Rezum Treatment Details

Week 3 Update.  No meds other than Flomax which now just take every other day.  With this change, On Saturday(12/31/2016) and today (1/4/2016), I started to get a slight burn in the morning (when meds skipped) when urinating followed by a slight burning sensation for a few hours – a feeling that I had to go or wasn’t finished voiding.  The urine was mixed with some tint of blood – something I hadn’t seen except the first couple of days.  Oddly, this is something reported by Dave96087 reported in week 3 of his recovery, not exact symptoms but similar discomfort.  This has really been my first instance of any pain since the original procedure.

At the start of the new year I took 3.5 hour drive comfortably.  Driving through rural country is usually a nervous time for me because I find myself constantly thinking about where the next restroom might be but felt more relaxed about it this time. I’m seeing less to none of the denatured cells in my urine.  It might be there but can’t see it anymore with the naked eye.

Last week, I was in a meeting that lasted 1.5 hours.  I went almost 2.5 hours w/o voiding.  What was interesting is that I needed to go at the hour but was able to hold it for another 30 minutes or so.  There have been a few other instances this week where I am voiding when I want to rather than when by body demands it.  Usually, I get the urge and I barely make it to the toilet.  Overall, still good with Rezum.  

I am now at 4 weeks.  I had failed to mentioned in my week 3 that I had a few nights where I only got up to void once overnight.  Yes, I am being more careful on my fluid intake at least 2 hours before bedtime.  However, I tried this before Rezum and didn’t make a difference so I quit monitoring fluid intake.

I am still taking Flomax.  Pain (discomfort) of any kind is completely gone.

Theoretically the expectation is that I will see changes at 30 days – buy I noticed slight improvement as early as week two.  There is noticeable change as well with respect to my ‘urgency’, I have much better control and postponement.  It typically comes on urgent for a few seconds but I control it and before long another hour passes before I actually go (some days better than others, but improvement).  I started doing Kegel exercises to see this helps me.

I cut caffeine out for the most part and again, I think it’s really helped me.  The intermittent burning sensation after voiding from last week is now gone.

Finally, I wanted to add a word about Prostate Artery Embolization (PAE) which is a procedure that I had considered in lieu of Rezum.  I had actually talked w/one of the Doctors in San Antonio, TX.  Urologist do not do this procedure but rather an Interventional Radiologist.  The IR DR had mentioned that they do these all the time on other parts of the body/organs – but Prostate is something new and he did probably 1 or 2 a month.  This is a whole other subject and there is plenty of documentation on this but my decision to not take it as my first option is that it can’t be undone and had a lessor success rate than Rezum.  It’s a permanent solution and essentially killing parts of the prostate by cutting off blood supply.  It could be a second option for me if Rezum does not provide the desired benefits.  It would be unrealistic to expect my urological health to be like it was when I was 20 but I’d be glad to avoid dependency on meds and not have to pee every 60 minutes.  I’d still pause before considering PAE only because that just isn’t a part of the medical protocol for Urology.  Maybe it should, but doctors who work with this disease (BPH) don’t think this treatment is appropriate. There again, there are Urologist who don’t do think Rezum is a recommendable option either.  For this reason, I considered Green Light as a secondary option but decided against it due to the Retro Ejaculation it would cause.  Overall, I made an informed decision that Rezum gave me the best chances of success and still allowed me to keep other options if it didn’t.  Thus far, it is proving to be the right decision.

This week, there were a few nights were I had 0 voids.  Man, I got up so refreshed, it was great to have that.  At most, I am now just getting up once per night.  Sexual activity is limited since I hate what Flomax does to my sexual health (RE and stumped orgasms).

Had Rezum done on 12/14/2016, 1 month report.

Follow up with PA today.  My IPSS score was 13 and nearly half of that is on the issue of urgency.

Overall, he had great feedback and indicated I was doing great.  At 4-6 weeks, he still gets grumpy patients who have not yet realized the full benefits of Rezum.  As of this last week, I had 3 days where I got up 0 times to void, 3 nights – got up just once and one night got up 2 times.  The one where I got up, I did not monitor my fluid intake.  This is really great progress.  My stream is better but urgency is the only thing that remains.  We discussed Kegel exercises but also prescribed Myrbetriq 50 mg.  He added that it would take a couple of weeks for me to notice improvement.  The PA added that because of my constricted urethra (BPH), the bladder got accustomed to constricting in order to push the urine out with the blockage.  Overall, got an all clear – no infections, no issues.  I mentioned that I had sexual activity in week 2 and he said it would not affect the overall treatment – but at this point all clear to move forward.  The Flomax can be stopped.  In a little more time, I will be much better and will have addressed the issues which led me to the hospital just a few months ago.  He added that I will continue to see improvements up to the 90 days.

Bottom line, if you have been on the fence, I hope this thread let’s you see the potential for Rezum treatment.  Some might be better in recovery and others may take longer.  What I have heard from the Staff is that Rezum patients typically don’t return to the office.  That’s a good a sign and assurance of what is possible.  Still, the Dr. will help you decide based on your individual scores and diagnosis, symptoms and physical condition whether it is a good option for you.

I took my first pill of Myrbetriq 50 mg this morning.  I’ve drunk lots of water all afternoon and not had to go so the impact seems immediate to me.  So, at this point, I will not update monthly unless I run into an issue and will update again after 30 days.

