Rezum Treatment Details

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I hope this is helpful to you all.  My age is age 51, prostate size was a 57 (3 times what it should be) and overall in good health doing resistance training and a jogger prior to BPH Diagnosis.

I had the Rezum procedure done this week (Wednesday, 12/14/16). I had to see a Urologist because of frequent UTI’s and ended up in the hospital with prostatitis on top of that.  It was a scare and was encouraged to see a Urologist.  I was diagnosed with BPH, the Doctor put me on Tamosulin .4MG which took about 45 days before I saw a noticeable improvement.  I had all the classic symptoms of BPH; urgency, dysuria and nocturia etc.  On the International Prostate Symptom Score (I-PSS), I was like a 33 out of 35 possible.  My doc. said I was in a serious condition and that medical intervention was required for me to improve.

I first heard of Rezum and was immediately interested.  The doctor completed a number of test to confirm the needed treatment.  I had a urine and blood test, DRE, Flow Test, Cystoscopy, Biopsy of the prostate.  My biopsy was negative but I did have chronic inflammation.  At this point, my Flomax was working pretty good but I still didn’t like taking all these chemicals but it also caused retrograde ejaculation.  Of all the test, the Cystoscopy was the most uncomfortable mostly the tube working through the uretha past the enlarged prostate.  Knowing what to expect, I could do it again.  I got rather worked up over the biopsy and in the end it was nothing.  I hardly felt anything – at most a mosquito bite type sensation on the first sample tissue taken out of the 12 overall.

At this point, Rezum and Greenlight were my only two options I considered.  Since retrograde ejaculate was an issue for greenlight, I decided against that.  Plus, Rezum gave me the option to consider other options if it did not work.

I am now on my 3rd day and I feel great.  On the day of the procedure, I got a pain shot and 4 nerve block injections, then got lidocaine in my uretha to prepare for the final step.  The nerve block shots are similar to the biopsy – but you get an additional 2 shots that go deeper into the Prostate. The doctor visit lasted about 2 hours, but the actual Rezum procedure was less than 4 minutes, the injections less than 1 minute.  Despite the local anesthesia, it did hurt but one can endure it.  I would say it was a 6 out of a 10.  For me, it felt like a needle going into your skin.  However, it is really just the last half of the injection you feel because of the accumulated steam.  Peeing when you have UTI is about the same level of pain as the injections.  So, if you can take that, you can take the steam.  Immediately after the procedure, my worst pain was from the urgent need of having to go and void.  I returned home and soaked in a warm bath for about 30 minutes.  I was out of the doctor’s office around 11:00 a.m. and by 1:00 p.m. I didn’t feel any pain.  In the day following, I felt a numbness or slight sensation down there but no pain.  Since I was not voiding as much as expected, I went ahead and did a trial run with a self-catheter.  I opted for that versus having to wear a catheter for a few days.  I’ve not had to use one again, 3 days from the procedure date.

The doctor did say it would hurt for about 5 minutes after the procedure which was uncomfortable but he hold me that I’d be pleased w/the procedure results in 30 days.

The procedure will cause inflammation of the prostate tissue.  This causes you to actually get a little worse off than where I was, but by day 2, I was back to where I was prior to the procedure.  I am continuing my Flomax until my next follow up.  The doctor gave me a prescription for the inflammation and also prescribed Urogesic blue.  This little pill I think shaved off much of my discomfort.  I took it immediately after the procedure from a sample they gave me.  Again, after a few hours I was fine and surprised that I was hurting or in pain like I had expected. 

I felt the need to post here because I think most folks will put bad experiences.  Mine was a good one and I’d have this procedure again in a heartbeat – even if I only see the mild improvements I’ve had to date.  That I know only 1 patient (out of 100’s) had returned to the office and it might just have been his prostate was too large or there was something wrong w/the Rezum tool.  I want to ditch the pill and get back on w/living.  I would recommend this to anyone w/suffering w/BPH.  The worst that can happen is that you spend money and it didn’t work – but the doctor said nearly all his patients don’t come back after the monthly follow up visit.

I will update after 7 days and then again after 30 days.   No sex yet and don't plan on it until a couple of weeks from now.  When I had prostatitis sometime back, it was very uncomfortable and since I possibly have swelling I don't want to try that just yet.

