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

Drummer

Since this is what you want this is what you have to research.

There is a lot of information on PAE on the internet. Not only do you have to research the procedure but you need to check out the doctor that does it.

There are many doctors that are doing them now. It is just where you are at. If you can also check with some of the patients that the doctors are doing. That would be helpful to you to.

When I did some research on it. I did find before they do it on the patient. It is done on the computer also as a mock procedure so they make sure they are putting the pellets in the right veins.

Good luck with it.......Ken

thank you ken you know i found a dr near me but i would like to hear from someone who had it done or had personal knowledge about pae

You will get a few.

We have had men that went to Virginia to have it done by Dr. Bagla He was the first to do the PAE in the US...... Call him and talk with him

This doctor that you found have you talked with him. Try to talk with some of his patients. How is his reviews.

Good luck. Ken

Go on Dr. Bagla site he has some videos

That dive bomb method sounds like the thing to do. Will try it! Thanks for the idea. So far, not feeling anatomical features; feels like I'm flying blind. Hopefully it'll improve over time.

John

Very sorry about that. Maybe it will improve...Ken

John

Very sorry about that. Maybe it will improve...Ken

Ken,

How are you doing now? The last time before Thanksgiving, you mentioned that you were sick with a high fever. I hope that you are doing OK now.

I had my Rezum done today at about 11:45 AM. I was on 1 valium and 1 percocet and it never felt that painful. I don't know why some guys are complaining about the pain. I have felt a lot worse. Afterwards, my driver and I went out to lunch at a restaurant that Al recommended. So far, I will recommend Al's choice of urologists and restaurants.

I have to wear a Foley for 2 weeks which is a week longer than I expected but I am good at following doctors orders. The bag was pretty bloody when I just emptied it.

I will keep this group posted as my recovery progresses...

Steve

That all sound encouraging Steve.

steve,

great to hear that your rezum went well.

i also had mine done today. i went under twilight and felt nothing. i woke up slightly sore from the foley. my urine is also red and told not to worry about that.

the doctor explained that my median lobe was very large and no medicine that i had been taken would have worked. he was very positive on the procedure for me. he's the expert on rezum so i was happy to hear that. he has me on foley until i see my doctor back home monday to take it out.

hopefully i can pee on my own then, if not the foley goes back in.

i asked how many shots and was told me that i received 11, 4 on each side and 3 in the huge median lobe. it was more than he thought he was expecting to do, but based on his experience, it was what he needed to do once he got inside the prostate and saw what was going on.

ill give update next week.

Steven

Doing much better. No fever. Just 1 stone. On Cipro for another week then I see my Urologist. How is your weather there. We had 46 the other day. It is a little early to have cold

So everything went well . How may injections did you have. Get some rest and relax....Ken

Ken glad you're better.

A kidney stone? Wow!

I'll definitely want to hear your updates Changejobs.

Buddy

I hope it works out for you. And does not cause you any problem. I still say that is to many. If it does not work it will cause a lot of scare tissue

Gook luck

Ken

Thanks David

Have another week of Cipro. See my doctor on the 7th Take care Ken

thanks ken. i hope you feel better.

Thank you buddy

I do feel much better. I hope all works out for you I'm just worried for you.

Will keep you in my prayers...........Ken

Hi Ken,

The high today in my part of Colorado was 48. We have some colder weather moving in. When I passed my kidney stone last December, I barfed in the sink 3 times and crawled on the floor. They put me on Cipro after the bladder scan showed 500 ml. When the urinalysis showed that I was clean, they told me to stop taking it so I still have some extra.

The Rezum procedure was a whole lot less painful than passing the kidney stone. I was expecting 8 shots (2/lateral lobe and 2/median lobe) and I got 10. The lateral lobes must have been bigger than I expected. Right now, I don't feel much pain at all but I am tired. That could be lack of sleep though. The bag has been pretty red today.

I am definitely resting tonight. I will see how I feel tomorrow about any exercise. I may walk around the grocery store. I am glad that I did a short 6 mile cross country ski on Tuesday.

Steve

Changejobs,

Wow, 3 in your median lobe! My median lobe was clearly evident in my cystoscopy as it pushed up the bottom of my bladder which the urologist called "volcanoing". I fully expected to get 2 injections in my median lobe. I did not expect 3 in each lateral lobe.

As I have written before, a large median lobe will just bend the urethra and stop the flow like bending and kinking a garden hose. The family-member-MD and I agree that no meds (Tamsulosin and Finasteride) would have made a difference on a bad median lobe obstruction.

The family-member-MD also said that from his experience, the longer that you are doing a surgical procedure, the less timid (or more aggressive) you are at doing it. Your urologist was one of the originals with Rezum so he knew how many shots to give.

So how long were you told to keep the Foley in? I was told 2 full weeks. I get it about the healing process so after 11 months of this, another 2 weeks is not a big deal to me

Let's keep up our progress reports!

See ya,

Steve

PS: That should say " did not expect 4 in each lateral lobe."

Steve

I hope you will be ok. 10 shot is over doing it in my book. I think after 6 is over kill. I hope it will be ok and not cause you any problem. Didn't you and Al have the same size prostate. He only had 5 shots same doctor.

I am going to put you on my prayer list and hope this does not cause you more trouble that you can handle. Time will tell. We will see if she make the right choice.

Ken

Steven & Change

I'm going to say some prayer's for both of you tonight.To me this is upsetting that a doctor would do that to you both. Knowing the damage that the steam can do to the prostate tissue. It is overwhelming. But it is your body's

I have you both down on my list. I'm at 54 procedure only time will tell if they worked

God Bless and Good Luck....................Ken

Hi Ken,

Al's prostate was easily half the size of mine.

Steve

No problem.

I thought there were the same size going to have to look it up again. I just feel it is to much. I do not respect her as much as I did before. That is to many injecting. I kept reading the booklet I have I feel that the 6 main injection which they state would do the job. 10 injection you may have well cut it out with all the damage that is done on the inside of the prostate shell.

