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

For most people it provides considerable relief from BPH. Sexual side effects are very uncommon - RE 2 1/2 % of the time, virtually no impotence and a fair number of people have found that it improves their sexual function. There is a study on that - I'll see of I can find it. I'll post the some way to get to it if I do

Hi Sam. I am 7 weeks post Rezum. Sex is still great. Possibly a little less ejaculation fluid, but not an issue with me. The flow is much better and only up 1 or 2 times a night. Read all the old post and you'll see is a good procedure for most everyone. Good luck.

REZUM does not cause sexual dysfunction per its website and clinical trial data..Go To REZUM com...

How long will recovery take and what's the rate percent of success for REZUM?

If you read these post you will see recovery is different for everyone. Generally a week or so with a Cath, and some meds. I took the Cath out in 5 days and really no symptoms since. I think it's the degree of symptoms you started with that has to do with recovery time. This forum gave me great over all information, especially with dealing with a Cath. It was painful for me but not most. It was a very quick procedure. I'd do it again. Hope this helps.

Recovery is all over the map. My symptoms were manageable yet I was self cathing for two weeks. Most people are voiding on their own within a week - manhy the net day.

Recovery varies - the bigger your prostate, generally the longer it takes to get the full result of the procedure. Most of the improvement happens in weeks 6-12, although there will be some prior to that. But there is improvement in months 3-6 too. Some people's bladders need to get used to the open canal and that takes some time - can be longer than 6 months to fully recover. Most likely, by three months your retention problems will be behind you, quite possibly sooner. My recovery was slower than most, especially with medium sized prostates (mine was just growing abnormally inward) and I was self cathing for 2 weeks and not better than before the procedure til about 7 weeks. Its been a bit over 2 months now and I'm still getting better.

Agreed...My  cath was in till week 4. Now at week seven I am getting a somewhat normal stream. Still on anti biotics for uti. still slight burning. Getting better with every passing week though.

The slight burning is normal at week seven. It became more of a wierd feeling than burning after awhile and I noticed recently that it was gone. You probably could have managed without the cath within a week or two - I don't understand leaving someone that way for a month. It gets better from here - the next couple of months will probably bring dramatic improvement

Thanks...

Thanks...

hey randy, if the urologist is experienced with the procedure some form of success (symptom improvement is almost certain). the steam injections start 1/2 cm from the bladder neck with injections left and right and every 1 cm left and right on the way out. more injections for medium lobe. For me, foley 3.5 days. able to urinate on my own though very slow at first. pick up in the stream around 14 days. gradual improvement after that. At 3 months leaking was much better, ability to hold off urination was getting better. Could not say no to urination before, Both continued to improve out to the 9 month mark, where I'm at now. ipss 22 to 8. Improvement is slow but as the body absorbs the dead cells you will notice the improvements. I asked my urologist if she could see the duct the produces ejaculate. answer yes and she stayed away from it. that is why retro is so low for this procedure. Researched all Bph procedures prior to deciding on rezum.

There are possibly other options. There is a very lengthy discussion of PAE on this forum, which is what I'm considering. I've also heard about some other procedures: HOLEP, Urolift, plus  a few others. Hopefully some folks more knowledgable than me will chime in. I don't know about HOLEP etc with regards to size, but that wouldn't be a problem for PAE. Not sure about the prostate pushing into the bladder. My only suggestion is to research this thoroughly. I and many others have not always been given the best advice by our urologists.

No, no, NOOOOOOOO!!!! Do not have that done. You'll be imptotent for 1-3 years if you're lucky. If not, you'll be impotent forever. Look into PAE, Rezum and Holep. And by all means have your doc show you how to self cath in the meantime. Its easy and allows you to live a completely normal life. Get a script for catheters, buy the Speedicath 14 portables and you're in business. No one will know as long as you can find a stall and it will take about 5 seconds longer than doing it the odl fashioned way.

