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

Good morning Lee.  I know that sucks.  I hated it I know it been over 4 weeks now but remember you just had surgery and your prostate is smaller and you were on Rapiflo and it will cause retro ejaculation. I was on flomax and rapiflo it took a month for that to get out of my system  It may take a while.  From what I have read about the Rezum procedure you will have less of a ejauclation because the prostate is smaller. Give your self some time to heal.  Good luck my friend  Hope you heal fast  Ken   

Hang in the Lee. Follow Ken's advise. The drugs will cause retro. I know its frustrating but don't unload on your doc just yet. Many of these procedure take months to heal. Best of luck to you

Lee,

These guys gave you good advice.  I had a couple of instances of retrograde during my recovery.  I think combo of drugs and procedure impact may be the cause, but no retro anymore for me.  My ejaculate amount is lower, I think due to smaller prostate size.  At 59, my sex life is still very important to me as well.  One big reason why I picked Rezum.  Sorry you're struggling.  I hope it gets better.

Nick

Thank you Nick.  Lee need all of us to give him hope.  He just has to let his body heal.  Glad all is going well for you now.  Take care   Ken 

Incidence of RE is 3.9 %. I had Rezum done in March of last year and had sex days (don't remember if it was 4 or 5, but something like that) and ejaculated fine - although at that time I couldn't pee at all and was self cathing. The doc put me on Rapiflo to try and help that and I went dry immediately. I stopped the drug after less than 2 weeks (didn't help me pee, gave me RE and other side effects) and recovered some over time - I don't ejaculate as much and it tends to be delayed by 5 - 10 seconds or so and is most normal if I go at it again within 2-3 hours.

I'll never know if it was the Rapiflo that interacted with my Prostate during healing or something that would have happened as I healed regardless (my Urologist's thinking) but Rezum definitely gave me sort of partial RE.

By the way, prostate size has nothing to do with the amount of semen you ejaculate as it doesn't produce it, just pushes it out. I doubt you have a legal case as they do publish the stats on RE and I'm quite sure that they have had their language written by attorneys to preclude any such action. I hope that over time things get better for you - they did for me - not as good as I had hoped but better than I feared. 

Good after noon Lee.  Just checking on how your doing any better.  I hope these have changed.  Ken

Funny, everyone is laughing and jumping around on the flashy REZUM web site

-- Jim

What happened to you is not supposed to happen and isn't at all typical. If you haven't already, contact your Urologist as something is wrong.

Man, I totally agree.  I am aged 51 and going on 2 months since Rezum.  I've pretty much got my life back with this simple procedure that seems like a miracle.  I remember when I couldn't even go to the track and walk one mile before needing to go.  BPH affected so many areas of my life.  Knowing that many of these folks on this thread might be on the fence, I started my own detailed experience I had with Rezum.  Unlike your experience, I saw tiny pieces of scab coming out in my urine for about 2 weeks.  The information on Rezum is that it will take a full 3 months to determine my maximum recovery but given at where I am at now, I'd be more than happy w/the progress I've made to date.

https://patient.info/forums/discuss/rezum-treatment-details-553352

Please comment and let me know if your experience was like mine.

Dr. U rocks. He did my Rezum in March, my results aren't quite as dramatic as yours and it took me 6 weeks til I peed better than before the procedure, but I'm way better and glad I did it. He's been treating me for several years and I didn't want the greenlight, so he kept me up to date on Rezum and when it was FDA approved (so insurance would cover it) I jumped on it.

I'm amazed at the varing degrees of satisfaction with this procedure.

Outtatoone and Dave78,

Congratulations on a successful procedure!

Both of you mentioned that urgency and other issues were resolved by REZUM. What about retention? Did you have retention prior to REZUM and do you know what your PVR (post void residual) was? Did either of you do a trial with Tamusolin (Flomax) or similar before surgery? What diagnostic tests did your doctor perform -- cystoscopy? ultrasound? Urodynamics? Other? Do you know what your IPSS score was prior and current?

How about sex and ejaculation. Any changes after the procedure? Any retrograde ejaculation (dry orgasm)?

Apologies for all the questions, but as you know, everyone doesn't get the same results even from the same procedure with the same doctor. A lot has to do with the anatomy/condition of both prostate and bladder prior to surgery.

Jim

 

Unklefester,  be careful with people who blog You can not believe everyones story.  Example being the guy complaining  about getting an pain killer shot up his anus, or the scope in his penis, or bleeding for 3 days.  If you honestly have a BPH problem these matters are trivial.

