It was almost a direct replacement. Very easy to install, just had to play around with the bypass pipe a bit, nothing special. We are in our van all the time and this is the best shower ever. We are on city water all the time. Not sure I would have bought this if we had done a lot of dry camping, but it was great. It is slightly different from the tank and takes some getting used to. I like to just set the temperature to 104 and shower with hot water. The temperature fluctuates a little, but not much. My wife turns it all the way up and regulates it with cold water. I did that but I don't like that it splashes so much and I reduced the hot water a lot and the cold water too much then the heater doesn't get enough flow and shuts off leaving you in the cold. I don't think it's a heating issue, it's a combination of a low flow shower head, city water pressure and just learning something new. I also have a washing machine, and this water only heats up to 123 degrees, which is enough for a shower, but not for disinfecting linens and dishes. It fills the washing machine with hot water, which a tank heater wouldn't do. We only buy dish and laundry sanitizer and it has worked well. I would highly recommend it, it's so awesome it doesn't run out of hot water and doesn't seem like it lasts without a few fun hiccups. Seems pretty economical on propane too.
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