Rezūm vs UroLift in Taichung: BPH day surgery, catheter and recovery

In short

• Shared: no hospital stay; both aim to keep ejaculation and erections.
• Urethral lift: faster improvement, but the objective gain in urine flow is usually smaller than after operations that remove tissue.
• Water vapour therapy: the improvement may be greater, but it takes weeks to months to become clear.
• Key point: the shape of the prostate, especially an enlarged middle lobe, matters more than the symptom score.
• First: prostate cancer must be ruled out, because neither procedure gives a full tissue sample.

Your symptom score: which step are you on?

The IPSS (International Prostate Symptom Score, 7 questions) shows which step of treatment you are on. You can do the IPSS self-assessment in about one minute.

The score is not everything. Even under 20, surgery becomes more necessary after acute urinary retention (suddenly unable to pass urine), repeated urinary infections, bladder stones, effects on the kidneys, or repeated bleeding from the prostate. A high score with a healthy bladder and a good response to medicine does not always mean surgery now.

About 4 to 12 weeks after the procedure, you repeat the IPSS to measure the effect. For causes, tests and every treatment step, see the complete guide to an enlarged prostate (BPH).

The two procedures at a glance

Both go through the urethra (the tube that carries urine), usually with no cut in the abdomen. A urethral lift places small permanent implants that pull the two side lobes outwards, like curtain tie-backs, so the channel opens at once. Water vapour therapy releases steam into the prostate a few seconds at a time; the heat kills the target cells, and over weeks to months the body absorbs them.

These numbers come from different patient groups, not one trial comparing the two directly, so 4.4% and 13.6% alone cannot show that one is better. Studies also count “retreatment” differently (a second operation only, or also restarting medicine or removing implants) over different follow-up times. The 2026 EAU (European Association of Urology) guidelines judge durability by repeat surgery, stopping medicine and needing new urinary medicine, but note that most studies report only repeat surgery and long-term randomised trials are lacking.

How both procedures are arranged at this clinic

• Who operates: the clinic’s urologists, Dr. Chao-An Chen and Dr. Kai-Wu Yang, in person.
• Anaesthesia: always sedation (IVGA). A board-certified anaesthesiologist checks your heart and lungs beforehand and monitors your vital signs throughout.
• Three visits: (1) assessment and blood tests; (2) the procedure, then home the same day, with no hospital stay; (3) catheter removal. After water vapour therapy, a visit at about 3 months reviews your medicine.
• Waiting time: usually about one week after you decide, depending on the anaesthesiologist’s schedule.
• Insurance and costs: the urine flow test, the ultrasound of urine left in the bladder and the PSA blood test before surgery are covered by National Health Insurance (NHI). If you are not enrolled in Taiwan’s National Health Insurance, the consultation and tests are self-paid. Costs are explained at the consultation. You can also ask about costs on LINE before you come.

This is the clinic’s current practice. Which procedure fits you, any other treatment needed, and the final cost are decided at the consultation and confirmed in writing.

Prostate cancer must be ruled out first

After water vapour therapy, the treated tissue is absorbed inside the body. A urethral lift removes no tissue. So neither usually gives a full tissue sample, as transurethral resection (TURP) or laser enucleation (HoLEP) does. If the PSA test, a rectal examination or imaging raises a concern about cancer, the cancer risk should be assessed first, before any minimally invasive procedure is booked. This is a clinical conclusion based on how the two procedures work.

When neither is usually the first choice

• A very large prostate
• Severe, repeated urinary retention
• A large amount of urine left in the bladder
• Clearly weak bladder contraction: the cause must be checked first, and surgery may not help
• A large bladder stone
• Repeated infections or blood in the urine
• Severe narrowing of the urethra (stricture)
• Prostate tissue is needed for pathology: enucleation or resection is chosen, not vaporisation
• Suspected prostate cancer: PSA and PHI first (a blood test here). If MRI or a biopsy is needed, you are referred to a medical centre
• You want the largest possible improvement in flow in one treatment
• Previous prostate surgery with complicated anatomy