Here's a sample post, actually the latest, from the PAE discussion:

One week ago I met with my urologists and we discussed retro. He has taken me off Tamsulosin and believes in two to three months the retro will subside and normal ejaculation will be the order of the day. I was taking both Finesteride and Tamsulosin and I believe that combination brought on the retrograde. In any event, the P.A.E. has brought about significant changes, all positive, as regards other areas of concern with B.P.H. I am glad I went this route and not the more aggresive ones offered by various surgeons.

Hello ASteve   I am very sorry that you are having this problem.  Don't let the doctor do a simple prostatectomy.  There is nothing simple having your prostate taking out.  Try to get information on Urolift...PAE...Rezum...CIC...or I-Tind.  These things will work for you.  Taking out the prostate will just cause more problem  Take care  Ken

My urologist who was part of the original clinical trial says the Rezum procedure can be done multiple times. They are presently doing clinical trials in Europe on large prostates and are having good results . They are also starting a clinical trial in the US using Rezum for cancer. This Rezum has pinpoint accuracy and I believe this may be the future concerning BPH issues.

I hope you have rezum my prostate exceeded 120 and wasn't recommended but my urologist knew I didn't want the trip so 8 weeks post therapy I'm doing great a little stinging last time my wife and I enjoyed sex and other than that normal peeing is still a little bit weak but I pee fine do by all means try rezum it may hurt really bad during procedure but it takes less than ten minutes so good luck

A lot has happened since I posted three months ago with alcohol-induced acute urinary retention.

Since my visit to ER on 7/27, I had a foley installed and was put on daily .4mg Flomax. Two weeks later I failed a void test - nothing came out! It's possible my bladder was too full from drinking a liter of water and then being delayed at the uro's office for 90 minutes in pain from a full (and very shy) bladder. Maybe my bladder shut down? So my uro installed a new foley and doubled my Flomax to .8mg. Boy was I mad!

Two weeks later I passed the void test! No more foley after wearing one for a whole month! But I was scared... I hated all the side effects from the Flomax, but was afraid to stop taking it.

?A week later I had symptoms of prostatitis, so I was put on Bactrim. On Day 9 of that treatment, I had a bad reaction, so finished with two more weeks of doxycycline, which took care of the problem. Without my uro’s knowledge, I then cut my dose of Flomax in half to .4mg.

Three weeks ago, I had another follow-up void/flow test, which I passed with flying colors with good flow (for me) and 43cc PVR. I asked my uro if I could go off the Flomax; he said no. Needless to say, I stopped taking the Flomax that day and have had no problems since. My flow actually improved within two days of stopping the drug.

Is it possible my uro got it wrong, that my AUR was only from my bladder shutting down (twice) and not from BPH? That’s the way I’m leaning. Since having the foley removed, I measure every time I pee and keep a spreadsheet diary.

I have taken REZUM off the table. In my mind, it is too invasive (like a biopsy). They’re still poking holes in your prostate to administer the steam. When I had a biopsy many years ago, it took me more than three months to recover from only eight pokes. I think there’s a good chance I’d have a nasty recovery from REZUM also.

PAE is at the top of my list should I decide to have my BPH treated. Going forward, alcohol will no longer be a part of my life!

ptientx,

I am not sure if AUR was your cause or not. I am trying to get to the bottom of it myself. I don't get Aur, because I can self cath if needed. But I do get locked up some times, and trying to figure out the cause. 

You mentioned alcohol. Do you think that is a cause for you?

I know if I wait to long to go to the bathroom I have more difficulty. And also in the middle of the night.

After reading a lot of the issues with Rezum, I think I will rule that one out. 

Its quite possible that BPH isn't your problem, or at least isn't your main problem. The only way to know for sure is to scope you. Prostates don't grow and relax, so if everything is fine except when you drink, its more likely a bladder issue, or a bladder issue that's exacerbated a bit by a slightly enlarged prostate.

If that's that case, I wouldnt' just take Rezum off the table, I'd take any prostate procedure off the table because they won't help, or won't help much. The only way to know is to get scoped. FYI - if you like to drink and are worried, have your URO doc write you a catheter script. Put one of those portable speedicaths in your pocket when you drink just in case. My guess is that this was a one-off that won't repreat often or ever - but either way, if its your bladder, no procedure on the prostate will help and all you can do is manage the symptoms (don't drink or self cath when you do at your option).

