Aquablation vs. RezumWhich BPH Procedure Is Right for You?

Two of the newer minimally invasive BPH treatments — Aquablation and Rezum — both use water in some form. That's where the similarities end. Understanding the differences is key to choosing the right procedure for your anatomy and your goals.

How Each One Works

Aquablation uses a robotically controlled, high-pressure waterjet to physically remove obstructing prostate tissue under real-time ultrasound guidance. It's a one-time procedure performed under anesthesia, with results visible immediately.

Rezum uses thermal energy in the form of water vapor (steam) injected into the prostate. The steam destroys cells, which the body then absorbs over weeks to months. It's an in-office procedure under local or light sedation.

Prostate Size: A Major Differentiator

This is where the two procedures diverge sharply.

• Rezum — Best suited for prostates roughly 30–80 grams. Not typically recommended for very large prostates.
• Aquablation — Effective across the full range, including prostates over 80 grams and even above 150 grams, where most other minimally invasive options aren't appropriate.

Recovery and Time to Results

Rezum is performed in-office and patients usually go home the same day. However, full symptom relief typically takes 3 months as the body absorbs treated tissue. A catheter is usually needed for several days to a week.

Aquablation involves an overnight hospital stay, but symptom improvement begins almost immediately after catheter removal at 24–48 hours.

Sexual Function

Both procedures have strong profiles for preserving sexual function compared to traditional surgeries like TURP. Aquablation has clinical data showing very low rates of ejaculatory dysfunction — a major advantage for men who consider sexual function a priority.

Durability

Aquablation has 5-year clinical trial data showing low retreatment rates and durable symptom relief. Rezum also has multi-year follow-up showing meaningful durability, though retreatment rates tend to be modestly higher, particularly in larger prostates.

Which Is Right for You?

The right answer depends on your prostate size, anatomy, symptom severity, and personal priorities. As a general rule:

• Rezum may be appealing if you have a smaller-to-moderate prostate, want an in-office procedure, and are comfortable with a gradual onset of relief.
• Aquablation is often the better choice for larger prostates, men wanting faster symptom relief, and those who place high priority on preserving ejaculatory function.

A consultation with a urologist experienced in both techniques is the only way to get a clear, personalized recommendation.