Vise versa  I am sure that different companies promote their own products on these sites.  Acting as patients.

All I can say is that.  I do not tweet.  I do not blog.  And I usually to not supply my opinions even to my closest friends.  But this procedure so dramatically improved my life and with little to no side effects I would gladly do it over and over if necessary.

Obviously everyone does not receive the same results of any procedure.  

Glad all went well for you.  Hope more men would go that way instead of surgery that cause more problems  Happy healing  Ken

Unk: I'm amazed at the varing degrees of satisfaction with this procedure.

-----------------------------

You will find the same thing in the PAE and Urolift threads. You will the same with GreenLight, HOlep, TURP, and any other procedure.

It's not the procedure. It not necessarily even the doctor, although that may be the case sometimes. Most often it's the pre-existing condition of both prostate and bladder that determines what the outcome will be.

That's why it's critical that doctors pre-screen and use a suite of diagnotic tests including the gold standard -- video urodynamics -- to better predict what a given outcome may be. Unfortunately, this doesn't happen much of the time.

Jim

Sometime it does take a couple of month's.  I'm from Orlando and my Urologist is starting to do the Rezum procedure in office.  I think He is a great guy he is always learning new thing to help his patients...Ken 

Thank you Dave.  You also have to remmember that all men heal different.  Also somemen can't take pain. And also some men over exaggerate everything.   Life goes on but we deal with things in our own way..  Take care glad all woked for you.  Ken

I will try to reply to all your questions as best I can. My post void residual was about 220cc prior.  It is currently 60cc.  I had flomax as well as every prostate and bladder medication ever made with no results what so ever. Again I have had this problem since my 20s and I am currently 65 so I have been through every battery of test ever thought of. cystocopy, ultrasound, urodynamics etc..  I am not sure my IPSS score but it was pathetically poor.  Getting up 7 time in the middle of the night and urinating almost every 15 minutes.  Knowing where the restroom was in every store we shopped.  And no longer being able to take hikes with my wife in the park defininitly put you at the bottem of the list. When I was 55 my 85 year old father used to laugh at me for urinating so often and his prostate was probably twice the size of mine. (it is not necessarily the size as much as the restriction on the bladder and uretha)

We had sex almost immediately.  As soon as the doctor said it was OK.  I am not sure now if it was after the catheter was removed 2 days

or if he recommended slightly longer but it was not an issue.

Currently we are having the best sex of our lives and I am not exaggerating.  I do not experience retrograde ejaculation and with this procedure it is much less risky.  And my orgasm are massively more explosive than before.  If I had to rate them I would say my orgasm is 5 times stronger and longer than before.  I never complained before but the improvement is dramatic and appreciated.  I honestly do not know if this has anything to do with the Rezume procedure.  And It probably doesn't.  But, it is a happy result I have experienced since the procedure. (probably just the fact that my wife and I can enjoy the moment and not have to worry about me having to stop and go to the rest room,  who knows)  

One other thing to think about is if this procedure does not work you have the option to do it again in 6 months or do another procedure if you perfer.  This was a major selling point to me.

Your statement of everyone not getting the same results is absolutly right and that is why I have waited so long since my procedure to even comment.  But I finally felt that if I could help one person similiar to me I would be accomplishing something constructive in my life.

Good luck with your research and I do wish everyone on this site could experience the dramatic results that I have.

Jim, my PVR was normal and I was on Flomax for several months.  I saw noticeable improvement from the drug but I hated the RE and the thought of all these chemicals in my body.  My Rezum details has much of what you are seeking.  Now that Flomax is completely out of my system and reduced obstruction thanks to Rezum my sex life is back to normal.  One of my friends is a urologist and he was recommending Green Light.  This made my decision all that more difficult.  I see my doc friend regularly and I am hoping to make him a believer as well.

Check out all the details here:

https://patient.info/forums/discuss/rezum-treatment-details-553352

 

Outtatoone and Dave,

Your answers seem to confirm what the literature says about surgical outcomes. Neither of you had significant rentention which often suggests LUTS (lower urinary tract symptons) being caused primarily by outlet obstruction (prostate) as opposed to detrussor contractability (bladder tone). Conversely, those with significant retention from poor detrussor contractability cannot expect to necessarily achieve the same results both you did, be it with REZUM or any other procedure. Positive Tamsulosin response has also been suggested here (a patient of Dr. Bagla quoting him) as an indicator of success, so it's interesting that Outtatoone (no retention) had a good response versus Dave (no response) who had moderate retention. 

