Addressing the rising burden of benign prostatic hyperplasia with minimally invasive treatments to tackle healthcare pressure
Benign prostatic hyperplasia (BPH) is a rapidly growing urological concern driven by a global aging population. With healthcare systems under strain due to increased demand, resource limitations, and surgical backlogs, hospitals may benefit from technologies that are less invasive for patients and less resource intensive for healthcare systems. Among minimally invasive treatments for BPH, Rezūm™ Water Vapour Therapy, now with the recently released next-generation Rezūm™ EVO Console, has the potential to deliver operational efficiency to hospitals.
Burden of Benign Prostatic Hyperplasia
BPH, or enlarged prostate, is a non-cancerous condition common in aging men. As the prostate grows, it can compress the urethra, causing lower urinary tract symptoms (LUTS). With life expectancy increasing worldwide, BPH has become a major global urological concern: in the last two decades, its prevalence has increased by more than 70%, now affecting 94 million men over the age of 40 worldwide, particularly in low- and middle-income countries experiencing rapid demographic changes. In Europe, BPH incidence rates are expected to continue rising steadily, especially in populations aged 60–79. About half of men at age 60 show some signs of BPH; by age 85, the figure rises to 90%.
While medications are the first-line treatment for mild-to-moderate symptoms, one in ten diagnosed patients may require surgery for lasting relief.
Minimally invasive treatments for potential improvement in operational efficiency
BPH treatment options range from lifestyle changes to medication and surgery. The European Association of Urology (EAU) considers transurethral resection of the prostate (TURP) the standard surgical approach. However, TURP can be considered resource-intensive for healthcare systems and invasive for patients: it requires general or spinal anaesthesia, access to an operating room and one or more days of hospital stay. It is known to have complications, including bleeding, strictures and sexual side effects, sometimes requiring a further procedure.
With hospitals facing surgical backlogs, bed and staff shortages, healthcare providers are increasingly looking for solutions that balance clinical efficacy with operations efficiency and quality of care. At the same time, patients increasingly prefer quicker recovery, fewer sexual side effects and less invasive options.
Compared to TURP, minimally invasive surgical treatments for BPH have the potential to generate operational benefits for hospitals, as patients can leave sooner1 and be treated more often in outpatient settings,2 which may positively impact hospital capacity. Given these dynamics, it’s probably no surprise that the use of TURP declined by 9.5% between 2019 and 2023 in Europe, with a corresponding 10% rise of innovative options like laser technologies and minimally invasive surgical treatments such as Rezūm™ Water Vapour Therapy.3
Rezūm Water Vapour Therapy: a proven and cost-efficient minimally invasive treatment
Rezūm Therapy is a minimally invasive technique that uses water vapour to shrink prostate tissue. It provides durable LUTS relief through five years following treatment without clinically significant impact to erectile and ejaculatory dysfunction.4 It treats a wide range of patients, including those ineligible for TURP or general anaesthesia,5 and those with more specific anatomies, like median lobe enlargement.6
The average procedure takes less than 10 minutes, it is suitable for outpatient settings under local anaesthesia,7 and carries low post-operative burden, thereby reducing re-admissions and follow-ups, thus creating capacity gains for the hospital.8
Budget impact analyses conducted in various European countries have demonstrated the potential of Rezūm adoption to lower expenditure for national healthcare systems, through reduced hospital bed days and operating time:
- in the UK, NICE estimates £550 savings per patient over four years compared to TURP. 9
- in Spain, potential cost savings have been confirmed by the Spanish national health authority Instituto de Salud Carlos III.10 Furthermore, Rezūm adoption is projected to save €29 million over four years, with reductions in operating room time (~7,000 hours) and bed days (~25,500)11, supported by real-world evidence showing zero-day stays versus multi-day stays with traditional surgeries. 12
- in Italy, Rezūm could potentially save €764 per patient compared to TURP, with broader adoption (replacing 30% of TURPs) delivering national savings of over €21 million, 14,000 theatre hours, and 80,000 bed days annually.13
Rezūm™ EVO Console: innovation for optimised care
Continuous innovation is key in making minimally invasive treatments more suitable to everyday clinical needs. The next-generation Rezūm™ EVO Console, recently introduced in Europe, brings in design developments aimed at improving usability and optimising operational efficiency. Staff can work independently across different clinical settings, thus aligning treatment delivery with the growing demand for outpatient care.
“In developing Rezūm Evo Console, we listened carefully to urologists’ insights on how to optimise their efficiency,” said Miguel Aragon, vice president of Urology and Capital & Services in Europe, Middle East and Africa at Boston Scientific. “The new console is designed to streamline ambulatory procedures in terms of space and resources, a meaningful advancement in BPH care that reflects our commitment to science and innovation.”
