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

Wonderful news! We do plenty of patients awake, but I will usually offer anesthesia to prevent the discomfort of the procedure.

Your symptoms should continue to improve over the next few weeks 

I don't know I am a Vietnam Vet and requested to have it done with the choice program and if I am correct as long as I went as an out patient my co-pay would only be $50.00 per visit to  specialist other wise my co-pay at the VA is only $15.00 when it is non service related.  I will see when the bill comes next month.  I guess I was a little tired last night and my counting was off.  I realized it as only been three weeks since I had the procedure done.

I am still dealing with the UTI problem though went to the VA  Saturday for urine test and they confirmed I still or have it again and put me on 10 days of AMOXICILLIN three times a day. usually clears up in 3 of 4 days then I am good for a couple of months.  I do think that once the prostate shrinks down and my bladder falls back in place and I learn to drink more water that will go away.(I hope).

Just please do a lot of research on any procedure.  Todd had it done last June and it has done nothing for him.  He still has to do CIC.  All he got was retro and he is not happy.  He is only 53.  I talk with him a lot and it took him 6 month's to decide on the REZUM procedure.  Now he wished he would have wanted.  Just be careful Ken

 What is FLA ?   Procedure 

 went for a scope 4 weeks ago,urologist said,have to do it before he would even consider  rezum procedure.  Put me on pills to shrink the prostrate and will see me in a few months. I asked him if he would measure the size of the prostate again,  he told me he would not measure unless I book the surgery . Something don't sound right. Can anyone help me . Dave G. Ps  what size was 80 g in my PSA was 3.7 he thought everything else looked fine. I was doing fine on Flomax.

Stan,

FLA is promising, but make sure you read all the patient reviews, as they are scattered about this site. I believe there are about 12 reviews which I would call mixed. About half seemed to have great results, quarter marginal, and the rest failed. There have been no reports here of retro, but one person reported inability to maintain an erection that was not there before FLA. Fortunately, Viagra compensated. My take on FLA for BPH is that it's got great potential but very little patient data to rely on and no published study data yet. Result wise I don't see much difference between FLA and the other non invasive procedures such as Urolift, PAE and Rezum. All three of those also seem to have mixed results. The advantage of FLA is no retro ejaculation, but the once case of erectile dysfunction out of 12 gives me pause. Personally, I'd wait on this procedure until at least Dr. K. releases his trial data.

Jim

That is good to know but out of them men how many get retro.  Once it done it's no turning back.  I hate when a Doctor tell a patient that it rarely happens and when it does.  They are surprised.  I heard many doctor tell there patients it's only 4% but it is more like 15 %. They are there fix the peeing problem If something happens oh well.  They give them a pill but once you get retro you are stuck with it.  Todd told me he hates his orgasm they are flat and not worth the time.  At 53 why should a man have to live like that and it did not work for him.  I know you said that the majority  of the patients are please but once it done you can't go back. He is still doing CIC I have read many article and trail from the UK and the US on many prostate procedure.  This statement is in all the procedure.  It also state that committee accept that damage to sexual function is not commonly reported in many of the procedure because it is often regarded as a inevitable consequence of the procedure.  I take it in plain english.  That Most doctor don't care about a mans sex life.  They are there is fix the pluming and if anything happens oh well.  They will give you a pill.  I have talk to the inventor of the Urolift Dr. Ted Lamson we were on the phone for a hour.  He gave me a lot of information.  He told me I can talk to him at anytime.  Also had a nice talk with Dr. Gordon Muir in London about GL.  He sent me a article that him and he's partners wrote on a mans ejaculation.  He has found out that you do not have to get retro from any procedure.  It just takes time and you have to stay away for some of the area's.  I am not done talking to any doctor that will talk to me.   I will get all the information to help has many men I can to pic the right procedure for them.  I know you are a caring Doctor ( Because you are on this site.  Wish more doctor would join ) and you care about your patients.  But we have to work on making these procedure better and less side effect.  Take care  Ken And Thank you          

My suggestion would be a new doctor. First, if you're doing fine on Flomax, I don't see the need for any diagnostics in the first place. Second, why put you on another drug (with a decent possibility of side effects that occasionally never reverse after stopping the drug) if you're doing fine now? Remember the "B" in BPH stands for benign. Symptoms drive action with this condition, not numbers. Some with prostates as large as 100g have no trouble peeing and no retention. Mine measured 30g and the bathroom ruled my life.

