In the past, men with larger prostates were often told they weren’t candidates for minimally invasive treatments and had to consider more aggressive surgical options, but this is starting to change. Advances in both technique and clinical experience with Rezūm Water Vapour Therapy are offering new hope to men living with symptoms of Benign Prostatic Hyperplasia (BPH) who were once told “no”.
Today, more and more men with larger prostates may have access to a simpler, more effective alternative that fits their lifestyle and treatment goals.
For years, prostate size played a major role in determining which treatments were considered safe and effective. Minimally invasive therapies were typically recommended only for men with small to moderately enlarged prostates (often under 80 grams). Men with larger prostates were frequently told they were not candidates for these options and were instead directed toward surgical procedures.
Treating larger prostates has traditionally been more complex for several reasons. A bigger gland means:
In earlier clinical trials, strict size limits were put in place to ensure predictable outcomes and patient safety. As a result, many men with larger prostates were automatically excluded from less invasive options, even if they were good candidates in other ways.
This long-standing size restriction is exactly what’s now being challenged, as newer approaches and growing clinical experience expand what’s possible for men once told they had no minimally invasive options.
Rezūm Water Vapour Therapy is a minimally invasive treatment designed to relieve urinary symptoms caused by BPH without the need for major surgery. It uses the natural energy stored in water vapour to target and reduce excess prostate tissue that is blocking urine flow.
Rezūm works by delivering small, controlled bursts of steam directly into the enlarged areas of the prostate. When the steam comes into contact with the tissue, it releases thermal energy that causes the targeted cells to break down.
Over time, the body naturally reabsorbs this treated tissue, which:
The procedure is precise, allowing urologists to treat only the areas causing obstruction while leaving surrounding structures largely unaffected.
Unlike traditional surgical approaches, Rezūm does not involve cutting, shaving, or removing prostate tissue in the operating room. Instead, it is typically performed in a clinic setting and requires only minimal anesthesia.
Key advantages include:
As experience with Rezūm continues to grow, the definition of an “ideal candidate” is evolving, especially for men with larger prostates.
You may now be considered if you:
For instance, in a 2025 study conducted by the Canadian Urological Association Journal, 259 patients with a prostate volume of over 80 mL were treated with Rezūm. The results of the study proved that Rezūm therapy is considered to be a safe, effective, and minimally invasive option for men with large prostates. It provides significant and sustained improvements in urinary symptoms, and as a bonus, has minimal impact on sexual function.
Candidates also include those with persistent urinary symptoms that are impacting daily life, such as:
Being told you are not a candidate for treatment can feel extremely discouraging, but with Rezūm, this is no longer always the case. For men with annoying urinary symptoms and larger prostates, new techniques and methods are opening the door to less invasive, highly effective options.
If you have been told “no” in the past, it may be time to revisit your options with Steinberg Urology. Book an appointment with our world-class urologist to start your journey to a better quality of life.
