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
steven108 ChuckP
Posted
I am on the journey with you guys, my heart goes out to you all. I have some info that might prove helpful to some of you regarding costs for Rezum.
1) Kaiser is now getting Rezum and it costs only your office visit co-pay--i.e. about $40-70! 2) Some urologists in my area are charging upwards of $3500-4000 for a Rezum treatment and doing 100+ a year, which is lucrative business. Turns out the cost to them after their initial equipment purchase is about $1150 for a single use applicator. Please see the interview below:
Medgadget: How much does Rezum cost? How expensive is this technology for physicians to use in the clinic, and how does the cost of Rezum compare to other minimally invasive BPH treatments options?
Paulson: The AUA has advised urologists to use an existing CPT code 53852 – transurethral destruction of prostate tissue; by radiofrequency thermal therapy. The national average Medicare reimbursement for CPT 53852 is approximately $1,950 when performed in the office. That means after paying for the device and whatever supplies the physician uses during the procedure, the net difference is what the physician makes on each procedure. The list price of the delivery device, which is single use, is $1,400 per device. The average selling price is just over $1,150. So if a physician pays $1,150 for the device and receives $1,950 for the procedure, they will receive $800 per procedure, less any other costs and overhead.
Hope that helps in this world of $7000 deductibles and negotiating for basic healthcare.
JerseyUrology steven108
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steve05114 steven108
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Another Steve here. I see the local Kaiser urologist in a few days after about a month on a foley catheter, about 2 months of self-catheterizing (inconvenient but not a big deal), 3 months on flomax (did nothing), and a month on finasteride (too soon to tell).
After reviewing the various options with a family member who is an MD, Rezum looks like the best surgical option. I reviewed the Kaiser website and it shows nothing on Rezum. So how did you find out about Kaiser doing Rezum and where are they doing it?
Thanks
rich15050 steve05114
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I’m not taking any flomax etc, and am already having good flows.
serenitytoo ChuckP
Posted
Thanks to all of you for contributing to this thread! Lot's of great info. I'd like to give back by telling you about my infection complication.
I am 69 years old and healthy. 3 years ago the BPH became troublesome and I started taking one capsule flomax. 1 year ago I upped to two capsules a day. Symptoms continued to worsen so I concluded that I'd rather have a procedure done while I'm younger rather than older. My hospital system is the largest in California and just recently approved Rezum as a treatment. I was the first patient at my hospital, but was ok with that because there were two doctors in the room, one experienced, and the Rezum technician. What could go wrong.
I had the procedure 12 days ago, the procedure took half an hour of prep, 15 minutes for the procedure, and hal an hour of cleanup. Antibiotic prophylaxis was a single Cipro 1 hour before the procedure, nothing after, I was told that was the "standard of care". I was send home with the dreaded Foley.
Three days later I was tested for Foley removal. Pay attention guys, this causes lots of anxiety. The Foley is removed in the morning. About 5 hours later you come back, pee (mine was dribbles), and they ultrasound to measure how much urine is left in the bladder, so-called Post Void Residual, or PVR. Mine was 250, they want less than 100. So the Foley went back in. If I were to go through this again It would have been great to know what my PVR was BEFORE the procedure. We're having this procedure because we have difficulty, then we have a procedure that immediately swells up the tissues to make things worse, and then we're supposed to have a good PVR. Really!?
The next morning I had the Foley removed again and then had the PVR test in the afternoon. It was 75, so the Foley was not reinserted (I now think that it was low because I hadn't drank enough)
That evening I got a small bout of chills. No fever. Ignored it. The next morning and afternoon I got bouts of chills and sweats, but still no fever and I felt ok, not sick. In the afternoon I got a fever of 101.5 and went to the ER.
At the ER a urine test showed I had a UTI. Normally that would have just gotten me a bottle of antibiotics and sent home. But because the UTI was COINCIDENT with a medical procedure, they went on high-alert because of the danger of sepsis (a blood infection whose risk of death increases 8% for every untreated hour!). I was admitted to the hospital and had iv antibioitcs for 4 days while they waited to see if my first-day blood draw showed any cultured bacteria (takes 3-5 days). Foley was reinserted. I was discharged on the 4th day with normal white blood cell count and a seven day supply of Keflex antibiotic. The fever normalized on the 5th day after it started.
It's hard to blame any one thing for the infection. In fact I could have infected myself, since there was no testing for a UTI before the procedure. My recommendation is that before this procedure, get tested for a UTI.
Yesterday I went through the Foley removal in the morning and came back later to test PVR. The first reading was 250. I was despondent but hung around for 30 minutes and was able to squeeze a little more out bringing me to 180. That was enough for the doc to send me home without re-insertion...yay!
Very weak streams today, but at least I'm getting it out on my own. I'll update in a few weeks with how the healing goes
oldbuzzard serenitytoo
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You probably got the UTI from the procedure - hospitals are full of germs and not so focused on not spreading them. You sound like you're back on the normal Rezum recovery track. They don't always tell you what to expect so here goes:
1) The improvement doesn't start for 30 days minimum
2) Maximum benefits happen weeks 6-12 and full benefits at 6 months
3) It will be slow going (literally) for another few weeks, perhaps 4 or 5 more.
4) There will probably be some blood and possibly some small pieces in your urine weeks 3-5.
5) There may be some urgency weeks 3-5 and some minor urgency after that.
