D day REZUM 6/30/2017 and after the treatment

Thank you and let you know

I didn't know REZUM need like a month to see first result, because the REZUM website give too many positive thought and make me expect too much, thank you anyway

Hi JerseyUrologyGr,

Thanks very much for contributing your thoughts to the forum. I'm curious about the Rezum procedure. How would you compare it, in terms of success, recovery, and side effects, with TURP and Green Light? 

I had a PAE a little more than two months ago, with mixed results. Any thoughts you care to share on that procedure?

Don

 

13 days after REZUM, before I can do 120cc each trip and today 7/13/17 I can still do only 25 to 30cc each trip, is there something not done properly?

I don't know much about the PAE procedure.

Rezum is a newer, minimally invasive procedure.

Side effects are pretty minimal compared to traditional resection procedures. General recovery is quick, but urination recovery takes several weeks to months, as it takes some time for the tissue to necrose (die).

I would follow-up with your urologist to make sure you are not in urinary retention.

In your experience, what is the success rate with Rezum? That is, what % of men experience significant improvement in BPH symptoms following Rezum? And how common is retrograde ejaculation with this procedure? 

Retrograde Ejaculation is lower than most traditional procedures; probably around 5%. Like any procedure performed on the prostate, however, it is unlikely to be 0.

Most men who have been appropriately tested prior to the procedure show significant improvement by month 4, but obviously every case is unique.

5% is very low, compared to traditional procedures. I once asked a urologist at Johns Hopkins what the % of RE was with TURP and Green Light, and he said, "100%--if it's done right." Why is Rezum so much lower?

I saw new out come on a trail for Urolift andTURP.   Urolift   RE 0% and Retro 0% Turp ED 3% to 35% and Retro 25% to 99%  Ken

Kenneth, 

Are those trial outcomes available online? If so, can you please send the URL?

Thanks,

Don

Don,

For the latest Phase III trial results, you want to go to the Procept Biorobotics website and click on "view the presentation here" which is on the left. This is not the Dr. Gilling video but the one by one of the co-athors, Dr. Roehborn. The retro data will be seen at the 1:36 mark on the video, noted as "cd1p events", but it goes by fast so you will want to

freeze frame. *

If you look at the chart, you will see 6.9% anejaculation (retro or no ejaculate) for aquablation against 24.6% for the TURP control group. This is misleading because all other studies show closer to 60-80% anejaculation for TURP.

To correct for this as best as I could, I therefore used the previously established incidence of retro from TURP (60-80%) and adjusted it by a factor of .29 (6.9 divided by 24.6). Using that adjustment I estimated that the realistic expectation for retro from Aquablation is closer to 17-23%. That said, someone better versed at math should feel free to check both my logic and figures.

* Of note is the way the retro figures are buried in the Phase III presentation, as opposed to with the Phase I and Phase II trial reports where they use the word "retrograde ejaculation" several times and make a big deal about it. This is not unusual, but just a reminder that the way these study reports are written is sometimes as much marketing as science, so caveat emptor!

Jim

Yes that is where  I read them  I will see what I can do  Ken

Jim,

Thanks very much for your interpretaion of the data. How do you view the ED data? According to Johns Hopkins, ED occurence with TURP is around 5%.

Don

Don,

Good question. I watched the video again quickly and didn't catch any ED data. Did you see anything? I believe it was mentioned in the much smaller phase I and II trials but honestly, I'm beginning to have some doubts on how accurate this trial data is based on those low retro figures for TURP I mentioned before. However, one alternate explanation for the low retro, other than inaccurate reporting might be that the TURPS were not very agressive. This could account for a lower incidence of TURP but also would effect the efficacy data comparing Aquablation to TURP. In other words, if you went along with this theory, then 6.9% would be an accurate indication of retro for Aquablation but some of the Aquablation versus TURP efficacy comparisons could be called into question. Lots of problems with trials in general, especially the early ones trying to get something to market. Personally, I'd wait at least a year after FDA approval for Aquablation and look things over then. 

Jim

Jim