And while I think refusing to do another diagnostic to see if the drug shrunk the prostate unless you booked the procedure is borderline malpractice - it won't matter anyway, because you're doing fine right now. I would find another urologist who is at least as concerned about his/her patients as he/she is about his/her net worth

Stan,

      My prostate was initially sized at around 50ml, but later by the Rezum urologist at 68ml. I was cathing several times a day for several months before I decided to go with the Rezum procedure. My PVRs were averaging about 200 - 250 and sometimes up to 350 or more. My biggest problem was the enlarged median lobe as well. My procedure was completely painless because I was given a sedative. I also had no pain after I woke up. I self cathed after the procedure to avoid using the Foley catheter, and that worked very well. I noticed a difference at around the 5 day mark; I could actually pee more than just a few ounces before cathing. I'm now about 6 weeks out and things are still going well. There was some minor discomfort starting flow for a while but that has almost completely disappeared. The procedure has had no affect at all on any sexual function, including ejaculation.

My Rezum urologist said that my experience is very typical. He has not had any patient who has had any sexual side effects, and he has done hundreds of procedures. 

Stan,

      I was seriously considering FLA before I visited my Rezum urologist. It helped that he didn't just tell me that it was for me. Instead I had to undergo a flow test and a TRUS (Trans Rectal Ultrasound) before he said that I was a good candidate. The TRUS allowed him to see the size, the enlarged median lobe, and gave him the locations to inject the steam. You probably wouldn't need the 10 injections that I received. The FLA sounds like a really good procedure with good results. But so does the Rezum, for most guys. 

Stan,

As I just wrote in another post, 1 person (8%) of FLA patients reporting here, had erectile dysfunction. Compare that 8% chance of erectile dysfunction against say a 10% chance of retro ejaculation with Rezum. Frankly, if I had to make the choice I'd probably take retro over erectile dysfunction. So, "it's only one person, only a 12 person sample", you may say. And that's the bigger point. We just don't really know with FLA for BPH because so few reported results so far.

But regarding "it's dangersoud to bladder and kidneys" -- retention is, yes, but self cathing is not. Self cathing protects both bladder and kidneys as well as any surgery or procedure, probably better because your PVRs will be zero after you self cath.

That doesn't mean you might prefer a surgical option, but you can feel secure that self cathing, even for life, will protect your bladder and kidneys.

Jim

Jim

Don't forget, if you have ED, you don't ejaculate anything so its not really a choice between the two. And I probably would choose a life of self cathing over ED. Just sayin...

Other than the PVRs, my situation was similar to yours, but my prostate was only 30, but with an enlarged media lobe. My IPSS score was close to yours (I don't actually remember the exact number) and I had Rezum done. My recovery was longer than many (was a good 6 weeks til I was better than before and close to 3 before I could pee at all) but it helped a lot and my IPSS score has been a 15 for 18 months.

Well, ED can be a bunch of different things. It's possible to ejaculate without an erection, so the hypothetical choice I posed does exist. But like yourself, I have chosen self catherization, so really don't have to worry about either as a side effect.

Jim

JJ - you've forgotten. I had Rezum and don't ejaculate much anymore. Sometimes I get surprised, more typically I get a delayed reaction 5-15 seconds after the fact. And I haven't had to self cath since I recovered from Rezum. But I still travel with em...just in case.

Jim

I am looking into GreenLight Laser instead of Rezum for median lobe/BPH. 

More precise, shorter recovery time...

Would you please give me your thoughts?