I'd like to emphasize that the above symptomatic associations with surgical outcomes is no substitute for careful examination and testing, including the gold standard -- video urodynamics. 

It's great that both of you had such good results. My purpose here is not to critique either of your doctors as to how well you were (or weren't) screened but just to point out that surgical outcomes are often more of a function of the details of ones pre-existing condition than the doctor or type of surgery itself. 

This is not to say all surgeries are equal, as the side effect and recovery profile can vary dramatically, but that the right procedure for one person may not be the right procedure for someone with different pre-existing symptons. And in some cases -- signifcant retention for example -- good surgical outcomes are questionable for all procedures without proper urodynamic testing. 

The problem is compounded by the fact that many urologists only do one particular procedure and tend to push that procedure on all of their patients without proper screening. Those can account for the stories of bad outcomes, regardless of procedure.

Jim

Your improved orgasms are almost surely because of the procedure. They don't let you post URLs here, but google Dr. Ulchaker and Rezum and you'll find a study that he participated in that documents that as a side benefit for many.

All of this can vary a lot. It turns out that I have an underactive bladder, which limited the relief I got from Rezum, as that was an underlying issue. Still well worth it for me, but that's a sidebar. Also, despite bladder AND prostate issues, I never suffered from significant retention, just trouble peeing and urgency.

u

I for one, am glad that I skipped all of those tests (I only had a scope). Yes, they probably would have predicted that I would still have some minor issues post procedure and perhaps even predicted the longer wait til beeing able to pee than most. But all of that would have come at considerable expense (mostly covered by insurance, but somewhere, someone pays for all of it), time and delay. My doc knew that my prostate was for sure a big part of my problem and that I was likely to get significant relief from the procedure. Everyone is different, but I'm glad he didn't put me through any more tests than he did.

Dave; Now that you have had the Rezum procedure over a year ago are there any "side effects" that you can tell us about???   I have had 2 Urolifts and have a total of 8 implants in me.  Its working out ok but I still get up on average of 3 times per night.  I've just learned to deal with it as they say.  How many times nightly are you getting up to pee???? I guess that would be my #1 question for you.  How big was your prostate???  Mine is between 45 and 50.

CHuck - sorry to hear that you're still getting up that much. How often do you have to go during the day?

Its kinda funny "OldBuzzard" but during the daytime I can hold it really good.  Easily 3 hours or even longer.  But at night you are at a "different angle" on the bladder and that makes a difference atleast for me as to how often I have to get up.  I would say 3 times per night is the magic number for me.  Iam not a very good candidate for the Rezum because my Urologist said he would probably have to take out some of the implants then.  So Iam going to wait and see how many guys have "Good Success" with the Rezum before I jump in the pool again.  You might remember I was one of the "early ones" to get the "PAE" procedure with no luck whatsoever. Then I've had a "Urolift" twice now and thats how I ended up with 8 implants instead of the normal 4. So I would imagine you might feel the same way after 3 procedures now that Iam in "No Hurry" to do a 4th procedure. 

I agree with your major selling point. It is the same for me. If my first REZUM treatment would not be sustained enough I would go at least for a second one. As I have posted here I was suffering on a urinary retention caused by an obstruction in the prostate and I had suddenly to live with a permanent urethra catheter. I had chosen Rezum to get free of it again and to avoid retrograde ejaculations. And since 2,5 weeks I know Rezum has worked for me. But because of the retention it might be that the obstruction needs a second shot. But that will be the outcome of an appropriate medical examination and so far I'm ok with the current results of my Rezum treatment.

chuck I have thge same problem. I pee maybe 4 time the entire day. I lay down at night and I pee every 15 minute for an hour or so. Quite a bit also ( ~300 ml ) Also at night my stream gets weak. ?During the day its fine

Chuck - I get that you aren't ready to jump into more procedures. Besides, if you can go 3+ hours during the day and pee reasonbly I doubt anything else would make it better. A lot of your issues may just be relearing to wait at night. If you can, try going back to sleep when you wake up to pee. The angle may have something to do with it, but I know that after Rezum, my days were better but my nights weren't and some forced retraining made it better. Most nights I get up twice - once in ahwile 3 times and occasionally only once. For me, it all depends on volume - when I have to get up a lot, theres a lot of liquid.

I did fail to mention that after the urolifts that I have had I have gotten off all prostate drugs.  Now the beauty of that is that my sex life is also great.  No retro and a wonderful climax.  Or as my partner says are you going to make me "messy" and I say "you can count on it".  Ha Ha Hope you guys have a sense of humor. 