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  • Posted

    Pleased to hear that things look good and thanks for the positive posting. Plese keep us updated and hope that you manage to come off the meds soon.
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  • Posted

    Great post. Thanks for sharing your experience. My biopsy was slightly more painful. I would describe it as like being snapped by a rubber band. Still not intolerable. I know some men (I think it has to do more with the doctor and pain meds givien) have much more pain during this procedure.). My cystoscopy was almost totally painless except passing the prostate (mine was 98cc) and even that was pretty mild. The cystoscopy was the procedure that psychologically bothered me the most. Thinking about a tube being shoved up my urethra. But with the numbing jelly it wasn't all that bad.

    Glad you had a good experience and look forward to your updates.

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  • Posted

    Good luck on your recovery.  A month after my REZUM 6/27/16 I thought REZUM was wonderful.  A couple of months later the pain I had before the procedure began to return.  The doc had me do a MRI which was negative and then a systosopy which showed that REZUME procedure was only about 50% effective so I still have blockage.  He put me on a nerve med, Gabapentin, to see if reduces the pain.  Gabapentin makes me feel like I am stoned.  So after 6 months he and his practice partners have not been able to find the source of the pain.  I had a easier time than you with the REZUM because they put me to sleep.  I will follow your posts and progress to see how you do.  Hopefully you will return to 100%
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    • Posted

      Thanks.  It's strange - but the day of my procedure was my last day of using Gabapentin.  After my hospital stay in September, my immune system was down and ended up with Shingles.  I was diagnosed with Shingles the first week of October.  Even though my blisters were gone and most of my redness I think had pain and itchyness 2 months later.  The doctor put me on a low dosage Gabapentin which has helped and hope that I am on my final days w/the Shingles.  I'll keep you posted.  What kind of pain are you experiencing and what was the size of the prostate?

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  • Posted

    I am feeling great, still absolutely no pain.  I’ve noticed more of a split stream and active bladder which I can attribute to chocolate and spicy foods though doctors indicate urgency and frequency up to 7-10 days.  Since I had improved rather quickly the fact these symptoms came back may be because of the chocolate/spicy food, I think.  In fact, the last couple of days I cut these two things from my diet and I felt a noticeable improvement.

    As far as meds, I am still taking Ibuprofen Tab 600 MG to help w/the inflammation, Urogesic Blue for any pain association to urination and still on Flomax at least until my next visit.  I’m also still taking the 500 mg Cipro for inflammation (chronic prostatitis) discovered during my biopsy.

    I am voiding about 3-4 times a night.  Still, no pain whatsoever since the procedure.

    A bit nervously and hesitantly about sex, I did have an orgasm on day 6.  It was anti-climactic since I felt the climax but it was very short lived and also completely dry, quite unusual.  It’s almost as if it didn’t happen.  Retrograde ejaculation (RE) is common with Flomax – but usually there is at least a little semen.  For me, RE makes me feel like I only get about 85-90% of the orgasm, it could do but I’ll be glad when I can get back to a normal one. Anyway, this was way too soon and probably not giving myself time to heal.

    Also, rather interestingly, I have noticed small pieces of scar tissue in my urine the last 3 or 4 days, with a slight tinge of blood on it.  It is about the size of a sunflower seed and a big sticky, which leads to believe it might actually be pieces of my prostrate that flow out with my urine.  I think it’s a good sign that my body is making progress to remove these denatured cells as a result of Rezum.

    I am thinking about cutting the Urogesic Blue to determine if in fact I need it and maybe in another week I may just take Flomax every other day to see how I am doing by week 4, thinking most of these meds will clear my body for the follow up.

    I will report again in a week to let you all know my progress.  Also, a couple more reasons why I don't want to stay on Flomax.  Although I was urinating much better, I was still getting up 2-3 times at night and would still get urgency.  It helped, but wasn't a magic pill for me.  Besides I understand that after time, the medication may no longer work and stronger doses don't necessarily mean it continues to work.

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    • Posted

      Dear Outtatoone and all of those posting on their experience about their Rezum procedure lol

      I have been following this blog prior to having the procedure and found it quite helpful. Like many have stated, it does not seem like our physicians provide full disclosure on what to expect post procedure.