Thank you 

Most of our patients will opt for a minimally invasive procedure before moving on to a TURP-type procedure, but everyone has different individual expectations.

Mike,

     I will be interested in what JerseyUrology says also. I can't speak for those who have had Greenlight laser treatments, but I have had a Rezum procedure a few weeks ago. For me, it was a painless and easy procedure. It took only about 10 minutes, but I was out, so I didn't feel anything at all. I woke up comfortable and had no pain. When I woke up, I got up and felt fine. In about 5 days, I noticed an improvement in urination, and within a couple of weeks, I was peeing like I did 20 years ago. Absolutely no sexual side effects. Not retrograde ejaculation. I started with a 68 gram prostate and an enlarged median lobe that was growing up into my bladder. My understanding is that a GL laser is another method of 'reaming' out the path for urine through the prostate. Most of the prostate tissue will be left intact, including the median lobe that is encroaching on the bladder (in my case anyway). I'm sure that a GL laser is a huge improvement over TURP, but if you're a candidate for Rezum, I believe it to be a better alternative. 

Of course you make some very good points. The most important one, IMHO, is that we are all a bit different, and what works for one person may or may not be the ideal treatment for another. And the best treatment can't be determined without some testing.

And another point that is important to remember is that a forum like this, while it's a great way to learn more about the options, the experiences of individuals here may not be representative of a larger group of men.

Some men do have irritation for weeks after the Rezum, but most of those patients are still happy they went with this procedure.

Like you as I mentioned before opted for the rezum procedure since I was evaluated to be a candidate for the procedure. In my case I had local and was awake during the procedure; it was a relatively a bearable process to under go. A little over a month now I have great flow and still improving, no wake up calls during the night and no retro. In my case I had enlargement in 3 lobes (50 gram) at 6 treatments; once I was free of the catheters it has been only getting better each day.  I actually researched and sought out the treatment and I’m extremely happy with my results I’m experiencing.  As in your case not all outcomes from the procedure are negative or catastrophic.

Peter

Wonderful to hear

Most folks do very well after the rezum procedure.

Rest assured,  Medicare and insurance would not cover a procedure’s cost unless it has proven benefit with acceptable risk.

I agree with what you have to say; I realize as others have that typically the men who have positive results are not publicly vocal about their results nor visit forums such as this one, but simply move on with their lives. This can represent a skewed sample of results for the rezum procedure and may discourage or encourage those men seeking some assistance in deciding their course of action.  Whatever procedure any man decides on he should make hisself aware of the process involved for the procedure, especially in the case of local anesthesia where you are awake during the procedure. It’s important in this case to remain calm and avoid more stress than needed, stress will only enhance any pain and prolong the procedure. 

Peter

I thought you reported 5% earlier, but maybe that was an estimate and not from your patient sample, or maybe I'm mistaken. Here, we are finding at least 10% retro with Rezum, and that's not just patient anecdotals but what men are reporting their doctors are experiencing in their practice.

Jim

Fewer than 1 million patients have had rezum thus far, and it’s difficult to put an exact number on it. However, other than urolift, it is likely to be lower than just about any other therapy offered.

I would think that if a man does get's retro from a procedure.     The next time he would tell his doctor especially if he had concerns about it before.  It is only right.  With reading up on the procedure I have found  that the doctors have a better outcome if they stay away from the center of the prostate and not do it aggressively like most doctor are doing.  Because they don't care about the retro they are just trying to get you to pee better.  I guess that's life  Ken

I used to be in the research/data business and I can say conclusively that a larger sample won't impact your statistics at all. Whatever it is now with close to a million on the books is what it will be with 10 times that many, unless they perfect the technique some, which they may. 10,000 is way more than you need for statistical accuracy.

And let me tell you, RE sucks. It doesn't feel the same at all, If you really want to know, take Rapiflo for awhile and see how it feels. Its not life ending and I have to say that I'm better off with RE and not ruled by the bathroom, but while I can't speak for others, its not inconsequential for me. I'm blessed to be capable beyond my years in almost all things physical and this is the first thing I've really lost. As I said, not life or death, but its like you can't taste your favorite foods as well. You could still eat and like them, just not as much. 

