REZUM--HAVE YOU HAD THIS DONE???????
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I had a nice conversation today with the President of the "Urology Times". He was telling me that there is a "New Procedure" that has been approved called the "REZUM SYSTEM". The company that makes the system is called "NXThera, Inc". You can google them up and lots of stuff comes up. I called them for a referral and they gave me a Doctor in Minnepolis that has done it over 50 times now. I called his nurse and she said he would call me back and answer my questions on monday. As you guys probably know Doctors are not very good at returning calls but we'll see what happens. Iam not very good at explaining how the procedure works but basically they take the device and put it up the uretha and vaporize the prostate cells which kills them. It works with high pressure "steam" that at a certain degree will kill the prostate tissue. My question for you guys is there anybody out there that has had it done to them and how are you getting along and are there "side effects", etc etc?????
35 likes, 5645 replies
leon67555 ChuckP
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I went today to have the rezum done at the surgery center. The doctor had me lay on my side and put a probe in my anus. I coun't take the pain. He gave me NO pain medicance and was wondering why I couldn't stay still. I had a very abd experience after three times I just couldn't take the pain. He said he would have to admint me to the hospital and have it done. I would have to be knocked out to have it done. I am very worried about the entire prcedure..... Not sure if I will have it done... Did you have it done?? If so did the doctor give you medicane for the pain??
Thanks so much. I am 58 years old and just wanted some releif from having to pee all night long.. I didn't like the medicane and it really didn't help me orther than dry ejaclations when having sex.
nealpros leon67555
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Neal
richp21 leon67555
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I had very bad pain issues with my prosoate biopsies, also through the anus. For the first one I got just a local, and it was beyond excruciating ( I have hemmorhoids) and the doc was quite blase about it. The second one (with a different urologist I can assure you!) I insisted on and rec'd general anesthesia. Piece of cake. The third one was a 3T MRI targeted biopsy and was in an office that was not set up for general anesthesia. The doc worked very closely with me to come up with a pain control regimen, and while mildly uncomfortable it was really OK. He had me take a valium and a pain killer that is used in post-surgery patients. I don't remember the name, but happy to try and track it down if that would be of interest.
uncklefester ChuckP
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FLDave ChuckP
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This thread has been very helpful to me and wanted to add my experiences for anyone considering Rezum. And if you don't care about details and wanna know where we are, I'm 6 weeks out, and things are SOOO freaking much better!!!! Details below will describe things still to go, but overall? Very positive experience, but a bumpy road, and well worth it.
Let's start. Me: 53 years old, very physically fit, high athletic activity. About 2 years of really noticeable urination problems but ignored it for a while as we athletes do.
April 2015 - went for a urological exam, diagnosed with mild BPH. I could live with the discomfort, and they prescribed FlowMax. I hate meds, so I refused to take it till it got really bad, in Aug 2015. I hated the side effects, mostly because of my athletic proclivities. My side effects were on and off RE (not a big deal) but heart rate racing, lightheaded, blood pressure screwiness and affecting my athletic performance obviously. So on and off I started and stopped the meds, just enough to keep the discomfort in check.
Fast forward to May 2016. Saw a doc in S. Florida about doing Urolift. Thought it was less traumatic than TURP, but alas, insurance refused to cover it. Doc educated me about Rezum, and perhaps insurance might change on Urolift in the next couple of months, so sit tight and revisit at the end of the summer. Saw that insurance was not happening, so I scheduled to do Rezum on Oct 20, 2016.
Oct 20 - The procedure did not take long at all. The "prep" of numbing up the prostate was not much worse than getting novicaine in my gums for a dental appointment. They put some numbing gel in Mr. Winkie, and then the injections to the prostate. Again, uncomfortable, but not painful. At this point, I could not see what was going on down there, and I expect a scope was put in Mr. Winkie, because they told me the procedure/probe/steam injector goes in the back door. That part of the procedure was relatively painless. There were 3-5 "injections" that vaporized the prostate tissue and it was not more than a couple of minutes (this doc is one of the most experienced in Rezum and as an aside, there was a Rezum rep in the room as well). I did, however, experience severe discomfort at the tip of my penis and from the feel I can only imagine he was moving the scope around to make sure and watch what he was doing from inside (I had a lobe of the prostate pressing up in at the bladder pretty severely). It was not long (5 mins but felt like a year), but intense in that respect. He told me he zapped probably about 80% of the prostate tissue.
Went home about 20 mins later with a Foley cath. Obviously unfun. Some bleeding and oozing out of the tip onto the cath tube, and really, really sensitive there, not unexpected. The next couple of days I was getting used to it, and the pain slowly got better. Neosporin with pain relief helped, as did lotsa Advil. This doc said 6 days with the Foley, as his (extensive) experience is that any shorter is doing a disservice taking chances of needing to reinsert.
