Rezum

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I am 61 with 35 cc prostate. I have a small median lobe and high bladder neck. I could not tolerate meds. My post residual is less than 15 cc. Uro-dynamics is consistent with obstruction. I wake up about 4 times a night and it messes my sleep as I am still working. 1st urologist was recommending TURP, but I thought it was a drastic measure. PAE is not the best for a small prostate with high bladder neck. I looked into FLA but I asked two physicians from reputable medical centers who use the technology to treat prostate cancer and they say it is not as accurate as claimed by the doctors who use it and there is the risk of perforation. My urologist , who is a professor of urology, is now is recommending Rezum and he has done more that 100 of those. He has also experience with HOLEP, Urolift, TURP. I am scheduled Nov 20th but I am hesitating because messing with bladder neck can have risk of RE and incontinence and the fact that my prostate is small and most of it would be cooked considering that only a small portion of it is causing the problem, but I don't know if there are other options. Any response will be greatly appreciated. Ken have been very helpful in these posts.

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  • Posted

    My problem seems simiar to yours , small prostate but bladder obstruction, confirmed by urodynamic study , made worse recently due to a nasty UtI. I was recommended a bladder neck incision which I was told was far less invasive than other options (UROlift was not offered for some reason ) . It has a quick recovery time but likely to result in RE. Meds worked well for me for 6 months .

    I have not had it yet but im now regretting not having it when offered . I know Nick on this forum has had this option done.

    All the best

    Darren

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  • Posted

    My situation was very similar to yours, I had Rezum done and I'm very glad I did. It was a life changer and sometimes I can't believe how my life used to revolve around the bathroom. If your doc has done 100 or more, go for it. If he/she offers a twilight option go for that too

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  • Posted

    If your post residual is less than 15 cc do you need to do anything right now? My Urologist told me anything less than 40 or 50 is normal. Maybe think about CIC before you go to bed as an option.

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    • Posted

      I can void okay, do you mean to leave the catheter in all night, I don't understand. My main concern is to preserve the bladder before it becomes lazy and to get up less at night.

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    • Posted

      No, just self-catheterize before you go to bed, it should hopefully empty you so you don't have to get up during the night. A little difficult at first, but once you get used to it not that big a deal. Also buy you some, or maybe a lot of time before doing any type of procedure.

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    • Posted

      that won't be necessary because I empty very well and I can void without cath and if i cath myself before sleep I would still get up at night. All it does is increase the risk of infection and more cost. But thank you for your suggestion.

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  • Posted

    Is your only issue that you get up 4 times a night? Do you keep a urination/defecation journal? I recommend that you do. You might find that the volume of urine you void at night is well over 30% of the total you urinate in a 24 hour period. If so, that might be contributing to the 4 times per night. With some lifestyle changes, you might be able to cut down the number of trips at night.

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    • Posted

      I get up about 4 times a night because i have the urge to urinate and the flow is slow and it is stop and go about 2-3 times and many times i feel I don't empty completely. During the day I also have to go about every 90 minutes with urgency and slow stream. when I go out I worry about having to urinate and I am on the lookout for bathrooms. I don't drink water so I do not go to the bathroom. There is lots of urgency.

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    • Posted

      Hi NBCP:

      If you want to get an idea of the maximum urine flow rate, you can buy a device from Amazon that you pee into. It consists of an orifice at the bottom, three chambers and a bowl at the top. As you pee into it, the urine backs up into one of the chambers because the orifice is small and doesn't let much urine flow out. You look for the chamber where the urine level is the highest and that gives you an idea of what the maximum urine flow rate was. If the level is in the lowest chamber the max flow rate is between 0 and 5 mL/sec. In the middle chamber it is between 5 and 10 mL/sec, and in the top chamber, the maximum flow rate is between 10 and 15 mL/sec. If the level reaches the bowl at the top, then the maximum flow rate is greater than 15 mL/sec. The device is called "Uflow Meter" and you can buy it for about $11 on Amazon.

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