REZUM--HAVE YOU HAD THIS DONE???????
Posted , 385 users are following.
I had a nice conversation today with the President of the "Urology Times". He was telling me that there is a "New Procedure" that has been approved called the "REZUM SYSTEM". The company that makes the system is called "NXThera, Inc". You can google them up and lots of stuff comes up. I called them for a referral and they gave me a Doctor in Minnepolis that has done it over 50 times now. I called his nurse and she said he would call me back and answer my questions on monday. As you guys probably know Doctors are not very good at returning calls but we'll see what happens. Iam not very good at explaining how the procedure works but basically they take the device and put it up the uretha and vaporize the prostate cells which kills them. It works with high pressure "steam" that at a certain degree will kill the prostate tissue. My question for you guys is there anybody out there that has had it done to them and how are you getting along and are there "side effects", etc etc?????
35 likes, 5645 replies
Rkraft ChuckP
Posted
So what type of bladder issues did you have and how was that fixed? They told me my bladder wasn't holding any pee, so put me on bladder relaxing, urine retention, drugs and 6 weeks later said it is holding back to much.
jab51992 ChuckP
Edited
I had Rezum therapy two months ago (Jan, 2020). Recovery has generally been good. Very little pain other than soreness from a few days of catheterization post-op. Urination has been great from about the 2-3 week mark.
I wasn't sexually active during my first 3 weeks of recovery, per Dr. recommendation, but between the 3-6 week marks of recovery, ejaculation was quite normal... even after taking Tamsulosin for 3 months prior to the procedure, and during recovery. There was a little blood, initially, but otherwise fine. Since around the 6 week mark, the amount of ejaculate has decreased substantially. It's not completely dry, but there is very little output.
I'm perplexed because it seems if the procedure were the culprit, I wouldn't have had normal ejaculation initially, only to begin experiencing retrograde ejaculation at this point in the healing process. Could it be a cumulative effect of Tamsulosin over time? Could it be that I've healed in such a way that now something is blocked that wasn't before? I stopped taking Flomax about a week ago, but haven't noticed any improvement yet.
Has anyone experienced a similar onset of RE, or have any suggestions as to the cause or potential cures? My Dr. told me healing wouldn't fully complete until around 12 weeks out, so maybe I just need to be patient, but given I haven't experienced RE until a couple weeks ago, I'm a bit concerned.
Any suggestions or similar experiences would be appreciated.
Thanks!
russ_777 jab51992
Edited
There have been others that have reported this. As the disintegration of the transition zone glandular tissue in which the steam was injected occurs over time as the body absorbs it, the size of the prostatic urethral cavity increases. I suspect it is possible that if and when the cavity gets "too large," the muscular contractions that normally force the semen through the urethra can't close down enough to force it out. The chamber is too large for the round, so to speak.
The other thing that could happen is one or both ejaculatory ducts could become obstructed. That's where about 70% of the ejaculate comes from if I remember correctly. It's unlikely that Rezum would damage the verumontanum where the ducts exit into the urethra since it is not part of the transition zone and the steam is confined to the prostatic zone into which it is injected. However, if you had a median lobe that was treated, that may be possible as the ducts go through the central zone which I believe the median lobe is part of. See diagram below from wikipedia.
All of the above is speculation as I am not a medical professional. Hopefully what you're experiencing is temporary. Good luck!!
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bill1095 jab51992
Edited
Chuck, I had Rezum Sept. 2019. I had the same experience as you describe. Initially I was ejaculating and then it began to decline. I thought it was intermittent for a while, but I now have full Retro. I did have 2 or 3 shots to the medium lobe. My prostate was only 60 but I had experienced BPH symptoms for around 9 years when I finally got this procedure. I'm 59 y/o. Orgasm's were initially fairly normal, but then for a while I experienced a slight pain as I was approaching orgasm that would cause a brief interruption to the normal arousal cycle. That didn't last too long and it was probably after that "coitus interruptus" period that I developed full Retro.
Now for the most part I have normal orgasms, with no ejaculation. It has been a slight adjustment as it has made me feel a bit not normal. I just remind my self that as long as the orgasm is normal and pleasurable it doesn't really make any difference. I haven't talked to my doc about this as I haven't been in for my 6 month check yet. Btw, you were lucky as your procedure and recovery went much easier than mine.Best wishes as you deal with the retro. It will be interesting if you eventually ejaculate normally after more healing.
jab51992
Posted
Wanted to provide a quick update to this post as circumstances have changed and I want folks who may be considering Rezum to have the full picture, at least as far as my experience goes.
