REZUM--HAVE YOU HAD THIS DONE???????
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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
laura00828 ChuckP
Posted
They told us every 4 weeks change for Foley. Of course they put in a new one after urodynamics test. They also told us general or spinal for supra so I do hope we can find someone who offers local as an option. Thanks again for all this insight a🙏🏼nd will let you know what happens.
steve05114 ChuckP
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To All,
I had my urodynamics tests on Monday, July 30, after 1 month of a Foley and 5 months of self-cathing. The results on the filling part were good but the results on the emptying part were bad. My question to everyone on this forum is at the end of this post.
First the good news. When they were filling my bladder up, the test numbers were consistent with the numbers that I have been recording in my Excel spreadsheet that shows my times, self-cath volumes, and urge-to-pee sensations. The First Desire to Void at 150 was low, as I usually feel this at about 195 ml self-cath values. The Normal Desire to Void at 250 and Urgency at 350 were right on.
Second the bad news. When I had to empty my bladder on my own, I could not. It was an outright fail. So while my bladder could feel that it was filling and expanding which suggest my bladder has indeed shrunk since when it held 2 liters of pee in mid-January when the Foley was put in, now over 6 months later, the muscles in the bladder appear to have still not recovered.
What I find odd though, is that when I self-cath, I always get a good solid flow using a 14 Fr. catheter, so unless this good flow is just due to gravity, (or "hydraulic head" for the engineers here
), I don't understand why the 2nd part of the urodynamics tests would show such bad values. Does anyone have any comments on this?
After the urodynamics tests, the urologist said: 1) If no changes in 6 months, then we will check urodynamics again, and 2) At this time, it is unlikely that surgery would be helpful given minimal, unreliable bladder pressures/contraction *** but this not unreasonable to try ***.
So my questions to everyone are:
1) The theme of damaged/compromised/weakened bladders and surgery has come up before on this forum. Has anyone had damaged/compromised/weakened bladders AND done Rezum?
2) If so, had the damaged/compromised/weakened bladder recovered (as identified by urodynamics tests), or if not, then did you go ahead and try Rezum anyway?
3) What were your results after Rezum?
Thanks in advance,
Steve
ken19524 steve05114
Posted
Steve,
I don't understand how your urologist came to his conclusion. I also 'failed' the peeing part of the urodynamics test. But that was because of the restriction due to an enlarged median lobe of my prostate cutting off the flow through the urethra. I could only void a few ccs, but with an FR14 catheter, no problem. Rezum fixed the restriction part.
If I were in your situation, I would definitely get a second opinion from a different urologist.
steve05114 ken19524
Posted
@ken19524: I don't understand how your urologist came to his conclusion.
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Hi Ken,
Thanks for the reply.
I don't *fully* understand how the urologist came to his conclusion either. Unlike the urinalysis that showed me that I had a UTI (I never felt anything but the numbers said that I had one), where I could *easily* look up on the Internet what the numbers meant, with the urodynamics test, I don't know what the numbers mean and I am having difficulty finding good information on the Internet (with Google Scholar).
It is interesting that you say enlarged median lobe obstruction was cutting off the flow in the urethra, but with an FR14 catheter, no problem. One of the more interesting articles that I came across was in the July 2017 Asian Journal of Urology, which used the analogy of a lateral lobe obstructions as "stepping on the garden hose" and a medial lobe obstruction as "bending or kinking the garden hose". One of the key points of the article was that an enlarged median lobe causes more of an obstruction than enlarged lateral lobes.
From washing my car, where I will sometimes step on the garden hose (lateral lobe) and sometimes bend or kink the garden hose (medial lobe) where the latter really cuts off the flow of water, I totally got it.
Question: Are you saying that the very small diameter catheter used in the urodynamics test could have been forced closed by the enlarged median lobe obstruction while the bigger FR14 catheter can just passes through the obstruction?
From discussion with the family-member-MD, the next step within the next few days is to set up an appointment with another urologist who does Rezum and was recommended to me by someone at NxThera in order to get a 2nd opinion and get a consultation on Rezum. The family-member-MD says that I should redo the urodynamics test as part of the 2nd opinion, but at $1000, doing that again is unlikely. Not that I want tubes being shoved up 2 holes again
Steve
steve05114 ken19524
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@ken19524: I also 'failed' the peeing part of the urodynamics test.
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Hi Ken,
I forget to mention one thing. What I failed was the emptying part *after* they filled me up by way of the catheter. I never did the emptying part before they artificially filled me up because I am totally blocked. Which "peeing part are you referring too, after you naturally filled yourself up or after they artificially filled you up?
