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

Rising, you're right, that doesn't sound right. Have you talked to your urologist's office about your concerns? I suppose that they may just tell you that you need to wait a little longer, and they may be correct. But I believe that a typical Rezum procedure shouldn't have those symptoms at 6 weeks.

Regarding the urgency, I found that ibuprofen (400mg) worked well for me. What have you tried so far?

Good luck to you.

My last uro visit was Jan 4th and next one is Jan 25th. Urine seemed to be clearing up a somewhat about a week or so back then went back the same as just after the procedure.

Nothing my doctor suggested or prescribed worked re urgency or frequency.

Like I said in an earlier post, I never thought things would get so much worse AFTER the procedure.

Wish I could say I'm optimistic about the upcoming appointment.

Whatever information I get out of this guy is like pulling teeth - that's no exaggeration.

I've documented everything from day one.

It's always ok to get a second opinion from another reputable Urologist who does the Rezum procedure.

When you google rezum everything that returns gives this picture of being in and out the same day and back to normal routine within a week. Blood in urine maybe up to 3 weeks and 'you MAY have to wear a catheter. That hasn't been my experience and it looks like I'm not alone.

Rising.

Sorry that you are still having a problem. Rezum will work for most men but sometime it does take longer for some men Try to relax if you can. I know it's easier said and done. I don't know if a hot bath or shower would help before bed.

Ken

Buddy

What David is telling you is a good idea. If your doctor is not giving you the right answers. Get another doctor that will.

Good Luck.....Ken

Rising,

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Just to 2nd David on the importance of getting a 2nd opinion from another urologist. I saw 3 different urologist before I chose the one who finally did my Rezum and was highly recommended to me on this forum.

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I am now at 7 1/2 weeks and doing GRRREAT! The Rezum is working, my streams are getting better and my PVR's are dropping. After AUR this time last year, and several years of BPH, my life is returning to near normal.

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Steve

Thanks Steven, and everyone else for the comments.

I'll see what this doctor says this week.

As for other opinions, I'm thinking what's done is done at this point. I was told by a nurse that they may want to do a cystoscopy to see what's going on in the bladder.

For me that's yet another intrusive procedure into an area that's clearly already traumatized. I looked it up and the aftermath of that would be more of what I'm experiencing now. I'd of have thought I'd be seeing signs of improvement by now and feeling really deceived.

it quite possible that some of the dead tissue is still blocking the prostate. 99% of the time it clears itself out, but could take a few months.

Would that cause the continued blood in the urine? I'm dealing with urgency issue as best I can but having blood in the urine nearly 7 later is not easy to take.

Rising,

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The cystoscopy will give you and the urologist a better idea of what is going on in your urethra and your bladder, and yes it will further traumatize the area. Remember that the BPH is only half of the problem, with bladder damage from BPH being the other half.

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Have you been doing any self-cathing after your Rezum? If not, then you may consider doing it before you go to bed so that you are completely emptied at that time which means less chance of getting up to pee in the middle of the night. My 2 cents.

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Steve

Thanks Steven,

No I haven't done any self cathing. Had the Rezum on Dec. 13th. I regard the urgency as the least of the issues here. I've researched the cystoscopy and based on everything I read, there's probably less than ZERO chance I'll let them do that.

As for the cystoscopy itself, same stuff I read online prior to the rezum. Down played after effects and risks of complications. Whatever is going on with the bladder/urethra at this point, I'm thinking was CAUSED by the rezum procedure. I certainly had no blood in the urine prior to the rezum.

Ultra sound/xray is about all I'd let them do.

im not sure about that, but everyone heals at a different rate.

How much blood is it? Just at the start?

My blood cleared at the end of the 4th week.

The Rezum info is a joke. They make it sound like a walk in the park. However, I'm seeing big improvements and glad I did it.

Yeah it's just at the start. I'm concerned that it's still happening. Hoping for improvement soon.

granted a cystoscopy is not pleasant,I've had it done twice, but it's a very common procedure and the only thing to worry about as far as I know is a UTI. I understand you won't want it done so soon after your surgery, I wouldn't either.

Still it might be necessary if the bleeding doesn't stop after a couple more weeks. I don't know if ultrasounds etc are as good at showing what is going on. Also bear in mind, just the smallest amount of blood can color the urine and make it look a lot worse than you think.

rising,

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Did your Dr send you home with a Foley catheter?

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If so, how long did you have it installed?

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How many steam shots did you have?

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Best wishes for your recovery,

Allen (Al)

Yes I came home with a catheter. They removed it the next day. 2 days later I had to go the er to have it put back in. Horrible experience! Had it in for the next 5 days. It's been nearly 7 weeks since I had the procedure. No way I'm going for a cystoscopy. Why in hell would I subject myself to that. So the md can cover his ass? I'll see what I'm told on my next appointment but I can't say I'm hopeful.

this has been a bad experience all around. Even if I improve after down the line I don't know if it was worth this. There's a lot more I could say than I want to say in this forum.

I thank everyone for the comments.

Feel free to say more. The more you are able to communicate the more clues and information people have to give you better advice.

Good Afternoon

Rising. Like David said feel free to say whatever you are feeling. I have said many things people don't like but it is just my opinion.

What you are going through is not right and your doctor not standing by you is not right either. Before you had the procedure done did you talk with any of the men that he did before you and see how they did.

I hope things do improve. It does say that it can take up to 6 months to see some results but what your going through is a lot to deal with.

Good Luck..Ken

Rising,

I felt like you did in week 4, and then things improved really fast in week 5. Sounds like your healing is just taking longer than the rest of us. Hang in there.

BTW, I don't know your physical condition, but I have found walking seems to help me a lot. Take care!

Tim

reZum was the worst thing i ever did

Rising,

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My cystoscopy, was by far the absolutely coolest part of the whole process. Nothing else came close. Seeing the bladder trabeculation, median lobe protrusion, and lateral lobe compression in real-time and then discussing this with the urologist put everything in place .

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The cystoscopy confirmed what myself and the family-member-MD concluded was a "classic" median lobe obstruction that resulted in a total obstruction of my urethra below my bladder. If I didn't have to pay for it, I would do another one just to compare the "before and after pictures".

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The procedure was not painful although there was a little bleeding when self cathing for the next few days. As Mike said, a cystoscopy is a very common procedure. It sounds like your urologist did not do one before your Rezum, which would concern me. Did your urologist at least do a TRUS instead?

