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

I found this info, "But by the end of 2002, the perineal pain and sexual problems he had experienced for years became intense. He stopped riding and, desperate for answers, saw several urologists before the last finally diagnosed pudendal-nerve damage, caused by his leaning into the protruding nose of his bicycle seat"

wow wow thanks. I'm going to invest in a special bicycle seat. Thanks

Yup, riding a bicycle will get the prostate and the pudendal nerve. One of my and the family-member-MD concerns with UroLift is how the implants would hold up to bike riding which puts pressure on the groin area.

In my younger "adrenalin-junkie" days, I worked in a bike shop and rode about 250 miles a week. I wonder if my current BPH problems are at all related to the many miles of road-biking that I did back then.

These day, I prefer to hike and cross-country ski...

Hi... yes, when I ride I feel some soreness in what I think is the prostate area... so I stopped... one factor may be I was using Fr 16 caths... which I think were too big for me and caused some soreness in that area even if I didn't ride... I am on 12's and 14's now... will have to take a ride, see if it improved...

I am considering a Urolift procedure at some point... and I have a feeling that may well end the riding days for good... can't imagine bike riding is good after that procedure!

Sreven & Tucsonjj

Good evening guy's.

I don't know if this will help you or not. But here goes. I have not been on a bike for many years.

After about 8 weeks I went back to the gym. I use to go on there bike that that stay still. I did it for 30 minutes a day for 4 days a week after I would run on the treadmill for another 30 minutes never had a problem

You have to wait tell you are ready. I know my doctor told me 4 to 6 weeks. It is really up to you to try it. But go slow at first and work your self up

Take care...........Ken

Thanks, Ken,

If it was a stationary bike with the narrow, hard seat, like most road or mountain bikes have these days, that is good news... IF, however, it is one of those wide seats on a "recumbent" (sit down) bike... the seat is big and wide enough not to hurt like the smaller ones... (my gym has both kinds) and we will still have to see if the real ones hurt...

Your Doc said OK to ride a bike after 4-6 weeks? that is encouraging...

Hello

Yes he did. When I saw him at 2 weeks he told me to wait for 4 weeks but I waited 6. They he yelled at me because I has sex 7 days after the catheter came out( 9 days after the procedure ) I just wanted to make sure everything was ok.

Yes it was the narrow hard seat.I have to start going back Have not been all year. Been away in Georgia most of the year and now I have till Tuesday till this heart monitor come off.

Maybe next month. We will see

Take care......................Ken

Someone should do a research on Bicycle riding & ED. Several decades ago I met a middle aged policeman who had a bicycle beat and developed ED which lead to his divorce.

yikes!

Jeeze... I guess I should stay away from riding! My brother had a Foley cath in for around 9 months due to a fistula... and ended up with ED... must be pretty easy to get it if any "insult" or damage is done down in the prostate region...

Wonder if the guy tried Viagra for his ED... my bro is going to try, but has cardiac issues too and I told him to speak to his cardioDoc first...

Cop is probably better off without that gal... seems harsh to leave over ED...

GL with the monitor Ken... hope it comes out well... LOTS of drugs these days for cardiac issues... my bro is 64 and in 3 or 4 of them... a herbal called "arjuna root" is interesting too, but best to leave it up to your Doc... IF he is a good one... lots of quacks out there...

Take care...

Hello

Yes he is I have had him for 15 years. My heart doctor. I had a 9 Hour Ablation for A-Fib 2 years ago they are checking to see if it is failing or if I need another stent. Have one of them to.

I have been lucky no pill for heart. It just I'm may have to have another ablation it it is. I have had 5 attack that seam like the A-Fib ones I had before

I find out next month

That's life........Ken

Jeeze, Ken, no pills for your heart issues? Time for a second opinion, bro... there are VERY effective drugs for Afib... Carvedilol, Cartia XT... my brother is on both and his Afib was brought under control...

5 attacks is not "lucky", friend!

Just my opinions... but worth a 2nd look, even if you are very happy with your current cardiologist... having serious Afib and not being on anything is, to me, a shock.

Hi Ken,

Just to 2nd Tusconjj's point that 5 heart attacks is not lucky. If you are not on any medications, it is time for a 2nd opinion from a 2nd cardiologist. The family-member-MD is a firm believer in 2nd opinions, even when he gave the 1st one.

Steve

Tucsonjj

That is right. I am on no heart pills for right not. The only thing I take is Brilinta 90 mg 2 times a day for a stent I had but in on the right side for a artery that was 90 % blocked.

I have had him for 15 years and I due trust him. Years ago I was on about 5 different pills. That is when I was 340 pounds. The last few years I stay at 175 to 180 (I had a stomach problem ) Been off the heart pill and blood pressure pill for 3 years.

I do have to get a new Cardiac Electrophysiology doctor. Because the one that did mine ablation 2 years ago is not taking my insurance anymore. I'm with the Florida Heart Group and my doctor does have one he want be to see but he wanted to do some test first.

I have had this monitor on for 26 days and I can get rid of it on Tuesday. I have had a couple of spells with it on. I also have a heart monitor in my chest. Had that put in 2 1/2 ago It has a 3 year battery. I want that out to.

I also did a stress test last week. I have all ways done a chemical stress test. But this time I had to do the treadmill because my insurance would not pay for it. I did the other one but only could do 8 1/2 minutes. When they put it on the third level I could not run anymore. Was out of breath.

We will see. What will happen. I really do not like taking a lot of pill. At one time I was talking 15. Down to 3. You name it I have had taking it.

Will I think that's enough about me. Son's working home alone. Going to take a hot bath and relax before I make dinner

I wish you all good health & Please do your research before you commit to anything

Best Wishes.......Ken

Good man, Steve... did you send this to Ken as well as to me?

Yes, sounds odd he would not be on any meds... very odd... but maybe his CardioDoc knows best... I have become very skeptical of all Doctors after a few bad experiences... but who knows? Hope Ken makes the right choice... a 2nd opinion is always good, IMO... but you have to go with your gut, eh?

I understand about wanting to limit meds, ken, and none of my beeswax, but getting a 2nd opinion is, IMO, smart. I look over patient reviews on Healthgrades and Vitals online... it helps find a decent one...

I have a good friend in the Venice, FL area... he used to be closer to Orlando... says the healthcare choices in FL are lousy... hope YOU have better luck!

Steven

I guess I did not explain it right. I had 5 A-Fib attacks not heart attacks. My heart rate would go from 150 and 200 with cold sweats, could not breath, pain and the shakes. I love when they tell you to relax. Has they are asking you question and sticking needles in you arms.

The year I had the ablation done I was in the hospital 9 times.It was getting so bad I know most of the nurses and the people that took you for test. I had to changed my electrophysiologist because he was not doing anything.

I do feel I am lucky. My brother and 2 of my sisters have heart problems. My brother who is 75 now had 4 heart attacks. First one was when he was in his 30's He also had a A-Fib problem. They burned the whole back of the heart. Mine he burned the whole left side I also had a sister that had a heart attack when she was 39. She died 2 times on the way to the hospital. She would not listen. She smoke and loved her beer. She died at 44

With in the last 6 month's my brother's A-Fib is back. He has to take a pill for the rest of his life. I will see what they want to do with me. Being I'm 63. Would it be worth going for another ablation.

Thanks for the concern guysKen

Steven & TucsonJJ

Yes that is true there are good and bad doctor's all over this world. You just have to keep looking.

My heart doctor I have had for 15 Years. I was sent to him by my nieces boss which is one of the top heart doctor in Michigan. She is his surgical nurse. ( Over 20 years ) He was the first one to find out that I had a blockage on the left side of my heart.

He was great. I was in Michigan my father just died. He did a EKG and told me he could till I was not getting enough blood flow on the left side. He told me to be at the hospital at 10 AM and tell them that I have seen him the day before.

