REZUM--HAVE YOU HAD THIS DONE???????

Good afternoon Peter.....I hope this works for you.  Can you tell me why you had a Rezum and was any other procedure offered.  Why did they do 6 shots.  With him doing that do you know you are going to end up with retro ejaculation or was that not a concern of yours.  With all the Rezum we have had on here there has been a high % of retro on even 4 shots.  I hope it works well for you.  They do say that there will be no improvement for 3 months  Good luck  Ken

Kenneth;

Number of "shots" (treatments) is related to prostate anatomy; 6 is nothing too unusual. The chances of retrograde ejaculation is quite low with this procedure. While we warn patients that it can be some time before improvement, we've seen plenty who are pleased within a few weeks.

Thank you for answering me on this   But a lot of men that have had the Rezum procedure on here that we have heard from had only about 4 shots and they all ended up with retro and more problems.  You say it low but you never answered me when I asked you out of the patients that you guys have done the Rezume procedure on.  What was the % of retro.  My urologist and his partner look into doing this procedure when it first was approved.  They took a survey on Rezum before they got into it.  Would you have this procedure if you know that it can cause retro.  75% said that they want to pee better but do not what to lose there ejaculation.  They found out that a lot of men do not want to take the chance of retro.  Even if it does help with peeing better.  Urolift is the most popular procedure for both of them.  When the patient is a candidate.  It is up to the man to pick his procedure and deal with the side effects.  You doctor do want to help us pee better but most of you don't care about our sex life.  You feel that being we are not having kids we don't need it.  There have been some doctors over the years that I have been on here that they joke about it.  Believe me it's not joke   Have a great day...Ken

I would say probably less than 10% chance of our patients end up with retrograde ejaculation.

The vast majority of our patients don't care about it, and are always counseled about this before the procedure.

Thank you for getting back to me so fast.  For me and some of the other men 10% is to high of a risk.  But if they are well informed it is there choice and there bodies.  For me that will never happen.  My prostate will be with me till the day I die.  Even if I get cancer.  My kids and my urologist know how I feel and it's my choice. Before any surgery with my prostate I have them sign a paper that my prostate is not to be cut at or removed for any reason.  I do not give any of my doctor's full control.   Thank you again  Ken 

@JerseyUro: The vast majority of our patients don't care about it, and are always counseled about this before the procedure.

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Do you suggest a "retro trial run" with Tamsulosin, or similar? The way it was put to me, and many others here, is something like: "(    ) will not affect the quality of your orgasms or sex life at all. The only difference is that the sperm will go into your bladder instead of coming out. If you don't plan on having children, it's a non issue".  And that would be with the good doctors!

To me, this isn't objective counseling but a physician biased sell, not that it's necessarily being done consciously. Let the patient experience retro for a week or so, then make a decision.

Hi Jersey Doc,

My Denver Urologist and his partners starting doing Rezum,  I was told they see around 10% - if you're saying the vast majority don't care my guess is they are either much older or they haven;t experienced the dry orgasm. People who've taken drugs like Finasteride might even have lost libido altogether so they don't care either.

My Urologist used to do Green Light which he said was bloody and painful then switched to button turp which he apparently prefers to Rezum, I think because it's a sure thing he can remove obstruction and there is 100% chance of Retro but he must believe most patients don't care about that.

Thank you Jim for saying what I was thinking.  A doctor learns in school that all men have a orgasm but not all men have the same.  Before I had the Urolift done I was on Flomax and Rapaflo The orgasm sucked.  The build up was there but when it hit it was flat.  No feel at all no sensation.  I do know some time there is no change but most of the time there is.  We have heard on here men that still have a there ejaculation but the orgasm is a 1/3 of what it was before.  They are not happy at all. And they give up on sex all together.  And sometimes the doctor will refuse to see them.  Please get all the information you can and before you have anything done that will cause retro. Have your doctor put you on a pill to give you retro so you know what your going to be living with for the rest of your life......Because the doctor is not going to live with it you are...Have a great day  ken  

Mike.  Most doctor are just looking to fix the peeing issue.  Your sex life is not a concern.  You may as well put us out in a field like they do old horse's.  I for one will never give it up.  Take care  Ken

Hi Mike,

It's interesting that the docs are now acknowledging a 10% rate of retro, because early on when we made that estimated here based on "anecdotal" we were told our stories can't be trusted. FWIW the Rezum web site lists 3.2%  Not surprising, because trial subjects are cherry picked. I wonder if folks realize that there is no trial data for Rezum for patients who were in retention! This brings up the question how many of the trial procedures were really necessary and could they have treated the patients with less invasive measures.