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I wish you the best in recovering. So far, my Rezum is working as planned and starting at about 4 weeks and accelerating after 6 weeks, I am getting better and better with each passing day.

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Steve

Just to 2nd Tim on the value of walking! It has helped me a lot too.

Jan 7 Rezum -Jan 16 Foley removal....

after night of jan 19th. where i was going to the bathroom every 2 hours with reduced flow things are back to "normal" where the last 2 nights up 3 times with increased flow and a couple of drops brownish blood before pee.

I wonder if the brownish/reddish blood is dead tissue ?

How does the body get rid of dead tissue ?

I started yoga and tennis again yesterday (easy) and had no issues last night or this morning.

I think 2 weeks back at the tennis court is quite good.

Although not fully tested, the signs are sexual functions are ok

the flow is slightly improved ( and i am hoping it will get better)

and after post op with my urologist on Jan 29th I hope to stop the pills.

Above were my objectives and if i have to get up 3 times with quick voids, I can live with that and may improve upon it from what i learned from this forum . (managing fluid intake, no alcohol, socks etc)

My heart goes out to rising and the problems he has had. If you let us know where you live maybe this forum can help to direct you to a well known second opinion urologist?

Hello Mark

I hope it keeps going for you. Just give it time.....Ken

Your doing good for that time frame and should improve a lot more by week 5 or 6.

Great to hear!

Yes, I peed blood and dead tissue for a month. I assume once it stops, the body heals from the inside instead of externally.

My last uro visit was Jan 4th and next one is Jan 25th.

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Rising,

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A lot of posters who have had their Foley catheter sooner than 2 weeks after Rezum have reported the same results (ER visits, more blood, etc) as you have experienced.

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When you see your uro on Jan 25th, please tell your uro about your ER visits and that posters here who had their foley in for 2 weeks after Rezum did not have to go to an ER and are much happier with their Rezum results. Mine was in for 2 weeks, no problems at all like you had.

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Now I know that won't help you, but maybe your uro won't put any more men thru what happened to you.

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Best wishes,

Allen (Al)

Wish i could edit a post on this site!!!

I meant to say:

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A lot of posters who have had their catheter removed sooner than 2 weeks...

Allen (Al(

so far so good Tim, thanks for all the tips you gave.

Hey Allen

I think that some of these doctors are in a rush.

It may be better to keep the catheter in for 2 to 3 weeks depending on how many injections are giving. Reason that the prostate is going to be inflamed. A man that has 5 or 6 may not need it in for more then 10 day but if the doctor does 10 to 12 injections that is a lot for that prostate to take. It may need 2 to 3 weeks to heal.

I for one would rather have it put in when I'm out they have it put in when I'm in pain Men that have it in longer do much better with there recovering.

All the best........Ken

I hear you Steven,

Maybe that will reassure others here who may have reservations about the cystoscopy. I suppose I'll never know how cool it might be since I'm not going anywhere near a cystoscopy.

On another note the blood in the urine seems to be gradually dissipating. That's a positive. It's nearly 7 weeks after the rezum and nothing has unfolded as was described to me by my md and the online information which, in my opinion is essentially the 'script' they want out there. I'll see how things go in the coming weeks before I can give the process my verdict so to speak. Thanks to all for the comments.

Thanks for the info Allen. I had a catheter placed right after the Rezum and removed the next day. Before I left that day the MD (in a rare moment of actually informing me of something) said there was the small possibility I'd have to have it reinserted if I had any difficulty urinating over the next 24 to 48 hrs. Difficulty turned out to be an understatement. I had to get it reinserted and I told the MD all about it.

Allen I wouldn't too surprised if this site wasn't monitored by urologists or other medical personnel.

Some of the comments I've seen in here read like the standard online Rezum advertisements.

Take care

Steven,

Glad to hear your doing well. I have followed these discussions since April 2018, But stopped getting emails from "patient.info', Dec 22, 2018. Just started getting emails again today after communicating with Patient . Found out I had marked one Patient email as spam, after that patient.info stopped sending emails, zero. A person named Charlotte at Patient found it out and reinstated me. Some people who disappeared from Patient may have done the same thing, Jim James for example.

The last thing I remember from Dec 22, 2018, is you were about 4 weeks out from Rezum, and still having considerable problems. It's good to hear your doing well. Who was your doctor and where are they located ? What kind of anesthetic did you use ?

Thomas

Thomas, Re spam mail, I found it was something to do with gmail, as soon as I switched to yahoo mail I started getting them again. I never marked them as spam. I've had this issue before with gmail and no matter what settings and filters it still goes to spam mailbox.

My theory about Rezum is that it just doesn't work for some people and no one knows why, or they don't understand enough about how many injections and where to place them - so they do what seems to work for most patients. It could be some docs know from experience that certain prostate shapes, let's say big median lobe, don't respond, but they do it anyway hoping it will. They get paid either way.

I know my Urologist started doing Rezum, but apparently he is not a fan and has had to redo some of them as a turp because it just didn't work. He will still do Rezum if you ask him, but only if he thinks it has a good chance of success or you just tell him you want to roll the dice and hope. He doesn't need the money his practice is booming and I think he is ethical.

This is the price we pay for trying something that is minimally invasive and not proven yet. I've been through this with PAE and FLA and it's no fun waiting for weeks but at the end of the day I knew I was kind of gambling because these procedures were so new. If anyone is curious PAE did nothing and in fact caused me more problems because I didn't have a Foley after the procedure, so I suspect it stressed my bladder. FLA helped some, but not enough to be a long term solution. It's been a couple of years since then, I think my bladder has settled down because I've been doing self cath, but the prostate has probably grown back a bit. Still I figure it bought me a few years of not having to do something like a turp. Or wait for something better to come along.

Well what exactly is it to be 'proven'. I don't know that I've read that it's unproven.

You google Rezum and it's 'studies' show this and show that. Effective out to 3 years. general claims of symptom improvement in as little as 3 or 4 weeks. One site says as little as 2 weeks. Then there are sites that sort of give the impression that the rezum is such a great advancement but with hardly any specifics at all. I don't think that's by accident.

From what I've seen and read there should be more honesty in how the rezum is promoted.

I can't argue with what you are saying rising. Not only Rezum, many things are not marketed honestly. Oxycodone when it first came out was supposed to be non addictive and there are probably thousands of such examples. Studies can be rigged, who knows, they might have intentionally not taken trial patients if they had a shape or size of Prostate they suspected was not good.

