Rezum, olympus button turp or other?

Hi Riggs,

From what you describe, sounds like high pressure due to obstruction per urodynamic testing. The good news is that your bladder is still in the game but not strong enough to pass the obstructive prostate on its own. 

One approach is to remove the obstruction -- turp, urolift, rezum, etc -- and hope that the bladder has enough game to empty itself. Sounds like at this point in time it's dependent on the procedure, but still questionable. 

The other approach is to continue to recondition the bladder through self cathing (CIC). This is the approach I took three years ago in a similar situation to yours. 

I didnt have the Urolift option back then or Rezum, but frankly I'm not crazy about either at this point, and I don't like the sexual side effects of TURP such as retrograde (dry) orgasms. 

Unless one of these new procedures grabs your attention, I'd just continue on with CIC until either something better comes along or if your're lucky your bladder will rehab itself to the point where either you won't have to cath at all or only have to cath now and then. That's where I'm at today, from cathing 6x/day three years ago to cathing only maybe once a day or every other day now. Other than that, things work pretty normally with no significant symptons of bph.

Have you ever done a void log? Just write down the time and amount of each void and note beside it if the void was natural or from the catheter. You want to adjust your cath schedule so you're never carrying around more than 400ml at any one time in your bladder. So, for example, if you do a natural void of 100ml, and then cath rightt after another 500 ml, you were carrying around 600 l which is too much and will keep your bladder stretched. In that case increase your cath frequency. 

We also have several threads dedicated to CIC that might be helpful. 

Jim

Hi Riggs, you haven't mentioned any possibility of taking medications. Meds may allow you  to urinate again by relaxing the obstruction. Some people have side effects from meds and some don't. Self cathing is fine but it is not for everyone, and can be inconvenient at times. Just don't rush into surgery. You may regret it. Hank

I've also read that if meds don't help you, surgery probably won't help you either. Hank

I had the Rezum procedure just over 5 months ago. My prostate was 54 grams, with a smallish median lobe. I had 3 steam injections on the left, 3 on the right, and 1 in the middle. The original plan was 2-2-2, but the doctor adjusted based on what he saw during the procedure.

Like you are planning to do, I had a cystoscopy prior to the urologist saying that Rezum was a good option. This is essential data to have in my opinion.

I picked Rezum since it seemed to be a low risk option that would allow more aggressive treatments later if needed. I sought out a urologist that had experience with Rezum (he was involved in the clinical trials and had done more than 80 before me) since my local urologist had not done any at all. He was willing for me to be his first patient, but I was not.

I'm happy with the results thus far. My IPSS has dropped from 23 to less than 10. Recovery was relatively quick, on the order of 3 days until I felt physically normal and capable of doing all activities. I delayed sex for 21 days, just to give the prostate time to heal. The first month of sex wasn't the best, but things got back to normal after that. At the 4 month followup, I told my doctor that the enjoyment was 110% of what it was pre-Rezum. He said that he hadn't heard this before, but it just feels better.

I'm now 62 and in pretty good health (5'8", 145 lbs), except for this pesky BPH. This may be a factor in my results, along with doctor capability.

I hope this helps you make a decision, Riggs.

Best wishes,

  Bill

Hi Riggs,

Glad it worked out! Experience definitely seems to count with some of these newer procedures. Being number one isn't always a good thing!

Jim