He explained what he was going to do but I was so nervous I did not pay attention. My brother dropped me off and I did what he said. Within 45 minutes I was in a gown, IV in my arm and on a gurney going into a surgery room with everyone waiting. They tried to put me in a twilight but I was so nervous I watched everything on the monitors. I could see my niece circling the table. She could not help that day.

After the heart catheterization he told me that I have a blockage on the left side that was at 50 %. My doctor did one in 2016. It was over 60 but he could not put a stent in because medicare will not paid unless it is 70 % or over. But I was lucky when he put the dye in. He found the one on the right that was at 90 %

I will see what he what's to do. If they what to do it again or just put me on pills

Best Of days....KEN

PS.. My Urologist is a great guy. I have had him for 4 years.. But there is one things we all have to remember. Doctor's can suggest what they want us to do. But it is up to us what they will do. I also never give total control to any doctor.

Ken, Point well taken. Steve

Ken,

Got it! I was thinking that you had heart attacks. I have been lucky. My heart rate is low. On a bad day it is about 60. I walk 3 miles in a little under an hour each day. Walking is a good low stress exercise.

Walking is good for the mind too...

Other than some athletic injuries (1 knee and 3 shoulders), I made it to 61 1/2 without any significant health problems. After I passed the kidney stone the last day of 2017, I have been in BPH-AUR hell.

Hopefully, some time next year, I will have my Rezum done and I get back to full day hikes and cross-country skis. At least, I have been able to maintain a base level of fitness with my daily walks.

Take care,

Steve

Well I am happy that you are able to deal with it. How big is your prostate and are they sure it is your prostate. Just asking

I had kidney stones when I was 47 they were the size of jaw breakers. That is how I ended up with a stricture

Why are you going to have a Rezum. Have you looked into anything else

Have a good day Ken

Hi Steve, what are your BPH symptoms and why did you choose Rezum ? Hank

Hi Ken, a friend of mine is taking a beta blocker for his AFib. Hank

Thank Hank.

My brother is on something now. His procedure lasted over 3 years.

Have to see what's up when I see him not month

Ken

Hi Ken,

I have severe BPH and AUR. After 3 1/2 weeks of a Foley last January and February, once it was removed, I have not been able to pee on my own. When the Foley was put in, they took out 2000 ml of pee. By my memory, before the Foley, my IPSS was 29. If you are not familiar with AUR and IPSS, then you can look that up.

At this time, I do not know if I am a candidate for Rezum until the TRUS is done and I know my prostate size. Based on the DRE, one urologist estimated it at about 40 grams. I see another urologist who does Rezum on November 2 and depending on how that goes, the next steps are a cystoscopy and TRUS.

I chose Rezum because after reviewing all of the options with the family-member MD, Rezum appears to be the procedure that is least invasive and with the least complications. Other options that we looked at included standard TURP, greenlight laser TURP and Urolift. The "gold standard" TURP too often has complications.

I am very fortunate to have a family member that I have known for over 60 years and has practiced medicine for over 40 years. As such, I can get a professional opinion by another doctor who will not be doing the surgery so they do not have a stake in the outcome other than their concern for me as a family member.

What they told me has included:

1. Doctors will push for the advocate for the procedure that they do, so if you see a urologist that only does TURP, then they will tell you to do TURP. That is why it is good to see more than one urologist.
2. Insurance companies will be reluctant to approve and cover Rezum until Medicare approves Rezum although the FDA has already approved it.
3. In January 2019, Rezum will have its own billing code which may help with 2 above. Currently Rezum is lumped under a more generalized billing code.
4. Medicare will drag its feet on approving Rezum for economic reasons and not medical reasons because if all the men with BPH who has been holding off on surgery because of the morbidity of TURP had a Rezum, then Medicare's costs for prostate surgery would skyrocket.
5. Note that the medical definition of morbidity is: Refers to having a disease or a symptom of disease, or to the amount of disease within a population. Morbidity also refers to medical problems caused by a treatment.
6. Do a less invasive medical procedure 1st (Rezum) and see if it works before doing a more invasive medical procedure 2nd (TURP). Of the prostate procedures available today, Rezum and Urolift are the least invasive.
7. UroLift involves implants which if they do not work, will remain in the body unless removed by a 2nd surgery and may need more implants added a 2nd time too. Also if you are highly athletic, stresses to the groin area my damage the Urolift. I am still very athletic.

This pretty much covers you and Ken 1995's questions. I will know more after I see the 2nd urologist on November 2 and I will try to post then. Again, I am very fortunate to have a family member that I have known for over 60 years and has practiced medicine for over 40 years. This has been critical to my decision process.

Steve

Hi Steve, Urolift will not work for you because of your severe chronic retention. See my posts on "urolift overview" and "urolift limitations on urinary urinary retention". I agree that your best bet now is Rezum. Hank

Thank you for the reply. It looks like you have a plan which is good I wish you luck

My Urolift is great my clips are in the same place that my doctor put them in.

Once they a hear to the prostate they are not going any were. If I have to have a couple of more clips in a few years it's no problem. I would rather do that then have a procedure to cut it out. ( the string can be cut. )

I do not want any side effects which the Urolift has none. I enjoy sex and my ejaculation I am not giving it up. I do not know if that is a concern or not but Rezum has a 15 % risk of retro

I have a list of 42 men that had the Rezum procedure 18 ended up with retro.

But it is up to a man to pick what he wants and can live with. I wish you good luck in whatever you do

Ken

Steve what Hank is saying is true. I did not know you have retention. Urolift will not work if your bladder is in retention.

I have to look it up also on Rezum I don't know if Rezum will help a bladder in retention.

Also I do not know who you are seeing but there have been many men on here with retention and the doctor has all ways told them that any procedure has a 50 - 50 chance of working. Which men's that a 50 % chance of not working.

PLease look into it. Ken

Ken,

I am well aware of the retention issue and the 50-50 chance and I have already been told this by the doctors. With 2000 ml of pee taken out there is some bladder muscle damage. The cystoscopy may provide additional information on this. At this time, after 9 months of catheters, I am willing to take the chance that there will be some improvement. After the Rezum, while I may not be able empty completely on my own, maybe I will be able to partially empty and then just have to self-cath once a day.

Steve

Hank,

Where are your posts? On this subject forum or another? If on this, then at about what page?

Thanks,

Steve

https://patient.info/forums/discuss/urolift-limitations-in-urinary-retention--682242

If your main issue is bladder dysfunction, most procedures will not help that much. Some better uros will refuse to do procedures unless the retention issues are mostly resolved. If you were to have Rezum, research for some studied results that show how much it helps on retention (PVR). Hank

Hank

Steven

I am happy that they did inform you. I hope after the procedure you get some relief

Good luck.........Ken

From what I've just read, Rezum is not that good for retention either, maybe just a little better than Urolift. If I have to pick numbers to predict % improvement rate for retention, it would be 10 for Urolift, 20 for Rezum, 30 for PAE, and much higher for TURP or HoLep. Hank

I already had resume done it did help

Hank

For TURP & HOLEP doctor have been telling patients 50/ 50

Ken

Tom

Glad it helped you

Ken

To hank I had Resume dome on June 18 this yr. And it's made me worse. I just had to pee 5 times from 3.30pm to 4.30pm today. Resume is a waste of time

All together it's made my life HELL! I have to wear depends all the time

Hi Hank,

I hear what you are saying. TURP is more invasive and more effective at removing the blockage, but it is the highest in morbidity and complications. HoLep is a variation on TURP as is Greenlight laser. You are not telling me anything that I don't already know.

Steve

Tom

So sorry that happen. Does the doctor say what went wrong. It sounds like the bladder neck is not closing or a sphincter muscle problem

Good luck I help you can find out what is wrong

Ken

... For TURP & HOLEP doctor have been telling patients 50/ 50 .....