Thx Old Buzzard. I agree!  Sorry to vent, but I  don't understand why most uros seem to think RE is inconsequential and hence don't seem to be going out of their way to expand their breadth of experience or improve their procedures to avoid it in the case of BPH. I think they look at RE as meaningless relative to life or death cancer treatments and just have not adjusted to a different mindset when considering it as a cost/benefit issue relative to relieving LUTS.  I think that is in part why it takes so long for something like EP Turp to even be considered , let alone perfected. It's a shame that this wasn't something Uros aggressively strived to discover/perfect from day 1, understanding that any loss of any sexual function is traumatic for sexually active men, especially single men without an understanding or reassuring wife, LOL!!!  My experience is that urologists seem content with the idea that RE is of little consequence relative to relief.  And even if it was "the same orgasmic feeling" , which it  is not, despite that they typically will sell that bill of goods, it is not the same experience , especially when considering both partners in the sexual experience.  Calling all urologists, THIS IS NOT "NO BIG DEAL" .  Stop impeding your efforts to strive for better treatments and/or to suggest alternatives to your patients because you are complacent about these consequences!  Especially when there are so many other procedures being tested  (like PAE or FLA which are not generally in the urologist field), this is a shocking "take it for granted" attitude, in my opinion.   Maybe these other procedures aren't the same immediate level of relief as TURP, or even as much relief in terms of flow,  elimination of retention,  etc.  But if they are enough relief to provide a happy and safe  QoL, without the cost of RE, potential incontinence or even risk of ED,  then I do not understand why most Uros 'poo-poo' the procedures as "not as effective" . They don't seem to understand that,  even still , they may be a more preferable path to many, if not most, IF NOT ALL, seeking relief from LUTS if they fully understand all the options.  Of course, in most cases that would mean guiding their patients to an interventional radiologist or a different urologist who does an alternative procedure that they don't do. Maybe more Urological groups need to start including the IRs as part of their practice and sharing. At the very least, they need to put more effort into figuring out ways to perform their more traditional procedures in more careful ways that will reduce the risks currently associated with them.  EP or Button TURP are good examples that just won't move fast enough to determine their relative success (and always start in other countries!!). I don't know how realistic or effective they are, but we'll find out many years later than we should. Meanwhile, those of us thrust into the serious end of the LUTS pool , to the point of blockage and catheters, are stuck with dilemmas and no great answers,  all while usually getting no help or guidance from the uros  in exploring and wading through the research and minefields. I know there are exceptions, but that has been my experience.  This is a life changing, serious ailment.  Urologists need to be less complacent about considering the various alternatives relative to a patient's lifestyle. Of course I would rather have a treatment that provided almost certain and relatively immediate relief, but at what cost? I hope the urological field will one day eliminate the passive view  toward RE and the other risks associated with traditional procedures and put more emphasis on eliminating these risks and human costs when it comes to BPH. 

I think urologists should, as part of their training, be forced to endure as much of what they put their patients through as possible. That includes taking alpha blockers that cause RE and wearing a Foley for a few days. Some are very callous about the impact of what they prescribe and do.

I'm fortunate that my Uro isn't like that. He compassionate and empathetic, but he's my Urologist because the first one wasn't. Maybe the reason some docs say no one ever complained about RE is that they felt they would be laughed at or not taken seriously.

