease is found in the initial stage which prostate gland size is not too big, treatment can be started with urinary tract dilation medications for easier urination. In some cases, the physician may prescribe medications for enlarged prostate. Alternatively, if there are complications from enlarged prostate such as not being able to pee, blood in the urine, urinary tract infection, bladder stones, impaired kidney function, the physician may consider the surgical treatment which is performed through microscope. The surgeon inserts an endoscope through the urethra to remove the prostate gland that blocks the urinary tract with an electric coil or laser.

What is Water vapor therapy (Rezum)?
Water vapor therapy is another popular treatment option. It is a technology from oversea that Thai physicians have brought to treat the patient since 2015. Over the past 5 years, treating enlarged prostate with water vapor therapy provides good outcome by approximately more than 95 percent which is similar to the standard treatment.

How to treat with water vapor therapy 
During water vapor therapy treatment, the physician will insert the scope and instrument through the urethra into the prostate gland and then release steam at 103 Celsius to cells of prostate. When cells of prostate are exposed by the vapor, prostate cells will die. As time passes, the body will gradually then eliminates the dead prostate cells and cells of the prostate gland that block the urethra will shrink. The size of the prostate will reduce as well which enable the patient to urinate more easily.

Which kinds of patient are suitable for treating with water vapor therapy treatment? 
    • Enlarged prostate treatment is appropriate in case of the prostate that is not so large which is between 30-80 grams
    • Patients who do not want to take medications for enlarged prostate for a long period
    • Patients who take medications and has side effects such as low blood pressure, dizziness or erectile dysfunction
    • Patients who take prostate medicine and their symptoms do not improve or do not respond to medications
    • Patients who are not healthy enough to have general anesthesia for a long time during the surgery

The advantage of Water vapor therapy
    • It is an arthroscopic treatment without the surgery, so the patient has no scar
    • The treatment takes only 10-15 minutes
    • After the treatment, the patient can return home for recovery, patient is not required to stay overnight at the hospital.
    • Less blood loss, fast recovery
    • No anesthesia required. Use only a mild sedative or topical pain relievers

Nevertheless, treating enlarged prostate with water vapor therapy is still limited in patients with artificial urinary sphincters, penile prosthesis or artificial penis including the patients who have urinary tract infections. These patients have to consult with the doctor first to find the right suitable treatment plan.
Treatment outcome

During the first week after the treatment, the patient will have difficulty urinating due to swollen prostate.  Doctors therefore recommend wearing a urinary catheter to allow the patient to urinate easily for approximately 5-7 days, depending on the size of the prostate. The patient can return home and spend a daily life as normal. After that, the patient will follow up with the doctor as scheduled to remove urinary catheter and observe the symptoms at the hospital.
After the urinary catheter is removed, the patients will urinate more and more easily, this will be clearly noticeable after 1-3 month of treatment. The successful rate is 95 percent which is similar to standard treatment option.
For patients with problems of enlarged prostate, we recommend you to visit the physician for physical examination and diagnosis. At Phyathai 2 Hospital, we provide several treatment options whether medications, standard surgery and the new treatment method like water vapor therapy. 
Enlarged prostate is the disease that men should not overlook because if there is complications arise, it will make the treatment more difficult. Therefore, men should observe themselves, and consult the physician immediately if initial symptoms occur.