I agree with that, as far as retention is concerned. For Rezum, PAE and Urolift, it would be much lower. Hank

Thomas, if your peeing too often is due to high retention, which is often the case, I now can understand why Rezum did not help you. Hank

If you already know Urolift and Rezum are not good to solve your retention, why even consider them ? I am not suggesting TURP either, it's too bloody. HoLep is probably the best, with much less bleeding. Hank

I think there might be some misunderstanding of what they mean by retention and recurring bladder infection. Pretty sure what they are referring to is retention due to bladder dysfunction, i.e., not someone who has retention due to the blockage itself. There is a big difference. After all, the whole point of all of these procedures it to reduce or eliminate the blockage. So if that is what is causing the retention, then presumably any of the procedures would be available, depending on OTHER issues, such as size of prostate, whether a serious median lobe problem, etc. Most if not all of us with serious BPH have some degree of retention due to BPH. So you need to distinguish that from bladder damage or dysfunction. And btw, most of us who have had low flow BPH for years (or in my case eventually NO FLOW!!) , have thickening of the bladder wall and some degree of "damage" from the extra work it has had to do to push through the restrictive area.In my case, I had SEVER retnetion, and ultimately COMPLETE retention. I had manual cath incidents of as much as 1100 ml/cc before having a foley, and then an SPC put in.I also had a couple infections, which are virtually inevitable once catheterized. In other words, they weren't recurring infections from being backed up over long periods of time but not catheterized. They were infections from having a catheter. to deal with the retention.

I had REZUM June 29, after being with an SPC for about 4 to 5 months, and a Foley for a month before that. I had a pretty large Prostate (about 65 to 85 , depending which measurements you consider), and Median Lobe intereference. Before the catheters, I had SEVERE retention, and eventually COMPLETE blockage (and therefore complete retention). I am now off all catheters and am able to pee on my own (as of a few weeks after Rezum). It's not the best flow, but adequate, enough for a normal lifestyle, and very good if I occasionally still take Alfuzosin. I dont take it regularly, but do from time to time, and then flow is very good. I still have a bit of retention, maybe 100-125 ccs, especially if not using the Alfuzosin, since flow is not fire hose-like. But after 60, it is not uncommon for any of us to have mild retention. So its a little circular to say that Rezum (or any particular procedure) is not best to address chronic retention or infection unless what you mean is retention and infection resulting from a bladder that is not functioning well, as opposed to the very prostate blockage that you are trying to relieve!! 😃

scott, how how long after the rezum did you start feeling better and able to pass urine?

Thomas, sounds like you're having a very hard time why don't you get it to you get a TURP?

I empty my bladder all the way. My Dr says my body is building to much pee. Not sure why. So there going in me in 2 weeks with a scope to see what's going on up there

Hi Steve, Please also make sure you see my reply to Hank regarding the "retention" issue and Rezum, or any other procedure for that matter . Sounds like you are in a similar situation as I was b4 REZUM.

scott95643@ : I think there might be some misunderstanding of what they mean by retention

Just to second what Scott is saying here.

1. BPH blockage results in retention.
2. Retention results in a distended bladder and bladder muscle damage.
3. Bladder muscle damage and BPH blockage results in reduced flow to completely blocked flow.
4. Surgery (TURP, Rezum, other) clears the blockage.
5. Flow and emptying may not be perfect but it is good enough to pee again.

Self-cathing once a day may still be necessary to remove the residual but that is a lot better than 4 to 5 times a day.

Steve

Within a week or so I could pee some. But I had an SPC and used a plug as opposed to a bag before I had the procedure. So I was able to continue to try to train myself to pee a little bit on my own whenever possible before the REZUM as well, although never enough to not be dependent on the cath. So it wasn't like an all or nothing change after the first couple weeks. But it definitely was better to the point I felt i might be able to remove the catheter after about 3 weeks. I wasn't totally confident doing it quite yet. But after 4 weeks/a month, I was confident enought to get off the cath and go it on my own, and have been ever since.

Scott, you had severe retention before. And you rehabbed your bladder to a good degree with months on catheters, Foley as well as SPC. Some good doctors insist on bladder rehab before a procedure. Then you had Rezum. You still have retention. You still need meds. I can conclude that Rezum did not help your retention that much, just like all studies indicated.

It is now difficult to know which one helped you more, Rezum or rehab. Hank

Thomas, how can you be sure that you empty all the way, without a bladder scan or a catheterization ? Some people thought so but ended up carrying over a liter in their bladder. Hank

Hank, in the above message, you estimated the % improvement rate for various procedures. Do you have some real data that backs up those numbers? If not, you could be doing a real disservice to those who are looking for help for their BPH problems.

I think that the percent improvement for properly qualified patients who undergo the Rezum procedure is closer to 90+ percent. It's also much higher for several other procedures than what you are 'estimating'. If Urolift and Rezum doctors weren't seeing 90+ percent success in their patients, those procedures wouldn't be happening.

I wonder why a "scope" (Cysto?) would determine the cause of that... it only examines the bladder and urethra... neither "build pee"... are you sure your Doc is not "Scoping for dollars"?? Many do...

I think that issues would be more related to kidney function and an intake/output evaluation... I build a lot of urine overnight... I think it is called "polynuria" or some such... might look into it IF you build much more at night than during daytime...

JMHO!!

Yes, I mentioned in my post , or one of the replies, that I was able to rehab a little bit for that reason. But not true that Rezum did not help. No matter how much I worked on trying to pee on my own while on SPC, i could never empty more than maybe 200 in best case. Sometimes none, sometimes less.After rezum, I am definitely able to pee relatively normally every time, and empty most, and maybe sometimes leave 100 or so behind . But again, to say my problem was retention is a little circular, as it is the blockage that caused my bladder damage, and the blockage itself also causes retention. So just to refer to "retention" is not enough. It's just a matter of distinguishing whether you are talking about already having gotten to a point where your bladder damage (which could maybe even be from other causes) is too severe to resolve the problem by removing the blockage, or whether it is still primarily a blockage problem. My point is only to say that it is not correct to say that Rezum will not help with retention. It depends on the causes of the retention. That is the whole reason you want to do Urodynamic testing ahead of time, to see if your bladder is still trying to work, which mine was. Then they are able to conclude that it is more likely that the blockage is the primary problem. Not definitive, but a good bet. The problem with my bladder was that it was trying too hard to work to push past the obstruction, and the latter, the obstruction, was the primary cause for my retention.

Having said that, yes, it may not be a perfect solution, and a TURP would definitely open things up more definitively and be less likely to have continued retention if your bladder is totally fine. That is because it definitely opens the channels, in part by cutting the bladder neck! But some are willing to live with a reasonable and acceptable level of retention instead of doing a TURP, which may have other unwanted consequences that they feel are less desirable., including almost certain RE. For some, it comes down to what consequences they feel are more or less acceptable.

ok, signing off, in case anyone messages me or replies. will catch u later!! Good luck all!!!!

Hank

Would you not have some pain or discomfort in the groin area

KEN

Yes, I have collected from published data from studies, that indicated success level of different procedures, in this case, I only discussed retention, in term of PVR improvements. It's about 10mL for Urolift, 50 for Rezum, 86 for PAE, 195 for TURP and HolEp.

Talking about success rate, it's easy to claim a success as long as there is an improvement and the patients come out alive. But how much improvement is also important, and also how misleading the claims can be. One needs to verify the claims before accepting them and spreading them around. That would be a disservice.

Studies also indicated Qmax improvements, 3.5mL/sec for Urolift, 4.0 for Rezum, vs 15-20 for TURP and HoLep.