My Urologist was very up front about what they've seen - he has a partner who has done it much longer, one of the pioneers of the technique - his nurse told me they are seeing 10% Retrograde Ejaculation, Rezum claims it's much lower, like 3% ?

Anyway here's hoping you will have a sudden turn for the better, sometimes people take longer to heal like everyone says.

@mark5750: I wonder if the brownish/reddish blood is dead tissue ?

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The brownish/reddish blood is old blood passed from the prostate to the bladder then peed out. The bright red blood is new blood. Remember that a little bit of blood goes a long way to color the pee.

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Read about necrosis and phagocytosis to understand how the body gets rid of the dead tissue created by the Rezum steam injections killing the prostate cells. IMHO, Rezum is a rather ingenious approach of letting the body do the work compared to TURP, GLEP or similar.

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Be careful with the yoga and tennis. In the first few weeks, I had to back off twice on my exercise as it restarted the bleeding. At 7 1/2 weeks, I am OK now and did a 7 mile cross-country ski today and made the most yellow snow in a few years. It felt good as my objectives from Rezum are being achieved 👍

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Steve

They don't want to tell you how its really going to be because you may walk away. If my doctor would have said you'll be so swollen that you'll need a catheter by week 3, and it will hurt like hell to pee for a month, I might have said thanks, I think I'll wait a bit longer. Now I'm glad I did it.

@allen98488: Wish i could edit a post on this site!!!

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I know what you mean about that 🙄

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Steve

@thomas37368: Found out I had marked one Patient email as spam, after that patient.info stopped sending emails, zero.

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I had the same problem with my Comcast email after making the mistake of marking 1 patient.info email as spam. In IT, they call it a "block feedback loop" where when you report an email as spam, the sender then puts your email address on a block list. I had to work with Danny at Patient to fix it.

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So who is your email service with?

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I had my Rezum done by Dr. Nancy Huff at Advanced Urology in Parker, CO. She was recommended to me by Al. I liked working with her and I would recommend her too. Before the Rezum, I had 1 Valium and 1 Percocet about 1 hour before the procedure which involved 10 injections and it was not that painful. Afterwards, I went out to a restaurant that Al also recommended.

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At 7 1/2 weeks, I am comfortable in saying that the Rezum has worked for me and the remaining problem is the recovery from the moderate bladder trabeculation. In the last week my streams have increased and my PVR's have dropped below 100 ml and my recovery appears to be accelerating. I am peeing better now that I have in several years 💦 👍

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Steve

Mike and Other's

It is very hard to figure out what is good and what is bad. Some procedures work for some men and some don't. That is why you have to be very sure what you do. Yes I have heard that from other nurses and doctors about the retro. 10 to 15 %. That is high I think. The add push 3 % like you say. It's a selling point.

I have been keeping track on this site of the men that have had it over the last 2 years. Out of 60 men I have 32 with retro ejaculation. Some are okay with it and some don't like it but what done is done.

I hope everyone that has it get the results that they are looking for and can be happen with the outcome.

Good luck to all..........Ken

@rising28843: You google Rezum and it's 'studies' show this and show that

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Use Google Scholar and not plain vanilla Google and you will get a lot more information on Rezum. When the FDA approved Rezum in December 2015, it had gone through, I believe 2 years of testing at urology clinics across the United States.

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At this time, there is probably 5 years of data, but only 3 years have been published. Before I retired, as a scientist, I was on both ends of the scientific publications business, and it often takes over a year for a paper to get published.

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The family-member-MD who guided me on this almost year long journey summed it up with "Rezum is a game changer because all the 65 plus year old men who have been doing nothing because of the known morbidity and complications of TURP will try the less invasive Rezum before TURP and see if it works".

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He also said, to choose a doctor who has done enough Rezums, with 50 being the magic number. The 1st urologist that I saw only did TURP. The 2nd that I saw was a new doctor and had only done 12 Resums. The 3rd urologist who was recommended to me here, had been practicing for over 20 years and done Rezums for over 2 years.

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I hope that you improve and your Rezum works for you.

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Steve

Ken,

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Absolutely no RE here! Yes, no RE is a selling point for Rezum. One of the reasons that I chose Rezum over TURP was because the percentages for ED and RE with TURP were way too high for me and they were much lower with Rezum.

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Steve

Hey Steven

Yes very happy for you that it worked and you have no retro. It would be good if more men had better results.

Maybe it the doctor who does it. The last few have been having a lot of problems and the urologist are not really doing anything for them.

Only time will tell.............Ken

Ken,

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Yes, the doctor that you chose can make a difference. That is why a researched a few. I should have done the same for the guy who did the plumbing on my remodeled bathroom. Better to make a mistake on my upstairs bathroom plumbing, than my personal internal plumbing 😖

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Steve

Yes that is true. Hope all stayed good for a long time....Ken

Thanks Steven.

I tried Google Scholar (which I'd never heard of) and yeah there's a lot more information alright. But, hey I don't know man.

Okay maybe with your background as a scientist you found the info on google scholar helpful. Seems to me you'd have to be a doctor or clinician or in medical school to swim through all that's presented when you 'google scholar' rezum.

Here's one of the links I did explore from the google scholar search: ?

I'm learning some things here though.

Moderator comment: I have removed the link(s) directing to site(s) unsuitable for inclusion in the forums. If users want this information please use the Private Message service to request the details.

Steve,

Thank you for the information.

Obviously I am watching for any changes/feeling during yoga and tennis and I am taking it easy on my opponents 😃

7 mile cross country ski is very impressive and great to hear that you are trackable .

let's see where we are in a couple of weeks.

Thanks Steven,

I took your advice and did a 'google scholar' search of rezum. Yeah there's a lot of information. Heck of a lot. I'm thinking your background as a scientist came in pretty handy here as the tons of information that returns seems to intended for doctors, medical students and other clinicians. I don't know that the average person would be inclined to swim through all the documentation that's presented. I responded to your post about 9am this morning and I included a link from one of the sites google scholar returned. I explored that site but at the end of it all not much was there other than is present on the other rezum sites although the claims were toned, down and general as to specifics.

My response to you from this morning was never posted and is still (7 hours later) listed as: THIS REPLY IS WAITING TO BE MODERATED - I added the capital lettering. Is the delay due to the fact that I included the gooogle scholar link in the post?