6 days out, I went for a follow up, and Foley out, I was okay to go home without it. Doc told me it was gonna be worse before it is better, but as long as I can pee myself, go back on the FlowMax for another 4 weeks or so, and be patient. Now, a little side trip here; Whether or not it is wise to not go home with an antibiotic as a matter of practice is debatable.My doc does not prescribe one as a matter of course unless it is needed. Unfortunately, late in the day that I got the Foley removed, I ended up in the emergency room with a really really really bad infection. All of the details are irrelevant, but suffice to say that I had well over 105 fever, and I needed some pretty serious antibiotics. So if you're doing this and get sent home without an antibiotic, I urge you to second-guess the doctor and push on that a little bit.
Weeks two and three (the first two weeks after I got the catheter removed) were very bumpy. Specifically, it burned like a living hell to pee. I'm surprised I didn't break my fist a couple of times banging on the window sill. The flow was slowly getting better, but man did it burn like hell.
Week four was a major turning point. I suspect the burning was because there may well have been a scab or other loose scar tissue inside the tip, because at one point I believe that some tissue actually came out during my urine stream. The next morning, I have to tell you, it didn't hurt very much, and I was p*ssing like a firehose.
Today is six weeks post procedure. I just got off the phone with the doctor (because I don't live locally and I actually flew to Florida to have the procedure done) and my frequency has not diminished a lot; I was going about three times during the night, and I still am, but I don't feel the crazy urgency the way I did before, and when I do go, the flow is great. My concern is that maybe my bladder capacity has been reduced, or maybe there's something else. Also, at the very end of my flow, there's a little bit of burning. The beginning and middle is fine but at the very very end there's a slight bit of burning at the tip still. Dr. tells me both of these things are normal and to be expected. He said that with respect to the volume, my bladder is still figuring out how to go back to normal operation after almost 2 years of being in constant spasm. He also said the burning at the end, is also part of the healing process and I'm still only six weeks out, and my body is still trying to get rid of a lot of things. Essentially, both of the things that I was a little concerned about, he said are exactly to be expected. He said the first thing that will happen is over several weeks the flow will get better, and then after that, the volume gets better.
Another item I'm sure is of interest to you is my sex life. Before Rezum, no ED and only minor RE from the Flowmax. Post Rezum, no ED problems at all, and only once had a little ejaculation discomfort, but otherwise, from a sexual function standpoint, no problems before, none after thankfully. (and to directly answer some other posts, I never measured my semen volume nor went for a distance contest, but it's all working pretty normally)
So to finish up this rather long story, it was indeed a bumpy road. There was discomfort during the procedure, but considering where I was and where I am now, I would do it again. Pain is temporary. Of course, as with any medical procedure, your mileage may vary, but I wanted to share my experiences as well.
Best of luck guys!
tsolano FLDave
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kenneth1955 FLDave
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Thanks Dave. I'm glad it worked out for you. It's great to hear from a patient that went through thing first hand. I hope all stay well Take care Ken
oldbuzzard FLDave
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FWIW, my doc says that weeks 6-12 generally provide the most improvement, so you may well get better still.
jimjames FLDave
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Thanks for sharing your experience and glad things went well. Do you know what your post void residual (PVR) was before and after Rezum? That is one factor that can effect night time frequency but your doctor did mention some others.
I second your suggestion regarding prophylactic antibiotics for these types of procedures, including even cystoscopies.
Jim
randy_85492 oldbuzzard
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Old Buzzard, I'm taking both Tamsulosin .4mg and Finasteride 5mg once per day...Finasteride is suppose to Reduce the number of times I have to go pee and, especially, at night...The Tamsulosin is suppose to help prevent Retention..Neither seems to be helping me that much..What's your experience?...Please Adise....
uncklefester randy_85492
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Fernasteride is supposed to shrink the prostate but it takes time 6 - 12 month. Tamsulosin should work fairly soon. When I started taking Tamsulosin I was taking it at lunch time. It didn't seem to help much. I switched to 7:30 at night and things have been better. Remember to watch your diet. It can raise havoc with your prostate
mike588 randy_85492
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Finasteride might work if it shrinks the prostate but it will also shrink your libido I would avoid that one altogether - Tamsulosin works well but gives you dry orgasms. If you are taking both and after a while it's still not working you might need surgery. Many opinions here as to what is the best surgery.
oldbuzzard randy_85492
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Randy - I never tood FInasteride because there not only does it often kill libido, sometimes it never comes back so I said no to that one. I later found out that because my prostate problem is more the direction its growing (inward) than its size (30) that Finisteride wouln't have worked for me anyway.