God bless, ya have a great New Year!!

Month 2 – Post Followup 2/10/2017, Rezum done on 12/14/2016.

During my second month, I took Myrbetriq 50 mg and this helped to ease the bladder contraction and thereby reduced that sense of urgency that I frequently had.  Simultaneously I quit taking Flomax and noticed a slight dip in the force of my urine stream for a week or two which is not now an issue.  Also, since I am no longer on Flomax sexual activity has returned to normal with an improved strength of my orgasm and normal ejaculate.  Surprisingly, even the volume of ejaculate is 3-4 times of what I was getting just a few months back (before RE due to Flomax).

This last week (week 8) I have felt almost back to normal on all fronts.  I am producing more urine overnight I can now void 500-550 ml or about 2 and 1/3 cups.  Aside from Myrbetriq, the Kegel exercises have provided much help. 

Overall, I can say that I have much more freedom and peace of mind.  I’ve been able to increase my walks and jogging distances.  Just a few weeks ago, I couldn’t spend more than 20 minutes on the track before needing to go.  This week, I’ve seen my bathroom trips go 3-4 hours at a time and no discomfort from urgency that I felt before.  I still get it here and there but much of it is now gone.

My IPPS score has gone from 33 at the time of treatment to a 5 today.  My PVR was 0 this morning, urine infection is negative.  The doc. mentioned that my recovery has been better than average.  There are just so many variables that go in to recovery:  age, size of prostate, general health.  I feel like my choosing not to use a catheter was a real plus and probably reduced many of the negative symptoms experienced by others.  Overnight, I may get up 0 – 1 times per night.  In one instance, I slept 10 hours and never got up.  I wake much more refreshed and ready for the day. 

I do not have a 3rd month Dr. visit since I don’t feel like it is necessary.  I am now taking 0 medications of any kind and the constant thought of having to know where the bathroom is now gone.  It’s a new kind of freedom.  Since my recovery can take another 30 days, any improvement beyond this point is just plain gravy.  I’d be happy w/what I have now.  I am perfectly happy with the decision to do Rezum.  It was certaintly worth the few minutes of pain and discomfort.

I am now over 3 months - which is the maximum time frame where results can be expected.  Rezum has been a miracle for me.  I recently took a long trip and can say that I passed Rest Stops (w/bathrooms) without stressing out over that.  I am back to an average of 6-8 urinations a day on average.

Nocturia:  about 0-1 per night.

No more pain during urination.

No weak stream.

No straining.

No split stream (intermittency).

Urgency is practically gone - would say it is more like normal.

No more pills.

No more stress w/going somewhere to exercise for fear of having to go.

No more incomplete emptying.

No more leaks.

If I had to take my prostate survey once again (IPSS), I'd say I probably a 0 now and was a 33 just a few months ago.

No wait on Rezum, I would recommend this to anyone who is healthy and suffers from all the classic symptoms of BPH.  The only thing I'd like to know is measure my prostate, I'll report on that again later.

 

Thanks for posting this and please do keep me informed on your progress.

Hi, Folks. It's been a while since I wrote last on my Rezum. I don't regret the treatment but I've concluded that it's only a temporary fix. My doctor says, I am one of the few who have returned but it seems to me that others folks don't come back because they figure it's not worth going back to the same doctor or they feel like they are out of options and just live with BPH. My first Rezum treatment seemed like a wonder treatment and gave me measurable improved results in a matter of days. However, it lasted less than 3 years. Knowing the symptoms, I found myself back to where I started. I'd been one of the first people to have this treatment when it was still late in the trials (2016 ish). At the time, no one really knew how long the treatment would last. Having now had the treatment twice (again in 2019), I can tell you, at least from my own personal experience, it will last 2-3 years. For the cost and the pain associated to the treatment, I wouldn't do this again. And, much of the literature I read indicates that results from retreatment won't be any better than the first. This was true in my own case. And, for some reason, my second treatment caused retrograde ejaculation and my ability to have more reliable and hard erections. The doctor said it was all in my head. The regular flow of my ejaculate returned about 1.5 years later. Stumped orgasms are rare due to Flomax but there is a chance of permanent damage, I got lucky that my sexual functions eventually returned back to normal.

Presently, I'm back to all my classic symptoms of BPH - nocturia, urgency, reduced flow, start/stop stream. I had been looking at a pamplet for Urolift which my doctor was excited about, but having done more reading - no way! That is also a temporary fix. I'm now researching what I do next. I've got two doctors I am now consulting. So, I will either have PAE or Aquablation. I'm thinking I'll be okay with either one. Aquablation can preserve all of your manhood functions and seems based on similar type of procedures you'll get 10+ years benefits, in line w/some of the more instrusive procedures (gold standard i.e. TURP). Lastly, Rezum never really treated my urgency. I've heard many of the other doctors on YouTube say the same. I hope you find this useful. I you are interested in something that is minimally invasive, painful and just something to buy you some time to find something more permanent, then Rezum is an option. I didn't have Aquablation as a treatment option at the time. PAE was still fairly new and Urologist really don't like to hear about it. I consulted with an Iterventional Radiologist and he said that PAE is now the primary treatment option in Europe. The good news is that if it doesn't work, you can still go to one of the therapies offered by a Urologist. The downside is that my insurance Aetna may not pay for it so I'm still waiting to hear which way I go.