Scott.  Good for you.  Don't do anything that you don't want to do. Let me tell you what I have got out of some of the article that I have read.  Many urologist do not consider a mans ejaculation a sexual function.  They like you say over look it and don't talk much about it.  They say you don't need it and a few doctors told his patient that it's easier to clean up and then laughed.  Doctor main concern is to get you to pee better if anything happens they trow a pill at you and tell you everything will be the same.  That is bull.  They will not be going through the side effects they just move on to the next guy.  Take control like you are doing and don't give in to anything you are not ready for.  Take care  Ken  PS  EP Turp still has a 10 % chance of retro.  That was the last trail I read on it 

Old  I don't know if when you read up on a procedure.  When it said side effects Retro is not the side effect that they care about.  It is like the 9th or 10 one down.  It is really no concerns of the doctor.  I am with you. Part of there training should be some of the experience that they put there patients through.  Maybe they would have more empathy for them.  Being on here 3 years I have read many reply's when a man tell's his doctor that the procedure gave him retro ejaculation.  First they looked shocked, They tell them I don't know how that could have happen.  Or the best.  That rarely happen's.  When you meet one of these doctors Say thank you and turn around and go out the door and find one that cares.  Good luck one and all  Ken  

Hey Jersey, r u familiar with the group in LA called Comprehensive Urology. They are connected to Cedars. They do Rezum out here, and just wondering what if anything you may know about their experience. Actually, I should say at least one of the guys in the group does them, because I know one of the Uros in the same group not only doesn't do them, but doesn't believe in them !!!!  And you guys wonder why we are all so confused!!!!!  THX !   ;-)

Hi JerseyUro,

Hi

Maybe you can help me on an unrelated issue. Not surprisingly, I've been colonized on and off with various bacteria over the four years I've been doing CIC, but for the last 6-12 months it's been Staphylococcus epidermidis. For the most part I'm asymptomatic.

I think we can rule out contamination because of multiple positive cultures and fairly sterile samples

taken directly from the bladder directly with an intermittent catheter. T

Urinalaysis always shows positive nitrites which suggest a gram negative bacteria. But Staph epidermidis is gram positive. Any thoughts?

Thanks for any help.

Jim

Cic isn’t sterile and there will likely be flora in a culture

That said, I always recommend evaluation by your urologist in person

Understood. Let's make this a hypothetical case and assume that the staph epi is not contamination. There have been documented cases of this and even symptomatic staph epi although uncommon.

So, (1) assuming I actually have staph epi in my bladder, albeit asymptomatic, why does the urinalaysis always show positive nitrities when staph epi is gram negative?; (2) Now let's assume it is contamination, so why do I consistently show positive nitrites? Multiple cultures show no gram positive bacteria? 

Thanks.

Jim

Correction: Last sentence should have read: "Multiple cultures show no gram negative bacteria? "

Another way of asking the hypothetical question is how is it possible to have positive nitrites in the urine but a negative urine culture? Online research suggests "positive nitrites highly specific for bacteria infection". The only thing I can think of is that there is colonization by a gram negative bacteria (either alone or in addition to staph epi)  but it's not showing up on multiple cultures. Thoughts?

Jim

"Asymptomatic" by CIC standards but urine does have leucocytes and blood compared to  periods such as after treatment for symptomatic utis where urine was clear. I have had the usual workups for stones several times because of the blood.

I understand colonization is normal with CIC and doesn't require treatment. The question was how can I have urinalysis with positive nitrites with a urine culture showing a gram positive bacteria? Positive nitrites are associated with gram negative bacteria, not gram positive and that's not "google" it's textbook. I did speak to my urologist about this and he didn't have an answer but thanks for your time.

Jim

Jim

Neal

How many steam injections did they give you and where in the prostate ?   Do you know if they injected in the median lobe ?  My prostate is about 70g and I also have the enlarged median lobe.

Thomas

       My prostate was measured at 68g. I got 10 shots, 4 on each side and 2 in the median lobe. I noticed a difference in about 5 days, and was peeing pretty much like normal within a couple of weeks. 

Ken

Ken, 

You stated "My Rezum urologist said that my experience is very typical. He has not had any patient who has had any sexual side effects, and he has done hundreds of procedures." Is he including Retrograde ejaculation in the no sexual side effects. Some urologists think that RE is not a problem for older men and don't even mention it in their results. I think you mentioned  the urologist is Kevin McVary, and he uses a TRUS test to plan where to give the injections, is that correct ?