As healthcare systems need to deliver greater efficiency, there is an opportunity to refine existing minimally invasive procedures through innovations that better support both operational needs and patient care, particularly in response to the challenges of an aging population.
Read here to learn more about Rezūm EVO Console.
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1 Length of hospital stays: MIST (0.2–1.4 days) vs. TURP (2–5.25 days). Source: B.W. Turney, J.-N. Cornu, P. Schatteman et al., Evolution of the Endoscopic Surgical Approach for Benign Prostatic Obstruction in European Countries, Eur Urol Focus (2025), https://doi.org/10.1016/j.euf.2025.03.014
2 Outpatient rates: MIST (78%) vs. TURP (mostly inpatient: 1–12%). Source: B.W. Turney, J.-N. Cornu, P. Schatteman et al., Evolution of the Endoscopic Surgical Approach for Benign Prostatic Obstruction in European Countries, Eur Urol Focus (2025), https://doi.org/10.1016/j.euf.2025.03.014
3 B.W. Turney, J.-N. Cornu, P. Schatteman et al., Evolution of the Endoscopic Surgical Approach for Benign Prostatic Obstruction in European Countries, Eur Urol Focus (2025), https://doi.org/10.1016/j.euf.2025.03.014
4 McVary KT, ElArabi A, Roehrborn C. Preservation of Sexual Function 5 Years After Water Vapor Thermal Therapy for Benign Prostatic Hyperplasia. Sex Med. 2021 Oct 30;9(6):100454.
5 McVary KT, Rogers T, Roehrborn CG. Rezūm water vapor thermal therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia: 4‐year results from randomized controlled study. Urology. 2019 Apr;126:171‐9.
6 Woo HH, Gonzalez RR. Perspective on the Rezūm® System: a minimally invasive treatment strategy for benign prostatic hyperplasia using convective radiofrequency water vapor thermal therapy. Med Devices (Auckl). 2017;10:71‐80.
7 McVary KT, Gittelman MC, Goldberg KA, Patel K, Shore ND, Levin RM, Pliskin M, Beahrs JR, Prall D, Kaminetsky J, Cowan BE, Cantrill CH, Mynderse LA, Ulchaker JC, Tadros NN, Gange SN, Roehrborn CG. Final 5-Year Outcomes of the Multicenter Randomized Sham-Controlled Trial of a Water Vapor Thermal Therapy for Treatment of Moderate to Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. J Urol. 2021 Sep;206(3):715-724. doi: 10.1097/JU.0000000000001778. Epub 2021 Apr 19. PMID: 33872051
8 De la Cuadra-Grande, A., Rioja-Zuazu, J., Domínguez-Esteban, M., Torres, E., Blissett, R., Woodward, E., … Fernández-Arjona, M. (2023). Budget impact analysis of transurethral water vapor therapy for treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia in the Spanish national healthcare system. Expert Review of Pharmacoeconomics & Outcomes Research, 23(5), 499–510. https://doi.org/10.1080/14737167.2023.2189591
11 De la Cuadra-Grande, A., Rioja-Zuazu, J., Domínguez-Esteban, M., Torres, E., Blissett, R., Woodward, E., … Fernández-Arjona, M. (2023). Budget impact analysis of transurethral water vapor therapy for treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia in the Spanish national healthcare system. Expert Review of Pharmacoeconomics & Outcomes Research, 23(5), 499–510. https://doi.org/10.1080/14737167.2023.2189591
12 Iván PM, Alberto BA, Lluís PC, Maurizio D, Jose Luís GB, Francisco Javier VP, Almudena SB, Jaime GH, Esperanza TM, Pablo BA, Gabriela OA, Manuel GB, Miguel Ángel C, Alberto CG, Emilio LA. A real-world evidence study of interhospital variability in the surgical treatment of patients with benign prostatic hyperplasia: the REVALURO study. Int Urol Nephrol. 2025 Mar;57(3):775-784. doi: 10.1007/s11255-024-04239-7. Epub 2024 Oct 29. PMID: 39470938; PMCID: PMC11821794.
13 Blissett RS, Blissett DB, Oselin M, Demaire C, Woodward E, Siciliano M, et al. Transurethral water vapor therapy for treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: a cost-minimization and budget impact analysis from an Italian healthcare perspective. Minerva Urol Nephrol 2023;75:343-52. DOI: 10.23736/S2724-6051.22.05020-0