As I mentioned, around the 6 week mark after my procedure, my ejaculate diminished substantially to barely a drop. That condition lasted for about a month, then started to gradually improve. By around the 12 week mark, I was pretty much back to normal from an ejaculation perspective.
I still don't know why I had that period of RE symptoms. I suppose it was just part of the healing/recovery process.
Bottom line, it took some time, but I can say now that the Rezume procedure was, for me, an absolute success. Urination is great, bladder completely emptying, no RE.
I'd be curious to know how common this type of situation is during the healing process. Anyway, hope someone finds this helpful.
patrick45945 ChuckP
Posted
FWIW, I have been doing CIC for several months and have normal sexual function. My bladder gives signs of returning to normal function so I will continue to avoid more intensive procedures. I have become habituated to CIC and it is no more hassle than flossing and takes less time.
mitch87647 patrick45945
Posted
HI,
Can I ask you what is CIC?
patrick45945 ChuckP
Edited
Yes, Clean Intermittent Catheterization, a non-surgical method of emptying the bladder through self-catheterization. Many here use it while avoiding more intrusive surgical procedures that may have irreversible and undesirable side effects. I am hoping to rehabilitate my distended bladder using CIC as others here have done. You can do a forum search for more information and experiences of those who use this method.
Good luck!
Patrick
mitch87647 patrick45945
Posted
Thanks,
I was actually thinking of trying that.
Can you give anymore information about this procedure?
What about the possibility of infection?
Is it a recommended practice by any medical authorities?
Thanks for your help
Mitch
steven05114 mitch87647
Edited
Mitch,
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CIC or self-cathing is pretty much standard operating procedure for men with bad BPH who can't pee on their own due to prostate blockage, bladder damage or a combination of both and don't want an indwelling Foley catheter. This is BPH 101 kind of stuff so see your urologist about it instead of relying on this forum. Besides, you will need a doctor's prescription to buy catheters.
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Steve
davidaami mitch87647
Edited
There are a couple of threads on patient.info about CIC and I recommend you read them because there are lots of good tips on there. You'll probably get better information from others who are already doing CIC.
https://patient.info/forums/discuss/self-catherization-issues-and-problems-552686
raygar13 mitch87647
Edited
Get the problem fixed. Self cathing is better than a trip to the ER, but urinating on your own is so much better. I did a lot of internet research on BPH solutions. Rezum by far made the most sense. My prostate was 150, ipss score about 23. Had the procedure 14 months ago and am way better. No medications ipss down to 8. Am I perfect at 63 ....no but no longer leak and can hold off urination again. flow is good. no meds, back to almost normal.
patrick45945 raygar13
Posted
Happy to hear Rezum is working well for you! I hope you continue to improve!
However, there are posts here by those that weren't so fortunate and did not have good outcomes with Rezum. Best thing IMHO is to work with your uro and mutually decide on a plan of action that is best for you. Although I am only into month five of CIC, so far my uro has supported my intent to continue CIC indefinitely in hopes of rehabbing my bladder.
In the end, everyone does what's best for them, hopefully based on thorough research and consultation with their uro. CIC is no big deal for me and I intend to continue to avoid surgical procedures with a low chance of success which my uro has estimated at 20-30%. I'm hoping CIC will improve those numbers!
Patrick
steven05114 raygar13
Posted
Raygar13,
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Yes, it is best to carefully research the various BPH solutions available today. Don't rely on your urologist to make the decision for you as they will chose what they do. After extensive research with the help of the family-member-MD, I chose Rezum.
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I had my Rezum at the the of November 2018 and it was successful. My IPSS went from 28 to 6. I went from total retention and 10 months of catheters to PVR's that are consistently under 70 now. My bladder took several months to recover.
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I highly recommend Rezum done by a urologist who has done at least 50 of them if not more (but then you know I say this). I am 63 and my peeing is back to almost normal too.
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Steve
davidaami steven05114
Posted
Congratulations Steve. Your PVR has come down even more. That's really good news.
raygar13 steven05114
Posted
when I asked my urologist how do we fix BPH....TURP After doing the research of all the procedures I told her I wanted Rezum.....she said my prostate 150 was too large but fortunately Richard Levein of chesapeak urology who participated in the rezum clinical trials 30 to 80 had done a patient with 151 and was doing fine. she consulted with the Rezum rep who gave us the go ahead. She probably wasnt the most experienced at rezum but after 15 injections, I got very good results. Procedure was uncomfortable but not painful, no bleeding (finesteride 2 weeks prior), and no pain afterward. foley 3.5 days no infection. wnet off flomax day 14 went urination picked up a little.
steven05114 raygar13
Posted
Raygar13,
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The 1st urologist that I saw only did TURP so he tried to discourage me in having a Rezum. Through this forum, I found another urologist who had been doing Rezums for 2 years and was highly recommended.