You probably had a good Rezum experience and are trying to help but no one can be like you. Therefore, study data are the only things that can be trusted in this environment. Hank

No offense, but... Do YOU have any "real data" that shows a 90% success rate for Rezum?

Just my UroDoc's opinion, bit the Rezum is not desirable... very painful... long time healing... leakage, etc... why not do a Green light laser, which has to be a little more discerning as to the amount of tissue removed from the prostate, than shooting steam in and boiling the material away? Sometimes boiling away enough to cause retro-ejac... Urolift seems to be a far better FIRST procedure... and if major prostate issues... why not a HoLep?

Ken, I didn't know I had retention until I had a kidney scan, but I wasn't carrying 1 liter. Someone else on this forum was, and I don't remember whether or not he had any pain. He thought he gained weight. 😀 Hank

Instead of living with any retention... why wouldn't a guy just do intermittent cathing? At least while considering options... that is where I am now... cathing is not a problem at all, but 4X/day is a lot and somewhat restrictive on activities, travel, etc... BTW: Most comfortable cath I have found is the LoFric Primo... ( I do fr 12) just an FYI.

I am, at 62, leaning towards a Urolift... perhaps later in life a HoLep. I am fortunate to have a Doc that is expert in the HoLep... most can't do it at all...

That is the first I have heard of someone retaining a lot of urine in their kidneys... Are you sure you don't mean a bladder scan/sonogram?

HEY KEN

If you look at the trail for Urolift is a minimally invasasive procedure. It effectively leads to a rapid reduction of symptoms while preserving all sexual function. And improvement in symptoms and peak urinary flow. A 50 % improvement in quality of life. And low retreatment rate of 2 to 3 %. They also say that 60 to 90 % will see improvement.

The Rezum Procedure I found that 78 % of men will see 30 % improvement of what they had before. Doctors are saying that it is a good procedure but with the procedure it will save your sexual function ( erections ) But has a higher rate of retro then they are putting in there literature 5 to 15 %

All men have the right to pick what every they feel is right for them. They will have to deal with any of the side effects not the doctor.

The Other Ken

They ask about retention: They said 81% of the men that were in retention were able to void after 28 days post- Rezum

I would ask for a bladder scan as well. Hank

When they scanned my kidneys they also scanned my bladder, maybe as a bonus ? Hank

Hank

Isn't is strange how things happen. We never know..

Later my friend. My program is on. Time to get off for now Ken

" ....While Urolift procedure works for over 90% of men with symptoms of enlarged prostate who are ideal candidates for the procedure ...."

To be ideal candidates, there are lists of inclusion and exclusion criteria. One of the exclusion criteria is "chronic retention". Hank****

@ken19524: If not, you could be doing a real disservice to those who are looking for help for their BPH problems.

It is important for anyone using this forum to know, that most of the people on this forum are not medical professionals so yes, saying the wrong things does do a real disservice to those that are looking for help with their BPH problems -- but then we all should know the limitations of the people posting here.

I have gained a few gems of wisdom on this forum, but there are some posts that I have learned to block out. One person here, directed me to the urologist who did their Rezum and I will be seeing them in a few days. Maybe I will end up on having a Rezum done by them and my BPH-AUR problem will be improved.

Hopefully, I have been able to provide some help by conveying to this forum the information that I receive from the family-member-MD who is guiding me through this difficult process. Having an independent doctor on your side has helped me a lot.

Steve

@hank1953: Yes, I have collected from published data from studies

Hank,

Can you post the citations for these studies on this forum. You may not be able to post links, at least when I have in the past, most posts went into moderator never-never land. I would like to download and read these studies. I have read a lot of them...

Thanks,

Steve

Self Cath was not an option for me. And the retention I have ow is not something I notice. I pee relatively normally and at pretty normal intervals. Usually only have to get up once at night, and that tends to be just before the morning, like 4 am or so.

Also, Holep and Green Light are virtual certainty for RE, whereas Rezum is very low incidence. For particular REZUM docs , they may not have had any reports of RE in their patients, or it's as low as 1 or two percent. But I think in general most docs will report it's at most 5%, and it may realistically be a little higher. For me that was relevant. For some, maybe it isn't, in which case it may make more sense to go with one of the TURP-Like procedures.

It's alos not that intolerably painful for everyone. Some say it wasn't horrible, others say it was excruciating. But it is very short (time), and if you do twilight, then it is not painful at all. The reason it is reported as sometimes very painful, is that it is quick and simple enough to do while you are awake!!!! I suspect that if you tried a TURP or HOLEP awake (which you couldnt , as they take much longer and are much more invasive) , that they would be pretty damn painful!!!! LOL.As for healing, it's not like a pain thing, (for me) , but you are correct that you need to be more patient about getting the full results. The dead tissue needs to be absorbed and carried away by the immune system , since it isn't actually being cut or cored out like Holep or Turp. And its not as dramatic of a change in flow as TURP relatives, though if it works, it is enough to resume (no pun ntended) a totally normal lifestyle. Everyone is different , but for me, after a couple days there was no real obvious feeling of healing, though there was blood in urine for some days, and in semen for a few weeks. But that's true of all the procedures; in fact generally less so for Rezum. But its not like I had any adverse feelings that kept me from going about my normal days (other than the catheter that I already had anyway !(SPC thru abdomen)). For most who would not already have a catheter, I know that is a big negative, but it wasn't an issue for me, beyond the fact that I wanted the damn thing out as soon as possible! I knew that with this procedure , I had to wait a little longer than would have been the case with TURP or any of the TURP relatives like Holep, etc.

But all in all, there are lots of reasons many go with the quick and minimally invasive Rezum over the TURP relatives., after weighing the various pros and cons. I may eventually one day still have a more definitive TURP like procedure. But so far the Rezum has worked well enough. Who knows, maybe in another year or so they'll have even better options, or they'll be able to do TURPS and similar procedures without destroying the bladder neck and causing certain RE. But for now, Rezum was a simple option to give a try and that does not preclude one from still being able to do a different procedure like Holep or TURP later. Here's hoping everyone on here ultimately has a procedure that works, whatever it is, and that allows them to go back to living a normal life !!!! PEACE

" ... Since US FDA approval in 2015 numerous studies on Rezum have been published, including one randomized controlled trial (RCT) with a 36-month follow up, one crossover trial and one pilot trial, with an additional recently published retrospective study post-approval.8–11 In 2016 a pilot trial by Dixon and colleagues, following up at 24 months demonstrated a mean change of international prostate symptom score (IPSS) from 21.7 to 9.6, a mean improvement of Qmax from 8.3 ml/s to 12 ml/s and a mean change of post-void residual (PVR) from 78.5 to 62.8 ml.8 The results from the 5-year RCT, currently with a 3-year follow up, has shown a mean improvement of IPSS of 11 points, a mean Qmax improvement from 9.7 ml/s to 13.2 ml/s and a mean PVR improvement from 81.5 ml to 55.1 ml (p < 0.001).10 The crossover trial has demonstrated a mean improvement of IPSS at 12 months from 19.4 to mean 8.6, a mean Qmax improvement from 10.3 ml/s to 16.2 ml/s and a mean PVR decrease from 101 ml to 83.8 ml (p < 0.001).12 Crossover trials are particularly useful in highlighting outcomes as participants serve as self-controls, so possible placebo effects can therefore be negated. These results point towards a significant improvement in clinical outcomes in all studies including IPSS, Qmax and PVR with p < 0.001 as outcome measures, with the greatest improvement seen in IPSS, which every study reported as having a mean improvement of over 10 points. Clinical improvements were seen from as early as 1 month post procedure. Furthermore, no de novo cases of ejaculatory dysfunction were reported in any of the selected studies. Retreatment rates varied between 3% and 5%. " ...

