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

I can do only like 15 to 50cc each time, thank you

In that case I think you might find CIC preferable to wearing a Foley for reasons previously given.

Jim

Thank you, since I already start slow jogging yesterday and I always sweat a lot, maybe around 500cc sweat, and then I go like 3 times an hour, so bladder feel OK, when I massage the area, feel normal

Thank you and do you know where I can get Foley? Ride aid and do I need prescription?

Hi Morris,

It's not called a Foley when you self cath. It's just called a catheter for self cathing. 

No, you probably won't find them in drug stores and even medical supply stores have limited selections. Most of us work with online distributors who mail us the catheters each month. 

Yes, an Rx is required, at least from the major distributors. Do you have Medicare or another insurance that covers catheters? If you have Medicare, they pay for up to 200 catheters a month. 

If your not having any meaningful voids, that usually translates into 6 catheters day or 180 a month. So have your urologist write a rx for 6x/day. If you have any obstruction from your prostate, I also recommend you start with a hydrophillic catheter with a Coude (bent) tip in size FR14. The online distributor can help with the rx and paperwork.

Jim

Some popular catheters here are the Coloplast Speedicath coude, the Coloplast  FLEX Coude, Lofric Origo Coude, and the Bard Magic 3 hydrophillic Coude catheters. The distributors will send you free samples, so you might want to try more than one in the beginning. With the exception of the Coloplast FLEX coude, the tip of the other catheters have to be oriented properly. So make sure you learn about that before using. More information in the self cathing threads, or you can ask more questions there. Here's a link:

https://patient.info/forums/discuss/self-catherization-issues-and-problems-552686

Got it, thank you

Yes that is true.  But one cuts at the prostate and the other steam.  With the rezum procedure you have a better chance of not getting retro.  I myself would have done Rezum first instead of having him cut out my prostate.  THey do the same make a tunnel.  I hope you get better.  It seams like your doctor talk you into something he wanted to do not what you wanted  Hope you get better  Ken  

Actually it is a very different procedure than a conventional TUNA (Prostiva.) 

We have had great success with it with many of our patients who had previously failed an old-style TUNA procedure. Early studies are promising as well.

Hi JerseyDoc,

Does your practice use the temporary Spanner Stent either as a Foley alternative or as a diagnostic device?

Based on some studies and testimonials on their web site, it sounds like a novel alternative/adjunct to urodynamics in differentiating obstruction versus bladder function with LUTS.

Apparently if the patient is able to void with the stent in place, that suggests a functioning bladder and good surgical outcome, but if the patient still retains with the stent, then that suggests a bladder issue and a compromised surgical outcome. 

And unlike urodynamics, it actually gives the patient a real world demo of what their voiding will be like after a prostate reduction surgery or procedure, according to the manufacturer. 

Seems like you get a lot for a ten minute relatively non invasive procedure, and yet we don't hear about it a lot.  

Jim

Yes.

 We were the pioneering practice for the use of this with the procedure 

So does it work, as advertised, ie -- If the patient can empty well with the stent then they will tend to do well with a prostate reduction procedure, and if they retain with the stent, they won't?  

Also, if you're using the stent for diagnostic purposes, do you: (1) put it in, see if the patient can void or not and take it out. Test done; or (2) put it in, send the patient home with the stent for a week or so, assuming they can void in the office. If they can't void in office, take it out. 

Jim

How is the efficacy different?  When I had the TUNA, it worked for about 1 1/2 years. 

It is a very different energy source with significant anatomical changes postoperatively

That being said, it is a relatively newer procedure, and can't tell you what happens 10 years down the road

It's not  perfect but it is a decent proximation. We mainly use it postoperatively to avoid a catheter 

What I don't quite understand is why the stent needs adequate detrusor pressure to work, since for example a Foley does not require detrusor pressure.

As I understand it, both have a tube going into the bladder held in place by a balloon. The only difference is that the Foley exists the urethra and the stent remains just short of the external sphincter. 

With the external sphincter shut, I get that the urine will not flow, but that's regardless if there's detrusor pressure or not. 

However, I would think that once the external sphincter volunarily relaxes/opens, both the Spanner and Foley would function the same. In other words at that point (external sphincter open) shouldn't the Spanner empty the bladder whether there's detrusor pressure or not?  But it doesn't in cases of inadequate detrusor pressure, according to the manufacturer. 

Maybe you could help explain why. Thanks. 

Jim

 

 

But how many man end up with reto from both   Ken

 Very few 

I understand why there's no retro with PAE and Urolift. But why would be there such a low rate of retro with Rezum? Like TURP and Greenlight, it destroys prostate tissue. What's different about Rezum?

When Greenlight first came out, the rate of retro was relatively low, compared with TURP. But then urologists realized that for long-lasting effects, they had to destroy more tissue, and the rate of retro went up. I have to wonder if the same thing will happen with Rezum.

It could be as high as 5-10% from what I read here. That's not "low" in my book. 

Jim

Well, it's a lot lower than TURP or Greenlight. Every uro I've talked to (and I've talked to quite a few) has said that if done right--that is, if enough tissue is destroyed--TURP and Greenlight almost always cause some degree of retro. 

Don

 

That is good to know But we look at %.  I feel i to 2 % would be good but like Jim said 5 to 10% is to high.  I think alot of me would go for help sooner if the side effect were lower.  Will all the procedures we have they should be ajusted to the patient and the way he want it done not so cut and dry.  If a patient want a GL or some other laser.  If the patient is afaid of retro and tell the doctor to stay away from the bladder neck and the duct and seminal vesselh e should do that for his patient.  Or with Rezum.  If the patient said I will try that but I only want the right side of the prostate done. I don't want the lift touch  it should be done.  The steam does not know what is good tissue or bad and if you steam the left side you are going to damage the good stuff on that side.  Retro is very high I know you tell every 4% but it more like 10 to 15%.  I know I have read some men after a procedure say loosing there ejaculation is a small price to pay to pee a little better.  But why should be have to pay anything we should not have to give up anything.  Life is to short to live out your day with that ejaculation it goes with my orgasm.  God gave it to me and no man is going to take it away.  I am a very stubborn man and I do not give full control to any doctor no matter what it is.  Take care and thank for being on here and have a good day  Ken

I have been told by my urologist that it is substantially higher than that at around 20% after 2 years.

Turp and GL you get retro because the doctor don't care what they cut out they will cut every thing in there way. Doctor do not feel we need it because we are passed having kids.  I got a e-mail from one of the Rezum nurses when i asked about retro.  She sthatrez um does not cause retroBut sheal sosaid being the prostate will be smaller you will get less fluid.  But we have had some men on here that have had it done. And within a month they were dryed up.  Rezum caused them to have retro. Take care  kEN          

That is to high.  I would never that that chance  Have a good day  Ken