You don't have a diagnosis yet, so I'd get one before considering any procedure. If it is BPH, I wouldn't rule out Rezum, but see what your issue is before you do anything is my suggestion.

Motoman and oldbuzzard - thank you both.

Motoman - I am also very slow in the middle of the night and first thing in the morning. I find that walking around for a couple of minutes before voiding helps a lot.

You have to use common sense. If you stop Flomax and your flow/PVR increases, stays the same or is normal, then you don't need it regardless of what your doctor says. If he doesn't get that, find another doctor!

Don't remember your history but sounds like you were put through Foley hell when you could have been taught to self cath. That and Void Test Hell, when they fluid you up like a balloon which increases the chance you will fail the test even though you might be able to empty your bladder normally with a normal fluid load.

Things seem OK now, but if you think you might lock up from time to time from drinking alcohol, then learning self cathing can save you a trip to the doc's office or ER and make you much more independent. But if you pass for now, definitely insist on that option the next time they want to use a Foley on you. Also, self cathing is a reasonable option if you don't tolerate Flomax well, should you even need it again. 

Jim

We have similar issues in terms of "locking up". Even though my PVR is now mostly normal even without cathing, I have a tendency to lock up (AUR) on occasion which necessitates self cathing. 

Sometimes it is after alcohol (beer) but not sure if it's the alcohol or the fact that alcohol is a diuretic meaning the bladder will fill faster. Can also happen in the middle of the night or after an afternoon nap. And also if I drink a lot more fluid than usual.

The common denominator on all of the above seems to be too much urine in the bladder for my detrussor muscles to expel. 

Lately, however -- and this may offer you some hope -- I've only really locked up twice in a couple of months even though my bladder sometimes carries more than 400ml which usually was the lock up point. Like yesterday I naturally voided 400ml and cathed 100ml, meaning I was holding 500ml but had no problem naturally voiding. (The cath wasn't necessary but I only used it as a test to see what was left after voiding 400ml). 

So it's a hard one to figure out, as you know. Bladder capacity seems key, but not always. Haven't had beer lately so that could be a factor. Also have observed that physical activity seems to help as well. And ironically, sometimes increasing my water intake helps, but sometimes not. A lot of variables but even though it only happens once in awhile now, nice to have those catheters in the drawer just in case.

Jim

Jim, What's Locking-Up?...Do you mean Retention starting again? ...What concerns should I have at this point?

Hi Jim,

     Reading your post triggered a question that I've had for some time. I definitely have an enlarged prostate (98 cc) with some LUTS  moderate severity. The one symptom that was of most concern to me only happened on occassion only the first time I would wake up at night (maybe 1 to 2 hrs after going to sleep) where I would have great difficulty peeing at all, and definitely did not empty my bladder completely. After partial emptying, if I lay down for even just one minute and then got up and tried going again, my bladder would empty. I'm now taking Flomax every other day, and most LUTS are under control except by the end of the second day. I'm wondering if you have any explanation for the first nightime peeing problem. Thanks so much.

Rich

 

Hi Randy,

Some of us go into acute urinary retention (AUR) from time to time. AUR means you can't urinate at all, and therefore requires a catheter to drain the bladder. That's what I meant by "locking up". 

In my case, I have normal post void residuals even without cathing but "lock up" from time to time. This seems to be caused mostly when my bladder holds more fluid than its muscles are able to push out through my obstructive prostate.  

If you've never had AUR before, I wouldn't worry about it. Also, you've had an operation to reduce your obstruction, which I have not. That said, since you now know how to self catherize, should you ever go into AUR, you can simply catherize and save yourself a trip to the doctor or ER.

Jim

I believe it's called "double voiding" and is a typical sympton of BPH. 

Don't know your history, IPSS score, or other symptons, but sounds like you're in a 'watch n' wait' mode and have not had any surgery, just Flomax?