Anyway thanks for your comments and all the others.

@rising28843: Is the delay due to the fact that I included the gooogle scholar link in the post?

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Rising,

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If you post a link, then your post will go to the moderator. Links appear to be OK in private messages though which are not moderated. There is a "create link" icon (after the "numbered list" and before the" insert image" icons) in the message editor. I have not tried it though.

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I have used Google Scholar for a long time. I was guided through this process by a family member who is an MD. He would tell me what to research and then I would find it for him. He would do the heavy reading and then advise me on what to do next. It was good teamwork.

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I would pass some of the teamwork results on to this forum.

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Steve

To all,

I've been wanting to provide a one year followup to my Rezum procedure for a couple of weeks now.

The reason I've been rather slow to type this is because I'm sensitive to the guys who haven't had such an easy time of it. I had an overall easy procedure for several reasons, and that's why I think that I need to share my experience here.

I believe that there are basically three things that can make the Rezum procedure go well. I think it's really poor of the parent company (formerly NxThera and now Boston Scientific) that they don't do a better job training some physicians and that they don't provide the kinds of recommended practices that would make it go better for the vast majority of patients. Here are my three recommendations: 1. choose your Rezum urologist carefully. There is obviously some skill involved in the procedure, and the more experienced the urologist, the more likely there will be a good outcome. Within this first recommendation, the urologist must also first make sure that you are an appropriate patient for the procedure. This should, as a minimum, involve at least a TRUS imaging of the prostate and surrounding tissue, as well as a cystoscopy. If your urologist doesn't insist on at least these procedures, then go elsewhere. 2. Insist on either a general type of anesthesia (twilight) or very carefully administered local anesthetic. (definitely push for the twilight!) 3. Before the procedure, learn to properly self-catheterize, so that you can use catheters to empty your bladder for as long as you need to after the procedure. When done properly, Rezum is a very effective procedure for BPH, but it does cause the prostate tissues to swell up as the body's natural response to the localized injury. This swelling will cause a problem because your bladder needs to be able to empty itself. The manufacturer of the Rezum equipment/procedure needs to address this issue better. Patients are suffering far more than they should because of this one. Almost all patients are currently offered a Foley catheter for 'a few days'. However, most of us here are aware that the swelling takes longer than a few days to go down. Personally, I self cathed for about 4 weeks, although I could have stopped at around the 3 week mark. But since each of us is different, that may take longer for someone else. But a Foley for a few days is simply not a good answer (IMHO).

Thanks for your comment very interesting - I'm curious, did you self cath from day one to avoid having a Foley ? I was wondering how the swelling would affect that?

What is the TRUS imaging for? Can't they see what they are doing when they start ?

Mike,

I need to provide some background that will help answer your questions.

I am 66 years old, in good health overall. Went into retention in 2017 and that is when I started to self cath. I was using catheters on average of about 4 times per day. My urologist at that time suggested a bipolar TURP because of course that is the only procedure that he did. After only a little bit of research, I decided to continue self-cathing while I researched surgical alternatives to the TURP. About 9 months or so after the retention episode, I had the Rezum procedure in Springfield Illinois by Dr. Kevin McVary. He's now at Loyola near Chicago. He agreed to my request for the twilight anesthesia and for self cathing afterwards. About a month before the procedure, I underwent a urine flow test (flunked badly) and a TRUS (TransRectal UltraSound) to ensure that I was a good candidate for the procedure. My prostate was estimated at 68 grams and with an enlarged median lobe.

My procedure was an ideal experience. I had no pain and woke up feeling good after the 10 shots of steam. My understanding is that the TRUS imaging was to identify where to apply the steam shots. I got 4 in each lateral lobe and 2 in the median lobe. I self cathed once at the hospital and again about an hour later halfway through the drive home (at a gas station rest room). I was expecting a lot of pain from the 16FR catheter after the procedure, but I could barely tell any difference from the sensations before the procedure. I had blood in my urine for a couple of days but never did have any blood in my semen (tested around day 4). I did have feelings of urgency for the first week, but had good luck with 400mg of ibuprofen, so I didn't need any additional medication.

I had been keeping track of my PVR (post void residuals) all along, so I watched as my PVRs eventually went down to around the 100cc average in the third week. I put off stopping the catheters for another week, but it became clear that it wasn't necessary.

Now, a little over a year later, I'm urinating as I did a few years ago: not race horse flow, since I've never had great flow since I was young, but it's working like it should.

Ken,

I'm not at the point of needed Rezum or any other treatment YET but my time is getting closer. So I'm researching choices now. I tend to agree with you about finding the most experienced urologist with the Rezum procedure. I'm in South Florida but am willing to travel a bit to find the best urologist for the job but how do I go about finding him?

Ken,

I agree with you 100%, well said. The swelling for me was appox 3 weeks. I had to learn to self cath on New Years day and did it for a week one time each night.

Flow at night now is about as good as day, so that is a big improvement already.

Tim

Thanks again Ken that is exactly what I wanted to find out, very interesting and encouraging,

I also have the dreaded median lobe, and I was worried the extra steam injections would be too close to the ejaculatory duct. 16FR - ouch - I was thinking that if there was blood or bits of tissue after the procedure the 16 FR size would actually be the best way to go.

Regards,

Michael

Pete,

If I were looking for a urologist, I would start with the Physician Locator on the Rezum website. Then I would call and talk to at least 3 (just my suggestion) urologists near you from that list to get a feel for how many procedures they have done. At least that would be my first question. I would also ask what testing they require prior to a procedure.

After you narrow down the list, get an appointment with your best candidate. Take a list of questions with you to the first appointment and get answers to your questions. If you're not comfortable with the answers you're getting, it may be an indication that you should look elsewhere.

I found this forum when I was forced to self-catheterize and needed help. It has been a great help to me, so I want to be as helpful to others as they have been to me. Unfortunately, a lot of the guys on this forum are here because their Rezum experience hasn't been as positive as mine was. There's always a chance of that happening. But I believe that, if you follow the recommendations in my post above, you will greatly increase the chances that you'll have a good outcome.

steven.

how do you know your PVR?

I imagine he can measure his PVR by self-cathing just after he urinates naturally, and therefore determine how much urine is remaining in his bladder.