In all seriousness, she really doesn't mind. 

OB, You didn't have retention, so your doctor concluded it was obstruction and not weak detrussors. If you had retention, it may not have been so clear cut and urodynamics could help predict outcome. It's not any more invasive than cystoscopy.  

Jim

Jim,

I am failing to see what the urodynamics would tell you. If you have retention or not, what will it show? And would it make a difference in what direction you go anyway?

I have retention at times, but having video urodynamics won't fix that. All the doctors I have seen believe it is in part caused by my prostate, even though it isn't really that large. So they are all proposing some sort of removal of the obstruction, to make it easier for my Atonic Bladder to get rid of the urine.

i had the Itind done, and that really didn't fix things, so have been looking at FLA and Rezum as other options. 

I have seen you mention video urodynamics as the gold standard in several responses, so I am wondering what that might tell me that is going to help my situation.

Thanks

Motoman have contacted Dr, K ?

Motorman,

Urodynamics will quantify the obstruction through pressure flow analysis. It may turn out that regardless of prostate size, the lower urinary tract symptons (LUTS) are not being caused primarily by the prostate. If this is the case, then any type of prostate reduction surgery/procedure -- be it REZUM, iTIND, PAE, TURP, etc. -- will not work. 

So what difference would it make? I can give you my own example. I came to my doctor with significant retention three years ago. Based on this, he didn't think any procedure would help my then stretched bladder because even if the obstruction was removed, what guarantee did I have tht : (1) my detrussors would be strong enough to void completely; (2) that it was an obstruction problem to start with?

For those reasons he suggested 6 or 12 (can't remember) weeks on a cathether (or CIC) to decompress the bladder followed by urodyamics. The concept is that after 12 weeks the bladder isn't going regain much more tone, so urodynamics will be done when the bladder is optimum.

Because I was not at all in a rush for surgery, I probably waited three months before I had urodynamics. It showed high pressure, low flow, which is the usual indication for prostate reduction surgery. Had it showed low pressure, low flow, then I would have 'failed', meaning they would have not considered me a good surgical candidate. There are studies that also suggest the same. 

Where my case differers from the studies is that I showed that bladder decompression through CIC can continue to help with bladder tone beyond the 12 week period, even beyond one year. So, at some point, my bladder got healthy enough without surgery. 

No doubt I had (and still have) some obstruction. At day 1, probably no surgery would have helped because my bladder was so stretched and my detrussors so weak. At three months, my bladder was probably in good enough shape through CIC for a successful surgical outcome, but not good enough to void properly without surgery. At 2 years my bladder was in even better shape allowing near normal voiding function without surgery and without CIC. This is where I am today. 

Jim

 

Motorman and Others,

You can google this for more information. Article by "Nitti".

"Pressure Flow Urodynamic Studies: The Gold Standard for Diagnosing Bladder Outlet Obstruction"

CORRECTION: Where in the first paragraph I say "will not work" , it is more accurate to say "it will not work as well, and possibly not at all"

Motorman,

I answered before in general, but in your specific case urodynamics, by quantifying your obstruction through pressure flow studies, would help you decide if your first course of action should be to remove more obstruction (surgery) or to focus more on bladder tone. I was able to do the latter through CIC but there are classes of drugs now being used to help atonic bladders where LUTS is more secondary to the bladder than obstruction.

Jim

Jim

It has been a little less than a year the actual procedure was about mid April last year. My prostate was estimated at about 50mm also but it was badly expanded in the bladder neck region.  Making my bladder neck look like a cone rather than a funnel. My doctor focused on this area so as to get it to shrink the most.   I have had no side effects  2 or 3 days heavy bleeding.  3 or 4 weeks of mild blood in urine. Chunks of skin in urine for about 6 weeks.  And as I mentioned previously 1 big marble size ball of skin at about 5 weeks.  No retrograde ejaculation.  And no sexual disfunction.  In fact as I mentioned before my sex life has never been better and my orgasms feel much stronger.  I went from urinating every 5 minutes and getting up 7 times at night to urinating every several hours and maybe getting up to urinate only 1 time at night probaly about 50% of the time.  Other days I do not get up at all.  I have gone from urinating at a maximum of 200ml sometime  only a few drops to now urinating at a minimum of 600ml up to 850ml.

This has honestly been the best decision of my life.  I love my wife dearly and feel my decision to merry her was the best decision of my life prior to this.  But push come to shove the misery I was in prior to the Rezume and how well I feel now I feel I would choose the Rezume procedure as my best decision.  I would never tell my wife this though.