Thomas

Jim

I'll try to answer your questions as best I can. 

Yes, my urologist for the Rezum was Dr. Kevin McVary, and he did use a TRUS to determine the size of the prostate. I really don't know whether this ultrasound also gave him an idea of where to inject since the TRUS was done several weeks before the Rezum procedure. I made the assumption that it gave him an idea where to inject, but now that I think about it, he would have had to have a video of the TRUS available to him at the time of the Rezum procedure. It would be too difficult to remember the anatomy of each and every patient when several weeks had passed between the TRUS and the procedure.

When he told me that RE just wasn't a problem with any of his patients, I believed him, and I still do. 

Jim,

      My second appointment was to get the urodynamic testing, and, at the same visit, the TRUS. Since I could only urinate a very small amount naturally and had to use a catheter for the other 400cc, and since the TRUS indicated a 68gram prostate, as well as the enlarged median lobe, I became a candidate for the Rezum procedure.

      I was given the twilight sedative. I don't know which one. But I woke up 30 minutes after going 'under', and felt just fine. 

      I found Dr. McVary by searching the Rezum website for the nearest urologist. I was fortunate that he was the closest, about an hour and a half drive. 

Ken  I have been reading your post on your procedure.  I don't remember if you said you have retro or not.  In the last line when you said he told you that RE was not a problem with his patients.  The was I  understanding that his patients did not care if they got it or not.  If he told you none of the patents that he has done did not have retro That would be more up front.  But what he told you is not answering the question.  I just got through sending a e-mail to the hospital to see if I can get a hold of him so he can answer the question.  If it is true that hundreds of his patients that he has done has not gotten retro.  He needs to tell the other doctor what he is doing so right so they can do it also.  Ken from Orlando  

Dee,

      No, the TRUS isn't painful. You lay on your side while a smooth, rounded device is inserted in your rectum. The urologist will move it slightly and rotate it to allow him/her to get a view of the entire anatomy. Uncomfortable? a little. But definitely not painful.

Ken,

      No, I definitely did not get retrograde ejaculation, and neither did most all men who have had the Rezum procedure. You seem to be very focused and concerned about the ejaculatory function of the men who have suffered from BPH. These men, like myself, have to choose which procedure to have done to them if they want to reduce or eliminate BPH symptoms and/or get off the drugs that they're taking for those symptoms. Yes, some men may end up with some degree of RE, but the relief of symptoms from BPH are a 5 - 10 times per day consideration. That is a huge improvement in quality of life.

Rezum may not be a perfect procedure, but in today's medical world, it offers a simple, almost painless (completely painless for some) and quick recovery procedure that also offers a pretty good guarantee (my educated guess is 98%) that you won't get RE. Compare that to a TURP where you get the same percentage guarantee that you WILL get RE. 

Your rants about retrograde ejaculation on this forum are doing a disservice to the men who are still suffering from the symptoms of BPH and are trying to learn from the experiences of others. Some may be avoiding Rezum because of your comments, and may end up choosing a TURP partly because their urologist offers it, but also because they think that, if they're going to end up with RE anyway, they might as well go with the TURP.  And what a difference in pain, recovery time, risks of side effects when comparing TURP to Rezum.

Your doc seems very thorough with both urodynamics and TRUS. Did he do a cystoscopy? Personally, I think it's a good idea but wth TRUS and urodynamics, I could understand a doc not doing one. I also like the fact that he offered twilight. There was another very good rezum doc mentioned by someone else but due to what I assumed were hospital constraints, he could not bring in an anesthesiologist for twilight. Some men have done very well with local, but others have complained about the pain.

Jim

Jim,

       I agree that he did a good job of qualifying me for the procedure. Perhaps his experience gave him enough confidence with just the TRUS.

       I was ready to insist on the twilight anesthesia, but he agreed immediately. I wonder why a patient anywhere else couldn't insist. Surely those urologists have done enough Rezum procedures to know that some patients won't get completely blocked from pain with a local anesthetic.