If that's so, things will tend to get worse over time and at some point your urologist might suggest a TURP or other invasive operation. Just know that there are less invasive alternatives out there such as PAE, Urolofit and Rezum, although each is not without risks or side effects per the reports here. 

And, there is also self cathing, the path I choose instead of the TURP my urologist offered me. Wish I had started it years before. Again, don't know what your entire situation is, or how you tolerate Flomax, but I didn't like Flomax at all with the retro ejaculation. One non-invasive alternative to Flomax is Daily Cialis (5mg) and then again, there's self cathing.

Jim

I haven't had any procedures so far. IPSS score about 9 when I'm on Flomax, but the side effects (severe nasal congestion and persistent cough) are pretty bad ... that's why i switched to every other day. I was on finasteride for 6 months but it didn't really do anything except lower my PSA, so stopped it. I have researched PAE, and am seriously considering it.

Re: daily Cialis. When I've used Levitra for ED, it gets my sinuses going also (seems to be a theme!), so I'm wondering if daily Cialis would do the same. My URO doc said ED doses of Viagra or Cialis would be essentially the same as Levitra.

With an IPSS score of 9, even on Flomax, I personally would not be thinking about any sort of operation or procedure, even one of the less invasive ones. 

You could try daily Cialis (5 or 2.5mg) and see if the side effects are more tolerable. But if not, then it's reallly a personal choice between what I see as three options. 

(1) Continue the course with Flomax and live with the side effects.

(2) Stop the Flomax and see if you can live with that, assuming your retention will not cause other medical issues.

(3) Stop the Flomax and give self cathing a try. It will empty your bladder completely any time you need to. If you don't like it, you can always go back to the other options. 

Jim

If someone has to self cath without meds, his true IPSS score is way higher than 9. Personal decision, but I would think that needing to rely on a catheter even on and off would be a reasonable trigger for one of the less invasive procedures.

That's where I drew the line - too much of my life revolved around the bathroom and I only used a cath twice in four years, but I knew where I was headed.

 

For me, needing to  self cath was not a trigger for an operation, but rather it was what I considered a reasonable alternative to an operation. Very happy with my choice or I would have had a procedure by now. As to IPSS and meds, I got the impression from Rich's posts that they weren't doing wonders for him. In my case, Flomax had no effect on my IPSS after a few weeks. 

Jim

Jim

FYI - My 3 URO Docs stated if the REZUM was not successful, that the only choice they would offer next would be a TURP....Based on All the TURP Complications mentioned on this forum, clinical trials, prostate articles, etc. I was determined not to have a TURP....Like Jim, I would try Self-Cathing, before I would do a TURP or any other procedure with the exception of a PAE....Both the REZUM and PAE are rated by patients as the Best BPH treatment procedures available and clinical trial results confirm that...

Thanks, Jim, your advice on this forum has been amazing!

Randy  Stay firm them NO WAY  Good luck  ken

Hi Jim,

    Thanks for your reply. I don't really see that any of the three options that you mentioned would work for me long term. The Flomax sinus congestion frequently causes lack of sleep as I wake up unable to breathe, and spend the next hour(s) blowing my nose and coughing, not to mention the discomfort during the day. Going w/o Flomax is OK short term, but my Dad had to have emergency surgery due to AUR, and I don't want to put myself at risk for that or for possible bladder or kidney damage. And I would try PAE before going down the self-cath route. I will talk to my doc about the daily Cialis and perhaps give that a try before committing to PAE.

The meds don't work for the vast majority of people regardless of which one and if they do, its almost always a short term solution. PAE, Rezum and Urolift have worked for a lot of guys in this forum. Without doing the math, my sense is that there are a couple of faliures for each, but the success rate on this very unscientific sample (this forum) is about 90% for each.

I believe the PAE studies show an 80% success rate, but it can be redone if it doesn't work the first time.

Hi Rich,

When you say, "going w/o Flomax is OK short term", do you mean that would be your choice if not for your long term concerns?

Because if that is the case, routine monitoring should alleviate any concerns about either kidney or bladder damage. Both of which you are probably many, many years away from given the symptons you describe.