Thank you.  I will look it up.  I do not know why he did not share this info with me, but I am not complaining.

Jim,

Thanks for the reply. I have had the urodynamics test done before, but not video urodynamics. It showed low pressure. Three different uro specialists have suggested removing any obstruction would be better than doing nothing. My PVR is almost always really low, and when it is not, I can tell. That is when I will use a cath, it has been happening more often lately, almost like a swelling.

I am not aware of any bladder medication other than Bethanechol, which I learned about on here. I have tried it, but mixed results with that.

If you have low pressure then your outlet obstruction cannot be quatified. So hard to tell if it's outlet obstruction or compromised detrussor function. Sometimes in these cases doing nothing is better than doing the wrong thing. Not sure where the low PVR fits into this.

Bethanechol has had mixed reviews and isn't used that much anymore, however other drugs are. Just not sure if you're supposed to use them if you have obstruction, which is unclear in your case. I'll try and dig up something I read on these drugs. Sounds like it might be a better next step than surgery. Meanwhile CIC might help if those PVRs increase. Helped me.

Jim

I sent you a private message with a couple of links. You might want to further search under "underactive bladder". It's a complicated subject and even the experts are winging it a lot for lack of clarity. Still, sounds like worth looking into this area before doing more surgery. I couldn't find the article about drug recommendations but will get it to you if I find it. 

Jim

I got it, thank you. Will check it out.

I am having an MRI next week. I'm hoping that will show something. 

I got relief from the Itind procedure for a while, but it went away. That's why I was thinking something like Rezum might be a good longer term solution

How long did relief last with iTind? Could it be accountable to any steroids they might have given you? If not, then maybe another procedure might help. Have you been following John's story with FLA? It's only one case, but I like the fact that it's so focused and exact. Maybe after Dr. K's trial there will be more data. Meanwhile, Dr. K. recommends a specific type of MRI, it's in the FLA thread somewhere. 

Jim

Hey there Out.  Not aren't you glad you dod not take your buddy up on the GL procedure.  I know it was hard for you to tell him know but I think no man want to lose any sexual function.  Take care and happy healing  Keny

I was told that there was nothing that could be done for underactive bladder. Is that true or not?

Underactive Bladder is a complex basket of symptons often characterized by a stretched (flaccid) and low detrussor activity. 

Sorry ... last post got cut off... try again...

---------------------

Underactive Bladder is a complex basket of symptons often characterized by a stretched (flaccid) and low detrussor activity. It can be caused by many things including obstruction (prostate), nerve damage, even years of bad bathroom habits such as "holding it in". Underactive bladder can be caused by BPH (enlarged prostate) but as the symptons can be similar, it's often confused with BPH which can result in failed surgical treatments. To make matters more confusing it often co-exists with BPH.

There are a number of treatments available, including bladder stimulating drugs, but the literature is mixed on how effective they are. 

Self cathing (CIC) is listed as a treatment but not a cure, and while that may be true, I was able to rehabiltate my underacttive bladder enough through CIC to avoid surgery and to finally pretty much get off the catheters with very acceptable voiding and retention and a low IPSS score.

Jim

 

I would say I had relief from the Itind for a few months. It was not from any steroids, I never took any. Just some NSAIDs when the device was implanted. And I had the real thing, as I went to Spain to have it done.

That sounds encouraging then for future procedures. 

Regarding the MRI, Dr. K (FLA) recommends the 3T MRI and also recommends I believe a particular brand of machine for best imaging. It's in the FLA threads or you could PM John. Also forgot to ask, what did the iTind docs offer in way of explanation?

Jim

How long did the iTind results last

I would say 3-6 months for the Itind results for me. But I'm guessing my Atonic Bladder doesn't help things. 

Good afternoon my friend.  Did they know that you had a Atonic Bladder before they did the procedure.  If you have your bladder fix do you think it would work better.  Just asking  Ken

Yes they did know I had an Atonic Bladder. The Dr recommended Holep to remove as much obstruction as possible to allow the weak Bladder to overcome anything. I did not want to go that far to begin with, and the Dr that did the procedure was OK with trying the Itind as a first step. He did say that most Americans seem more cautious than Europeans, who would rather be done in one procedure. 

I cannot bash the Itind procedure, as I am sure it is effective for most people. I'm sure the Itind people would rather I had never had this done, although it did provide relief for a while.  I was told PAE would not be an effective procedure either by Dr Issacson.