      I had my procedure under general anesthesia on 08-Dec-2016 and wore a  foley catheter for 4 days. It has been 3 weeks today since my procedure, and would like to also share my experience to date.

      Foley removed 12-Dec-2016: experienced some pain and heaviness and tenderness in the groin area later that day and was prescribed TMP/Bactrim DS (a/b for possible UTI) and Mobic (anti-inflammatory) - symptoms resolved within a day or two.

      Week 1 (15-Dec-2016): I have seen some improvements in flow with some blood in urine which eventually turns clear, however, there was discomfort and irritation in the urethral/prostate area after voiding, which subsides after 2-3 minutes.

      Frequent and urgent urination during the day (5-9 times/day)

      Week 2 (22-Dec-2016): Similar to week 1, same issues with some additional improvement in flow.

      Week 3 (29-Dec-2016): Similar to week 2, again some improvements in flow, still some blood and discomfort/irritation after voiding.  However, not frequenting the bathroom as much during the day (3-4 times/day)

      Has anyone experienced the discomfort/irritation after voiding 3 weeks after the procedure? I have been on antibiotics and would rule out a UTI. I am assuming that this will eventually go away in time.

      As mentioned, earlier, it seems as though the doctors really don't tell you what to expect post procedure.

      I am still taking alfuzosin ER for BPH at this time until my doctor tells me to discontinue.  I see him again on 18-Jan-2017.

      I hope everyone finds this information helpful, and will update again in January.

      Happy New Year all.

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    • Posted

      Great synopsis Dave.  I wish you the best.  I've not seen any blood since day 1 and also no pain whatsoever.  As mentioned, my first day, I felt a numbness or slight sensation in the groin area but it went away after a hot bath.  Even before that, I felt something there but it was barely noticeable. Your tenderness after the procedure is probably from wearing the cathey. I have experienced a slight pain (in week 1) once after voiding - like someone kicks you in the rear (acute pain like peeing w/a UTI) but less intense.  However, I did get that once or twice during my prostatitis before the procedure.  Of course, at that time I felt like was peeing through an IV line and now more like a straw thanks to Flomax.  My guess is 2-3 minute pain is from inflammation. I am anxious to get off my last drug so I can better guage my progress (unvarnished from meds).

      I only got 4 steam injections (related to the size of the prostate) maybe that makes a difference on pain and blood afterwards??  I was also very careful I didn't take aspirin or anti-coagulants.  I got a laundry list of all meds prescribed or OTC to avoid for at least 2 weeks before the procedure.

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  • Posted

    OK.  I am two weeks out from the Rezum treatment.  Here is a quick update.

    Overall, I feel like I am making small progress.  Here is why I think that:

      The volume of urine output has increased by a few/couple of ounces from my first week, now can pee up to about 15 ounces.

     The time between bathroom visits is also up – can go up to about 1.5 - 3 hours now.  This varies depending on my intake.  But, initially days after the procedure I was going probably every hour.

      Improved Nocturia. I am making it a point to monitor my fluid intake late at night.  This has helped a lot.  I am probably now doing 2-3 bathroom trips vs. 3-5 in my first week.

      I have less of the split stream or revisits to the bathroom.  On the first week, I'd urinate and about 2-5 minutes later I'd be back again - getting much less of this now.

    I still see small pieces of scar tissue.  I cut the Urogesic blue and have had no effects as a result of that.  However, on one occasion I had a large piece of tissue going through my uretha and I felt it travelling as I voided.  I hadn’t had that sensation until I got off of the blue (pain) pill.

    I have also complete my Cipro 500 as well as the Ibuprofen scripted for inflammation.  Thus, the only pill I am taking now is Flomax.

    During week one, I just had stumped orgasms and completely dry.  However, right at week 2 I got my first full orgasm with ejaculate. This doesn’t usually happen especially if you are on Flomax because it causes the Retro Ejaculate.  At this point, I am at least back to where I was prior to the procedure so enjoying about 80% of an orgasm.

    The only thing I am still experiencing is urgency.  I don’t get much notice when I have to go, I hope this improves.  Lastly, I've not had to cather since that 'trial' run I did on day one.  Overall, getting back to life but still think or worry about where the restrooms are when I go someplace.

    If I don't see much change this week, I might just update you all at the monthly intervals.                 

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