Let me 2nd ken's recommendation of going to someone extremely familiar with rezum. Even though I lie in a city with many dr's that do Rezum, i could never get straight answers out of any of them on how many they done. I was close to using one of them until i got a UTI after the cystoscopy. I read about ken's dr in Illinois that was the lead on the study. i found Ken through this forum who discussed at length his experience (thanks again Ken). I then found out the dr Mcvary moved to a new hospital in chicago, which was easier for me to fly into. they took my insurance. I sent him my records. he told me that I was a good candidate for this and made the decision to go. I am so glad i did. While im not where i would hope yet, my flow has increased in the morning to a point it hasnt been in years. Also NO RE.

Hi Ken,

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I agree with most what you are saying here and you are providing valuable information for anyone who is thinking about doing a Rezum.

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1. Choose your Rezum urologist carefully, "the more experienced the urologist, the more likely there will be a good outcome." or as the family-member-MD said "50 Rezums is the magic number". My urologist did not do a TRUS, but we discussed this. Both the cystoscope and the Rezum instrument will measure the prostate length which will determine the number of injections for the 2 lateral lobes. My cystoscopy clearly showed the enlarged median lobe pushing up the base of my bladder so she knew to add 2 more injections for the median lobe as per NxThera's instructions.

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2. Insist on either a general type of anesthesia (twilight) or very carefully administered local anesthetic. This was not an issue for me as the 1 Valium and 1 Percocet that I took did the trick. Different people have different pain thresholds so a twilight anesthesia is a probably a good idea for all. In either case, you will need a driver so you might as well get knocked out for the Rezum unless you like talking to your urologist while it is being done.

   .

   3.Before the procedure, learn to properly self-catheterize, so that you can use catheters to empty your bladder. This is absolutely critical as the Rezum will swell your prostate so your peeing will get worse before it gets better and this may last for a few weeks. Yes Boston Scientific/NxThera needs to better explain the post-Rezum swelling issue so men know what is happening and why they will need a catheter for a while.

   .

3. Finally my 2 cents that the issue of how long a Foley is in should be better addressed by Boston Scientific/NxThera. Personally, I was OK with having the Foley in for 2 weeks as was required by my urologist. For many men, a few days is not enough for the swelling to go down and self-cathing after that may introduce more swelling. When self cathing, I could tell when there was more swelling.

   .

   Once again, good job on your post!

   .

   Steve

CJ,

.

Just as David said. 1st pee normally until I am done. 2nd self cath into my measuring container. This is my PVR.

.

Steve

ProstatePete,

.

If you are in south Florida, you may want to hook up with kenneth1955. He may try to talk you out of a Rezum as he did a Urolift instead, but that is OK. Just don't have too many beers as that does not go well with BPH 🍺

.

For starters, check out the Physician Locator on the NxThera Rezum website. Continue to do your research, on both the available procedures and the urologists doing them. ken19524 gave some good pointers on the urologist.

.

If your situation is such that don't have to rush the procedure, then take your time and learn as much as possible. Besides this forum, you can find a lot of details on the various procedures with Google Scholar.

.

Good luck,

.

Steve

CJ,

.

Yes, my flow has increased to a point that it hasn't been in years and no RE! Making the yellow snow again when skiing feels good to 😎

.

Steve

Couldn't agree more Ken !!

Following with the above recipe I found the same Dr. Mcvary with Ken's help and I am 2-1/2 weeks out from Rezum. Although too early to say anything , I feel doing good and feeling good so far. I strongly agree in the above fundamentals and my choice was for Rezum and i am happy with it so far but wanted to chime in not for Rezum but the overall process.

BTW: I had one more step; an MRI( Siemens 3000) in between TRUS and Cystoscopy as I had high PSA and my last MRI was in 2016 to check and eliminate cancer again.

I had 12 shots on an 80 cc prostate ( at the limit of rezum by FDA recommendation) with median lobe and as reported earlier carried Foley for about 10 days.

Although I learned CIC ( I travelled internationally often and learned it not to go to ER in a foreign country and also carried and used FR 16 as apparently, It puts the least pressure for accidental rupture of the Urethra (?) ) I did not have to use it after Foley.

I seems to me all procedures can be successful based on the characteristics of the prostate and personal objectives as long as 1. the Dr. 2. systematic and methodical process combined with Dr.'s experience to validate the procedure's success probability 3. prolonged Foley usage after the procedure and 4. CIC experience in case needed. These 4 things seems to be the common denominator to all procedures with cost/insurance coverage built in to personal objectives.

I learned a lot from this forum received unselfish help from individuals and I hope the above can help some people as well.

mark,

very happy to hear things went well. dr mcvary is top notch. are you from the area or did you travel to see him.

i see from an earlier post that you have a uro follow up later this month. is it with your local uro or with mcvary ?

Mark and Ken,

.

Yes this forum is awesome for getting information, and the recent posts by you and Ken (and maybe me) are really putting the key information (your common denominators) out there to help other guys in their Rezum decision process.

.

Mark, with 12 shots, where were they? Were they 5 per lateral lobe and 2 in the median lobe? I had 10 which were 4 per lateral lobe and 2 in the median lobe.

.

Again, I did not have a TRUS and I discussed my concerns about this with my urologist. I understand her logic as the prostate length and median lobe were identified in the cystoscopy which would then guide the Rezum injections. Al provided me with the notes from his Rezum (this is private info), so I knew that the urologist would avoid the areas of the prostate that would cause RE.

.

Other than calculating prostate size from prostate geometry, are there other things that the TRUS can identify that would guide the Rezum injections?

.

So far so good in my post-Rezum recovery. My peeing and PVR's are getting better each day and there is no RE so I am satisfied with my decision to have a Rezum done.

.

Thanks,

.

Steve

CJ,

I leave west of Milwaukee about 2 hrs away from Dr. Mcvary.

My first post op appointment is with Dr. McVary on Jan 29th.

Steve,

Frankly I don't know as I came about after the procedure and saw the Dr. for a couple of minutes where he said "it went as expected; it is a large prostate" and I was in twilight zone!

I'll find out more during the appointment.

I do not have RE but had some blood in semen. Before the procedure Dr. said that there would be blood up to 4 weeks including some in semen. He also said Urologically blood is not a concern except for the patient.

I have a sometimes a couple of drops of blood before pee but am not concerned after hearing a lot of the guys bleed for up to 4 weeks.

I don't know how important really TRUS was as MRI seems to give them more than TRUS does ?

I have not measured PVR as there was no sign of bladder damage during Cyscostopy and no feeling I should.