Steve, I am not against Rezum or Urolift or any procedures. They all serve a certain special people. Make sure you fit within their capability. Don't fall for all the hypes or those faked patients that come here for dubious reasons. Hank

Self cath not an option? Hmmmm... haven't heard that before... ah well, we all are different... and btw, I get up once a night every night to self cath!

I think I have that situation (syndrome?) of much more urine being generated at night than during the day... (polynuria?) so even though I cath right before bed... I still have to get up once a night to cath again and get 400-600ml then.

Not my beeswax, but if retention is not noticeable... and you pee at normal intervals... and only get up once a night (very normal, or better than normal for most guys over 50)... why do a procedure?

You might try adding some magnesium, 400mg/day at least... and some Pygeum and Stinging nettle root... it used to help me a lot in the years before I finally was unable to pee on my own anymore... GL to you!

@hank1953: Since US FDA approval in 2015 numerous studies on Rezum have been published, including one randomized controlled trial (RCT)

Hi Hank,

Thanks for the screenshot. I asked for a citation so that I could both look up and download the article for my own use. For example, one of my favorites is:

Keong Tatt Foo, 2017, Pathophysiology of clinical benign prostatic hyperplasia, Asian Journal of Urology, Volume 4, Issue 3, July 2017, Pages 152-157.

which discusses lateral vs. median lobe obstructions. What you posted was not what I asked for. Professionally, I have been on both sides of scientific publications.

Thanks,

Steve

@Tucsonjj :Self cath not an option? Hmmmm...

Same here, my high volumes and the only time that I go over 400 ml are in the mornings after I have slept for the night. The family-member-MD says that this is common. Going over 400 ml may not happen for a few weeks and then it may happen 2 or 3 times in 1 week. I am not sure how this pattern effects the bladder recovery process where I am not supposed to go over 400 ml.

The toughest part for me is the overnight self-cath as I need to be up for about 20 minutes before I am awake enough to "thread the needle". By then I am so awake that I have breakfast, watch the news and check my email. Then I go back to sleep for a few more hours. So either way, getting up to self-cath once a night, or 3 or 4 times a night before the total blockage, BPH has screwed up my sleep...

Steve

Steve,

where do you live?

Yes, I understand that keeping volumes under 400ml is necessary for bladder recovery... BUT... I now cath 4X/day and I really don't want to go to 5X/day or more... I think that I will have to limit liquids... even more than I do now... I used to drink LARGE quantities of filtered water daily... can't do that anymore!

Even limiting it somewhat, I still often get 500-700ml... rarely less than 400ml per cath... I am not TOO worried about it, as my bladder function still is OK, says a UroFlow test... I have had pee problems since my mid-20's (now 62)... and finally, I just became unable to go and had to start cathing... I think I'll have to cath until I choose to do a procedure, my UroDoc likes the Urolift much better than the green light or Rezum... he also does the HoLep, but I am not ready for that until I am older...

I actually have an easier time cathing when I get up at 1-4am and am relaxed and sleepy... maybe you need a smaller fr? I started with fr16's and they gave me lots of resistance problems and a sore prostate after... I now use mostly fr12's (LoFric Primo's are the most comfortable, IMHO)... I even tried a fr8 sample once or twice, man did they go in easy... took a long time to empty the bladder though!

BTW: I used to cath sitting down... when I started cathing standing up... MUCH easier.

I believe JimJames has a whole thread on here about using self-catherization as a means to rehabilitate the bladder and enable one to eventually void urine again back to normal.

Mark, I am in Boulder, CO. Steve

Tucsonjj,

I self-cath standing up too. I am limiting my fluid intakes too. My Excel spreadsheet says that my average self-cath volumes are about 280. I have also made some significant changes to my diet to limit my salt input. I am using an fr 14 catheter but when I wake up, it takes me a while to focus, so I need the 20 minutes for that. I am also 62 but did not start to have pee problems until my mid-50's. Your often getting 500-700ml does not sound good.

Steve

Volumes of 280 are great... while my 500-700ml sounds bad, it really is just a matter of my taking in too much in fluids... and probably too much salt... can't pee out more than you take in, right? I keep meaning to switch to Morton Lite, which is 50% potassium chloride... I do take a Emergen-C most days, which has 200mg of potassium (which counteracts sodium)...

MY main problem is... even if I dramatically reduce fluids... or cath an extra once or even twice a day... I still have an obstruction... either the bladder neck, prostate or both. Until that is corrected... I will always have to cath. Keeping the volumes down IS important in terms of keeping some bladder function... but when I first got tested, prior to beginning cathing... I was retaining a liter or more... so 500ml cath production (my average) is pretty good for me... and I feel much better being empty several times a day!

I do not need to be wide awake to cath... I can do it in my sleep almost... and, like I said, being very relaxed helps things go faster... for me. We are all different... but 20 minutes to focus seems a lot... you must be a DEEP sleeper! You DO use pre-lubed caths... yes? Which brand? I could see if you had to goop up your caths B4 using... that would be a bit more complicated, just in keeping everything relatively sterile...

JJ

Interesting... and I hope Jim is OK... I think he is having some issues... hope whatever they are, they improve...

I have been having restricted flow since my mid-20's... in fact the very worst times were around 28 or so... so... I am a long term obstruction guy... a UroFlow showed that I still have some good bladder action... but am not sure that cathing alone will return my ability to pee normally... as I have not done that for over 20 years... I am afraid I need another procedure... I had a BNI and partial TURP (Doc did the TURP without my permission) around 30 and it lasted for 10 years or so... but didn't bring back full flow...

I have no issues with cathing, other than inconvenience... so I will continue, and try to reduce fluids... it would be GREAT if full function returned... but... doubtful.

thanks for the info, though!

steve, I'm in the Springs, so if you know of a great urologist in Boulder or Denver please let me know.

Hello I sent JIM a message a week ago have not heard back He was having some medical problem. Also problems with his computer. I will send another PM message to him later.

I will let you all know if I hear from Him Ken

Tuscon, you wrote that you're cathing 4 times a day. I've been on a foley the last 30 days. Am considering Resum, FLA, and Uro. Am also considering eating my way out of it, by ingesting lignans and isonaflavoids every day for a few months, combined with Flomaks. They took my Foley out on day 29. I was good for about 24 hours, and then AUR kicked in again, and so, another Foley. As the AUR was beginning, on day 30, I tried self cathing, standing up, with a standard disposable 14" pre-lubed, but only got it in halfway, when it ran into something that from my perspective, just wasn't going to give, so I bailed, withdrew the thing, and made the frantic drive to the ER. It was a whole lot easier and painless than I'd ever believe, but for the part where it ran into something that wasn't giving. When they take this Foley out in 3 weeks, though this may be wishful thinking, I'd like to be able to try a hybrid program, of self-cathing, and using the original equipment. It worked for one day, I figure with some patience, and self cathing, it may work again, intermittently. It actually was so easy, the self-cathing, it just seems preferable, though I've never done it, to having the Foley 24/7. Any thoughts you or anyone might have are certainly much appreciated.

Thank you, Ken, send him my regards... he sounds like a good guy, hope he is OK.

Yes, 4X/day... and maybe should go to 5X... as I average around 500ml... maybe I'm drinking too much water and taking in too much salt.

I had a LOT of failures to "go in" when I started cathing... especially with the popular Coloplast "Speedicath" fr16's... even drew blood a few times... scary...

You have to stand and guide it in, your Johnson pointing down at a 45* angle, ... and be patient! You have to really try to relax everything "down there"... imagine relaxing even your prostate and bladder... keep up some mild pressure, but don't ever force it... I feel some mild resistance at the prostate, then much more resistance at the bladder neck or sphincter (not sure which it is)... you should soon feel like you are getting the urge to pee... sometimes it used to take me 30 seconds or more... and then it should slide in... start flowing... advance it another inch or so and BINGO!