I still have the Holep as an option if nothing else works, as well as cathing. But I am not a fan of cathing, as it really affects my active lifestyle, and my travel plans. If I was older and hanging around the house more, it might be a longer term solution.

And I am not aware of any method to fix an Atonic Bladder. Just try to keep it from getting worse. 

Motorman: And I am not aware of any method to fix an Atonic Bladder. Just try to keep it from getting worse. 

--------------------------

I had a very atonic bladder and for all practical practices it has been fixed enough through self cathing (CIC) so that I can in most cases void normally without retention and live an almost sympton free lifestyle with an IPSS under 10.

This is not to say that CIC will rehabilitate all atonic bladders because everyone is different both in terms of bladder/detrussor health and the degree of obstructio. But it's logical to assume that I am not the only one who can fix their bladder through CIC.

Jim

Good afternoon Motoman.  I found a few ways to help a atonic bladder.  If you don't want to do CIC.  There are 2 non surgery procedures you can try at home.  You may have try this all ready.   The first one is called:   Crede is a bladder voiding technique in which a patient manually presses down on the bladder. In effect this squeezes the urine out of the bladder.  The second one is : Valsala another technique works by useing the abdominal muscles as if having a bowel movement.  This puts pressure on the bladder and forces urine out.  I would try anything before I have a surgery that may not even work and cause me more problems.  I can't see how cutting out your prostate will repair your bladder.  It's the same with a man on here Frank he is 87 has retension but the doctor want to do a turp but told him that it will not fix the retension and he will have to still to CIC.  Why have a surgery and it is not going to fix the problem but cause you more.  Good luck  Ken  I would ask Dr. Issacson to think about it again and give it a go make the prostate smaller  I forgot if you ever said your age

Thank you for that .... Jim

Yes, I am aware of the crede and valsalva methods. And aware of JimJames  repairing his Bladder somewhat by doing CIC. I would do the same if it gets to that point.

I would try surgery because 3 different doctors think it will help, and having already done the Itind, I know I got relief from that for a time. I'm willing to accept the risks to not have to live on catheters for the rest of my life if that is an option. I'm still relatively young at 53, and don't like the thought of needing to rely on catheters and a good place to use them. I was just on a 2 week trip to a third world country. All of a sudden I go into retention and realize if that continues I do not have enough catheters packed for the trip.

I was also in two situations where I had to cath myself on the side of a road in mixed company and that sucked. So willing to take a risk with the hope that things will improve.

At your young age the side effects are not worth a may work procedure.  Why can't you do Itind again or Try rezum.  At least they don't have any sexual side effect.  53 is to young to give it up and it can happen with surgery.  At 61  I would never do a surgery that will cause me retro ejaculation they suck.  Look into rezum there are alot of men on here that have had good outcomes.  Please give it a chance.  It may be the best thing for you.   Some men that have had it say that there erection are great and there orgasms are intence.  Good luck  Ken

Motoman,

Your approach makes sense. Just wanted to point out to others reading this that in some cases an atonic/underactive bladder can be rehabilitated through CIC to the extent that I no longer need to use catheters except on a very occasional basis. As for a travel tip for catheters, it's not a bad idea to pack at least one re-usuable catheter with you. By washing it after use, a single re-usuable red ruber or vinyl could last for weeks. 

A note on crede or valsalva. With little or no obstruction, OK. But not a good idea to use it on a regular basis if obstructed as it can cause fluid back up to the kidneys. On the the hand, gentle tapping on the bladder or other stimulations (known as reflux voiding) should not be harmful and can sometimes help get the flow started. So can changes in position.

-- Jim

I think you would be a good candidate for Rezum, PAE, Urolift or FLA. None of these are really surgery as you they don't put you under for any of them. Based on the posts here - 80-90% of men seem to get significant relief from them. The good news on all of them is that, aside from being minimally invasive, doing any of them doesn't preclude doing any of the others if it doesn't work. Given that you had relief for as long as the iTind worked, you're probably a good candidate for any of the four I mentioned.

FWIW, I have an underactive bladder (didn't know til after Rezum) which means I'm not perfect, but got a lot of relief from Rezum and am in no apparent danger for retention. At your age, being tied to a catheter seems unfortunate and inappropriate given all of the easy procdures available. I suggest waisting no time in looking into all of them and choosing one.

Ken,

Your response is predictable, because it is always the same. Sexual side effects are the least of my worries. If I can avoid them great, but peeing without needing a catheter to do so is far more important to me. 

I have had RE from drugs (Rapaflo) in the past. It wasn't great, but I could live with that if I could pee when I wanted to. And I read on here that RE from drugs is different than RE from surgery. The only way to know that would be to hear from someone who has had it from both.

