Rezum is terrible

yes I looked at some medical literature comparing urolift to rezum. The literature stated that at 6 months the rezum was Superior to urolift. I've been having a lot of frequency urgency and nocturia for several years. Have been on uroxatral and Cialis.

What do you think the gold standard is now to clear a wide channel in the prostate? Laser, Steam, Heat, bipolar turp?

I have nocturnia.  Apparently, its not a disease.  From my ovenight urine bag, I see that my frequent urination was normal, from drinking too much liquid.  Thanks for your post.  Makes me think.  Sorry to hear.  Blessings..

Good point. Thank you

When I looked at PAE, there was a huge diff between "the literature" and the 2000+ "anecdotes" in these forums.

 

My sincere apology to u.  my earlier post seemed to be insensitive while u are suffering but I really wanted to help.

Since u considered only Rezum and Urolift, I assume that all resective techniques that will result  in RE are not acceptable to u. Yes? Since u had read literature on Resum before the operation, I also assume that u know what the complications are and the recovery time. Thus, the complication u are having now is not typical. Yes?

For many urologists, the old gold stand is TURP and the new gold standard is HoLEP. HoLEP has the longest durability, best function outcomes (including the widest channel) and will work for small to very large prostates. But the chance of RE is 88%. I have done a lot of research on HoLEP. if u are interested we could exchange information. 

The gold standard has not been invented yet. Everyone should ask their urologist which method he would personally choose if he needed it and why would he personally choose it.

Thank you. I've been doing more reading and it seems as though HoLEP is the new standard. Yes, I was aware that it would take longer to recover from REZUM. How do I find a HoLEP superstar in Colorado?

Have time to explain what are the differences? I am surprised u could find 2000+ anecdotes.

I am not qualified to make comparisons but I recently had a bipolar TURP and the results have been excellent. No significant problem and massive improvement in flow and bladder voiding.

You post suggests that u know the importance of finding an experienced HoLEP surgeon as the learning curve of HoLEP is steeper than other BPH surgeries. To ensure that they get the best result, Some informed patients had chosen to travel great distance so that they could be operated by the most experienced surgeon.

as u may know Peter GIlling of New Zealand is one of the inventors in 1998(?) and he is well known and is regarded as an authority in HoLEP.

Don't know anyone in Colorado. below are the surgeons whom patients have very high regards of and are the sought after surgeons of HoLEP:

1) Lingeman of Indiana U (?) went to New Zealand to work with GIlling (2000?)

?2) Krambeck of Indiana U(?), who is a protege of Lingeman.

Both Krambeck and Lingeman have done thousands of HoLEP and are the authors of a well cited US HoLEP study.

3) Akhil Das of Jefferson university hospital in Philadelphia 

Das also went to New Zealand to work with GIlling in 1998(?). Has been doing HoLEP since and have done thousand of HoLEP. He was recommended to me by other HoLEP patients.  I am his patient and found him unusually caring, patient and willing to spend time to listen to his patients and explain complications in detail. As far as his caring attitude is concerned, None of my other urologists even comes close. He also had published several papers with GIlling on HoLEP.

4) Chris Deblasio of Long Island. He is an instructor of HoLEP and his surgical coordinator told me that he also has done thousands of HoLEP. He also seems to have some relationship with the  HoLEP equipment manufacturer.

I have some key HoLEP references. If u are interested, plse let me know.

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My sincere apology to u.  my earlier post seemed to be insensitive while u are suffering but I really wanted to help.

Since u considered only Rezum and Urolift, I assume that all resective techniques that will result  in RE is not acceptable to u. Yes? Since u had read literature on Resum before the operation, I also assume that u know what the complications are and the recovery time. Thus, the complication u are having now is not typical. Yes?

For many urologists, the old gold stand is TURP and the new gold standard is HoLEP. HoLEP has the longest durability, best function outcomes (including the widest channel) and will work for small to very large prostates. But the chance of RE is 88%. I have done a lot of research on HoLEP. if u are interested we could exchange information.

Just wondering what did ur urologist who did Resum say about ur situation and what is his proposed solution? And what is ur plan if ur situation does not improve?

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There is always death in any surgery, same as walking on the road may be hit by a car. I have read many trial reports using Various BPH surgery techniques and have not come across that patients died because of the surgery. Yes, in some trials, there were death, but it is very rare. Also most BPH patients are very old, they could have other illness during the surgery , their health were not as good as a young man. Thus , it is difficult to pin point the death was due to the surgery. Even with that  the death rate is exceedingly small. So please excercise caution  when u said thing like that in a forum in which there are many readers seeking information. 

97cc is a large prostate. For example, TURP does not want to operate on s prostate larger than 80cc. There is risk of waiting too long to seek surgical correction as the bladder has to work hard on forcing the urine out and could be damaged. For such a large prostate, the best procedure is HoLEP. There is a lot of info on HoLEP on the website steadyhealth , just google HoLEP enucleation experience.

Yes, there is s kind of drug  called 5-Alpha Reductase Inhibitors that may shrink the prostate. Firstly, it may take a long time to work and secondly It may work for some and some have severe side effects. 