Remove slowly... I find cathing when I am pretty full is easier than when I feel no fullness... and if you cath when you are bursting full, you might get some leakage around the cath... don't worry about it... when I used to get a "fail"... I'd get even more uptight and made everything tighter... so breath... breath... relax... the Foley is MUCH wider than your fr14... or the Fr10's and maybe Fr8's you should try... and IT went in ok... right? 😃

I personally found that LoFric Primo is the most comfortable... and strongly recommend trying some samples of Fr 12's 10's and even Fr 8's... the Fr14's are likely too big for you... two great suppliers that will be happy to send you samples (with your Doc's prescription) are 180Medical (ask for Christen) and Byramhealthcare... if you don't mind lubing your own caths... the old red rubber type is very comfortable, seems almost too flexible, but it WILL work.

I too am hoping to regain normal urination by cathing... but honestly, I doubt I will... I think I have a constriction of the bladder neck and/or in the prostate area... had this for MANY years... and until that is corrected... I don't think normal function will return. Keeping your bladder fairly empty will maintain bladder function, as in being able to squeeze the urine out... which IS important... but will not correct tightness/blockage in those areas... just my opinion... hope you have a very good urologist... I had a loser... now have a very good one... if you still have trouble cathing... your UroDoc should show you some tips in his office...

GL to you, hope this long-winded screed helps... and remember... RELAX!!

No Problem I will.....................Ken

Hi Tucson, You apparently misunderstood or missed the original thread. I was in complete retention, and ultimately had foley Cath for a month and then SPC (in the abdomen through the bladder) for 5 months.I DID already have a procedure, Rezum. That was the point of my posts. I was describing my Post-procedure condition to you, and pointing out to an original poster that one cant just refer to "retention" out of context of the causes of it. In any case, I had Rezum on June 29. Best, Scott

how how long did it take you to see benefit after the procedure, And how long did it take you to see the full benefit?

Thanks so much for your insights Tuscon; they are immensely helpful. 8s sounds good to me - not worried how long it takes; just getting the cath to paydirt will prevent a visit to the ER. It sounds like you've been doing this a while. Do you ever plan on having a procedure, or, are the caths you use so, for lack of better words, convenient, that it's just not worth the risk, annoyance and cost of a procedure, e.g. Resum, FLA, Urolift.I was incredulous, once I got the guts to actually put the 14 into the hole (there was really no choice at that point!), how easily it went in, until it got stopped at whatever it got stopped at. Thanks again

I am often confused these days (daze?)... sorry!

John98818,

I live in Castle Rock, CO, age 75 and I had my Rezum done by:

Dr. Nancy A. Huff - She is one of six Uros (the other 5 are Men) at,

Advanced Urology

11960 Lioness Way #210

Parker CO 8014

303-695-6106

Located in Lincon Medical Center complex which is Just east of I-25 and on the south side of Lincon Ave. They have a second location in Aurora, Co.

I am VERY happy with her and would have Dr. Nancy A Huff repeat the Rezum procedure again if I ever need it again.

Allen (Al)

To John, it's been over 4 months and there's been no improvement for me

. Resume was a waste of my time. If anything it made me worse.

guys, i had my Rezum at the office of Dr Huff, but done by a different doc. I only got a valium and vicodin for pain and it was a rough go. ALso, i'm 40 days out and not satisfied with improvement....if any. did you have adequate pain control w Dr Huff?

thomas , what is your plan now? another procedure?

My pleasure... several good guys helped ME out when this was new to me... yes, I too was surprised at how painless cathing was...

Yes, I have pretty much decided that a UroLift is right for me... my UroDoc is VERY competent, he dislikes th Rezum and the green light laser, still thinks the old TURP is ok in some circumstances... The FLA sounds OK, it didn't come up in conversation with the Doc... he is one of few Docs that can do the HoLep... a great option IF you are older or have significant prostate issues... but I am comfortable for now doing the self-cath thing... so in no hurry... unless my insurance comes into play... a potential cancellation would have me doing a procedure soon.

GL to you, let me know how the Fr8's or Fr10's work out for you!

my Dr Nancy Huff scheduled me for May 24, 2018. Prior to that day, I was given these instructions:

1.Stop all blood thinners one week prior to procedure and continue taking other prescriptions

2.Celebrex, take 2 pills at 8PM evening prior to procedure. (anti-inflammatory)

3.Cipro 2daily, first pill at 8PM evening prior to procedure, continue 2 per day for 5 days. (antibiotic)

4.Valium, 1 pill 1 hour prior to procedure. (for relaxing)

5.You must have a driver to and from procedure. (she won’t do without this).

I followed the instruction exactly as directed.

I was awake and had 5 Rezum steam shots. The pain was not a bad as the Hornet bee stings I have had. I only had minimal bleeding stains that day and for the next couple days.

My stream is very strong now and my volume seems to be getting better each week, I still have retention due to the fact that my bladder had grown and had held 2000 ltr several times before due to prostate blockage for years which I did not know I had until complete blockage happened after a hip replacement operation .

Here is what Dr. Huff entered in my report:

"After informed consent, the patient was placed into dorsal lithotomy position. The bladder was drained with a catheter, and Lidocaine 2% 50 mL was instilled into the bladder. Urojet deployed into the urethra. The Rezum procedure ensued after 20 minutes of anesthetic dwell time. The Rezum probe was positioned and the prostatic urethra was measured from the bladder neck down to the verumontanum. In this patient his right side was treated in 2 lateral locations and the left side was treated in 2 lateral locations. The median lobe was treated in 1 location, approaching from the patient's right side. The verumontanum, sphincter complex were spared. After removal of the Rezum probe, a 16 Fr coude foley was then placed. The patient tolerated the procedure well."

Today- 10/29/2018 @ 3:00 PM, Dr Huff is going to scope my bladder to see what might be going on in my bladder.

Allen (Al)

Have you considered HoLep? WILL give you retro-ejac... but will at least probably fix the rest of your issues...

What's retro ejac?

Retrograde ejaculation... after a procedure that significantly removes prostate tissue, which is most of them (not Urolift or ALA)... when you have an orgasm... nothing (or much less) comes out. Supposedly the "sensations" are the same... but most say they aren't.

FYI: Cipro is a very dangerous drug... you can research that online... I always ask for an alternative to it... and any of its class.

you're you're still improving after 5 months?

Tuscon, about 90 Fr 14s came in today that my doc ordered before I knew an 8 was lots smaller; the Fr14 is the kind I'd tried and failed with on the day I made another frantic run for installation f a 3rd Foley in 31 days; I am now made to understand that the reason I was able to pee unaided, for 24 hours, when they'd taken out the Foley out on the 29th day, and sent me home, discharging me Foley-less, was because the Foley is like a stent; so when you take it out, the urethra inside the prostate doesn't just collapse upon itself immediately; it waits about 24 hours till about the time you want to believe you're cured, and then it collapses, and renders you unpeeable.That's when I tried to insert an FR 14. It would sure be nice if the Fr14s worked for me. I mean, I've got 90 of them and would hate to see them go to waste. Is it mainly a matter of sliding it down to the sphincter, stopping (if/when the catheter stops), holding the catheter end gently against the sphincter, taking a deep breath, coughing, wiggling your toes, saying a prayer or two, hum Jingle Bells, and just waiting for the thing to open, like open sesame? Were your first tries on your own, all by your lonesome, or did you have a nurse help you through it? Thanks

Keep the 14s ! You might be able to use them later after you learned how to with smaller sizes. Hank

Hello

What Tucsonjj is saying is true. Most of the time the feeling is not the same. Some men are lucky. Retro is when the semen goes up into the bladder instead of out the penis.