I took Tamsulosin and didnt like the RE or occasional dizziness so I switched to ALfusosin which had no side effects for me. I'm not sure either drug helped much, but I stayed on alfuzosin because it didn't bother me and I figured that even a minor improvment was worth it with no other problems.
I ended up having Rezum done and my story is documented earlier in this thread
uncklefester oldbuzzard
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Pldbuzzard, Thats something I didn't know regarding the fenasteride. I don't know my prostate size, myn uros haven't been forthcoming withat info. I have a new one now that is contacting the radiologist that did mt CT scan. All 3 uros have told me my prostate from the DRE my prostate is ~ 35 - 50 grams.It seems kind of small compared to other fellows here. I assume mine is growing inward also.
oldbuzzard uncklefester
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jimjames uncklefester
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Hi Uncklfester,
My understanding is that DRE is not a reliable indicator of prostate size.
Didn't they do imaging before you started the Fenasteride. Really should of if not for initial diagnosis but at least to gauge progress accurately.
That said , if future imaging shows it to be at all in that size range it begs the question why you are on fenasteride in the first place with all of its side effects?
Sometimes urologists just throw the book at a problem -- be it with drugs or surgery -- rather than follow the Hippocratic oath and do the least harm.
I know you've seen multiple uros but maybe time to look again. Preferably someone at a larger teaching hospital who will be more up to date on testing and protocols.
Jim
randy_85492 oldbuzzard
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uncklefester jimjames
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Hi Jim,
Yes my orginal uro did imaging, CT scan with contrast. He wasn't very forthcoming with info and pushed to do TURP. By the grace of God my work schedule interfered my TURP procedure. I requested fernasteride to hold me over while I decided which procedure to go with. Then I started researching procedures and realized TURP wan't the be all to end all. My present uro is definitely up on the latest advances. He specialty is HOLEP which is why I selected him. Trying to get to the bottom of my bleeding problem is difficult. If blood isn't coming from prostate why would I have surgery you may ask. Trying to pass some rather large clots through an enlarged prostate can be scarey. Problem is, the bleeding episodes are months apart. ( Thats not a complaint LOL ) Hard to chase it down when its like that. When I was scoped last year they saw nothing in my bladder. My uro just said I had a swollen and inflamed prostate. Honestly, its tough getting answers
randy_85492 uncklefester
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The Only problem I am having presently is having to pee too often AFTER MY REZUM PROCEDURE...I go 4+ times at night and 3-4 times the rest of the day..My primary care doctor prescribed the finasteride to HELP REDUCE the NUMBER OF TIMES I had to pee everyday...I've been taking it for ~ 3 weeks, but there's No Improvement...My current URO states if I Stop Taking Tamsulosin, I'll Cause Retention....Thus, I'm stuck for the present with Two Meds that don't seem to be helping....In thought After the REZUM neither Retention or Having to Pee more than 1-2 times at night and 2-3 times during the rest of the day, ie. 3-5 times total, would be the New Normal for a person my age, 72 years old.....I expected my Bladder to relearn and Reduce the times I had to Pee to the Normal Number...I had my REZUM in mid-August and came off the Foley Catheter ~ 1.5 months...The Number of Times I'm having to pee per day is not improving/reducing. So what do I do now?...Jim James and Old Buzzard - Can you adfvise too?...
oldbuzzard randy_85492
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It doesn't sound to me as though retention is a likely problem. 3-4 times day isn't bad at all - most people go more than that. IF your Rezum procedure was performed correctly, your prostate shouldn't be a problem any more, at least not one that could cause retention.
It sounds as though your bladder is the problem - if there even is one. My doc told me I might have urgency issues for as much as a year, so this is probably your body reacting normally. You can likely drop the two meds right now with no impact on how well or often you pee. If I'm wrong (which I doubt) then you can always start them up again and self cath until they start working again. FInisteride takes 3-6 months to hve any impact - so I doubt its doing anything anyway.
You might try Myrbetriq. It will help with the urgency, but will also weaken your bladder push, so be prepared if you have any trouble pushing things out. Again - if adding or dropping any med causes a problem, you can self cath for a few days or a week until you get things working again.
To summarize - you are probably just dealing with normal urgency that's to be expected after the procedure. Your doc clearly doesn't understand your problem (and may have other issues as well - leaving you on a foley for 6 weeks was not only not part of the recommended protocol, it was pure torture) and you'll need to either find another or direct him pretty forcefully IMO. You should: get set up to self cath as a back up (which I don't think you'll need but is great to be able to do and will keep you from ever going to the ER for retention), get off the drugs you're on and consider going on myrbetriq, which might make your night time urgency less severe - but either way, it probably gets better on its own. If you're peeing well, the rest will probably take care of itself over time.
jimjames uncklefester
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Hi Unck,
I would ask for a copy of that CT scan with contrast so you will have prostate size and other info in black and white. Always ask for copies of everything as unfortunately they are not always offered.
