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

Hi Frank,

I asked Jersey Doc about your case last night. If you scroll around you might find the posts. Long story short, he thought that Rezum was worth a try, not too much to lose. And if that didn't work, you could then try a TURP or Aquablation. His other advice was that before making a decision to personally see a doc who performs Rezum as well as TURP to get both a knowlegeable and less biased opinion. I would add that you probably want to find a doc who has done at least 100 Rezums. Hope this helps.

Jim

Hi jimjames,

Thanks for posting the advice from Jersey Doc about getting a "knowledgeable and less biased opinion."

Currently, I am in the "self-cath and bladder recovery stage" while we see if the finasteride and flomax works so I have a lot of time to gather information and get opinions before surgery is even considered.  I am fortunate to have a close family member who as been an MD for over 40 years and I have known for over 60 years.  In the time that I have known them, they have given me advice about getting knowledgeable and less biased opinions.

This super important when the possibility of surgery is involved.

Steve 

Jim, Thanks my good friend for posting with Jersey Doc. Jim Do you  know of a way I can find a Urologist that has done at least 100 Rezume:s. Thats the only way i would consider this Rezum? Jim is this surgery? 

Thanks 

frank,

Frank, Rezum is a procedure performed in a doctor's office using blasts of steam to vaporize parts of the prostate. Don't need general anesthesia, but what I've read, best if done under some sort of twilight anesthesia. I might start with Northwestern Memorial Hospital which I believe is highly rated. Also if you go to rezum .com there is a physician locator by city. You could then call likely candidates and ask how many rezums they have personally performed. Cross checking references with online rating sites likes healthgrades can sometimes be useful as well. You also might want to start a thread here, something like "anyone know a good rezum doctor in the Chicago area". Generally a good idea to interview and get evaluated by more than one doctor.

Jim

Hi Frank,

As jimjames said, Rezum is done right in the doctors office and uses steam unlike other procedures like TURP that are done in the operating room and use lasers, hot wires, or other.  In Rezum. the steam kill cells inside the prostate and then the body removes the dead cells over a short period of time, reducing the size of the prostate so you can pee again.  In TURP, cells are cut away and removed during surgery so you can pee again.

The main negative of Rezum is that it has not been around for a while so we only have about 3 years of data, which actually looks good.  The FDA only approved Rezum near the end of 2015.  Because Rezum kills cells and the body removes them naturally, there is also the possibility that over time, the body will regrow these cells and the procedure needs to be done again.

The problems of TURP are well covered in this forum, mainly damage to the sexual function of the prostate so I will not mention them here.  Rezum is supposed to have less of this problem.  Personally, if I had a Rezum and the cells grew back in 5 or 10 years and I needed a procedure done again, I would bet that the technology of prostate surgery would have another 5 or 10 years to improve.  Because of the sexual function of the prostate and the number of men with BPH, there is incentive to improve the medical technology.

As such, today, I am inclined not to go with the "old school" TURP even if urologists call it the "gold standard".  At this time, Rezum is a promising alternative, we just don't have the long-term data yet - and - the number of urologists sufficiently experienced with this new procedure is limited.

Regards,

Steve

  

Jim, I have called Northwestern Memorial,Loyola Hospital ,these are teaching hospitals. Northwestern does have urologists that do Rezum,with no twilight anesthesia. i would never consider this without it.I have found many urologists near by that do Rezum,but no twilight<which i can't understand.

Without twilight and a urologist that is not a rookie I shall keep doing CIC.

frank, 

Frank - FWIW, I had it done without any anesthesia and it hurt like a mother------, but I'd do it again. You're probably looking at 60 seconds of actual pain to be off the cath for good. I wouldn't let anyone without a lot of experience do it, but sometimes I'm amazed at how my life quality has improved without having to worry about the bathroom. 

Your outcome was similar to mine - it was over 3 weeks before I could pee and 6 before I could pee well. Fortunately, I was self cathing from the start, so no Foley. Ended up with partial RE, otherwise had good results. 

Hi Trikerjon ,

I hope your  RE  will be just temporary  problem  .  Foley catheter  for   30-4 = 26  days ?   Why ?

  REZUM is a very good method,  but relatively BLIND one  and may occurs  such problem with RE  in case the steam harmed ejaculating ducts. 