The two procedures without a hospital stay at this clinic suit a prostate of about 30–80 mL. For a prostate over 80 mL in men who can pause blood thinners, the 2026 EAU guidelines list three first choices: open surgery (only without equipment for endoscopic enucleation), holmium laser enucleation (HoLEP) and bipolar enucleation. Thulium laser enucleation, laser vaporisation and traditional resection are alternatives. For high-risk men who cannot stop blood thinners, laser vaporisation is first choice. Enucleation peels the enlarged gland away through the urethra and removes it in pieces. It needs spinal or general anaesthesia and usually a hospital stay; HoLEP arranged by this clinic is done with a stay at a partner hospital.

If this is you, still come to the clinic first: we measure size, flow and urine left in the bladder, test PSA, and explain the right operation. Bring any ultrasound or health check report.

Which one may suit you?

Both assume moderate to severe symptoms. The EAU says the choice also depends on other illnesses, fitness for anaesthesia, how severe the blockage is, how much side-effect risk you accept, and the surgeon’s experience. A simple question helps: which worries you more, a slow improvement or a catheter?

Tests before the procedure

1. Symptoms: the IPSS.
2. Blockage: a urine flow test and a check of urine left in the bladder.
3. Shape: prostate ultrasound for size and a middle lobe pushing into the bladder.
4. Other diseases: urine test for infection and blood; PSA (or PHI) for cancer risk.
5. If needed: cystoscopy (a camera into the bladder) to see the shape of the blockage.
6. Decision and pre-operative risk assessment: medicine, urethral lift, water vapour therapy, or laser or other surgery.

A low maximum flow rate (Qmax) is a clue, not a diagnosis; a normal-looking one does not rule out a blockage. The decision is never based on the flow report alone (reading the urine flow report (Chinese); for older men, anaesthesia assessment before prostate surgery (Chinese)).

Before your visit: drink as usual; do not empty your bladder just before arriving or hold it until very full. If you have ever been suddenly unable to pass urine, tell us and do not hold it. Bring your medicines (some, such as diuretics, antihistamines and cold medicines, affect passing urine) and earlier reports. You can do the online IPSS (Chinese) beforehand.

What the studies show

Water vapour therapy: in a five-year randomised trial, the IPSS fell by about 48%, quality of life improved by 45% and the maximum flow rate rose by 44%, lasting five years. Repeat surgery within five years was 4.4%. A 2024 single-centre study (80 vapour and 68 lift patients) found a larger average improvement after vapour, but the groups differed and were not randomised, so it cannot prove vapour always works better.

Urethral lift: studies summarised by the EAU show the IPSS improves by about 39% to 52% and the flow rate by about 32% to 59%, with gains still present at five years. Compared with TURP, the improvement is usually smaller.

Sexual function: a urethral lift does not cut or heat tissue; in studies, erection and ejaculation mostly stayed stable, with advantages over TURP in keeping ejaculation. The five-year vapour trial found no device- or procedure-related sexual problems and no lasting new erectile dysfunction. A 2026 review in Sexual Medicine Reviews (14 studies, 1,306 patients) found no statistically significant change in ejaculation scores (MSHQ-EjD) from 1 to 24 months. But most studies were observational with a clear risk of bias, data beyond 24 months are limited, and patients were mostly from Europe, North America and the Middle East. “No significant change” does not mean no risk. For both procedures, the risk of lasting new erectile dysfunction is low, but any treatment through the urethra can cause temporary changes in ejaculation, semen volume or erections, from inflammation, pain, anxiety, a pause in sex, infection, medicine, existing blood vessel disease or individual factors.

Middle lobe: this is tissue that grows up from below the bladder outlet, sometimes like a ball blocking it. Vapour can be injected into it, and its labelling and core studies include it. For urethral lift, the MedLift study showed a specific technique can treat it, but the 2026 EAU guidelines still see long-term data as limited. So the decision also looks at how far it pushes into the bladder, the bladder neck, the surgeon’s experience, and whether you accept uncertainty about the effect and retreatment.