When your URO used the TRUS to pick locations to inject steam, do you know what locations he was looking for ?  Was it the median lobe, ejaculatory ducts, bladder neck, or other lobes ?

Thomas

Unfortunately, some doctors can't offer twilight because an anesthesiologist is involve, so it's always good to ask beforehand like you did. We have a member here who has been looking for a Rezum consult in the Chicago area and I will point him to your doctor. It seems to be the best non-invasive procedure available right now, especially for men contraindicated for Urolift and PAE because of large median lobes. I would consider it myself if my condition started going South but right now the marginal potential benefits would not merit even the very small risk of retro or other complications. Again, glad things are working out for you and keep us posted on your progress. As a heads up, some men report better sexual performance after Rezum.

Jim

Good morning Ken.  Very happy for you.  But there are many men that do nor want to lose there ejaculation function.  Most doctor do not consider the male ejaculation a sexual function and don't feel we need it when we get older.  The main reason the doctor is looking for is to help you pee better.  A man has the right to pick any procedure they want.  TURP's are not being done has much because there other procedures to pick from Got this from the Mayo clinic.  I feel if your doctor has a good run and no one ended up with retro. I wany to know what he is doing that the other  are not doing.  I feel this would be good for many men.  There are a lot of us out there that getting retro after a procedure is not want they are looking for. Why do we have to pick one over the other.  Ken

Yes, it's an ultrasound. TRUS = Trans rectal ultrasound.

Thomas, 

      I don't know for sure that my urologist was using the TRUS to determine where to inject, although he did note the enlarged median lobe. Other than that comment, I can't speculate on what parts of my anatomy he was looking for.

JerseyU,

      So, an anesthesiologist is required for a twilight or general type of anesthesia. But aren't they also needed for a local anesthesia? Perhaps not, but I just don't know.

      I see that the NxThera website emphasizes (over and over) that the Rezum procedure is a simple in office or outpatient procedure and does not require general anesthesia. It's clear to me that they are doing their prospective patients a disservice by over-selling that approach. 

      I applaud you and your associates for doing most of the Rezum procedures with a twilight anesthetic. From a patient's perspective, that is definitely the way to go. And from the surgeon's perspective, I would think that having a patient 'out' means that you can concentrate more fully on the technical task at hand without worrying about how much pain your patient is feeling. 

There are plenty who do this without twilight- there are plenty of men who will actually have a vasectomy without twilight- but I think these procedures are uncomfortable, so I offer twilight for everything 

@Ken: I see that the NxThera website emphasizes (over and over) that the Rezum procedure is a simple in office or outpatient procedure and does not require general anesthesia. It's clear to me that they are doing their prospective patients a disservice by over-selling that approach. 

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

Hopefully I get this right --Twilight is technically "general anesthesia" but it is a very mild form. So when someone states a procedure can be done without general anesthesia, they often are not meaning twilight. The other thing is that some men may not want twilight for a number of reasons. Rezum can still be done under local although many men (not all) report it can be painful.

Jim

Was McVary in Springfield when you saw him. That's apparently where his office is now.

Jim

My vasectomy was about 30 years ago. A local anesthetic only.  It wasn't fun, but I knew what to expect, so I don't remember it being all that bad. (but if I had a choice now, I would choose twilight!)

Jim,

      Yes, Dr. McVary is now in Springfield, Illinois and that's where I've been seeing him at the SIU (Southern Illinois University) Urology department.

Ken

Jim

Jim,

     I know that you're only joking about the carpooling, but it gives me an opportunity to share my thoughts on the general subject of traveling distances for treatment. For some treatments, such as FLA, where there are very few specialists, I think it does make sense to communicate with, and perhaps eventually travel cross country to get treatments. However, for a treatment such as Rezum, which now can be reached with a reasonable drive from most anywhere in larger metropolitan areas in the U.S., I think that a guy should be able to get good treatment locally. For me, it took one initial visit, and then a 'testing' visit, before the actual procedure. Then there are followup visits that are important as well. And that's not to mention how important it is to be able to see your Rezum urologist if you have a problem that needs to be addressed before the next scheduled visit. That would be a lot of traveling if a person lived several hours away from the treatment facility.