They talk about a 33% decrease in IPSS scores. Thats like going from 30 to 24. Not that big a deal in my opinion. A lot of discussion now in the med community about the ethics of sham procedures in trial to eliminate the placebo effect of a surgery being studies. Did Rezum do a sham procedure? If not, how much of that 33% improvement was the placebo effect? How many years out have these patients been followed if any?

A prominent cardiologist just twittered something to the effect that he'd sign a trial consent form if it said that the data of all trial participants would be made public up to three years after the procedure. It was sarcastic, the point being that we really don't know what happens to patients after a usually very short period after the surgery.

Caveat Emptor, especially with these very new procedures.

Jim

The way a doctor (or anyone) presents something to a person, has a significant impact on how a person will make a decision. Any pollster will tell you that they can get any response depending on how questions are asked. This is even more true with people in authority, like doctors. Add to this that people are making these decisions under stress, and in most cases being offered few other alternatives. This is a tremendous responsibility for the physician and based on my experiences, they all fall way short of the bar of objective counseling, especially when it's a procedure or surgery they are doing in this practice. 

Jim

Ken, If that is the case it shouldn't be - for example if I break a toe and doc says he can operate, but I will lose some movement, or just let it heal naturally, it might be crooked but I will have full movement, If I'm a soccer player I want to know all my options, and if I go to a Urologist if they don't explain retro issue they are being negligent.

I'm one of the RE Rezum statistics and guess what, it DOES impact orgasm quality. I occasionally ejaculate normally and there is a noticeable difference. I'm only a statistic of one, but for me it's not one of those in the, "if you're not planning on having more kids it's no biggie" camp.

100% of our patients will be trialed on alpha blocker prior to a procedure.

I would be surprised if there are patients who would have a procedure who weren't on alpha blockers.

That is very true  Ken

Mike that is very true.  But most doctor that you only spend 10 to 15 minutes with do not give you all the information on what ever he is telling you that will work.  Some doctor underplay our sex life.  They either tell you all will be the same or That does not happen a lot it's rare.  Most of the time it a bunch of bull.  Take care  Ken

Thank you for sharing that with us..  There are other's on here that are not happy with the retro issues. But after there procedures the doctor does not have a reason it happen.  I have a article that I printed up.  Going to have to fine it. It was written by a doctor.   It said that any procedure that is done you don't have to get retro.  It can be preserved.  It just that it takes more time to do it and most doctor just want to get it done and move on to the next.  I was very impressed with the article and with him.  I guess the main thing you have to do is fine a doctor that care enough with your concerns.  Buddy  I like the one by the doctor that said it's less of a mess to clean up.  CLEAN UP CAN BE FUN TO  Take care all  ken   

Hi Kenneth1995,

 I had requested the procedure after researching online last year. The procedure was still under review when I inquired about it to the urology dept. of the group I go to.  My reasons were the following: 

Urine flow sporadic, 

Retrograde ejaculations sporadic,

Finasteride reduced the size of the prostate but did not reliably reduce symptoms.

 I was told that the incidence of retrograde ejaculation was cited as 10% but realistically it’s more in the range of 15%.

I had 6 treatments due to all three areas creating restrictions due to enlargement.

Glad that's the case with your practice, but unfortunately many times it isn't, both from stories here from others and my own personal experience after hearing several presentations of TURP or other procedures that might result in retro. And in cases where a patient may try an alpha blocker, sometimes the correlation isn't pointed out that this is what you may get permanently if you do this or that. Again, what is often pointed out is something to the effect "that it will not effect your sex life or orgasms". An opinion at best. Also, not all alpha blockers produce retro in all patients. I think the responsible discussion would address this issue directly which it often doesn't. 

