Rezum Treatment Details
Posted , 27 users are following.
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.
4 likes, 44 replies
bob955 Outtatoone
Posted
Just an FYI - Dr Steve Kaplan at Mt Sinai NYC - who is a world renowned voiding expert told me PAE is too new to use it - and also it is temporary.
You'd have to check with your own doctor re this.
Bob
Outtatoone
Posted
Update. I am no longer recommending Rezum. Here's why. I sought out Rezum because I felt that it gave me some options until better treatments came along. Well, in my case, Aquablation seemed like a viable treatment. I had 2 treatments of Rezum and each treatment lasted less than 3 years, the second time around the improvement was less noticeable and I ended up getting retrograde ejaculation. However, I got some of my normal function back w/o any treatment or drugs. The doctor said I've been the only patient where that has happened. Bear in mind, Rezum claims as on of their treatment benefits is not to have an ejaculatory downside. In my second instance of it, it did affect me.
Unfortunately, because of Rezum, the doctor was adamant about not doing Aquablation. He said the tissue was no longer in it's pure form and that he would have to 'dial down' the pressure of aquablation and there were yet no studies yet for people with my medical history. Moreover, he was concerned about having to perhaps do another redo or 4th surgery, each time having its own risks. This was a disappointment because I felt the right treatment had finally come along. The doctor did say that had it not been for Rezum, he would gladly do aquablation. So, this month 10/2022 I ended up doing BPH but my doctor tried to spare my ejaculatory function. He knew I was not interested in retrograde or 'dry orgasms' so he used a newer technique to try and save that. I do not yet know if it worked or not but I was glad to know this modified technique was an option. I'm now 5 days out and feeling rather normal. Really my side effects and recovery pain weren't any different than with Rezum. I hope you have found this helpful.
ted1960 Outtatoone
Posted
Hi,
What does this mean?
"I ended up doing BPH"
I had an unsuccessful Rezum, and then I did have Aquablation.
compiler ted1960
Posted
You reported you still not fully empty your bladder, and still having cathe after the aquablation. So it(aquablation) was not successful. Your Uro recommends TURP. You are one of few patients reporting the aquablation was not successful. Can you detail why the aquablation was not successful in your case?
Outtatoone
Edited
My apologies for the confusion. I meant to say - TURP for my BPH, at least a modified form of the procedure (for the golden standard). From my research, I have concluded that Aquablation is the new golden standard. So, TURP was my second choice.
compiler Outtatoone
Posted
Your 5 years experience really kicks the Rezum to curb! Is there any 3 years or more positive Rezum experience to refute it?
Outtatoone compiler
Posted
It does. I wouldn't have been bummed out as much had I been able to do Aquablation instead. In August 2022, I ended up getting yet another UTI infection, Prostatitis. It was bad timing as I was about to head out on an Alaskan cruise, trip for 12 days. My last UTI landed me in the hospital so I didn't take it lightly. Interestingly, on my UTI follow , the doctor said this, " ... I am beginning to change my tune about conservative treatments ..." I took it to mean non-resective treatments thought I reminded him that Rezum was my decision but it didn't seem like that comment bodes well for Rezum. However, the doctor also made several statements that he was getting people back from Rezum. I'm just wondering if they just went to a different Dr., because I sure thought about it so perhaps there are others that had a better experience out behind 3 years. My guess is that most folks give up and just live w/symptoms figuring there isn't a better option out there. The whole theory or sales pitch for Rezum is that you can do other options if it didn't work. I did watch a few videos from other Urologist who seemed to indicate that Rezum does have a limited impacted, possibly 3-5 years. Both of mine, resulted in short term improvement of 2.5 years or so. The other 6 months was doing the lab work all over again and getting in the queue for the procedure. I'm hoping TURP has a longer range benefit for me. I'm now a full week out and having less discomfort when peeing and am having a little better bladder control. The first couple of days, I was having some leakage and near accidents as I couldn't hold it back but that's improved quit a bit now. I didn't see any blood past the 3 day mark so that's a good sign for me.
compiler Outtatoone
Posted
So you underwent the transurethral resection of the prostate (TURP) because your prostate condition after two Rezum procedures was not favorable for the Aquablation therapy. How much prostate size was reduced by two Rezum procedures before the recent TURP, by the way?
Outtatoone compiler
Edited
Exactly. Oddly enough, it is not part of the protocol to remeasure the prostate following surgical intervention. Also, I don't know how accurate those things are anyway. I've had several over the years and it seems to be partly subjective on the operator and/or clarity of the sonogram. Having said that, prior to any BPH treatment prostate size was 57 and right before the TURP it was 45. I think the doctor was looking to ensure my prostate size was above 35 to recommend the right treatment protocol or insurance purposes.
compiler Outtatoone
Edited
45 cc prostate is not very large. Many patients can live with it. UTI infection and prostatitis can be resolved by antibiotics and anti inflammatory drugs. However, the patient should decrease the sexual activities to avoid UTI and prostatitis. Hopefully TURP does not affect the sexual function.
Outtatoone compiler
Posted
Thanks and agree on the size. It's not so much the size as it is the level/degree of obstruction. Some people have 200, 300 cc with no obstruction so they don't have any symptoms. I know folks with smaller sizes than mine who have a greater level of obstruction and thus complications from BPH. The sexual functions was the primary reason I wanted to avoid TURP but the effects of the surgery are still unknown, still have another two weeks before delving into that. The doctor performed a modified version of TURP since preservation of sexual capabilities was important to me. My preference is to avoid antibiotics given I've had to deal with bacterial resistant infections while in the hospital.
cali-mike1970 Outtatoone
Posted
Hi, read your thread and really found it enlightening. I haven't considered Rezum because this summer that I started looking into options, many of the doctors that don't offer it said they get alot of Rezum returns and it doesn't last. Same with Urolift.
I concluded PAE and Aquablation would be my first step because I'm in my early 50's and don't want RE. I found a doctor in the midwest (Nebraska) that advertises doing epTURP (ejaculation sparing). Do you mind me asking if you are in the central midwest or by chance the West Coast and found a doctor out in CA or nearby that does it?
I've heard the recovery from epTURP can be easier than traditional TURP, but the results are comparable. Did anyone say that or do you think you've just been lucky with your recovery?
I'm worried I have a mild prostatitis going on and whether it will get worse if I do a procedure, but I guess I can have antibiotics on hand or take them preventatively just before and after the procedure. Any insights on any of this is appreciated.
Outtatoone cali-mike1970
Posted
Hi, actually that is what I had done, epTURP. It has only been a little over a month but I am getting retrograde ejaculation so that is disappointing. I'm not sure if that is going to change but I suspect it won't. Since you have not yet treated BPH, I would go directly to Aquablation. It's the perfect solution you are looking for. Yea, Rezum is a temporary measure and not worth the effort. In fact, my epTURP recovery was no different than Rezum, it felt about the same but I had to reduce activities i.e. exercise for 2 weeks with TURP. I'm actually in Texas. Best of luck to you, it sounds like you are doing your homework.