From wedmd:

5-Alpha Reductase Inhibitors

These stop your body from creating one of the hormones that makes your prostate larger. They prevent growth and in some cases even shrink it. This can improve your urine flow and ease other BPH symptoms as well. They seem to be most helpful to men with very large prostates.

These drugs have two other benefits as well. They may:

Lower the odds that BPH will lead to other problems, such bladder damage

Make you less likely to need surgery

It can take up to 6 months to see the full effects of 5-ARIs, and you have to keep taking them to get results.

Side effects: This medication is not for use by women. Pregnant women should not be exposed to itbecause it can lead to birth defects in male babies.

Other side effects when men take it may include:

Erectile dysfunction

Lower sex drive

Retrograde ejaculation

Some of these side effects may get better as your body gets used to the medicine.

5-ARIs may also lower your PSA (prostate-specific antigen), which affects one way that doctors look for prostate cancer. That isn’t harmful, but it may help to get a PSA test before starting these drugs. Also, the FDA now requires labels on 5-ARIs to include a warning that they may be linked to an increased chance of high-grade (or aggressive) prostate cancer.

Names: There are two main 5-alpha reductase inhibitors:

Finasteride (Propecia, Proscar)

Dutasteride (Avodart)

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U are not ranting but try to point out to readers  how important to find a caring urologist!

I didn't do any better with my urologist and in fact a bit worse than u. At least u could submit written questions., but for me I spent about $5000 on three tests and after that never got a call from my urologist to tell me the results. I called his office a couple times to request explanation of results,but at the end still no explanations even at in-office consultations. I had an earlier urologist who also behaved similarly.

I bought all my document from my uro's office to Jefferson with the intention of telling Dr. Das that I had done these tests and no need to do them  again and want them to be placed in my account at Jefferson. Had never expected Dr. Das to explain the results to me. But he did which caught me by surprise.   All the complications, both short and long term, were explained to me using his own patients data at Jefferson. He also made sure that I indeed wanted HoLEP and not Urolift. So he was not trying to convince me to select the technology which he offers.

To readers reading this threads, please find an urologist like Dr. Das who would explain the procedure carefully to u so u know what are u getting into even if u have to spend a lot of time to find such a person

To me, The bladder neck preservation is not an advance but it is common sense. But the low power en bloc no touch in my view is indeed an advance. There was a Russian study using this technique and had gotten very good results.

Are u still suffer from any other complications? Are u happy with the results from HoLEP?

Sorry, attached text that is not relavent by mistake. My apology.t

U are happy with the outcomes and have not suffered from serious complications is what counts. Congrats! However statistics is also at play here.

to my understanding, some said TURP was the old gold standard for BPH.  It uses an electric current loop to remove the BPH overgrown tissue a little piece at a time. HoLEP, for example, some urologists think it is the new gold standard. It uses the enucleation technique, it removes the overgrown tissues in one, two or three big chunks, like peeing off the meat off from the skin of a slice of orange. Each technology has different set of complications.

My urologist only does bipolar turp and says that's the bomb. Thoughts?

Thank you!

Don't understand that what "bomb" meant. If he meant it was the best technology to cure BPH, It suggests that he is biased.

My original urologist also recommended bipolar TURP because, at the time, that was all he did. When I went to see him about my BPH issues a couple of years ago, his first statement was: "you'll never ejaculate again". He was very honest and upfront about the fact that a bipolar TURP would result in retrograde ejaculation. Yes, a TURP will improve urine flow. But the retrograde ejaculation was not something that I wanted to end up with. Also there is a much greater chance of incontinence and ED with a TURP. Much of the success depends on the skill of the surgeon of course, But those possibilities are much greater than with something like Rezum. With Rezum, the urethra is kept intact and the prostate is reduced where it is restricting the flow. With TURP the urethra is cut out along with a small part of the prostate. 

BTW, my original urologist is now training to do Rezum. Since he didn't offer it at the time, I went to a urologist elsewhere who did my Rezum procedure. 

John,

      One other important comparison between a TURP that your urologist thinks is so good and a Rezum procedure: the recovery time. When I had my Rezum procedure done, I woke up from a twilight anesthesia (the procedure took about 15 minutes total) without any pain at all. Since I was self cathing, I went home immediately (my wife drove me home because of the anesthesia requirement) and resumed pretty much a regular schedule as soon as I got home. With a TURP, you're going to be in the hospital for a least a day, and peeing blood and tissue for some time afterwards. If you read some of the experiences of those who have had TURPs, I think you'll see what I mean. 

Also please keep in mind that this site, as helpful as it is, will tend to attract only 1. those who are trying to find out what to do, and  2. those who have had a less-than-positive experience. That goes for just about all the procedures that are available. 

PAE thread is in this very same forum, iirc.  2000+ replies 

Good point.

how bad is retrograde ejaculation anyway? I guess if you're done having kids in the sensations the same does it really matter? Anyone have experience?

Yes I'm self cathing now it is reasonably pain-free and much better than a Foley catheter

RE is obviously a big issue for some people. Bipolar TURP will cause this. However I have found that the sensation is actually better than before (I was on combodart by the way). I would rather ejaculate than not, but the trade off, considering the misery of not being able to empty my bladder and not being able to go without a toilet for any length of time, is massively on the positive side, for me anyway.