I am hoping to learn more when i see Dr. McVary.

Mark, I would agree that an MRI is the preferred imaging procedure. I just mentioned TRUS because a lot of insurance companies don't want to pay the cost of an MRI. I don't know what the actual cost to Medicare or insurance companies ends up being, but from a quick internet search, the average cost seems to be around $2500 here in the U.S. whereas the average cost of a TRUS is closer to $250.

However, cost aside, I agree that an MRI is MUCH preferred.

ProstatePete,

Re: Searching for best Rezum urologist...

.

Based on my successful Rezum experience at a Urologist Partnership Practice.

.

In addition to what others here have already said, I recommend that you search for that type urologist facility.

.

The one I have, has 6 Urologist (5 men and 1 woman) and at least 3 Drs are on site each weekday at one of the two locations they have. Mine is the Woman Dr and I would use her again if needed.

.

There are multiple advantages of this type facility. Multiple Drs doing the same procedures allows them to share their daily successes and/or problems while they all gain experience in improving their skills much faster than if they were just in a one person practice.

.

Best wishes on your search.

.

Al (Allen)

2 hours is not bad at all. i flew in and would do it again. he really cares.

btw, i was in milwaukee 30 years ago. i remember summerfest and stayed in an area i believe was called st francis.

Mark,

Why do you say "used FR 16 as apparently, It puts the least pressure for accidental rupture of the Urethra" ? Is it because a smaller diameter may puncture the urethra creating a false passage ?

Thomas

Thomas,

When I was learning CIC , My Urologist at the time recommended FR 16 . Having read a lot of correspondence on the forum and people's recommendation FR 14 or FR 12 I questioned him as to why FR 16.

He recommended FR 16 strongly and mentioned some numbers of XX/cm 2 (square) which I took as pressure it exerts on the urethra.

I might be totally wrong on this as I have not researched it and at the time, It made sense to my engineering background and to my ignorance on medical calculations.

A lot of people react to FR 16 size with " Ouch" and I always wondered if there was a another scientific reason to the size and therefore wrote my remark with a question mark.

Mark,

Mark,

A Urologist I went to in Florida, also strongly recommended FR 16. I was using the red latex catheters, at that time, which are more flexible. He did not give a reason except that he had been in the business for 40 years. Since then I have used FR 14 in the red latex and 12 in others.

I think one of the reasons Urologists use a larger size in their office is because they don't bend as easily, so go in faster, with less problems, saving time, which is important in an office setting. I could be wrong but have not heard of another good reason.

Thomas

6 week post Rezum update: I woke up twice last night 1:30 and 5:30. Flow is way better than before the procedure. At 5:30 I measured 400ml which is the highest I have measured since checking. Normal for me in the past year has been around 250, so it seems my bladder is getting back to normal also. So far, I'm happy with the outcome. Follow up with doc tomorrow to see if I can get off Flownax.

Tim

way to go Tim, Great news, Let's hope it goes like this for a long time.

@timothy81571: At 5:30 I measured 400ml which is the highest I have measured since checking.

.

Tim,

.

What was the 400 ml a measurement of? What you were able to pee out at one time?

.

Steve

Yes. I was just surprised by the amount since 250 was my normal average. I'm assuming my PVR had to be pretty low also for that one.

Update part 2: My PVR was 6ml this morning at the doc. Next appt in 2 months when they re-check max flow and discuss getting off Flowmax.

Tim

Hi Tim,

.

What was your condition before Rezum? You have probably already posted that.

.

From 2/day self cathing, my PVR's are now under 100 ml, with the last one being 75 ml. My streams are strong but last only about 10-15 seconds and repeated attempts are required to empty. I suspect that this is due to the bladder damage. At least I am getting strong streams now when before the 2000 ml AUR incident and complete blockage of January 2018, I was only getting several minutes of intermittent dribbles.

.

I consider my Rezum a success. It is just a matter of how the bladder recovers now.

.

Steve

During the day I had a good stream, but would only pee about 250ml. Also had urgency and frequency issues. PVR probably between 25 and 75ml. Night time was slow stream, less volume, slow start and finish, typical BPH stuff. A few times almost total retention. I was afraid I was going to mess up my bladder so decided to do something now rather than later. Also hate flowmax and wanted to get off it.

Three week post op appointment after Rezum:

Apparently I had 12 shots which is the max. 5L, 5R and 2 at Median lobe.

Blood subsided and just a drop (or two if I have a long time 4-5 hrs in between pees) which looks like a dark pee now.

No pain, all physical activity resumed.

He did Pee test and zero PVR .

Before the procedure I used to take Alfozusin in the morning and 5mg Cialis at night without which I had difficulty to pee. I stopped Cialis a week ago with no problems at night. I still get up 3 times but with improved flow and quicker. He said signs are good and things will be settling down there and he wants to see me in 3 months but asked me to continue the Alfozusin till I see him again.

He said with Max number of shots he wants to have ample time for things to settle down here.

I am doing good and feeling good and really nothing more to report.

When did you guys stop the alpha blockers?

Mark,

.

Congratulations on your zero PVR! In the last 4 weeks from when I first started to open up to now 8 weeks post Rezum my PVR has dropped from 250-270 to 75-100 ml when I self cath, now only 2 times a day. For guys over 65, (I am 62 1/2), these are OK PVR numbers.

.

Before I go to bed, I self cath so I that I am completely emptied and then I don't have to get up at night 🚫💦👍💤 I highly recommend it for a good night's sleep!

.

What was your condition (BPH, AUR, other) before your Rezum?

.

I am still on my alpha blocker as the urologist that did my Rezum told me to stay on it. I see the original urologist with Kaiser on March 11, at which time, I will ask about getting off the Tamsulosin. I have never liked the blurry vision side effects of it. Hopefully, my eyes will recover.

.

Steve

My uro suggested that I continue the Tamsulosin after the Rezum procedure, so I did continue it for about three weeks. I never did have any side effects from the 2/day Tamsulosin (except for greatly increased semen volume), but I just didn't feel that it was necessary for urinary flow at that point. So I stopped taking it a couple of weeks before his recommended stopping point. For that matter, the Tamsulosin never did seem to make any difference in urine flow anyway.

Hello Ken, Steve and all,

*"What was your condition (BPH, AUR, other) before your Rezum?"