Thanks,
Steve
ken19524 steve05114
Posted
Steve,
I doubt that you need another urodynamics test. I guess that I don't recall the details of my urodynamics test, or it was somewhat different. But what I do remember is that, trying to void on my own wasn't successful, but using a catheter (FR14) my bladder was able to push the urine/saline out with no problem.
Again, I'm not a medically trained person, but it sounds like your bladder is doing the same thing: pushing the urine out when there isn't an enlarged prostate pinching off the flow.
Considering your current situation, I don't see why a Rezum isn't indicated to reduce the size of the prostate in the areas where it is blocking the flow. There certainly is very little to no risk involved. But you might want to consider seeking out one of the more experienced Rezum urologists in your area to hopefully ensure the outcome. Even if your bladder is 'weak', it could rehabilitate itself much more easily over time without the flow restriction.
hank1953 steve05114
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steve05114 hank1953
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Thanks for stating the obvious. Can you please answer the questions that I posed to the forum. That was the reason for my post.
Steve
TKM steve05114
Posted
Are you saying that in the second part of the urodynamics test you could not urinate even through a catheter ?
Thomas
steve05114 TKM
Posted
@thomas37368: Are you saying that in the second part of the urodynamics test you could not urinate even through a catheter ?
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Hi Thomas,
Yes, in the 2nd part of the urodynamics test after they filled me up with 650 ml of sterile water, I could not pee it out through the very small diameter catheter that is used for measuring pressures in the test.
What I find odd is that when I self-cath 4-5 times a day with a 14 Fr. catheter, I always have a strong flow. So unless this strong flow due to gravity alone, it don't see that my bladder is NOT helping to push the pee out.
Steve
TKM steve05114
Posted
It sounds like something may have gone wrong with the test. The catheter could have been kinked like you suggested, possibly because of the median lobe. Maybe it slipped out a little so the drain hole was covered, by the urethra. Maybe a blood clot or other debree plugged the small diameter of the drain hole. Maybe the Urologist can give you one of the small diameter catheters so you can try it on your own at home.
Thomas
scott95643 steve05114
Posted
Yeah, I dont quite understand the difference between being UNABLE to pee at all while the cath is in for UROD test, versus good flow with 14 g CIC. I thought that the URO test was more a function of the measurements and whether your bladder was contracting in the "emptying" process, not just whether gravity was allowing some emptying. So what they may have been concluding was more that your baldder just would not contract, regardless whether you were having some flow or not. Flow may may have something to do with the much smaller tube for the uro test. Also, the more full ur bladder is past a typical full 350 to 450 cc filled bladder, the more stretched and less strong the bladder is and harder it is to push out. I have a harder time with voiding on my own if I oversleep or overwait the voiding past 400 or so ccs. Doc explained to me that is normal. that was also true when I was in severe retention. When my bladder stretched past 500 or 600 ccs, it basically shut down, but once I had it emptied, I was able to void a bit on my own for another several days until i would leave enough built up behind that it stretched to way overfull again, then it would shut back down. So I am surprised that they would have filled you all the way to 650. DiD they also try voiding at 300 or 400?? Another thing I was told is a good indicator whether your bladder can contract reasonably well, is to push/bear down while emptying with the cath (CIC or otherwise). If the flow increases through the tube when you push, then that is a good sign that your bladder can contract. sdh
steve05114 scott95643
Posted
@scott95643: Yeah, I dont quite understand the difference between being UNABLE to pee at all while the cath is in for UROD test, versus good flow with 14 g CIC.
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I am somewhat confused by the urodynamics test too. After they filled my up with 650 ml of water, I could not empty my bladder whatsoever at all and I had about 10 minutes to try. But when I self-cath 4 or 5 times each day with ouput volumes usually between 200 and 350 ml (with an occasional below 200 ml or above 400 ml), I have a good flow through the 14 Fr. catheter and when I "push/bear down" when self-cathing, I can increase the flow.
You may have a good points that "past a typical full 350 to 450 cc filled bladder, the more stretched and less strong the bladder is and harder it is to push out" and "When my bladder stretched past 500 or 600 ccs, it basically shut down." I am somewhat suspect about the urodynamic test's emptying results. I am OK with the urodynamic test's filling results which are consistent with what I have been recording with self-cath volumes and urges to pee.
You may be right about the bladder being too stretched out to contract when it is overfilled and it shuts down. At any rate, next,this week, I will be moving forward with my plans to see a 2nd urologist who does Rezum so that I can get a 2nd opinion...
Steve
jimjames scott95643
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Jim
jimjames steve05114
Posted
Jim
davidaami jimjames
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It's incredible how much knowledge is collectively in here among you guys.
steve05114 jimjames
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"Urodynamic testing is not real world data so it has a lot to do with who is running and analyzing the results. If they fill the bladder too fast you may not get real world results." That is the same conclusion that I am coming too also.
jimjames steve05114
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Jim