It's not just Frank in the Chicago area who will likely find an excellent, caring urologist close to home, but also several others who might be reading this forum and contemplating what to do. 

I agree that finding the most experienced urologist would be the best way to go, but I think that getting the care from a more local facility is better in the long run. 

Some may disagree with my opinion, and that's fine. Each of us should decide what is best for himself. 

Thank You VERY MUCH.,

frank,

A competent anesthesiologist needs to administer it and closely monitor you the entire time 

Mine was awful without general. It shouldn't be allowed.

Neal Pros

frank,

      TRUS is an acronym for Trans Rectal UltraSound.  A probe is inserted into the rectum and provides a more accurate sonogram image of the prostate and surrounding tissue. A TRUS has various uses, but for BPH, it is used to determine the size and shape of the prostate. I found the TRUS to be slightly uncomfortable, but certainly not painful. The fact that the urologist was demonstrating the procedure to a pretty young intern made me forget about any slight discomfort.

Good morning Frank.  Still trying to help you out with the problem.  Any of the office's in Chicago that I have called do the Rezum in the office only.  I sent a e-mail to the company and got a reply telling me that the Mayo Clinic does the procedure.  I have been in contact with the Mayo Clinic in Chicago It is on West Lake Ave in Gleview, Ill.  She said the you are about 35 to 40 minutes away.  The nurse I talked to was going to give his supervisor to get more information and see what doctor may be able to help you.  I hope they get back to on Monday...................................................................................... Now I'm going to say something it has nothing to do with Frank. There are a few men on here that I'm to concerned with retro ejaculation.  That you are just trying to fix your problem.  But why should men have to give up anything. Enough is taking away as we get older.  In this time and research it should be done without side effects.  Any surgery you can have complication but when the doctor put a camera in your penis and goes up to the prostate he can see where all the good stuff is. He's only concern is to get you to pee better.  And if you don't they offer you a little blue pill.  ( Canada's are Purple ) That is were he forget he is a man and what our body does.  There is a Doctor that I'm in contact with in the UK.  Nice guy.   He and some of his colleagues wrote a paper on this.  In the paper it said that any surgery that is done to the prostate for BPH you do not have to get retro. Even a Turp.  You just have to leave all the good stuff alone and just get rid of the tissue that is causes the problem.  That is also where finding a good doctor help's.  I would tell you what the stuff is but my spelling on them would not be good and it is very Technical.  Now remember this is only my opinion and ever man has the right to have any procedure he want and his doctor should be concerned with what his patients is concerned about.  Not by pass it or make a joke or say it rarely happens . While looking some stuff up on one of the Rezum site today. I came across something that I have never see before.  I may be taking it the wrong way I'm going to type it just the way it is. Based on our study's ejaculatory function was preserved in 97 % of the patients.             HOWEVER men with BPH are at a higher risk for other potential urinary ejaculatory challenges and there is a possibility that Rezum may uncover a underlying condition.  Now we are going into a procedure to fix one problem and after it may cause us more in the out come.  I don't think this is right.  We are letting this man do something to us that is  very real he has our life in his hand.  I have wonder when a doctor is doing a Turp or a Laser procedure.  When he get to the ducts and the canal does he think about what he is doing to that mans body on that table just cutting away all of it . If you have a good doctor that is concerns about all the things in life.  When he comes across the ducts and canals he knows what it is about and avoids that area and just get rid of the tissue that is causing the problem.  Well this is getting to long.  I wish for ever man to pick wisely the procedure you feel that you can deal with the side effect and the outcome.   My God help us all     Ken

Did Todd have any sexual dysfunction/ejaculatory issues before REZUM?