Rezum and complications post op

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63 years old.

I had the Rezum procedure done on March 2nd. I had 4 oblations by the urologist. Got the first catheter out at 4 days; could not pee a bit. Had the second catheter out on the 10th; still could not pee more than about 50 ml. In went the 3rd catheter. Next day I had a fever of 100 F and felt like I was beaten up. Called the urologist and started an oral antibiotic. Went in on the 16th for another pee trial. Urologist took a urine sample. Still could not pee. 4th catheter and next day fevers again. Switched to another oral antibiotic as the first seemed to do no good. Bacteria sensitivity test showed that the bacteria was insensitive to both previous antibiotics. Started a 3rd oral antibiotic on the 22nd that showed bacterial sensitivity. By this time, my right testicle had swelled up to the size of a grapefruit, very painful. On the 24th I woke up with a 101.6 F fever. The infection was so advanced, I had to go into the ER (right in the middle of CIVID-19 outbreaks) at 4:00 am. They started me on IV antibiotics, and I spent 4 days and 3 night in the hospital to get the infection under control. 3rd day in the hospital, the x-ray tech put in a PICC line (right arm catheter through a vein to just above the right ventricle) so that I could be discharged and get IV antibiotics daily at home.

While in the hospital, the urologist wanted to do a pee test. Out comes the 4th catheter. I can pee about 100 ml every 15 minutes, but my retention is still about 300 ml. Urologist wants to cath me again. 2 nurses try to get a cath in, no luck. The urologist comes in to "install" the cath. He had to use what looked like a stainless steel coat hanger in the catheter to get past my prostate into the bladder. My worst experience in 63 years,

So, I am home now with the urinary cath in. I have my PICC line to get IV antibiotics. I'll go in to the urologist's office at 35 days post op to try and pee again, probably. If I need cathing, I'll ask about intermittent self cathing to get away from constant catheter and more infections.

Anybody else had similar experiences with Rezum?

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5 Replies

  • Posted

    I am very sorry to hear that you have gone through this, especially during COVID. Hope you get better soon.

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  • Posted

    Jeff,

    Ask your urologist about a supra pubic catheter. This might get you through until you get your issues under control. Sounds like you had severe swelling AND infections. A rough time. You are only 4 weeks past op so you may have another couple of weeks of swelling to endure. I had radiation to my prostate for prostate cancer in 2014 and had swelling that lasted almost 6 weeks - had Foley catheters in and out waiting for the prostate to "settle down" so I could pee on my own. One trip to the ER with intense pain before I understood what was happening to me - total retention. Nurse drained off 1300cc of urine!! I will never take peeing for granted again. At some point you will get through this.

    Tom

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  • Posted

    Update.

    I got the catheter out April 7th and the PICC line out April 8th. No complications from the PICC, and the infection seems gone. However, the testicle is still twice normal size (about 1/3 of the grapefruit), and the urologist says expect it to take a month or more to shrink back down.

    Can now pee fairly easily, but still on Flomax. Must use diapers as after 30 days of a catheter, my voluntary urethral sphincter can't hold back pee. Need to "exercise" it to make is stronger again. Flomax one per day is too much. Acts on involuntary urethral sphincter to relax it, and I end up peeing almost constantly. Every other day seems OK after titrating the dose.

    Side effect of Flomax, it also inhibits the anal involuntary sphincter (both sphincters have same mechanism of alpha-1 adrenergic receptor inhibition), so I end up pooping more often, also.

    Peeing feels lots of burning; since I've only had out the cath 5 days, I'm assuming the burning sensations will diminish and disappear over time. ANY FEEDBACK HERE?

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  • Posted

    Jeff, so sorry you seem to be having so many issues post-Rezum procedure. I am 65 and had the Rezum treatment March 11th this year. My prostate was about 70 grams. I had 5 treatments during the procedure. There was very minimal pain during the procedure, one of the treatments out of 5 probably a 1 on 10 pain scale & that was only for a second or two. Same thing with the prostate block injection of the lidocaine. Felt both, but only one hurt a second about a 1 again. Overall, the procedure was MUCH less painful that I had anticipated. Day one, no pain post-procedure. Day two, had moderate pain, took a total of 6 50mg Tramadol over 2-3 days. After that, no more pain meds. Worst part was having the catheter in place 5 days and a few very painful bladder spasms on day 3, which fortunately only lasted a minute or two. Quite a bit of blood in urine (3+ on dip-stick) for about 3 weeks and burning on urination, which was completely resolved by taking 100mg pyridium wice a day for about 10 days.

    When I went to have it out Monday, they had to do a test where they put in about 350ml sterile water before removing the catheter and you had to urinate out at least half of that or they would have to reinsert it! Fortunately, I urinated back 350ml! So thankful for that.

    The last two weeks I have had increased urine urgency to the point of dripping a bit before I could get to the bathroom. This is normal during the healing priceless and should gradually get better. Urine stream is vastly improved. I still feel a little very, very mild discomfort on urination in the area of the prostate for a few minutes after.

    Overall, I would recommend the procedure and have to several friends. At least for me, the procedure went well, had minimal pain during the procedure and minor issue post-procedure. Hopefully, the urgency will subside over the next few weeks as is typical. Everyone of course may have a different experience with the procedure as we all respond and heal differently. Of course the skill of the urologist probably also has something to do with it I suspect. Do hope you are doing better.

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  • Posted

    Hello,

    My experience with the REZUM procedure was fine. Very little pain, took about 15 minutes, and insert catheter and go home. 56 days post-op, I can pee easily with a much stronger stream and the volume is 2 to 3 times as much (100-150 pre-op to 200-300 post-op). Still have a slight burning sensation when peeing. The procedure was successful.

    I'm 20 days post catheters. I too had 390 mls of saline (not water) put in my bladder (I pushed it to as much saline as I could tolerate to get a really good micturition reflex response, and peed out 350 mls in a couple of streams about 1-2 minutes apart. We deemed that success.

    I still sometimes "dribble" urine when my involuntary sphincter lets loose and the bladder contracts. My voluntary sphincter can't seem to hold back the flow when this happens. Although the dribbling is less frequent, and I hope it abates. With all the catheterizations, I am wondering if I have some permanent damage to the voluntary sphincter that will not allow it to completely retain pee. I am doing abdominal floor and sphincter exercises to strengthen up both to help retain pee. I'll continue to post my progress for future REZUM prospective patients.

    My big issue was post -op infection of antibiotic resistant E. Coli. 3 different oral antibiotics not useful, 4 days in the hospital (with the covid-19 isolation, no visitors) on IV antibiotics, PICC line to get IV antibiotics at home, and 5 separate times for urinary caths. I was extremely careful to follow catheter care, but still ended up with a massive urogenital infection. My advice to anybody is really be careful with that urinary cath. It is easy to get infections and difficult to get rid of them infections.

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