I agree that you should make best efforts to locate the reason for the bleeding or otherwise it's a fishing expedition. And once you do locate it, make sure that the procedure offered will have a reasonable chance of fixing the bleeding.
Jim
uncklefester jimjames
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Hmmm I didn't know I could get copies of my scans.
I wonder, is it possible to have my next cystoscope recorded.?
jimjames randy_85492
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Hi Randy,
Finasteride to reduce frequency? I thought frequency was one of its side effects? Not a great drug IMO for a number of reasons. Recomended by a primary is not a recommendation. What does your urologist say? Personally I'd stop it right away unless presented with evidence against. And even then, I'd probably still insist on stopping it to see if my frequency decreases off of it.
As to Tamsulosin, how does your doc know your retention will increase without it? Do you know your current retention? I would get your current retention in numbers with Tamsulosin and then do a trial off Tamsulosin and have your retention measured then. I don't remember how much of a pain CIC was for you, but one advantage is that it's a highly accurate and instant way to measure retention any time you want, right at home! Alternatively you measure retention at your docs office via bladder scanner but make sure you do not artifically fluid load before.
I understand doctors can sometimes be overbearing and all-knowing, but in the end it's your body and the decisions should be yours. What I've found is that as long as my suggestions to the doctor were reasonable, they will go along even if they are not smiling at my involvement. If the doc won't go along with a reasonable request either find an advocate who can accompany you to the doc's office to help plead your case or find a doc who will listen and respect your wishes.
Jim
jimjames uncklefester
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Are you in the USA? If so, I don't even think you need to get copies through your doctor. Just call the imaging lab and tell them you want copies. They may fax you a release form but that should be it.
I think getting a cystoscopy videotaped would be great. Please let me know if you find someone who will do it. In concept, not only great for a second opinion without a second cystoscopy but getting it on record would no doubt make the physician do a thorough job.
My last cystocopy was so short it could have been sent via snapchat
And when I asked questions a week later about things other than the purpose of the cystocopy (bladder cancer screening) I got the distinct impression that the urologist was winging it and had forgotten everything he saw except for his report.
Jim
uncklefester jimjames
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Yes I am in USA. I had the same experience with my cystoscopy thats why I'm thinking about a video of it the next one if the new doc will do it. . I'm sure they do so many of those things they just look for abnormalities and forget everything else. Last time, the doc had the scope inside me, while he was telling me the results of my CT scan
I'm thinking, "Are you even paying attention to what you're seeing?". Anyway I think I will make phone calls for copies of my scans. Thanks for the heads up on that. I wonder if I can make an appointment with a radiologist to see what they think of my scans.
jimjames uncklefester
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Unk said: Last time, the doc had the scope inside me, while he was telling me the results of my CT scan [eek] I'm thinking, "Are you even paying attention to what you're seeing?".
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I think we have the same doctor
My guy was obviously running late and was in and out before I could ask my questions. And I mean out the door! When I asked the nurse if he was coming back, she said, "no he's finished".
Jim
kenneth1955 jimjames
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Jim and Un I got one for you. I have a stricture and he checkes it ever 3 months. He put the scope in and said the strictures is fine and I could feel him going in more and then I hear what is that. I'm thinking to myself excuses me. And he goes a little more and said what you have there. I felt like saying you got the camera what hell is it. That is when he found one of the implant let loose. Take care guys Ken
uncklefester jimjames
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I know what you mean. Mine did the thing. The scoping took all of 3 minutes. He said I could watch the video screen. I loook at it and its not working. Nurse says that hasn't worked in a while
I'm thinking what kind of half assed outfit am I dealing with. Then he says ( with the scope inside me ) I need to do TURP because drugs ( meaning fernasteride but he didn't call it by name ) take too long to work. He didn't even prescribe Flowmax to help with flow while I waited for TURP to be scheduled. I started educating myself on TURP and prostate issues. I requested a sugical consultation. I asked how eactly will you be removing ecess tissue. He wouldn't be specific, he just rattled of oh maybe laser, maybe heat, maybe radio waves etc. I asked him to prescribe me fernasteride while I waited for my postponed TURP to be rescheduled. That was it, I went to another uro in a competing hospital. My first uro is well regarded and affiliated with one of the biggest & best hospitals in the area. Scarey when you think about how little information he was willing to give me. I really believe he set me up to have another bleeding episode by not prescribing flomax.
uncklefester kenneth1955
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kenneth1955 uncklefester
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