Duodart, a combination of dutasteride and tamsulosin, is commonly prescribed for benign prostatic hyperplasia (BPH) and can be effective in reducing symptoms by decreasing prostate size and relaxing prostatic smooth muscle. However, as you’ve experienced, side effects such as erectile dysfunction, decreased libido, and ejaculatory issues can be bothersome for some patients.

Rezum, or steam therapy, is a minimally invasive treatment for BPH that uses water vapor to ablate excess prostate tissue. This procedure is typically performed in an outpatient setting and is designed to relieve urinary symptoms by reducing the size of the prostate. Here are some key points to consider regarding Rezum therapy:

1. Effectiveness: Rezum has been shown to be effective in reducing BPH symptoms, with improvements in urinary flow and symptom scores. Clinical studies have demonstrated significant symptom relief, comparable to some surgical interventions, with a lower risk of serious complications.

2. Durability: The effects of Rezum are generally long-lasting, with many patients experiencing sustained symptom relief for several years. However, as with any treatment, there is a possibility that symptoms may recur over time, and some patients may require additional treatments.

3. Comparison to Surgery: While Rezum is less invasive than traditional surgical options like transurethral resection of the prostate (TURP), it may not be as effective for very large prostates or in cases with severe symptoms. TURP remains the gold standard for surgical intervention, particularly for patients with significant prostate enlargement or complications such as recurrent urinary tract infections or renal impairment.

4. Side Effects and Recovery: Rezum is associated with fewer side effects compared to surgery, with a lower risk of sexual dysfunction and incontinence. Recovery is typically quicker, and most patients can return to normal activities within a few days.

5. Patient Suitability: Rezum is best suited for men with moderate to severe BPH symptoms who prefer a less invasive option and are willing to accept the possibility of needing future treatments. It may not be suitable for those with very large prostates or significant complications.

Before deciding on Rezum or any other treatment, it’s important to discuss your specific symptoms, prostate size, and overall health with your healthcare provider. They can help determine the most appropriate treatment plan based on your individual needs and preferences.