But that was your choice and you will have to live with the good or the bad.

Prayers go out to you. I think I will send her a comment to voice my opinion. If she told you that she was going to do 20 would you let her. I think men have a right to the number of injection they have. One day we will realize that less is better.

To me this is very serious and very up setting.....................Ken

Ken,

Do NOT send a comment to my doctor. How she treats my BPH is between me and her. You are not her patient. Am I being very clear on this?

When I discussed this with the family-member-MD who has practiced medicine for over 40 years, he was OK with number of Rezum injections that were done.

Thank you,

Steve

Ken, you really do need to back off and relax. These urologists who doing Rezum procedures are experienced, well trained, and have their patients' best interests at heart. I had 10 shots and it was the right number for me. I had absolutely no problems at all either right after the procedure, or in the months since. These guys who are reporting their experiences are doing just what the original poster in this thread asked: "what was your experience with Rezum?" Actually you're an outsider since you've never had the experience.

Do you realize how inappropriate it is to comment and 'warn' other men about a procedure AFTER they've already been through it? Your comments are not helpful at all to someone who's already been through it. What are they supposed to do? Go back and complain to their urologist because some guy on a forum thinks they used too many shots of steam? I know that you think you're trying to be helpful, but those are definitely not helpful at all.

Steven

All right I will not send anything to her. I still feel this is to many. But that is your problem. There are still many urologist that do not like this procedure because of the damage it does. But that is life

Hope all works out for you. Ken

Ken

I really get what you are saying but I am trying to stop men from just not being a ware of the side effects with the Rezum procedure. There are side effect with anything we do but after reading up on it and the things that my doctor have told me. It can go 2 way. It may work and it may not work and cause a lot of damage.

Men need to research there procedures. A doctor is just about man with some learning and in reality a doctor no matter what procedure they do do not really know if it will work until it's done.

We have had many men on here that have had to have many procedure because they felt that there procedure was the one and ended up having others. I just want them to be ready if it fails.

No matter what anyone said I still feel that over 6 is to many no matter how big the prostate is. If the injection are put in the main 6 area that should be enough to make it smaller and relieve the pressure.

I just feel sorry for men that are over worked on. You have been having enough problems as it is you don't need anything added.

I do hope ti all works out for you guys. I will pray and keep my fingers crossed.

Good luck and God bless you both..Ken

(some keys on my keyboard not working so please ekscuse spelling) - Fwiw, I saw a resum doc about 6 weeks ago; he said if he were to do it on me, it'd be 2 shots on each side; my prostate measured about 6 by 5 by 5, and he said he did not see any median lobe in the ultrasound; he's done about 25 of them, he said, in the past several months, and he's been treating BPH since the early 90s. He's done many TURP's.

*kenneth1955 > ★6 ken19524

Message

Ken

I really get what you are saying..... I still feel that over 6 is to many no matter how big the prostate is.

Kenneth1955, ref: # shots

You often refer to the picture of 6 shots you saw, I to have seen that picture, it is from the Drs 20 page users manual published by Rezum. The purpose of the 6 shots picture is show Drs how to overlap the edges of the shots NOT HOW MANY TO USE.

I have copied the part of page 11 &12 which instructs the Dr on how many shots to use depending on size/ length of the prostate. For clarity the < means less than, > means greater than.

**6 . While examining prostatic urethra, locate the apex of the prostate and the bladder . A TRUS and/or cystoscopy prior to the procedure can help obtain prostate measurements to determine the appropriate number of treatments .

**7 . Estimate the prostatic treatment length (i .e . from bladder neck to verumontanum) . This length is considered the vapor treatment zone (Fig . 13) .

**8 . Based on the length of the vapor treatment zone , determine the number of treatments per lobe (Table 3) . A treatment consists of a single 9-second delivery of vapor .

(a picture describes Treatment Zone Length as from bladder neck down to the verumontanum)

**9 . If a median lobe is present and judged to be in need of treatment, deliver one treatment if median lobe is <2 cm and two or more treatments if median lobe is >2 cm . If central zone hyperplasia contributes to an elevated bladder neck with a prostatic urethral ≥35 degrees, as evidenced by sagittal TRUS, deliver one treatment for an enlarged central zone <2 cm and two treatments for an enlarged central zone >2 cm .

(from Table 3 below)

From neck to Veru #shots per Lobe

less than 2 cm1-2

2-3 cm2-3

greater than 3 cm 3-4

**

PRECAUTION: Treatments in excess of those recommended in the guidelines may lead to prolonged irritative symptoms and/or catheterization.

**NOTE: A maximum number of 15 full treatments can be delivered with each Delivery Device.

Table 3 Guidelines for determining the number of treatments (lateral lobe)

(I left out steps 10 thru 23 that did not pertain to the number of shots)

**24 . For intravesical prostatic protrusions of either the lateral or median lobes, position Delivery Device 1 cm from the proximal edge of the protrusion and deliver the vapor treatment with the needle positioned approximately 45 degrees toward the midline . One treatment for a small median lobe (<2 cm) and two or more treatments for a larger median lobe (>2 cm) . For an enlarged central zone, deliver treatments 1 cm from the bladder neck with the needle positioned at 45 degrees toward the midline of the tissue . Do not treat on the floor of the urethra within at least 1 cm of the verumontanum .

**

Kenneth1955 I sincerely hope this post will further your under standing of why URO DRs use more shots than what your personal opinion of 6 shots is all that are necessary.

I also do hope that you take to heart and follow the advice from Ken19524. Posted above here today.

I'm glad that you are felling better,

Al - Allen

@steven05114

Steve, glad your procedure went well without it being that painful!

Sorry that I didn't mention the two week Foley use but I was not self-cathering and I didn't know what Dr. Huff does for those who do.

I asked her about the 2 weeks with the Foley and she said "initially the prostate cells swell after the steam treatment and you might have to go to ER if you could not void and I don't want that for you".

Now for the good news, with the 2 ltr Foley night bag, you will get 2 weeks of all nights of FULL SLEEP. I really miss that since I had it for 18 months.