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The Rezum (10 injections, 4 per lateral and 2 median) and recovery followed the standard schedule (like clockwork, textbook, etc.). I had blood in my pee for about a month and I was on Finasteride too.
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The procedure was painful but tolerated. Afterwards I went out to lunch with my driver and never used the remaining Percocets. I had a Foley in for 2 weeks and then self-cathed for 2 more weeks before I started to open.
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Due to bladder damage, it took 9 months for my PVR's to drop below 100 ml and now they are below 70. I consider myself cured but I am staying on Finasteride to prevent any regrowth.
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Steve
steven05114 davidaami
Posted
David,
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I have had several PVR's that are 50 or less, which for someone my age is very good.
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Steve
raygar13 steven05114
Posted
interesting, saw the uro in january. my update after 1 year was positive. she sent in a prescription for finesteride. I chose to not fill it...no meds if not necessary. have flomax but dont take it. 15 injections into a 150 prostate 13 and 2 to the medium lobe. Only had a local (2 lydocaine injection via rectum) no other oral meds, as I chose to drive myself home. Injections get warm around 7 second (9 second total per injection) 3 or 4 out of 10. will see uro again in may when we will talk about finesteride. psa was 29.8 prior to rezum and 19.8 after. Feels like I lost about 50 percent of the mass of the prostate which is in the inner part. It will grow again, at 62 it was 150, 5 times normal. 1 year later prostate was 130. I think the overall prostate structure remained intact and the mass of the inner prostate was substantioally reduced. Biopsy and 2 mri have been negative with the last one ruling out aggressive prostate cancer. larger prostates yeild higher psa's but will keep monitoring. only 63
steven05114 raygar13
Posted
Raygar13,
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I am staying on the Finasteride so hopefully I will not have to deal with BPH again for a long, long time. Besides, I have had no adverse side effects other than my bald spot filling in, which may not be adverse anyway.
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The urologist that I saw has her patients take 1 Valium and 1 Percocet 1 hour before the procedure. I was high as a kite when I checked in. I have never had a problem with my PSA which is usually around 2.5.
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Steve
raygar13 steven05114
Posted
I will read up more on finesteride, have flomax dont take. By not take oral medication i was very alert and aware. i was a little nervous before the first injection. but after, not too bad at all. we never talked about number of injections, was going to limit her to 10 but larger prostates 10 to 13. at 12 the rezum rep in the room alerted the urologist that the machine only had 3 more left and i was the last patient. so 15 it was.
russ_777 steven05114
Posted
The uro I consulted about Rezum seemed to have a flexible approach to offer for pain during the procedure. You could get knocked out by an anesthesiologist or elect to have a combo of what you and raygar13 had -- prostate nerve block injections on either side of the prostate + valium and percocet. That's probably what I would have done if I'd done Rezum. Easier to schedule that way since the anesthesiologist only visits their surgery center once per/month. I will say the injections via the rectum would be a little intimidating but I guess that's what the valium and perco are for. 😉
steven05114 russ_777
Edited
Russ,
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Some guys on this forum have recommended a twilight anesthesia. The 1 Valium and 1 Percocet worked OK for me. Yes there was some pain, put when I dislocated my shoulder, it hurt a whole lot more. I guess it depends on your pain tolerance.
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Scheduling was not an issue. Two weeks after my cystoscopy, I had my Rezum. After over 10 months of catheters, I was glad to get the Rezum over with. Four weeks after my Rezum, when I peed on my own for the 1st time in almost a year, I celebrated!
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Steve
raygar13 russ_777
Posted
the prostate block shots are same as biopsy which I did 3 years ago. And yes any oral meds are to relax you. Before rezum i have had 2 trips to ER for foley. cystoscopy (similar to Rezum) and biopsy. Prostate block is a little uncomfortable, pain 2 out of 10. I wasnt sure about my decision not to do oral meds, but one post said rezum is not painful. like I said about 4 out of 10. others have found it more painful. I will add during the procedure, twice they had to remove the rezum tool as with the water injected after the steam injection and the hard tube in the urethra created an urgency to go. I had this with foley but the sensation passes in a minute.Wouldnt hesitate to do again and probably will in the future. Only 63