Having said that, I am looking into Rezum and FLA, but would have Holep as a backup plan. I would not consider doing Itind again, as it was not effective for me. 

Jim, your symptoms seem similar to mine. Have you tried any procedures, or just use cathing when needed? And how long has this been going on? For me about 4 years. I think I ruined my Bladder in my 30's. I would get busy at work with customers and not be able to use the restroom. I actually thought it was a good thing that I could hold it so long not knowing the damage I was causing.

Hi Moto,

Interesting. I've also come to the conclusion that one significant cause of my flaccid bladder was "holding it in" as a younger man. It was sort of a "macho" thing to do back in the day but to do it all over again...

As to the Reader's Digest Version of my history -- 

Weak stream since my 20's, frequency from my 30's. I think the first time I was told I had retention was in my 50's but not sure about that. Retention started around 150 and went up to 300ml. Also, had a large diverticulum (bladder pouch) that could hold up to another 300ml when full. Flash forward to three years ago (mid 60's) where things started to go downhill fast. For four months (don't know why I waited that long!) I was only able to void by pressing hard on my belly (Crede Manuever). Frequency increased as only a little came out at a time. Finally saw uro and they drained 1.5 liters from my bladder via catheter after a 400ml natural void. I was overhydrated from drinking 9 glasses of water in the office, but still that's one h*ll of a PVR 

Uro suggested TURP (that's all they did) but wanted me on a Foley for six weeks first with follow up urodynamics to see if my bladder was in good enough shape for a successful TURP. 

I chose self cath (CIC) over Foley. Ended up passing on the TURP and continued with CIC. In the beginning, CIC 6x/day with 80 per cent of the void via cath and 20% natural although sometimes it was all cath. 

Over the next three years things became progressively better. There have been no prostate reduction surgeries/procedures of any sort. I did a few trials of Tamusolin and Daily 5mg Cialis with limited results. 

Today, most of the time I function pretty normally without any self cathing. My PVR (residual) is pretty much always between 50-100, occasionally a little higher and sometimes as low as 20. Void volumes around 250-350 when I'm hydrated. A little less when not and a little more with increased fluid intake. Average 1-2 bathroom trips per night. Occasionally more and sometimes none, usually based on fluid intake and daily activity or lack thereof.

The only hitch is that once every week or two I go into acute (or near acute) retention and cannot void. Still trying to figure out the reasons why but it most always happens with a very full bladder and I suspect prostate inflammation (prostatitis) is involved. The last two times this happened I was able to void after walking around a bit and doing some deep knee bends. In the cases where that doesn't work, I just pull out the catheter. But again, this only happens maybe once every other week. 

So, assuming my prostate has not shrunk, and giving the timing of everything, I think it reasonable to conclude that my improvement from being unable to void without bladder pushing to near normal function (IPSS in the 30's to now around 9-100 is due solely to bladder rehab through CIC. That, and I now try and heed nature's call. No more "holding it in"!

Jim

 

CORRECTION: My IPSS score (last paragraph) is 9-10, not "9-100" as written.

I know im predictable but that is a sexual function that I will not give up.  Some men have had surgery and there doctor tells them no problem And then when they have sex if they can it's not the same.and they just give it up because there is no feeling.  .  A man at any age should not have to give up sex.   I know peeing is your main concern.    But why give up one for the other.  Rezum and FLA are great procedure.  No Sexual side effects.  I feel you will be happy with either. I have never had surgery that gave me dry orgasm but I was on Rapaflo and Flomax.  When I had sex or masterbated  The built up was there but the orgasm went flat no feeling at all.  It was like I did nothing.  Got off them and had a Urolift  It's been 2 years and I'm still having fun.  Life is to short to give up anything but that is up to you.  I wish you well and good luck  Ken    

I get the impression from Motoman that he's not up for a self cathing program that might or might not work and could take years. He seems to want to find something that will take retention off the table and let him not worry or take any extra steps to pee. Rezum and/or FLA could well do that for him. You don't seem to mind dealing with a cath occasionally - but it sounds to me that if you ever had one of the less invasive procedures done you'd probably say goodbye to any chance of retention indefinitely and quite possibly forever.

Hi OB,

I agree. Just putting it out there for others as Motoman asked the question how I dealt with a similar issue. 

The procedures you mention weren't readily available three years ago when chose self cathing (CIC) instead of TURP. Had they been, I probably would have at least considered them. Not sure if the final word is in on any of them but PAE, Urolift, REZUM and iTind have my interest. Then there's FLA which concept I like the most because of the precision, but so far very little data, and only one case history here, although that was an excellent result. 