I hope they gave you a "plug" for the Foley to use rather than the leg bag for day use.

Sounds like you liked the restaurant.

Best wishes

Al,

Thanks for providing Ken1995 with more information.

BTW, I did not need to take any additional percocet before I went to bed last night and I feel good this morning. Before I emptied the bag last night, it was very red with blood. This morning, it only has a minor red tinge. I expect it to be even lighter by tonight. I don't have much else to report about yesterday's Rezum procedure.

Also, I contacted patient.info support about a bug that I am seeing on the website. It seems that after we have reached 100 pages, "Sort by latest" is not working after "99/102". Is anyone else encountering navigation problems and if so, have you found a solution?

Thanks,

Steve

Nisvan

I think that would work for you. It would be enough to open you up

Good luck...Ken

Allen, Steven and the other Ken

Allen I have read and re-read the 24 pages of that book-let. I still feel it is wrong to overkill with the injection. Just because it said you can go up to 15 injection does not mean you have to have it.

I still feel that it should not be up to the doctor how many you have. The patient should be told and agree to it. It your body.They if something goes wrong you can't blame the doctor

I think I take it to heart to much because I feel for the men that have been taking advantage of by there doctors.

I know there are some guy's that are going to be bad with me. But I want you all to know I feel for you and I don't want you to go through anything you don't have to BPH is enough to deal with.

I wish all of you that the treatment works and you don't have to go through anything else. Time will tell. God bless you all.......Ken

Hi Al,

I totally get it on the "with the 2 ltr Foley night bag, you will get 2 weeks of all nights of FULL SLEEP". I feel great today after a full night of sleep!

When I was self-cathing, I would have to get up after 5 hours, wait a while to be sufficient awake to self-cath and then I could not go back to sleep so I would make breakfast, watch the news, etc. Then I would sleep for another 3 hours.

Yes, I got a "plug" and used it this morning in the shower. I also opted for the smaller leg bag as that is what I had before with Kaiser. Based on my self-cath volumes, I knew that a 500 ml bag would be just fine for up to 6 hours and it is lighter too.

Yesterday night, the bag was very red, but this morning it is a whole lot lighter.

Steve

@kenneth1955 to allen98488

I still feel that it should not be up to the doctor how many you have. The patient should be told and agree to it. It your body. They if something goes wrong you can't blame the doctor

So Kenneth,

If someone demands the Dr to take your 6 shot advice and then it does not work. Who get the blame then, You?

Allen - Al

I doubt anyone on this thread is qualified to make a determination of how many steam injections are required doing a resume procedure. urologist are surgical sub specialists at a spent 4 years in college four years in medical school a an internship and a multi-year residency and then fellowship. just because you have a fat prostate doesn't mean you're qualified to tell your urologist whether you need for six or eight or 20 shots.

Allen

I just feel you have a right to know before hand and that will be up to you. Because you are the one that will be dealing with the out come.

Ken

There have been to many men talked into procedure that they were not told the whole picture and when something happens the doctor tells them I don't know when wrong.

It's not up to anyone but the man that is having it done.I for one do not give any doctor full control of what they are doing. No extra just what as been agree to

TO YOU ALL

I'm just done with the whole thing. This is just my opinion. I don't have to deal with your outcome and you don't have to deal with mine.

God Help Us All

The Rezum instrument is rigid. When it is first inserted, the instrument is used to measure the length of the prostate. The doctor then uses the length of the prostate to determine the number of injections as per NxThera's instructions.

For me, then most painful part of my Rezum procedure was when the doctor first inserted the Rezum instrument. The steam injections were not that bad. I guess that I could have asked the doctor how many injections I was getting at that time.

But I must admit that at the time, I was not thinking of this, my bad 😖

Steve

Would you have said no, I want less? The doctor surely knows better than us how many shots to do. I had my preop visit today. She said she will decide how many when she gets in there and measures. I will be out for the procedure and will have to trust her decision.

@john98818 toallen98488

I doubt anyone on this thread is qualified to make a determination of how many steam injections are required doing a resume procedure. urologist are surgical sub specialists at a spent 4 years in college four years in medical school a an internship and a multi-year residency and then fellowship. just because you have a fat prostate doesn't mean you're qualified to tell your urologist whether you need for six or eight or 20 shot>

I agree with you 100% regardless of the prostate size.

Al - Allen

Steven

I hope it works well for you......Good Luck..................Ken

@timothy81571: Would you have said no, I want less?

\

Coming from a family with a few MD's in it, I would not have said "no, I want less". When the first urologist that I saw pushed for TURP when I asked him about Rezum, I politely decided to move on...

30 hours post-Rezum, I am feeling pretty good -- absolutely no pain today but the pee in my leg bag is still red but much less so than yesterday. I expect that to improve. I am about to try my daily 3-mile walk.

Later,

Steve

steven,

glad to hear your feeling good. im feeling good to except im catching a cold.

my urine is also leas red today.

the only 2 issue i have is from the foley.

1- the area where it goes into the penis is sore so walking can be a bit annoying.

2- the tube that goes to the leg pouch gets a little backed.

do you have any of these issue?

btw how many shots did u get?

Allen

Sorry....If my doctor would tell me 10 injection...... I would say no. That is my right. But I don't have to worry about that my doctor will never do this procedure. It causes to much damage. If your concerned about side effects I would limit them Which I have a right to.

That's fine. You all have to do what you feel is right for you. That is why they have made so many different procedure to satisfy all of us. They are not one side fix all

Life goes on...............Ken

Hi Changejobs,

Q: 1- the area where it goes into the penis is sore so walking can be a bit annoying.

A: 1-rub some cath lube on the tube and on you where it goes in. Also check the "threading of the tube through your underware" and if the thigh secure point is slipping down. I had this same soreness problem last January after a day of snowshoeing. I was not skiing for obvious reasons.

Q: 2- the tube that goes to the leg pouch gets a little backed.