 There are 2 similar methods  : 1) REZUM  with  using  the steam to ablate ("cook up" hyperplased  prostate  tissue  near  urethra  ( steam with temperature  more then  100 grades Celsium )  with the risk to harm  near  sensitive structures like ejaculating ducts with RE effect , but can  harm  urethra too, due to all  "stings"  perforate urethra during the action .

2. FLA  -using  laser energy  which ablates hyperplased prostate tissue with temperature  about  80 grades Celsius . All is providing in MRI machine, where Interventional radiologist (IR)  has full control on exact    location, where laser focal ablation is  acting with accuracy of 1 mm. So  this is very exact method  and only not fully  experienced IR can  harm  some  sensitive structures.  Its not trans urethral ( TU)  system , so your urethra  remains intact.  

Both methods are based on following  absorption of dead tissue by your immunity system, where main actors are  T cells  (white blood cells) and  macrophages ( part of the immune system, that engulfs and digests cellular debris, foreign substances, microbes, dead cells, cancer cells, and anything else that does not have the type of proteins specific to healthy body cells on its surface in a process called phagocytosis). 

By both methods you can feel  relief of BPH syndrome  from few days  to  several months.    

Considering both methods  ( only ones which are effective when  Big Median Lobe is in place )   I selected FLA . After 4 weeks  I'm happy with it and the progress of absorption is  on the way . Relativelly good stream so far , stop of any medication , stop of CIC self cathing after  1 year using. Who needs details , pls PM me.   Have a happy Mayday   ,   Stan       

The good news is the vast majority of patients who have rezum do not end up with an ejaculatort issue long term. It is also covered by most insurances.

We have had excellent results over 3 years.

JU,

In your opinion, based on your experience, what is the rate of RE with Rezum? It seems that its more than their studies showed, but how much more?

Wow, you sound like you know quite a bit about this procedure, but you lost me with all the technical terms. I should have done more research before having it done. I didn’t realize that the ducts would be affected by the steam and I didn’t know the Uroligist poked me 11 times till after the procedure was over.

It was too late to make any decisions by that time.

 Thank you for your input 👍

Could you quantify a little more the number of patients in your practice that end up with retro in the long term? Also, some here have suggested that if they tell their physician to stay away from the ejaculatory ducts during Rezum then that should eliminate the problem. Is this accurate, and if so, how would staying away from the ejaculatory ducts impact the overall success of the procedure? By "staying away" I guess I mean staying MORE away than per protocol as I assume that the protocol is not to blast the ducts directly.

Jim

It is a very rare complaint. I'd say less than 5% off the top of my head.

We have closer to 10% retro reported here. Other than that the info here is anecdotal, would you think operator skill/experience might be the difference between what's reported here and the study data which is closer to what you report.

Jim

Have you yourself done Rezum ? I hear a lot of people say to tell the doc to stay away from ejaculatory ducts on one side - is that true? wouldn't you want to do that anyway ? I also hear that RE might happen at first then goes away - is there any explanation for that?

thanks for participating in the forum

Yes I've done Rezum. RE is fairly rare. If you have swelling of the prostate (from any procedure), the ducts could be obstructed; once the swelling goes down, they can become unblocked.

Jersey doc, I was told Rezum would not work for me, because my prostate is to large 74 grams.

I would like your opinion about this.

Thanks,

FRANK,

But you do have more then 4 % retro problems.  Once you have it if it does not come back in a few months it is fuse together and there is no going back.  And you just have to be one of the lucky ones.  Any treatment is a gamble.  You just have to pick carefully     Ken 

Hey Jim.  I read over the last 6 month's I don't remember who it was but this guy on here voiced his concern about retro to his doctor.  ( Some of us still care )  His doctor was very nice and told him the he would inject the steam at the top of the prostate and the bottom of the prostate.  He stayed away from the middle. So the doctor did 4 injection.  If you look at some of the films it looks like they inject in the middle of the prostate.  The Rezum worked for him and did not end up with retro.  But I think some doctors are to aggressive and are only looking to to get the man to pee better and are not looking at any of the side effects.  Ken  

Jersey Ur-oMine came back partially after Rezum but it's been over 2 years and isn't going to improve any further - is there anything not too invasive that can open them up more?

Jersey Ur-oMine came back partially after Rezum but it's been over 2 years and isn't going to improve any further - is there anything not too invasive that can open them up more?