As I mentioned before, I was taking Alfozusin in the morning and Cialis in the evening and probably peed every 2 hours day and night +/- based on how much I drank coffee & water during the day and sometimes wine at night.

and the last 3 months before Rezum I had really difficulty urinating some nights up to 15-20 minutes walking around and some nights I had to CIC . I did not have AUR but if I drank a lot of fluids and slept more than 3-4 hrs (on occasion with alcohol) , I would wake up with a lot of pressure on bladder and I had to go to the bathroom 2-3 times within the next hour to void completely.

After being diagnosed with BPH ( after 2 biopsies , before MRI) I was put on Tamsulosin and I did not like it for sexual side effects but I could tolerate it. I stayed on it for some time.

As BPH progressed and I started having difficulty voiding at night, they asked me to to take 2 pills day and night and after a while I complained about lessened RE and libido, they suggested Alfozusin and that definitely helped for about 2 years to have a reasonable sex life and I felt my pees were better till about 3-6 months before rezum with daily Cialis and later per above changing to day and night regiment with Alfozusin and Cialis combo.

I stopped daily Cialis about 10 days ago (only discretionary now) and I hope like Ken after a month or so I can try dropping Alfozusin and so far I think I can.

Mark,

Congrats !!! since you went back to Dr Mcvary for the followup, can you tell me what type of "pee test" did he do? did he measure you with an ultrasound to determine your PVR?

CJ,

it was just pee in the cup for culturing and an ultrasound that's all.

CJ ,

how are you doing where are you with the pils, any issues?

mark,

i wasnt on the pills. dr mcvary said that based on my prostates growth, pills would not have worked.

its now 2 months since the procedure. my flow is stronger. my pee in the morning is twice as long as it was prior to rezum. i can drink a beer without worrying how long it will take me to pee it out. i still think it will only get better.

i do need to go to my local uro to see my pvr. i will do that at the end of february

And no retrograde ejaculation ?

no retro. actually it feels the better than it has in years.

Hi Ken,I never heard of Tamsulosin causing INCREASED semen. I stopped taking it when my semen almost disappeared.Have you ever heard of increased volume from another source. I was taking one a day.

Drtom, I agree, I'd never heard of it happening either. But while I was taking the 2 Tamsulosin per day, my ejaculate was MUCH higher in both force and volume. After I stopped taking it, my ejaculations returned to what is normal for me. I asked a couple of urologists, including an andrologist (look that one up!) and they couldn't explain it either. Perhaps it had something to do with relaxing the vessels that carry semen?

mark,

My Uro wants me to continue Flowmax until 3 months, then flow test to see if I can get off it then.

Tim

that is interesting Tim! there must be a reason behind this.

well my Uro told me it was maximum number of shots and that it would take 3 months for things to settle down.

I just finished 4 weeks and I have to tell you i have no issues peeing ; if it isn't like a race horse, it is damn close to it!

I want to wait another month and than instead of every morning i will start delaying taking it to every 36 hrs, 48 hrs etc and see what happens. (btw: I take Alfuzosin)

Do you think we would do any damage; I don't think so.

guys ?

I don't understand why the urologists want us to continue taking these drugs for weeks and months after a procedure that is intended to eliminate the need for the drugs. I suspect that the reason that they recommend continuing the drugs is the same reason that they do so many things these days: to avoid any possible liability. I think it's up to us as informed patients to listen carefully to what the medical professionals recommend, do our own research, and if the risks are low, just go ahead and do what we think it right for us. I think that the risk for stopping these BPH medications a bit earlier than what the docs recommend is probably very safe. If you're not comfortable making that decision on your own, then talk to the doctor's office and ask about the risks.

As I mentioned, I stopped taking Tamsulosin a couple of weeks after my Rezum, and there was no issue at all. I did tell my uro, and he didn't seem upset at all.

The urologist that did my Rezum told me to stay on the Tamsulosin too. She wants me to check in with my Kaiser urologist in 3 months, so I will be seeing him in early March at which time, I will ask him about stopping the Tamsulosin as I would like to get off it because of the blurry vision side effect.

.

Because my Rezum was successful, I really don't see the need to continue the Tamsulosin as I agree with Ken, that the Rezum has removed the need for it. My PVR's from twice a day self-cathing are between 70 and 100 ml which is OK for 65 years and older and most likely due to the bladder damage.

.

I did a 9 mile cross-country ski yesterday and made the biggest yellow snow that I had done in years 💦👍

.

Steve

Steve, I know what you mean about the yellow snow thing. I did that a few times recently here in Illinois. Don't worry, we live in the country; no neighbors had to call the cops about the weird guy peeing in the back yard.

Hello all

It may be because doctor are all different and they may feel you may need it. But I do understand for maybe 2 weeks while your healing but remember it can take 3 to 6 month's to see results on some men.

I know that I did not have the Rezum. My choice was Urolift. I was on Flomax & Rapaflo only for 3 days. He told me that if I wanted I can stop after the catheter came out. So I did. Never went back on them. Thank god did not like them......

Have a great day..............Ken

I thought the Tamsulosin was meant to relax the smooth muscle around the urethra to promote a good opening for urine flow.

This is different from the action of the Rezum which is meant to stop the pinching of the urethra from the enlarged prostate.

Ken, for those guys whose healing and improvement are taking longer than average, then it probably makes sense to continue taking the drugs as you suggest.

I think that we're talking here about the guys who are seeing good improvements in flow, but whose uros are recommending continuation of the drugs anyway.

BTW, hope that you're feeling a lot better these days.

Yes Ken

Doing better was able to get 2 of my pills. Thanks for asking.

That is why you have a procedure to get of the medicine. I can't see taking a pill for 3 to 6 month's if you done need it. I think it has to do with money. Let everything else.

Have a great day. Glad your doing good.Ken

Hey David.

Tamsulosin ( Flomax ) is meant to relax the prostate and the bladder neck but does not make the prostate smaller. A lot of side effects also.

Rezum procedure is suppose to make the prostate smaller so you can pee better. The medicine work on both.

After I just wrote that line I just thought of something. They are treating the prostate with the injection what if the prostate is not the problem. What if the bladder neck is what is causing the problem????

You went through all the injections and after 6 month's of pain you still have the problem. I wonder if that is why it does not work on everyone. Just a thought.

Ken

Ken,

Rezum doesn't cause 6 months of pain. I would say 1 month of mild discomfort.

or were you speaking only of David?

Tim

Hello Tim,

I never did a Rezum procedure.

So Ken is referring to those who have done the procedure.