A: 2- if you meant to say "backed up", then check for blood clots clogging the tube. You can always separate the tube from the bag (like when I swap out my day and night bags) and clean this area. Always finish the cleaning with alcohol. If blood clots become an issue check in with your doctor ASAP!

I had 10 shots, 4 per lateral lobe and 2 median lobe.

Good luck. I need to take my 3 mile walk now!

Steve

It's great you're able to keep up with your exercise.

hi changejobs - i don't know how long you're supposed to have your foley, but i can tell you my eskperience from having one for 2 months, is that it's going to hurt around the tip of the penis something bad for the first few days, and then that pain there will slowly subside to almost no pain at all. Mine had a tube coming out of the penis, connected directly to a little trigger gun, with an on/off valve, about 4 inches long, with a spout on the end of it, and never any bag. I'd strap the little trigger gun to my leg at my upper thigh, but when I slept I'd let it lie loose. When playing racketball or hiking, I'd tuck my penis and the little trigger gun along with it, into my underwear, in the shape of a compressed "c" . When showering, I'd just put a small rubber band around the shaft of my penis, and the trigger gun, holding the two loosely together. You'll find a way. It won't be as bad, after about a week, as it's feeling these first few days. In the meantime, as Steve commented, that gel applied to the tip will alleviate the pain. Advil helps too. Hang in there.

One and All

Yes sometime a catheter can be a pain and a blessing. Do use the gel around the tip that will help also make sure you have enough give with the tube.

The second time I had one there was not enough tube and when I stood up straight it pulled down on the penis and it hurt. I ended up with the pee hole bigger so now I have to sit down to go to the bathroom because it sprays all over.

My doctor said that he could put a couple of stitches and I told him no. I can deal with sitting down

Take care Ken

@nisvan: When playing racketball or hiking

///

Hi Nisvan,

I have been thinking along the same lines. I do not have a trigger gun with an on-off value. Instead, I have a solid plastic plug to insert in place of the leg bag or the tube to the overnight bag. I can just hold the whole deal in my underwear as you have mentioned.

The MD wanted me to have the Foley in for 2 weeks after which I am scheduled for my 1st post-op follow-up appointment. I am supposed to take it easy for the 1st week and not do anything strenuous. I talked to the PA the day after my Rezum and she said that it was OK to use the plug and not the bag.

At this time, I am thinking of staying with the bag for the 1st week (I expect most of the bleeding to end by then), and then switch over to the plug for the 2nd week before my follow-up appointment so that I can exercise my bladder just like self-cath while not repeatedly passing a catheter during the healing period.

For the 1st week, I am thinking of just doing my 3-mile/1-hour walks everyday to maintain a base-level of fitness and if all is good, then in the 2nd week, I will try some cross-country skiing and snowshoeing. When I remove the plug, I will be able to make some yellow snow in the woods 🙄

I like this forum for the little gems of wisdom that we learn from one another. It is time to take my walk.

Steve

nisvan,

it seems that the foley tube that goes into the penis, goes in and out slighlty as i walk. is that what happens to you?

i believe that is walks causing the rubbing.

i put lube around the penis tip and foley tube thats attached to the penis, however that quickly gets used or wiped away by the underwear.

my foley goes out of the penis for about 3 inches then splits. one side i do not use. the other side i put a tube in that runs tk wither the day or night bag

changejobs,

Yes, that tube going in and out slightly, is going to cause you the most annoying pain at first, and you're going to feel like you're not up to doing anything. But have patience. In a few days to a week, that pain will mostly go away. So don't over do your walking and moving around for the first few days, otherwise, you could infect that area or cause some serious bruising.

The split to the one side to the part you don't use - that leads to a small bulb that was pumped full of saline, during the installation of your Foley. That bulb keeps the whole thing from coming out of your bladder. When they remove your Foley, a nurse will insert a syringe into that unused section, and withdraw the saline from the bulb, so that the catheter can be removed.

So, if you have a bag, connected to the other tube, and you're going to have this Foley in you for a while, you may wish to consider dispensing with the use of collection bags, and instead, have what's called a Flip-Flo catheter valve connected to the tube coming out of your penis, about 5 inches away from it. The Flip-Flo weighs less than an ounce and is about the length of your hand. Whenever you feel the need to pee, you point the spout of the valve towards the toilet, while standing up, and flip the valve. Out will come most of the urine in your bladder, about the strength and flow as when you were 18! You then turn off the valve, though I forgot a few times (not good!), clean the spout with some toilet paper, and tuck it in to a strap on your thigh. I was sleeping 3 to 5 hours a stretch. The more days I had one, the more hours at night I was sleeping at a time. The first few days with it, though, it was only an hour or two.

I had one for 30 days, and then another one for another 30 days. They attract a subtle odor after about 30 days, probably due to the bacteria building up on the inside. Your pee begins to really wreak.They're not supposed to be a long term multi month solution, because you're liable to inevitably get a UTI.

If you're going to need a catheter more than a couple of months, you may wish to learn how to self cath, instead, of having a full time catheter in you, in order to avoid having to wear one of these things 24/7, and to avoid getting UTI's.

The two Flip-Flo's I had never failed or leaked. I slept with them, hiked, played racketball, painted the house, but I always carried around a butterfly clip, in case the plastic tube broke. I was lucky to never have to use a bag. If you have a choice, using the Flip Flo valve seems a lot less cumbersome. It's also better for your bladder, than a bag would be, from what I've read.

@changejobs: i believe that is walks causing the rubbing

///

Hi Changejobs,

I took my 3-mile walk today (Saturday) with the Foley and another 3-mile walk on Friday, the day after my Rezum was done. Adjusting the thigh band is critical to prevent rubbing. If the thigh band is too lose and slips down, the tube will pull on you and that will contribute to the rubbing.

Is your bag on your thigh or on your calf? Last January when I had a Foley for 3 1/2 weeks, I had a calf bag. After the Rezum, I got a thigh bag. Also, the bag is only 500 ml as the smaller bag will weigh less and therefore pull down less. What size is your bag? A bigger bag can always be emptied more often.