I had it when I was taking some pills..It sucked

Have a good day Ken

Hi Nisvan -

It sounds like you may have had the same problem I sometimes did trying to insert a catheter. I would get about halfway in and it was like I hit a brick wall. I think the obstruction was at the external sphincter, before ever entering the prostate.

I tried all the suggestions you mention except Jingle Bells, but none worked. And the coughing one made me nervous about having coughed all over the exposed, previously sterile, catheter, so I threw that one away.

What finally worked for me was to back the catheter out a bit, lower the angle to where it was almost pointing downward, and try to relax my urinary tract as if trying to pee. Then advance the catheter again slowly. This almost always worked, and worked all the time when using hydrophilic coude Lofric catheters. (I use Fr14s.)

George

Hi, I actually was going to go to the urologist and have his assistant show me how and have me do a few in front of him (might be a good idea for you to do that)... but instead, watched a Youtube video... it seemed simple, so I did it on my own and got the first one in no sweat... I forget if it was a 16 or a 14... not too long after I had a few fails with 16's... so I got a few samples of 14's from the Doc, and they worked better... I found for me, 12's worked even better... actually 10's and 8's were easier to get in, but you might get some leakage around the cath with those smaller ones... no biggie to me... I tried several brands and, obviously lots of sizes... ended up with the LoFric Primo in size Fr12.

Yes, sliding it UP to resistance (I always get resistance, sometimes firm and it takes awhile, like 30 seconds or more... sometimes only for 5-10 seconds)... keep gentle pressure on the cath against the resistance... concentrate on relaxing the entire lower area, especially your b-hole muscles (when you do, you will find you have some tension down there), breath deep as you relax... vary the pressure a little, I sometimes try to turn the cath a little as I push by gently rolling the fingers holding it... I usually get the feeling like an urge to pee... then shortly after that feeling it slides in and the flow starts... push it in another inch and let if flow. When flow stops... pull it out that inch slowly and you will probably get a little more pee... then pull out slowly until out.

Once you have a few successes... you will be much more relaxed about it and will not assume that it will not go in. Give it time... I've waited a minute or more a few times when beginning... the longer it doesn't slide in... then more tense I got, so just give it time empty your mind and focus only on relaxing the area that the cath is up against resistance. I suggest you obtain an Fr8... those went in easier than the others, but take a long time to drain the bladder... but you WILL get more confident with them.

Keep the 14's... if nothing else, you can probably trade them to your UroDoc for other smaller samples. Once comfy with cathing... you might be able to use them... If you got them from a vendor and your Doc will not trade... ask if you can send them back for smaller. GL!!

Hi, George, not that it matters much... but the urinary sphincter is hit AFTER you pass the prostate. I think it IS that that gives resistance... or the bladder neck... not sure which, but would bet the sphincter... since it naturally tightens and loosens...

I personally can feel some minor resistance as the cath passes through the prostate... then it hits the much stronger resistance or "wall". LoFric makes a good cath!

Skoal!

Tucson, good suggestions. I was fortunate to get good instruction from the young female PA when I first went to the urologist's office with 500ml of urine that I couldn't pass. Her instruction was very similar to that shown on the Youtube video from Coloplast. If anyone reading this is interested, search for 'how to use speedicath flex coude' on Youtube .

One other suggestion that I would add to yours above is to, after urinating, put your finger over the end of the catheter as you draw it out. This keeps the urine in the catheter until you're ready to let it run into the toilet by lifting your finger off the end.

Thanks Tuscon, George, Hank. You guys are lifesavers. This kind of hands-on, literally, first hand, real life lessons-learned information - I just doubt it's available anywhere on the internet but here. I haven't seen any and I've been searching for days. I finally figured I'd no choice but to confess my dilemma on this forum hoping someone might be able to just put in layman's language how to get this right. The ads and the videos don't address very well this little matter of getting past the Gate, unless you opt for the coude. My primary doctor, when he ordered them for me, didn't say, "You're going to need some training on this." My urologist didn't even offer the possibility, or even the concept, of self-cathing. For him, my choices were either Button Turp (that's what he does and only does because he's "tried them all and Button Turp's the best"), or, Suffer. The 3 different ER doctors I'd had who'd overseen the Foley insertion never mentioned there was an alternative, once things settled down from the AUR trauma, known as self-cathing, that's hygienically superior to the Foley, if you're going to have a catheter longer than a couple of weeks. Same with Resum, Uro, and FLA. For all the new post-TURP procedures, you get the sugar coated version on the professional websites; and you get the real story with all the nuts and bolts and breakages, right here, from the people who are living with the consequences.Thanks and good luck to all.

Hi JJ -

As I understand it, there are actually two sphincters, an 'internal' one at the exit of the bladder and an 'external' one at the exit of the prostate. See the wikipedia page "Urethral sphincters". The one I'm referring to is the external one.

George

Hi, George,That I did not know... MY big resistance still is only an inch or less outside of the bladder... so is either the internal sphincter or the bladder neck itself... I don't know if the bladder neck can be "loosened" intentionally... I imagine the sphincter can be...

I would think that if resistance was met at the external sphincter... a guy would not have gotten the cath in very far at all...

I hope nisvan can get it done and it becomes very easy for him...

You are quite welcome... Not sure what your insurance situation is... but a 2nd opinion may be of great benefit... a UroDoc that only does the TURP may be a bit limited... from your description of his actions and lack of actions/advice... I would look around.

Try to fine one that is skilled in the HoLep procedure... it may not be right for YOU at this point, but shows a skill that is higher than most others...

I look on Healthgrades and Vitals online to see some patient reviews of Doctors... may be some shills there, but it helps avoid the really bad ones...

Ken, same one I watched! Only thing is, I am MUCH more comfortable and have MUCH less resistance when standing... and the guy was sitting... not sure if is just me... but the Speedicath (straight) was extremely comfortable going in.... BUT also gave me some of the most difficulty in getting past the resistance, even with fr12's.

Good advice on holding the end of the cath... but since I am cathing over the toilet... I just let it run out as it comes out of the Johnson... if NOT... a very good thing to do!

Just to second Tucsonjj on the importance of getting a second opinion when any surgery is involved. If your urologist only does TURP, then they will advocate for TURP. See another urologist who does or has done a few different BPH procedures.

Again, look at Healthgrades and Vitals online to see how patient have reviewed the urologists that they have seen.

Both of these are important in the decision process before surgery.

Steve

Good evening. I think all men have that problem. But I think it is the inner sphincter that give us the problem. When I have try it. I have go problem getting through the prostate and then it like it hit's a well. That is why when they tell you in the hospital when they try to do a catheter is to relax and take a deep breath

Good luck Ken

Hi JJ -

Yeah, I still have maybe 4 or 5 inches to go beyond my resistance point before I start to get any flow.

Glad the Lofrics work well for you too. Cheers!

George

Most likely your resistance is at the external sphincter. Hank

• What's external sphincter mean?

Sure sounds like it.

Hi, Ken, I agree, for ME, it is the inner sphincter... for George, the external, I would think...

When I am REALLY full, and I try not to let it get there anymore... I have had leaks around the cath... I think from the pee reaching the external sphincter, then flowing out as soon as the cath gets past that one... before the cath can get to the bladder and seal... no biggie, but I think that would explain it...

I never seem to have much resistance at the external or the prostate... only at the internal...

BTW: to add to the adventure... I just had my Cologuard come back positive. Now I get to have a colonoscopy... really didn't want to have to do that... and get to sweat out a possible cancer diagnosis... I am getting to be the all Doctor's best friend! 😦

You have two sphincters... I didn't know that... George here clued me in... you can bring up a chart of the urological sphincters... if you get resistance with only an inch or so to go, it is at the inner sphincter... if 4-5" or more to go... it is at the external sphincter... I think you would need to concentrate on relaxing to get by either... I'm very glad I only have resistance at the inner... not both!