David

Hey Tim

Maybe pain is to strong of a word. Discomfort sounds better. Some men get a better results faster then others. Rezum just take time if it is going to work.

Have a great day......Ken

Each person responds differently. My REZUM was on Dec. 11, and on Feb. 10 I still have pain, not discomfort, pain. I've made multiple trips to the ER and the urologists office.

My Rezum was on November 29, 2018. The only pain that I had was during the procedure which was not that painful. After the procedure, I never took the remaining pain meds in my prescription. The only discomfort that I had was from having the Foley in me for 2 week after the Rezum and that was no more uncomfortable than the earlier time that I had a Foley for 3 weeks.

.

I had blood in my pee for the first month, with the most in the first 24 hours. I started to open up at about 4 weeks. Now over 2 months out, I am well opened, peeing good, no RE, and life is great. My PVR's are between about 70 to 100 ml, but that is most likely due to the remaining bladder wall muscle damage. My Rezum was a success. In a month, I see another urologist for my 3 month followup.

.

Steve

just an update. i went to my uro today. im about 10 weeks out. i told him i still need a second pee a few minutes after my first in the am and have to push at times. he did a scan and said that my medium lobe is practically gone. my pvr was 49. he couldnt have been happier and thought the rezum was a huge success

Does your Urologist have an opinion about how you have to pee a second time shortly after the first time ?

he didnt comment on it.

CJ,

.

I still have to do a 2nd pee after my 1st pee too. I attribute this to the remaining bladder damage. The streams are strong which I attribute to the Rezum removing the blockage, the median lobe in particular.

.

A month from today, I see the original Kaiser urologist for my 3 month follow up as recommended by the urologist that did the Rezum. What type of scan was done to show that your median lobe was almost gone?

.

Steve

CJ,

.

A PVR of 49 ml is OK. I also have to push hard at times. This makes me fart too 😲

.

Steve

david,

i emailed mcvary and this is what he said

“This represents your bladder needing a “breather" after having been obstructed for so long. It should improve further. Its NOT dangerous, if fact it might be good that you are giving it a second shot”

I know I've had to give it that second shot and I don't have bladder obstruction, my issue seemed to be an overactive bladder or something like that.

What a curious issue.

i believe the scan was a sonogram.

CJ,

.

I agree with what Dr. McVary is saying here about peeing twice being good now. Its all about working your bladder again after it was not working right because of the however long you had the obstruction.

.

So was the sonogram image produced by a TRUS (Transrectal Ultrasound)? You would know depending on where they put the ultrasound instrument 😲

.

Steve

Hi Steve -

I have to do the 2nd-pee-after-my-1st-pee thing too. I was happy to find, after some searching around, that there's actually a term for it: it's called 'double voiding'.

George

I would love a PVR of 49 ml, mine was 793 ml on a Uro follow up visit yesterday (2/11/2019).

My bladder began stretching more than 25 years ago, I just did know...

Discussed trial of remote control electric shock probes to bladder muscle to force out more urine, if that works, a device could be implanted for auto shock control.

Allen (Al)

*not know (edit)

Has there been improvement? Is 793ml better than a year ago ?

Rezum done in May 2018, flow is good but bladder PRV has not improved more than 75-100 ml, if at all.

.

I asked Uro, why are there no Rx to reduce bladder size, she said various Rxs had been tried without success.

.

Al (Allen)

Hello Ken,

I did the same thing.

7 weeks after rezum; I am drug free and no issues. I stopped taking Alfuzosin 5 days ago and could not tell the difference.

Thank you for all the guidence.

Mark, thanks for the update.

Speaking of updates...I had a regular checkup with my local urologist last week. He is the one who suggested a bipolar TURP when I went into retention a couple of years ago. When he warned me that "you'll never ejaculate again", I decided to self cath until I found a less invasive solution. (of course he was referring to retrograde ejaculation)

My Rezum procedure went extremely well, so when I went back to see him last year for a PSA checkup, he was very interested in my Rezum results. He had done research on it and wanted to bring Rezum to the local urology clinic/hospital. However, he has not been successful because, as he put it, Rezum isn't currently being properly coded for reimbursement. When I told him that Boston Scientific had bought the rights to the Rezum procedure from NxThera, he said that was a good thing because Boston Scientific has the horsepower to get the procedure properly and completely approved.

I really don't understand what he meant, since my procedure was completely covered by Medicare and my supplemental insurance provider.

My point of sharing this information is because I have read that some guys have had problems getting their insurance company to pay for the Rezum procedure. Maybe there is hope that things will change.

ken,

before i had my procedure i checked with my insurance (allied) and also with my wife's insurance (united health care) for the codes that they gave me and both covered it.

given that rezum is fda approved, could it be doctors that are not experienced in rezum don't know which codes to use ?

Ken,

.

In January 2019, Rezum got it's own billing code so this should no longer be an issue compared to when you had your Rezum done.

.

With Boston Scientific buying NxThera, they are such a huge player in the medical devices field that there will be more Rezum.

.

Given how successful Rezum is without the complications of TURP (i.e. no RE), more and more urologists will be doing Rezum.

.

It is now up to Boston Scientific to smooth out the training issues that have been mentioned by some of us on this forum.

.

Steve

Steve, thanks for the clarification.

Ken

PSA Update

I just got the results from my latest PSA test this morning. 2.0 My PSA number hasn't been that low for around 20 or so years. A couple of years ago, before my Rezum procedure, my PSA number passed the 'dreaded' 4.0 number, and the urologist wanted me to have a blind biopsy. I refused the biopsy because of what I had read online about the risks vs benefits. Instead he ordered a different PSA test that also measures 'free' PSA as well as the total PSA. From what I understand, that test is much more definitive about whether cancer might be present. That test showed good results, so I didn't have to push for a 3T MRI-guided biopsy.

Of course the primary reason that my new PSA number is lower is because my prostate is much smaller now after the Rezum procedure of a year ago, and that's why I posted the results here in a thread about Rezum instead of in a thread about PSA numbers. BTW, if you get tested for PSA too soon after the Rezum procedure, the results will be inaccurately high because of the injury to the prostate. Mine was almost 6.0 about two weeks afterwards. I didn't know that at the time, but now I know that it's normal.

ken,

happy to hear about your PSA number being so low. i should probably get mine checked.

Btw, im 3 months done and things are well most days. still have some minor issues but for the most part peeing alot better.