I like Nisvan's idea of a valve. I got a solid plug that I can use instead of a bag and then use the Foley like self-cathing to exercise my bladder. I plan to use the bag for the 1st week and the 2nd week, I will use the plug just like self-cathing. That way, my bladder will get some exercise before my next doctor's appointment.

If I do some cross-country skiing or snowshoeing the 2nd week, I will be able to make some yellow snow in the woods 🙄

Steve

Hi David,

Thanks. Right now, I am focusing on base-level exercise as I was told not to lift over 10 pounds for the 1st week and my backcountry pack weighs 17 pounds. If all goes well, in the 2nd week depending on snow conditions I will try some cross-country skiing (good snow) or snowshoeing (bad snow). So far, the only problem that I had was fine-tuning the adjustment of the thigh band on the Foley, but I expected that anyway.

Steve

Lvscott

And all others

This and many other comments are our opinions. Which we have a right to. You just have to pick what procedure you want and hope all works out.

Have a good day..........Ken

i think the medical profession is still one that i hold on high regard.

There are some that are ethical, who still put a patient's well-being over $$$. As far as the other guy here, having some family members who are involved in the medical field who may be decent people does not represent the bigger picture in whole. Health care costs continue to rise here in the USA, while the quality of said care, both insurance and treatment wise here, declines. Right now, if the HC care industry really cares for patients as some claim, they can easily create new and effective treatments for BPH , such as direct injectable immunology drugs as one example. The reason they do not is because there's no money in it for them because those clinical trials would take too long, too costly for 'them.'

I brought up Holep and Glep to make this point - 2 vastly superior procedures with proven results the exceed "The Gold Standard" TURP, (Yes, I know about the retro), and both aren't anywhere close to being widely used.

HC is a big business with obscene profit margins, at least in The United States. All one needs to do is check out 10 year stock charts of the major health insurance companies, even big pharma to get a glimpse of this.

Hospitals are the #1 offender, where they make millions upon millions, charging patients often-times in excess of 10,000% margins.

Conclusion : The HC industry has a right to make $$, I don't begrudge them on this. My problem is when they put $$ far above easing individual suffering. Surely, there are good Doctors who do truly care about their patients, but they have become the minority and are equally as fed-up as many of us out there with the HC system at-large.

Uro's offering Rezum , UroLift, and other so-called minimally invasive treatments get the luxury of doing these in-office without general anesthesia which results in a big volume-higher turnover better profit margins for them, while the patients get the 'luxury' of recoveries that may or may not ease their symptoms - I can't speak for the U.K. as I'm an American who lives in America - My views are based on Health Care in The United States.

Steven and Guy's

To all the men that have to deal with BPH. Now I was not going to say anything but that is not me I have to give my opinion. I care to much to what happen to you even if you don't

I hope I put this the right. ?

We all deal with this problem in different way and we pick different procedures. Our doctors can suggest a procedure that may help us. But we should have a say in what is done to our body's.

Urolift, Rezum & PAE are good procedure to start with if you don't want to deal with any side effects or less side effects. Urolift is the only one that does not have any side effect at all. PAE does have a reduction in your ejaculation. Rezum will work for some men but there is a 10 to 15% chance of retro. If you can deal with that.

Now what I'm trying to say is you should have a say in what your doctor does to you. Let's take the Urolift first. Some men only new 2 clips or 4 clips. You can go up to 8 but you don't have to have it done at one time. 4 may do the job. You can always go back in and have the others put in. I have heard of that. It does work. You never know.

It would be the same with the Rezum. The book tell you that you can go up to 15 injection but way have them all at one time if you do not need to. The doctor can start out with 6 if it worked fine but if not you can have another 6 put in other area. You have to give any procedure a chance to work.

Men with BPH have to deal with a lot why should you have to deal with more if you don't have to. Life is to short. Procedure can be a justed to the patient. What works for one may not work for the other. You should not have to over dew a procedure

All I'm trying to say is do your research and voice your concerns to your doctor and if he or she does not listen it's time for another doctor. They should not give you the run around if they are trying to help. Like we are all on here giving our opinion. They are doing the same. It is just there opinion. But it's your body at stake.

God bless you all. Ken

I for one appreciate the feedback of guys going thru these procedures so we can learn from them. I'm hoping things stay positive since we all have enough issues. Thanks everyone!

with the foley in i seem to pee without knowing it. if you have the spigit it sounds like you dont use a bag. is that correct?

sounds interesting?

currently with the foley, most times i dont know im peeing? will i be aware when i have to go with the flip flip ?

has anyone else tried a flip- flop?

steve,

my bag size during the day is 32 oz - large.

i think the thigh band is good but i think the recovery nurse moved my thigh band higher and it mat be too close to the penis area . how far away is your thigh band to the penis?

im confused about what the solid plug. is that in addition to the plug for the bag and the plug for the saline?

when you try to pee do you see pee going through the tube to the bag? most times now i dont even realize that im peeing.

i go to doc tomorrow, take out foley and test.

@changejobs : my bag size during the day is 32 oz - large.

///

The distance that you are requesting is a relative distance 🙄 The distance between the top of the band and my crotch forward of my butt is 2 and 3/4 inches or 7 cm if you prefer metric.

The solid plug while made of plastic, can be thought of as a "wine cork". It is used to plug the main catheter tube that either the day bag or the tube from the night bag fit into. It is a primitive valve. When the plug is in, flow from the catheter is stopped. When the plug is out, the catheter acts like a self-cathing catheter. One reason that a Foley is put in after the Rezum is because the area may be too tender to self-cath for a while.

When I have an indwelling catheter (Foley), I do not try to pee as the catheter is putting the bladder in a constant state of draining. I will do this for the first week to rest my whole lower urinary tract (LUT) area while the swelling from the Rezum procedure subsides. The second week, I will just use the plug as per my self-cath schedule so that my bladder can exercise expanding and contracting.