Good morning

I get them confused. When I did mine I would feel like I hit a wall after the prostate Is that the inner sphincter or external. I know I'm taking a relaxer for my external ( Vesicare 10 mg ) sphincter because my doctor said it is to tight

I had a colonoscopy done last year I have to have them every 3 years because my father died of liver cancer and I have other relatives that died of other cancers. I think you will be fine just don't let them rush you into anything

Take care I have to go and get dress. Have to go am have blood taking 8 or 9 tube. ( 2 doctors Urologist & Heart )

Ken

I saw some benefit pretty much in first week to 10 days. Full benefit after 6 or 8 weeks,,, never really got any better after that.

All drugs are dangerous in one way or another depending on each persons reaction to them.

john98818

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Posted 17 hours ago

you're you're still improving after 5 months?

Yes John, at least is "seems" like that to me, my initial flow and volume was very low after Rezum procedure. Apparently due to my age, dead prostate cells were still showing up in my urine 4+ months after the procedure.

My over size bladder still remains a problem for me as I still have way too much urine retention after each void. So it could be that my bladder is gradually getting smaller.

Dr Nancy Huff was going to scope the bladder yesterday but I currently have a UTI which has to be eliminated before she will do the scope.

Allen

Is this a response to an older post? Not sure what you are referring too... Explain...

That would be the internal...

GL with your blood work!

Tucsonjj

★3

allen98488

Message

Posted 1 hour ago

Is this a response to an older post? Not sure what you are referring too... Explain...

**

I was responding to this:**

Tucsonjj

★3

allen98488

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Posted 19 hours ago

FYI: Cipro is a very dangerous drug... you can research that online... I always ask for an alternative to it... and any of its class.

Allen

@Tucsonjj :BTW: to add to the adventure... I just had my Cologuard come back positive.

Tucsonjj,

By chance, did you have a urodynamics test, TRUS, or any other test recently that would have resulted in your butt bleeding? My butt bled for a few days from my urodynamics test and then I had my annual exam along with the Colonguard test about 2 weeks later which showed the blood. This was a false positive as I had a colonoscopy about 6 months earlier which showed that I was totally clean.

Steve

Hi, Steve, yes, I had a Urodynamics test, but it was months ago... I did have a small 'roid a few weeks ago... so maybe have a few small ones hidden... I don't usually get those anymore...

I am having an abdominal and pelvic CT scan tomorrow, hope that will make me feel a little better... IF results are good... my regular Doc says not to sweat it, but I WILL have to finally have a colonoscopy...

Thanks buddy

That is what I thought . 8 tubes The women that does mine I never have a problem. No bruise I made sure I drink enough water. Sometimes my veins like to hide.

Ken

Ah... thanks for the clarification... yes, I think Cipro is dangerous... you can search "dangers of cipro"... and find lots of grim stories... since it is supposedly very effective in the urinary tract... it gets prescribed a lot... but REALLY messes some people up...

Yes, most drugs can be dangerous, especially if taken in a non-standard manner, but Cipro is dangerous even if taken as prescribed... FAR more dangerous than most. JMHO, if you don't agree, feel free to take it if prescribed.

Hey there my Friend

I have been taking Cipro for years for some of the infections when I get them. But I have never had a problem. But Derek just told me something that he read that if you had Tendonitis at one time you should not take Cipro.

I had Tendonitis years before my prostate problems. I got it from a inner lock ear infection in my left ear and got Tendonitis in the right shoulder. I think I am going to have a talk with my doctor when I see him. I have been lucky and I never want to deal with Tendonitis again. Could not use my right arm for weeks. Had it in a sling.

It can cause Tendonitis but a different kind

Ken

I just had a newbie draw blood this morning... she messed it up so bad on one arm (hurt like a bugger)... had to switch to the other arm... IF she had to draw any more... I think I would be in shock! 😉

Wow Tuscon that sounds terrible, after the first time she messed up, someone else should have been required to draw your blood.

Hi Tucsonjj,

Having a coloscopy is a real trip. Don't plan to go anywhere or be more than 15 seconds away from a toilet after you start drinking the human drano! Things will get so loose it will look like you are p*****g out your butt.

Follow the eating instructions carefully! If you are a healthy eater, you are going to be stuck with Rice Krispies and Wonder Bread for a few days and don't drink anything red. The procedure itself is fine. The prep sucks.

Once it is done, treat yourself to a nice meal and drink a lot as you will be dehydrated. Off course, for us on this forum drinking a lot has it consequences...

Hope it goes well for you.

Steve

I have had that happy with a new girl at another place. After the 3rd time I call the manager. She got it .

This women that I get at the place I go is very good . One stick and she in the vein. The 8th tube she only got a little more then 1/2. She said that was enough for that test.I think it was starting to stop. I drink a lot of water to make sure I would not have a problem. I don't mind needles.

In 2014 when I had sepsis. The six days I was in the hospital they took blood 43 times. I was so bruised all over my arms and hands. If they new that they were going to do that. Why wouldn't the doctor order a port put in . It would have been better for me and them.

Take care Ken

how did you know that "dead prostate cells" were in your urine?

Jeeze... yes a port would sure have made sense... makes a guy worry that medical "professionals" are sometimes not any smarter than a guy on the street... especially a guy who does his own homework...

Getting past sepsis is a BIG deal. My mom got it, but she was in her 80's and had dementia, so was weak to begin with... it took her down and eventually... out.

All the antibiotics they give a person with sepsis can really wipe out your gut... hope you loaded up on the probiotics then... and now. Skoal!

Thanks, Steve, I am not looking forward to the prep... but with a positive Cologuard... I really can't fight it anymore...

I am having two CT scans tomorrow, hope they rule out anything really bad... I have to drink Barium for those... but compared to the colonoscopy prep... it will be easy!

I had to start self catheterization recently too... seems like it all hit the fan at once...

Jeeze, at 62 and falling apart... they never told me that Scotch, Brew and cigarettes were BAD for me!!! (or... did they?)

😃

she was not very good at what she does... I have big easy veins in both arms. Ah well...

mod note: please don't discuss violence on posts even if made in jest.

Hiya, Ken,

Maybe you are one of the lucky guys that Cipro doesn't mess with... actually... I think the really bad effects are somewhat rare... but I have read about guys really badly messed up... permanently! As in really bad pain and other grim stuff... scary enough for me to avoid completely... maybe if I ever got sepsis... bit otherwise, no way.

I am no Doc... but seems like changing antibiotics would be a good idea, if for no other reason, your body gets acclimated to any one of them if over-used... if you do change... just avoid any others in the same class of drug! Your Doc just might switch you to a sister drug of Cipro. Avoid if possible.

Yes it was something. I have all ways been the type I'm fine and I will take care of my self. I thought I had the flu. The doctor told me that it was in my blood and hitting all my organs. The doctor told me that another week I would have went into kidney failure. I only have 1 in a 1/2. My left kidney is sitting on my bladder.

That was were I was introduced to a catheter. ( Never ask or told me nothing he just took my pants off and forced it in. He tried twice never got it in ) That is way I went to a lawyer and had papers done. That will never happen to me again.

I had a port put in before I left the hospital Had to have 11 more treatments

Take it easy..........Ken

Yes I was lucky. I will see what he has to say. I just want him to be aware of it. If I would have told him before I would have said something. Some of the antibiotics they gave me in the IV I could not even say. I still have the paper work from when I was in.

This may sound bad but most of the antibiotics the first 3 or 4 days gave me the runs. I don't know if this was the way your body got ride of it

Ken

Antibiotics of all kinds will cause runs if taken for awhile... let me know what he says!

Wow, pal, you have had some rough roads... hope things get MUCH better for you!

Yes I will. I'm going to see if he will give a scrap to try them and see what happens.

Ken