The two office fixes,
compared honestly
UroLift and Rezūm are the two BPH treatments done right in the office: no hospital, no general anesthesia, home the same hour. They solve the same problem two very different ways, and Dr. Sawkar, a UroLift Center of Excellence who offers both, matches the method to the man rather than the other way around.
Medically reviewed by Hari Sawkar, MD, board-certified urologist · Updated August 2026
Side by side
One holds the door open; the other shrinks the doorman. Both are proven, both are covered by Medicare and most plans, and both leave the operating room out of it.
| UroLift | Rezūm | |
|---|---|---|
| How it works | Tiny permanent implants lift the lobes apart | Water vapor shrinks tissue; the body reabsorbs it |
| When you feel it | Days, often immediately | Builds over 3 to 6 months |
| Catheter | Usually none | 3 to 7 days |
| What's left behind | Permanent implants (MRI conditional) | Nothing |
| Median lobe | Selective | Handled well |
| Sexual function | No new sustained dysfunction in the pivotal trial | Preserved for the large majority |
| 5-year retreatment | Roughly 1 in 7 | Roughly 1 in 20 |
Both are designed for prostates of roughly 30 to 80 cc. Larger glands point toward PAE or Aquablation instead, and the practice offers all four.
How men actually choose
Impatience picks UroLift
Relief this week, usually no catheter, and the cleanest sexual-function record of any BPH procedure. The trade: permanent implants and a somewhat higher chance of wanting more treatment years down the line.
Patience picks Rezūm
Nothing left behind, the lowest office-procedure retreatment rate at five years, and a median lobe handled without fuss. The trade: a week of catheter and months of gradual improvement.
Anatomy breaks the tie
A prominent median lobe leans Rezūm; a man who cannot accept any ejaculation risk leans UroLift; a gland measurement confirms both are even on the table. One office visit sorts it.
Common questions
Which works faster, UroLift or Rezum
UroLift, by months. The implants hold tissue open immediately, and most men feel the difference within the first week, usually with no catheter. Rezūm's relief builds over three to six months as the treated tissue is reabsorbed, with a short-term catheter at the start.
Which lasts longer
Both carry five-year data. Rezūm's surgical retreatment rate, roughly one in twenty by year five, is among the lowest of any office option; UroLift's is roughly one in seven. Rezūm also handles a median lobe more reliably, which affects durability in that anatomy.
Which is better for sexual function
UroLift holds the cleanest record: no new, sustained ejaculatory or erectile dysfunction in its pivotal trial. Rezūm preserved erections and ejaculation for the large majority as well, at slightly lower rates. If ejaculation is your single deciding factor, UroLift usually wins.
What if my prostate is too big for either
Both are designed for roughly 30 to 80 cc. Above that range, PAE and Aquablation take over, and Dr. Sawkar offers both, so nobody has to force a small-gland tool onto a large-gland problem.
One visit settles it
A symptom score and a quick prostate measurement turn this comparison into your answer. Same-day and next-day appointments, telehealth available, Medicare and most PPO plans accepted.
Chief of Urology, Providence St. Joseph Hospital · UroLift Center of Excellence · 250+ Aquablation procedures