Same with AUR. I would venture that most of us who have had AUR were in the "high moderate/severe" stage in terms of IPSS scoe. Do you know your IPSS score when you are off the drugs?

I guess my point is that given the risks of ANY surgery or procedure, and given the fact that newer, less invasive and hopefully better procedures for BPH are both progressing and coming on board every year -- it then is reasonable to watch and wait if your current symptons don't warrant a procedure. PAE will be around next year and the next,  but by then it may be more refined or perhaps something better will evolve. 

Jim

Hi Jim,

Is there a need for me to stay on Flomax now that it appears I'm Voiding normally and have Less than 100ml Retention?...Please Advise..Also, please read and advise on my latest comments to OLD BUZZARD...

Hi Jim,

When you say, "going w/o Flomax is OK short term", do you mean that would be your choice if not for your long term concerns?

     Not just the long term concerns. The sinus side effects are pretty bad, but I'm OK hanging in there for the short term while I gather information about my other options.

routine monitoring should alleviate any concerns about either kidney or bladder damage

    Curious as to what tests one would do for routine monitoring. Are any of them invasive, uncomfortable, and/or possibly cause UTI?

IPSS score when you are off the drugs?

    I don't really remember, but I would guess it would be higher at this pointas my symptoms do seem to be getting worse. I started taking tamsulosin almost 2 yrs ago (22 months).

   I appreciate your very clear expression in the last papagrarph of one of the pros for holding off any procedure for as long as one can.

   I researched Cialis, and it looks like it's quite similar in its effects (both good and bad!) to Tamsulosin and Levitra, so probably would cause similar side effects for me. Haven't ruled out trying it completely, but on this quiet Sunday morning I'm leaning towards not experimenting with it.

Rich

   

Rich,

If you did a trial run being off Flomax, and could live with the symptons, then "yes" monitoring by your uroloigst should protect you from long term damage. 

In my case the urologist did what I consider usual examination and monitoring. Periodic office visits consisted of giving a urine sample, scanning the bladder for PVR and a finger up the rectum to feel the prostate. Periodically he took blood to run a simple chem screen including kidney function tests. Also, periodically I had an ultrasound of both bladder and kidneys at the hospital which checked overall bladder health as well as making sure that there was no urine reflux into the kidneys. That' about it. My urologist never suggested I be scoped as part of Watch n' Wait.

As to daily Cialis, I found it better than Flomax, at least initially, but I did have some symptons. You may not have them. Got to just try it. If you do have symptons, you could try the 2.5mg dose as opposed to the 5mg. Or even 2.5 every other day. Got to experiment. One of the side effects I had from Cialis was heartburn and I solved it by taking OTC Prilosec an hour before breakfast. 

Jim

 

Jim, Can I stop taking Flomax?.....It seems I shouldn't need it anymore, because # 1 it doesn't help me and #2 the REZUM has corrected the BPH problem and I can Void normally now....also, a side affect may be causing dizziness.....Also, does AUR or BPH affect Bowel Movements?....

If you can void normally (PVR under 100) without the Flomax, I see no reason to take it, especially since you have catheters on hand to immediately empty the bladder should the retention return.

If the retention does return, then you can either continue with some self cathing and see if things get better, or go back to the Flomax. The decision then would be -- would you rather deal with self cathing, or deal with the side effects of Flomax. No right or wrong decision there. 

Lots of things can affect bowel movements such as drugs, fluid and fiber intake, exercise, etc. Not sure about bph or after effects of AUR. Neither has had any impact on my bowel movements that I am aware of. What I have noticed however, and has also been reported here, is that good bowel movements facilliate bladder emptying at least to some degree, but you don't seem to be having an emptying problem now. 

Jim

Hi Jim,

     I have played around with stopping tamsulosin, and at around 50 to 60 hrs after the last dose, I can tell that the BPH symptoms have returned. Still thinking about trying Cialis.

Rich

 

Steve, i am reading y post on y large P. and what to do - if Simple P Surgery was y only choice? mine P too is large at 220ml and SPSurgery is recommended. Just wondered whst did y end up doing?