When one is in acute urinary retention (AUR) as I was when 2 liters of pee was removed last January, it is standard procedure to have a Foley inserted for about a month so that the bladder is in a constant state of draining (i.e. resting). I relate this to my various shoulder injuries from skiing when my shoulder was put in a sling for a month to rest it before any physical therapy was done to rehab it.

I hope that I was able to help and good luck on the pee test after your Foley is removed.

Take care,

Steve

Changejobs,

I would assume just like self-cathing, with a Foley and a flip valve, your bladder will tell you when you need to pee, provided that your bladder has sufficiently rehabilitated to the point were it can tell you.

Again good luck when the Foley is removed.

Take care,

Steve

Hi Steven -

I've appreciated your contributions to this forum and I hope you continue to participate.

George

Hi George,

Thanks for your encouraging reply. From the various replies that I have received both public on this forum and in PM's, I am aware that my contributions are appreciated by most on this forum. I will keep everyone posted on my post-Rezum progress.

Take care,

Steve

I agree, George. Steven has been sharing his experience with the Rezum procedure, which is what this thread is supposed to be about. There are others who regularly post to this thread who haven't experienced the procedure and yet are trying to influence readers away from Rezum. I don't understand why, since for many men, it's the best choice for BPH available today. Hopefully in the near future, another, even better procedure or treatment will become available, but for now, Rezum is a top choice for many men.

Lvscott

What you are saying is very true.

There are many doctors out there that do care about there patients and will learn all they can about new procedure. You have to look. It may take you a while to find one but you can.

I have been watching for the new BPH injection ( Fexapotidie Triflutata ) This drug that have been working on for year's. They have had 3 Trails that did very well. The last time I heard anything on this was Feb 2018 when they applied to get it approved by the FDA

This injection would help many many men. Not just younger but older men that do not want or can't have surgery.It would give them another less evasive procedure to have. It would be done in the office. And the cost would not be that much. You have no hospital stay or down time. But there is nothing more being said about it.

I hope it has nothing to do with the $$$ I hope this would get approved by the FDA one day. We will see.

Ken

steve,

thanks for the detailed explanation. it is very much appreciated.

i do have another foley question. when i left the procedure, the nurse gave me 4 packages of bard dispoza bag (150832) for the leg and 4 evening bags, bard urinary drainage bag 154003. each bag is a complete kit that includes bag and tubing.

i switch completely from day to night and have been throwing them out. if i need to stay on them today can i reuse either the tubing and just get a bag, if so how do i sterilize either the tubes or the bag?.

@kenneth1955: I have been watching for the new BPH injection ( Fexapotidie Triflutata )

///

Hi Ken,

Thanks for the post on Fexapotidie Triflutata.

From a quick review, this looks like interesting stuff. It uses a drug injection to kill the prostate tissue as opposed to a steam injection to kill the prostate tissue as Rezum does. They both operate on necrosis but use a different method to induce the necrosis.

I will have to do further reading...

Once again,

Thanks,

Steve

Hi Changejobs,

You are welcome!

I have never been given that many bags the 2 times that I had a Foley put in (now and January 2018). I have never sterilized a whole bag. I always use a cotton ball and 70% isopropyl alcohol to clean the outside and inside ends of the tubes and plugs whenever I change out bags.

As I recall, in January, I was told that 1 bag can last about 1 month before it should be replaced. As I recall, one of the bags had instructions for cleaning that involved vinegar but I do not remember the details. Vinegar is also a disinfectant but not as strong as 70% isopropyl alcohol.

With any catheter, keeping things clean is very important to avoid urinary tract infections (UTI's). A few of us on this forum have developed UTI's.

Good luck today on your next step in the process.

Take care,

Steve

Steven

No problem. It's in the FDA hand.

Time will tell.

Take care.........Ken

Steven

I forgot to say after doing some research on this.

They consider that 1 injection would be the equivalent to taking the medication and 2 injection would be the equivalent to having surgery.

We just have to wait and see. This would be very big for the men that have to deal with BPH that can't have surgery or don't want to deal with the side effects

Ken

This is my field I work in - dev biotech, NX1207 was partially abandoned a few years ago >

"NX 1207. In an evidence-based review conducted in Austria, the authors reported that “All published clinical trials of NX1207 have demonstrated a significant improvement in symptomatic BPH.” However, they also point out that patient numbers have been low and that “there should be a large multicenter placebo-controlled validation study using 5 mg NX1207 with a follow-up of at least 5 years.” Subsequently, however, development of NX 1207 to treat BPH was abandoned in November 2014 after it failed to reach its primary endpoints.

Here's both the search in the trials, and the actual trial which finished in 2014..

https://clinicaltrials.gov/ct2/results?cond=&term=NX-1207&cntry=&state=&city=&dist=

https://clinicaltrials.gov/ct2/show/NCT01846793?term=NX-1207&rank=1

The trial results did show some promise, but you remember what you decided to rail on me with a few days ago? It's not going anywhere because the company that owns NX 1207 is out of money. They are a very small cap pub traded company. again, showing that $$$ is the main goal of new treatments, not patient benefit...

But, I deal with people who think like you constantly while I work in the midst of these very things as my living, and can absolutely assure you that the majority of HC professionally consistently place $$$ far above patient well-being. This is not slander, it's a sad fact. Somehow, you took this to mean I was slandering your family in which I never said they were corrupt. I said the majority of HC pros are - big difference.

Here's trials that are open and recruiting concerning BPH - https://clinicaltrials.gov/ct2/results?cond=bph&Search=Apply&recrs=b&recrs=a&age_v=&gndr=&type=&rslt=

Optilume™ BPH Prostatic Drug Coated Balloon Dilation Catheter System MAY, may provide something, although they are using Paclitaxel and the trials are in the Dominican Republic.

I'd like to see them use INCB01158, which is the pharmaceutical form of CocaVia. - cocoa flavanols... I have a small in with the company who has the exclusive INCB01158 license issued to them from Mars.INC, but they and another company are using INCB01158 primarily as an immunology metabolic reprogramming agent in various cancer types.

Lvscott

Thank you for saying that it is good to know .