And you may be right that any one of these procedures could help me say goodbye to my very occasional incidents of acute retention. The problem is it comes down to risks versus rewards. Three years ago, when I was cathing 6x/day, the rewards would have been significant. Today, however, I'm functioning pretty normal 95% of the time. So the question is why rock the boat? As we can see here, all of the procedures mentioned (I'll exclude FLA because we only have one case) have had both successes and failures. Take REZUM for example and at least two cases here of retro ejaculation. Someone mentioned around 4-5% chance. I don't think I'd risk even that small per cent just to save me from cathing once every 14 days or so. 

That said, should my condition get worse (things tend to get worse as we get older , I might reconsider and take a hard look at whatever is out there then.  Again, risk versus reward. 

Jim

You are correct about me Oldbuzzard. I don't want to have to deal with catheters if there is a solution out there. I don't need to use them much, it is similar to Jim I think. But it is unpredictable when I will need them, and how many I need. I can almost guarantee any time I am on an airplane I am going to need to use a catheter, especially if there is turbulence. I'm thankful there are now Speedicath compacts that fit in your pocket.

 

Dear JimJames,

I am 8 weeks post procedure, flow is good and off all meds.  Though, I am experiencing dry orgasms, which is disappointing, not sure what is going on and if this will resolve.  I have another follow-up in 6 weeks .... though I am not sure if I want to wait this long.  

I am wondering if anyone else is experiencing these symptoms post procedure.

Regards,

Dave

Hi Dave,

I'm assuming you're not on any ejaculation inhibiting drugs like Tamsulosin (Flomax)? 

So, Rezum seems to be promoted as a fast and simple alternative to TURP without the sexual side effects such as retro orgasm. Apparently, from what I read in this forum that is not true. Someone said they were told around 4% retro (dry orgasm) but it sounds much higher based on the case histories here. Maybe someone will go through the Rezum threads and do a count. 

I don't know enough about REZUM to say if your retro is temporary or permament but it has been reported here before. I assume your doc didn't warn you about that as they didn't several others here as well.

Jim

Hey Dave sorry for your problem.  I just watched a video from The Doctors  The one doctor had the procedure done and he is fine.  The Urologist that was on said that there is a 5% chance to get retro.  But it seam like it should be more.  You number 8 that has been on this sight that has had the procedure and has retro.  I am trying to get some information from my urologist  He is just starting to do the REZUM  I'm trying to find out if the men will get there ejaculating back being the prostate grows also trying to get some information on the procedure if it can be done on the right side top and bottom and only on the top of the left.  not the bottom to try not to distroy the ejaculatory duct.  I have not heard from him yet and you can't get a straight answer from the company.  If this is what is going to happen the % should go up.  Alot of men are having this procedure because they assume they will not get retro  Take care  Ken   

Dave,

I was dry at 8 weeks and it partially came back. I tend to ejaculate less and its delayed by 3-10 seconds typically, but it varies alot. A second orgasm within 2-3 hours is usually more normal and I don't know why.

I caution everyone NOT to use anecdotal eveidence from this site to gauge the incidence of anything. Most of the people here are having an issue - the guys who have a procdure where everything happens like they were told tend not to seek out a forum to discuss it. This is not a scientific sample - and the collective stats from docs who do this and any other procedure are much more accurate.

My issues started AFTER my doc moved me from Alfusozin to Rapiflo when I couldn't pee (and never fully resolved - I had normal orgasms with perfedt squirts after the procdure but before Rapiflo) a couple of weeks after undergoing Rezum. I would be interested in see the numbers regarding RE on guys that on meds that cause RE post surgery and those that werern't.

Thanks oldbuzzard for your feedback.  I would have to agree that the forum does not provide scientific evidence, but does gauge what people are experiencing from the Rezum procedure.

Prior to my procedure, I was alfuzosin 10 mg (uroxetral) once a day.  I never had problems with ejaculation.  I have been off meds since early January, and have no issues with flow.  They said the flow will continue to improve over the next few months; will wait and see at 3 months if the stream becomes stronger.  

I will be seeing my urologist in a few more weeks and hope that this RE is temporary - they claimed that this therapy had none to minimal sexual side effects, but nothing is guaranteed.  

I will post again as I get more info; good to know you were dry at 8 weeks also with some partial recovery, will see what my urologist has to say.

Thanks again for all the feedback.

Dave