Jim

That is good that you were inform.  How did the Rezum work for you and did you end up with retro?  I think it is higher then 15%  Have a great day  Ken

Like I said before.  Doctor are only trying to fix the problem with peeing.  The other stuff then can care less.  If they care enough for there patients they would come up with something else.  Urolift is the only prostate procedure that does not case retro.  And they are trying to take that one away to  The only way you can get retro from a Urolift is if the doctor messes up   Ken

Hi JimJames,

Originally I was on Flomax but requested to be prescribed finasteride after some months. The urologist did indicate some permanent side effects were possible in some patients but I felt I could beat the odds and chance it. The doctors I’ve seen at this group have always been informative and up front about everything. Their level of concern and caring has always been outstanding. The urologist who prescribed the finasteride reluctantly sided with my decision and I respect him for that. My experience with the alpha blocker has been overall positive with reduced semen as a side effect and reduction of prostate size.  Though the its size was reduced I continued to have the issues associated with BPH randomly and that is what motivated me to research further options. If I had the opportunity to choose again I would still have opted for the rezum procedure and my past course of actions.

It’s too early yet to determine anything only about 2 days since procedure.  Only problems I’m having are due to the catheter which are tube sizing may have been a little narrow allowing fluid seepage and bladder spasms; the catheter comes out tomorrow.

 

Peter  I had the same problem.  When I had my Urolift  I had a catheter for 3 days.  I had bladder spasms when I had my catheter in.  When the spasm hit I would have blood coming out and around the catheter.  After they take it out it will be ok  Ken

Some details if you have not researched it:

The prostate is made up of three lobes and any number of these lobes can become enlarged; the enlargement is due to a benign tumor. Regardless of the classification of the tumor I want it removed or destroyed to best ability with minimal damage to normal surrounding tissues.  This tumor is not cancerous and does not spread so don’t go into a panic.

The number of treatments (2, 4, 6) typically indicate the number of lobes that are enlarged and are restricting the urethra; in my case all three lobes. 

 I do want to avoid retrograde ejaculation but I have been living with it sporadically for a while; the chance of RE and the number of lobes treated should have no connection in my opinion. I could possibily see some connection in the number of treatments per lobe, in my case 2 per lobe which is typical. In the event one lobe requires 4 treatments the trauma to that lobe would dramatic and I would not be surprised of some complications.

Men with compromised healing due to other health issues probably make up the 10-15% who experience RE and the remaining probably victims of poorly performed procedures.

 There is also another side effect not mentioned often here is that you can also experience a reduction in your semen volume due to the procedure and that is something I would hope doesn’t happen too.

Some of this is incorrect IMO. BPH is not the result of a tumor. They don't know why a small minority of men get RE from BPH and poor healers are not the only ones who get it. I ended up (mostly) with RE from Rezum, am perfectly healthy/have no healing issues and one of the top Urologists at a major hospital performed mine - who was involved in the initial trials.

Its unclear whether procedure boo boos can cause RE with Rezum. Maybe Jersey Uro can comment on that - but it can happen with healthy men and skilled surgeons too.

Tumor is avoided in the context of BPH to avoid panic and confusion with prostate cancer; but the reality of it is that it is a benign tumor and this was stated by a urologist and confirmed by peers.

RE follows the same principle as any plumbing issue; path of least resistance determines the direction of flow. If the urethra has enough restriction to provide back pressure greater than the forward pressure during ejaculation the semen will flow into the neighboring bladder; the greater the force of the ejaculation the higher the likelihood of RE.  Scarring or hardening of surrounding tissue and other narrowing of the urethra can produce enough restriction or back pressure to result in RE. A more relaxed or subtle ejaculation is less effected by the restriction due to less back pressure. 

Peter who told you that you have a tumor and the tumor is causes your BPH.  If you have the Rezum procedure it is going to destroy everything inside the shell of the prostate.  Yes you may get RE because the steam does not know the difference between the tissue and block the ducts.  Also the prostate has 4 lobes.  Anterior, Posterior. Median and the Lateral Lobes.  I would check with another doctor or look into another procedure  Good Luck  Ken  

http://urology.jhu.edu/prostate/bph.php

BPH is a benign tumor and remains localized so it does not spread like cancer. 

I tried to post a link to John Hopkins stating that BPH is indeed a very common benign tumor found in older men.  Links are probably prohibited here and I hope I didn’t break any rules.

I do realize that destruction of cells by steam is not a precise instrument and has its risks but injected into the heart of the rogue cell zones with close monitoring can minimize the destruction of healthy cells.  The rogue cells offer no benefits and retard normal Prostate function by mere presence, This is the primary reason I elected to have the rezum procedure.