Once you can pee on your own, Rezum recovery is manageable and gets easier week by week. By about 6 weeks you're usually better than before. Its unlikely, but if you go into retention again, have them show you how to self cath so you don't have to wear a foley. Quick, painless, lets you void naturally when you can and live normally.
alan1951 oldbuzzard
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Oldyank oldbuzzard
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That's seems difficult. Urolift must be better. Anything, laser?
Oldyank ChuckP
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I'm very puzzled. I was thinking Urolift. My doctor had done 6 I told him he needed more practice. Then he mentioned Rezum to me. He said they are all great. I said he'd have to put me out no matter what he does. I hate pain. He mentioned a catheter for a day. I'm reading horror stories of them for 6 days, blood in urine, frequency. I had a friend that had a laser done and loved it. Right now I don't have a lot of urgency. I may get up once during the night, sometimes sleep through the night. I take the meds but hate the side effects but I don't like the stories I'm reading either.
with Urolift the prostate can keep growing which isn't good. With Rezum it kills it.
The problem is none really seem that safe or am I just reading the stories of the guys having bad problems.
ken19524 Oldyank
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Oldyank,
I think that you hit the nail on the head. I believe that, on a forum such as this, the majority of the experiences that you read about are from guys who have had some sort of problem. My urologist, whom I trust, says that my experience is fairly typical for his patients.
I had no pain during the procedure because I was 'out' during it (that should be standard procedure). I also had no pain afterwards. I did have some blood in my urine for a couple of days. And actually I could notice a difference in flow about 5 days after the procedure.
I think that one major advantage of the Rezum procedure over most of the alternatives is that the urethra is kept intact. Most of the other surgical procedures remove part of the urethra, and then the prostate tissue itself becomes part of the canal through with the urine passes.
The one drawback that Rezum has is that the prostate tissue swells up after the procedure, and some sort of catheter is needed for a few days until that swelling goes down. A Foley catheter is the usual procedure, but fortunately for me, I didn't have to have a Foley catheter inserted and then removed a few days later, because I had been self-catheterizing for a few months, and it was simple and easy to just cath 2 or 3 times a day for a couple of weeks until I had the courage to go without them. Self-catheterization is scary until you've been properly trained, and done it a couple of times. Then it's simple and painless. And for a procedure with such promise and results as Rezum has, it's a shame that guys have to suffer through the dreaded Foley catheter.
rich15050 ken19524
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U still have some blood in urine and in my ejaculations- but no pain or discomfort- I did get a UTI that was worse than having the Catheter for a week-
Overall, very pleased with the results and I’m still months away from the complete benefits-
Oldyank ken19524
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Ken,
thanks the whole thought of catheters is scary for get self all together.
Im a terrible patient. Waiting weeks or months to get back to normal or never getting back to normal would make me crazy. Urgency and blood are issues I don't have now. My friend who had the laser didn't have them. Why bother with either of these?
kenneth1955 Oldyank
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Oldyank kenneth1955
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Thanks Ken.
thats what I'm trying to figure out. All the doctors have their favorite procedure and don't want to do anything else so I have to find a doctor who does the safest most effective procedure.
oldbuzzard Oldyank
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A couple of things. If you're on any Alpha blocker but alfusozin, try switching to it. Most have no side effects and it usually works just as well. If you often sleep through the night and have no urgency, it doesn't sound as though your situation is all that bad. Maybe you don't need a procedure at all. They only develop more and better methods as time goes on - so if you don't have any major issues maybe waiting is the best solution. You will either have to wear a foley (I would refuse to have any doc do anything that would force that) or self cath for anywhere from one to 21 days after Rezum. Some docs will give you a temporary stent that usually prevents the need for that. You almost surely will have some blood in your urine at some point too. Its nothing really and goes away. You might have some urgency ( can be dealt with via meds if its too annoying - it also goes away) and it can take up to 6 weeks before you're better than before - might be worse at first. But then its all over and for most, smooth sailing.
oldbuzzard Oldyank
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Sadly, the docs favorite procedure is often the one that nets them the most $. Lasers are sort of last decades technology and even with great results, typically you have so much urgency that you have to wear a diaper for upwards of a month and it usually causes RE. Also, although rare, lasers can cause permanent devastating side effects. Uorlift Rezum and FLA don't. Urolift is good if you don't have an enlarged median lobe. FLA and Rezum are best if you do. A couple of weeks of discomfort and inconvenience are nothing when weighed against results and permanent side effects.
Oldyank oldbuzzard
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I take finesteride and alfosuzin. Maybe I won't do anything but I do hate the side effects, low libido, some ED. Urolift may be better, tough decision, scary.
oldbuzzard Oldyank
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rich15050 Oldyank
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Your Prostate to see what it looks- a nothing of a procedure if you are knocked out- that way- he can beat see what’s going on and the best treatment options. Good luck
nealpros Oldyank
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Neal Pros
alan1951 ken19524
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" ... I think that you hit the nail on the head. I believe that, on a forum such as this, the majority of the experiences that you read about are from guys who have had some sort of problem ... "
Spot on!
jimjames Oldyank
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OY: The problem is none really seem that safe or am I just reading the stories of the guys having bad problems.
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No, we have a good mix of sucessful and failed procedures here. For all different ones incld TURP. It's just you have to do your homework and read the entire thread(s) because the folks with the good procedures tend to move on but they do post here.
Jim