I read about that also. The last thing I read was from the BPH News. They were talking about there 4 Phase 3 trails.

This article was in there paper June of 2017. That the company announced that it has submitted a marketing approval application to the European regulators for use of Fexapotide Triflutate as a BPH treatment

I also read that the company took it to the FDA for approval in February of 2018. Have not heard anything else.

So I don't know what is going on now. We will see. You never know...........Ken

steven,

i hope all is well, i went today to get my local uro to get the foley out. He had only done 2 rezums in the past and thought that i would need 6 shots based on his original limited knowledge. when i told him that the dr did 11 shots his exact words were " I never heard of getting that many".

Well 11 shots seemed to be the perfect number for me. it shows what a going to a dr with the experience in the procedure and getting the correct number of shots is important.

before they removed the foley they filled up my bladder with sterile water and then asked me to pee. i pee'd out 250ml in a decent stream and left only 22ml in my bladder. Prior to surgery, my blaader was holding around 250ml. What a difference !!!

i thank this board for all its help. The idea of this board is for people to ask questions of people that have had the same problem and hopefully get their experience in the process. Also to find out what has worked and not worked for those people. you then are able to make a more informed decision.

cj

It won't be approved, EU is even harder to gain approval than with FDA... I'm a dev biotech analyst. My website partner is a scientist and inventor. As far as I can tell, only Dr. Song in China is taking the correct approach, in my opinion of course.

I'm trying Cocoavia as it's a natural form of CB1158.. My symptoms are livable - get up 1 to 3 times during the night, and my supplements along with a blocker pretty much has taken away the urgent and frequent urges to urinate. My only real concerning issue is a rather weak stream which sometimes is decently strong. I believe my issues may be more hormonally related, so I'm waiting on hormone blood test results.

Any gland issue, Thyroid, Pituitary, Adrenal (Adrenal is likely issue), etc, etc can throw off balance for the prostate gland - My prostate is barely enlarged according to Uro, but have yet to get an estimated size.

Because I'm in Vegas area, I have to deal with 'fast food' urologists - means they do a lot of guesswork, push TURP and GL PVP, and are far too willing to offer a procedure THEY WANT without concern or care for a patient, which is why I went off on Urologists in general in an earlier post.

As long as I can get by without retention being too bad, and because I self-taught myself to cath, I should be ok for a time in which I'm hopeful that better procedures emerge.

Hey Buddy

Thank you for that it's good to know. Who know what will happen.

There is a guy that I have been talking to that just moved to Vegas. He is only 31 and the doctor wanted to do a Turp. He told him no.

When he got to Vegas he found a Urologist that did the Rezum procedure. He had it done I think 3 weeks ago had 4 injections

Hope it works out for him.

Thanks again......Ken

@Lvscott: The trial results did show some promise, but you remember what you decided to rail on me with a few days ago?

///

Hi Lvscott,

First let me apologize for railing on you a few days ago. Moving forward, let's keep this positive and not rail on the doctors. Of the 3 urologists that I have worked with on my BPH, I would not think of them as focused just on the money. The 1st one, only did TURP and when I asked him some very pointed questions, he avoided answering them and only focused on TURP so I politely moved on. The second one was just too new and had limited experience. The third one was recommended to me on this forum and I have been impressed by her.

The 2 morals of the 1st story is that it is important on who you chose as your urologist and that this forum is valuable in helping to make that decision.

With a few MD's in the family, for many years, I have heard my share of stories of what is wrong with medicine in the United State. A recurring theme is not that the doctors are focused on money, but that the insurance companies are focused on money and often the companies' decisions are more economic than medical in nature. I have been up late at night, listening to the MD's in the family talk about it.

If I was more mature, when I was younger, I should have decided to be a doctor like the other family members and not a scientist as I turned out to be.

Because I am a scientist, I would like to thank you for your posts on "NX1207". I quickly looked at a few Google Scholar hits on this and I will get back to them as time permits. I enjoy reading this material. I definitely hear you on "that patient numbers have been low and that there should be a large multicenter placebo-controlled validation study using 5 mg NX1207 with a follow-up of at least 5 years." I definitely get it!

During my own research, I read the classic Finasteride study of over 3000 men that was published in the NEJM. I also read the classic CombAT study and a few spin-off studies. One of my favorites was in the July 2017 Asian Journal of Urology where they imaged prostates and compared the lateral lobes to the median lobe in terms of overall blockage. It was really cool stuff!

The moral of the 2nd story, for me at least is that educating ourselves about the various aspects of BPH is a good way to help us work through the process.

Thank you for your post on NX1207, and hopefully, I was not abusive, insulting and rude in my response.

Regards,

Steve

Hi Cj,

I am glad to hear that everything came out OK. I will let the forum know how my pee test goes next week.

As I recall, your Rezum was done by the same urologist as Ken from IL and this urologist is one of the most experienced urologists in the U.S. when it comes to Rezum so I would not be worried about the number of injections. I figure that it was 4 LLL, 4, RLL, and 3 ML, right?

And yes, this forum can be awesome!

Take care,

Steve

Apology accepted although it was not that big of deal 😃 I believe that Doctors, in this case, URO's should put their patient's interests first over their own. Where I live, the medical system is a disaster as Nevada ranks the 48 worse state in the USA in that regard. The Uros here are terrible. The one I'm currently seeing has done in excess of 100 Rezum treatments,, He did a Cystoscopy on me simply because I expressed interest in Rezum.

He did not warn when scope would be entering into tight spots, and that caused me some pain (I could have resorted to proper breathing techniques if he told me). He mentioned to me he saw diverticulum in my bladder, but my patient file make no mention of it, but rather says my bladder is mildly trablacated and ultrasound sound says NO DIVERT.... << that alone creates unneeded stress and anxiety.

My experiences with Doctors in general have been negative. They don't look you in the eye, they often won't answer questions directly, and look to move you a long so they can move to the next patient, and the most apaling part to me is a general lack of care of what is the ROOT cause of symptoms.

