Rezum

Sounds like you have already had a workup. How much urine are you retaining?

Also, are you currently taking any medications such as alpha blockers (Flomax, alfuzosin, etc.) and/or 5 alpha reductase inhibitors (finasteride or dutasteride)?

NBCP: With the thought of just throwing out some ideas, you might want to consider the option of self catheterization (CIC). I've only done it twice myself because I want to be able to do it in an emergency situation (if I can't urinate). There are many on this board that have a great deal of experience and could advise you if you are interested. They say that it doesn't take long before it is as easy as brushing your teeth.

Since you've only mentioned problems at night, you might only need to CIC before bedtime to make sure your bladder is empty. That might cut down on the number of trips to the bathroom at night.

Thank you, I will look into it. Do you need prescription for catheter and what size ?

i retain about 15 cc

i take Dutasteride but it has side effects but i tolerate. I cannot tolerate alpha blockers

I have used the SpeediCath coude tip. I like the idea of a self-lubricated, 'I don't have to touch the tube that enters', catheter. I have both FR12 and FR14 on hand for emergencies. I've only ever tried the FR12 {because it's thinner 😃}

Hopefully, some of the long-time self cathers will chime in with some advice.

One other thing. Are you sure you don't have a mild UTI? I'm assuming it is not a serious one, because I get the impression you have been suffering for some time. I had a very nasty UTI six months ago, that I never want to go through again. I now regularly check my urine with urine strips made by Siemens, which you can purchase on eBay for about $20 for 100 strips. PM me if you are interested in more details.

If you decide to get urine dipsticks, I strongly urge you to not get the cheap, low quality urine dipsticks on Amazon. Siemens is a good, consistent quality brand. Chemstrip, which I also use, is slightly better but about 3 times as expensive. I learned about Chemstrip urine dipsticks by watching a video made by a nurse in a hospital.

Which alpha blocker? I started on Flomax, but switched after a week or two to alfuzosin. Alfuzosin is a newer alpha blocker that seems to have less side effects for most men. It is widely prescribed in Europe and less so in the US (but is definitely available here).

This is a small amount to retain and shouldn't cause any problems if it is a fairly accurate reading.

I have had my own bladder scanner for almost a year now. There is a real learning curve on how to use it correctly. Frankly, I don't trust the hospital technicians to use them correctly.

When I went to see my new uro about 3 months after I had been using my own bladder scanner, he had his assistant measure my PVR with a bladder scanner. He used two different machines and each time got zero for a reading. I frankly told him that that was incorrect. Later while speaking to my new uro, I told him about the results from the technician's bladder scanner and he shook his head. The uro then performed a scan and got a reading of 68 mL, which is in the ball park of the PVRs that I measure.

After I got my UTI, I was in urgent care, and I requested a bladder scan. The technician came in and she could not get a reading except zero. To her credit she kept at it, putting the probe as high as my navel (which is clearly wrong). I then helped her and she finally got a reading of somewhere between 70 and 100.

Now bladder scanners are really not all that accurate. They are in widespread use because they beat the alternative of catheterization. Most bladder scanners are much more accurate when the urine in the bladder is greater than 100 mL. Below that there is more variance in the readings.

Alpha blockers give severe side effects. I have no UTI. There is a question of non-bacterial chronic prostatitis as there is constant irritation. Urine was checked, prostate was massaged and the fluid was examined, no infection

thank you for the info

I had a Rezum at the end of November 2018 and I have no problems with RE and ED. I had 10 injections, 4 per lateral lobe and 2 in the median lobe. The urologist stayed away from the area of the prostate that would cause RE. Find a urologist that stays away from the area of the prostate that would cause RE. Find a urologist that has done enough Rezums and not someone who is new at it.

My ED problems are no worse after the REZUM, and the sensation is still there. I was warned by my urologist that there was a 30% chance of RE. To keep the chances even lower was the reason for the 4 injections, I may have gotten better results with more injections. Everywhere I read said the chances of RE was much lower. At my last visit with the urologist last week he said it may still come back but someone on this site said it is probably gone for good. Sudafed was suggested, I tried it with no results.Good Luck

That is the $64,000 question I'm trying to figure out. My urologist wants to resect my median lobe with GLL PVP after a CAT scan revealed part of my median lobe has grown into the bladder neck and is causing inflammation and thickening in a nearby 2x2cm area of the bladder wall that is causing a lot of pain. This is two years after installing 5 Urolift clips which helped my symptoms for about 1.5 years. Apparently it is difficult to resect the ML that has become part of the bladder neck without damaging the sphincter that prevents RE in a healthy prostate/bladder neck even if a less invasive procedure like Rezum is used.

I gather that your odds are much better with Rezum in that scenario than with GLL PVP or TURP where the resection basically makes your prostate part of the bladder and you are left with only the outer sphincter to keep your shorts dry and nothing to force ejaculate forward instead of backwards. But I sense that the % of men who undergo Rezum with a median lobe being treated who then suffer RE is a good bit higher than the overall number studies have published. I don't understand why that is unless the lower RE numbers were out of populations with a smaller number of median lobes being treated.

I've consulted with a Uro who's done a lot of Rezums and feel that's my best course of action at this point. He said he thought it would take 2 injections in ML but did also say there is still a risk of RE with Rezum.

No RE here after 10 Rezum injections, 4 per lateral lobe and 2 in the median lobe. Still dealing with PVR's over 100 ml but that is probably due to bladder damage.

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S