My preferred choice is to have the immune system target these cells for elimination but this is still in the research stage and perhaps will become available in the near future as a safe affordable option.

Posting links aren't prohibited they just must go through moderation (ie be checked out by a person) to make sure they take you to a legitimate web site.

Jim

Hi jimjames,

Great news, thank you for clearing that up for me. 

I will have to look tat up.  Hope all go wells  Ken

EXCELLENT points.

Peter,

The definition of "tumor" is a growth or swelling, that's it. A benign tumor is a growth or swelling that is non cancerous. So, yes, that fits in with the definition of bph, but what other point are you trying to make? Tumor and cancer are not synonymous.

Jim

So Peter.  Do you have a tumor inside of your prostate. Or are you calling the prostate a tumor because it swell when we get older  Ken

I’m not saying that tumor is synonymous with cancer but they are also not normal cells providing any benefits. If I can rid myself of these cells I rid myself of the potential these cells present; that is all I’m saying.  The ideal is that the immune system deals with them but these cells masquerade as normal cells and avoid detection. 

Peter,

Yes, by definition, BPH is "a very common benign tumor found in older men". However, it really doesn't add any information to what we've known about bph for many years. I hope people aren't being put off by the word "tumor". It just means growth or swelling which is what happens to the prostate with bph. IMO focusing on the word "tumor" is adding more confusion than clarification to this subject.

Jim

My opinion is I have a tumor in my prostate, a mass of cells that do not belong there growing at an abnormal rate posing health risks without providing benefits. You can try to manage the symptoms, retard it’s growth or shrink it, remove the mass or remove the prostate.  I choose to remove the unwanted guest and his baggage. 

 You can choose to research the potential progression and effects of a benign tumor or just carry on. I’m just trying to logically approach the problem I’ve been living with for some time and act when I think I’ve found an acceptable solution with a high probability of a positive outcome. Additionally I don’t blindly take best case numbers and delude myself that this is the cure all either; I’ve worked with enough marketing people to realize they are entirely money driven and deceitful.

I hope I’m not coming off as rude or defensive and I appreciate the well wishes offered here but I do want to stay informed as well and not avoid the fact of the matter that tumors pose problems. Addressing  the problem when an acceptable solution appears has it’s risks too and each of us with some guidance and information should make an informed decision based on our criteria. 

Peter, you're speaking to the choir, ie telling the men here something that we already know. Yes, BPH/luts is caused by a benign tumor, in EVERYONE who has bph/luts, not just you. And many here choose to treat it with Rezum or any number of prostate reduction procedures. Others choose watch and wait and still others choose self catherization. All have their benefits and risks. Your choice is a reasonable one assuming you've had he prelimary tests like urodynamics to make sure it will work in your particular case. I'm commenting again, because you seem to infer that your "tumor" is something unique, it's not. BPH by definition is a noncancerous enlargement of the prostate gland, is the most common benign tumor found in men. ie BPH is a tumor. Let's not get hung up on that word.

Jim

Exactly my sentiment  and I tried to make it clear it is not cancer. I’m also trying to not candy coat and treat the problem as trivial and inconsequential.

 It’s a problem and it’s screwing with my QOL.  I have no problem with calling it a tumor and it prioritizes it for me by referring to it as such.  If you had followed further links you would have seen the possible future implications if future growth continued.

There is nothing special about my prostate or the growth. I’m probably over enthusiastic about being here and have someone to discuss the problems and decisions we make.  The opportunity is indeed rare and there are a lot of experienced men here to provide feedback.

From what I've been able to determine from doing research online is that only one person, the one who wrote the article for Johns Hopkins, refers to the enlarged prostate as a 'tumor'. In my opinion, that is a misleading bit of 'information' that doesn't agree with any other source. Using the term 'tumor' implies to most everyone that there is a separate mass of tissue, whether cancerous or benign, when in fact it is the tissue of the prostate itself that grows abnormally. Using the the term tumor does nothing to help help a patient suffering from the symptoms of BPH decide on a course of action. 

You're right about that. It's great to be able to learn from other patients (and a few dedicated urologists on here), about what others have experienced, and how to ask the questions to our healthcare providers that further help us on the road to better health and the quality of life.

I will drop the tumor from discussions since it’s becoming too much the focus and derailing important topics.