Recovery and the catheter

Urethral lift: the channel opens once the implants are placed, and you usually go home the same day. In the literature, most patients do not need a catheter for long, but this clinic routinely leaves one in for one night and removes it the next day. Blood in the urine, urgency, burning and pelvic discomfort can still occur; most are mild to moderate and often improve within two to four weeks.

Water vapour therapy: “swelling first, then gradually better”. The treated area swells for a while, so a catheter is often needed, depending on prostate size, urine left in the bladder and bladder function; the current advice at this clinic is 1–2 weeks. Both catheter routines aim to lower the risk of a failed removal and acute urinary retention, and the doctor adjusts the days to your recovery. In the first two to four weeks you may pass urine more often than before, with urgency, burning, blood in the urine or briefly worse flow. Improvement is gradual, over about two weeks to three months.

Living with a catheter:

• You may not need a bag all day. Some men can use a catheter valve that they open at set times. The doctor decides, based on bladder capacity and sensation, hand function and bleeding. It does not suit everyone.
• You can shower normally. Clean around the urethral opening every day and keep it dry.
• Early on, avoid hard exercise, long sitting or standing, and long rides.
• Before removal, a voiding trial checks that you can empty your bladder. A few men need the catheter longer after the first trial. This does not mean the procedure failed.

Risks and honest limits

• Both are supported by five-year randomised studies, but neither is a complete cure for an enlarged prostate. The improvement is usually smaller than after full removal or enucleation.
• Urethral lift recovers faster but leaves permanent implants, and its long-term retreatment rate is higher than after traditional resection. Water vapour therapy leaves no implant and can treat the middle lobe, but improves more slowly and more often needs a short time with a catheter.
• After either, there may be blood in the urine, urgency, burning, infection, pelvic discomfort or urinary retention.
• “Keeping ejaculation” means a lower risk, not that everyone keeps exactly the same semen volume and sensation. Results vary from person to person.
• If symptoms come mainly from an overactive bladder, too much urine at night or a weak bladder muscle, opening the prostate may not fully help.
• Prostate cancer, an active urinary infection, severe urethral stricture or a clotting disorder should be treated first. A web page cannot replace the ultrasound, flow, bladder and middle lobe assessment at a consultation.

Frequently asked questions

Related pages

• Water vapour therapy: the procedure day and recovery timeline
• Prostatic urethral lift
• Testosterone deficiency in men: night-time urination often comes with hormone and metabolic changes.
• Low-intensity shockwave therapy (ESWT) for erectile dysfunction: your current erections can be assessed first.
• Comprehensive STD screening: burning and frequent urination can also come from infection.

Appointments and access

Consultations are conducted in Mandarin, and can also be conducted in English.

Bring your medicines and earlier reports. The doctor checks prostate size, middle lobe, urine flow, urine left in the bladder, PSA and bladder function, and then you decide together. Asking for a parent? Describe the symptoms and current medicines on LINE, and the doctor can suggest a first direction.

昭安泌尿科診所 (Morning Urology Clinic)
No. 98, Boguan 2nd St., West District, Taichung City 403, Taiwan（403 臺中市西區博館二街98號）
Consulting hours: Monday to Saturday (closed Sunday). Online booking is open 24 hours.

This page was produced by 昭安泌尿科診所 (Morning Urology Clinic). Medical content last updated: October 2026 (same as the Traditional Chinese version). English version published: 5 November 2026. Medically reviewed by Dr. Chao-An Chen, urologist.

Sources: EAU Guidelines on the Management of Non-neurogenic Male LUTS, 2026 / McVary KT, et al. J Urol 2021 (5-year water vapour trial) / Roehrborn CG, et al. Can J Urol 2017 (5-year L.I.F.T. study) / Baboudjian M, et al. Eur Urol Focus 2023 (retreatment review) / Wong K, et al. Cureus 2024 / Rukstalis D, et al. Prostate Cancer Prostatic Dis 2019 (MedLift). Indications, contraindications and side effects follow the product information approved by the Taiwan Food and Drug Administration.

This page provides general medical information and does not replace an individual diagnosis or treatment plan. Suitability, risks, recovery time and costs are decided at a consultation with a doctor.