Google up CB-1158 (INCB01158) and read the literature on that. My website partner is an inventor and scientist. We exclusively cover public company Dev. Biotech so we constantly read a lot of journals. 1158 is very interesting... It's based on cocoa flavanols that Mars CO. happen to find in research. Now, it's become a clinical pharmaceutical in combo trials with anti PD-1 for various cancers run by Incyte and Calithera Pharma. Next to no one has thought to supplement that for BPH. I've been on it a week, and at first it causes inflammation but that is by design, so T-CELLS can identify the target. Google "Cocoa for BPH," a few NCI hits appear on this - it's highly anti-hypoxic. I've noticed a slight improvement in that time, especially with frequency and urgency.

I supplement that with drinking green tea (ditched the supp, bad DDI), cranberry supplements. 375MGS of cocoavia, Iodine, and Beta-Sitosterol along with Alfuzosin HCL ER a-blocker.

NX1207 has the right idea, but we need more research in using injectables straight into prostatic tissue. Dr. Song in China is the only URO in the world doing these types of treatments, and has had good success --- if you want to to fly to China 😦

BPH can be beaten - if only the medical community had motivation to get something done here. However, with cancer treatments bringing in obscene margins, along with other rare diseases, there remains little monetary incentive for pharma to engage in proper studies here < That is what PEEVES me off and inspired my rant the other day -- Scott

I wonder if the cacoa powder i add to my oatmeal will help with BPH.

@Lvscott: My prostate is barely enlarged according to Uro, but have yet to get an estimated size: My prostate is barely enlarged according to Uro, but have yet to get an estimated size.

///

Lv,

An obstruction caused by a median lobe can be very effective at shutting off the urethra while the overall prostate is not that large. The median lobe puts a bend or kink in the urethra just below the bladder neck causing it to close off. The analogy is a garden hose that when kinked totally stops the flow of water.

Ultrasound imaging should be able to identify the type of obstruction and as far as medical procedures go, the cost is not too high.

I hear you on self-cathing until medical technology on BPH treatment improves.

While not meaning to offend you about Las Vegas, I have heard the term "fast food" about the culture there before. I was in Reno a long time ago (I don't remember the year but Ronald Reagan was president) for a scientific conference and the all night gambling and drinking culture was new to me.

See ya,

Steve

I have no median lobe. Patient file just says, "Cystoscopy showed evidence of Bilobar hyperplasia" but again, without any median lobe.

I'd be interested in Aquablation once it becomes more widely available. Have considered FLA and PAE, but my symptoms are manageable now. I consider Holep and Glep the best procedures now notwithstanding the retro effect. Consider Button Turp to be decent, BiPolar ok, but Mono Turp I WILL NEVER DO.

Heck, my PSA is only 1.2 - 4 years ago it was 0.7...

Just self ordered an extensive hormone panel, waiting on results. I believe a good deal of my issues may be caused by adrenal gland or other gland problems.

Depends exactly what kind of powder. If it's processed, no.. Cocoavia = that's the best one - 3 pills = 375 mgs of flavanols. So, 20 servings per bottle. I have 9 bottles of it. If you look on Amazon for it, interestingly enough, there is a guy in the ratings section who does mention it has greatly helped his BPH symptoms when coupled with his Alpha Blocker.

@Lvscott : Google up CB-1158 (INCB01158) and read the literature on that.

///

Lv,

Interesting stuff. Please bear with me as this is not my area of science.

So CB-1158 artificially stimulates the immune system generating T-cells to treat cancer. Bringing this back on topic, to BPH, then NX 1207 (by way of injections), was designed to kill prostate cells by apoptosis and I assume like Rezum, then necrosis takes over to remove the dead cell material and then voilà (I just had to say voilà), the prostate gets smaller and the blockage is cleared up.

In a sense, I see both approaches, NX 1207 and Rezum as an advance in the approach to BPH treatment over the various types of TURP's that are still based on cutting away tissue. With TURP, the introduction of laser technology, which "seals as it slices" certainly reduced both the morbidity and recovery time.

Unfortunately, while the clinical trials were promising, the company developing the technology ran out of money and the clinical trials were seen as too small. It seems that NxThera is doing well and they were bought by a bigger company, Boston Scientific which suggests that the technology is viewed as a success.

I hear you on biotech companies running out of money. One of my ski friends who is a chemist, jumped from biotech company to company until she retired as they each ran out of money. She does a lot of painting now that she is retired.

Another ski friend of mine who is a micro-biologist went from pharma to biofuels to MMJ until the last company folded. Now she is a PhD who teaches skiing at the local hill and she seems a whole lot happier and less stressed.

I wonder if there is forums on patient.info about MMJ? Maybe I should look 🤯

I will look up Google CB-1158 (INCB01158) another night. Thanks again for the food for thought!

See ya,

Steve

@Lvscott: If you look on Amazon for it, interestingly enough, there is a guy in the ratings section who does mention it has greatly helped his BPH symptoms when coupled with his Alpha Blocker.

///

Lv,

Again interesting stuff. Have you read the classic CombAT study or any of the related spin-off studies? I figure in your line of work you probably have.

During this whole almost year-long process, perhaps my biggest problem that I had was a bad case of the blurry vision side effect from the Tamsulosin Alpha Blocker. An alternative would may have been worth trying.

Steve

Lvscott,

I would ABSOLUTELY NOT do a mono TURP too. I got to watch my cystoscopy and I could see my median lobe pushing up and deforming the bottom of my bladder which the urologist called "volcanoing". It was probably doing a major deform of my urethra too. Were you able to watch your cystoscopy too?

Steve

Thank you.

I will give it a look. Ken

Lvscott

This looks very promising. I will read more on it. There are about 3 or 4 I will look into.

Thank you.......Ken

steven,

yes, my rezum was done by the same as ken from IL. you are also correct on where the shots went.

i was told by the dr that the first 2 - 4 weeks after doing the procedure you may question why you did it as things will go up and down. i was up alot last night and i am straining to pee today. today i do not think im close to emptying bladder. ill give it a little time before i call him as long as i feel im getting enough pee out.