Rezum Treatment Details - Part 2

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Pre-Op:

The Rezum lasted exactly 3 years. I was getting up much more frequently. I took the IPPS survey and found that my scores had gone back up (to severe) so I went to the see the doc. The good news is that I don’t need a biopsy, PSA is below normal. The only symptoms mainly is my nocturia which was up to about 3-4 times a night, up from about one, once I got the Rezum in gear.

Again, I feel like the cystoscopy was as painful as the procedure itself, well just a tad less but if you can take that, you can take the Rezum. The doc did put me on Flomax once more which I really hated. It took about 30 days for me to see an improvement but more noticeable at 45 days and went back down to 1,2 of waking to urinate.

I am in better overall health this time around than last. I’ve lost 60 pounds and doing more exercises w/the core and isolation exercises for various muscles. I feel great – but I know that I can improve my health with the Rezum. I did consider the turip – but it seems that too is a 2-4 year limited use before having to do a redo. The size of my prostate went from like a 58 to a 51 or so - not sure if this is due to weight loss.

Oh, by the way, the doc mentioned that I was his first patient back from Rezum. I didn't quite get catch all the conversation when he mentioned what he could have done differently - but it seems I was a use case for his improved technique. The Doc felt much more confident adding that his experience over the years has improved in both the procedure and the results. My hope is that w/this, maybe I can get 4 years out of the 6 minute treatment. My last rezum was on 12/14/2019.

Day 1, 12/13/2019

Well, OK. Almost 1 day to the 3 years from my first procedure. The procedure started at 2:45 p.m. and last about 6 minutes overall. This time, however, I had some nitrice?? It was an extra $150. Comparing my first procedure against the 2nd, I would say that the first one was a 10 and then second one was a 4 w/the nitrice. I suggested to the medical assistant that just prior to the procedure, I should have gone to a 50 cc setting – I felt the first injection and steam. Immediately, after that I was taking major breaths to get more of the nitrice - but the last few injections were far less painful. It seemed that after the first one, I didn’t feel the other 5 injections of steam. Also a change from my last procedure (same doc), he put a catheter with a urine bag on me, I didn’t feel that.

Within a few minutes – probably 5-6, I was able to get up and go to the bathroom to empty the cath bag and get dressed. I had almost no residual dizziness or vertigo so getting dressed was not hard. I learned the cath bag needs to be secured to your front thigh. I am now 3 hours post procedure. I feel some burning inside my penis, but I think that is just the cath. It seemed my last procedure – went smoother post procedure but the cath should help me to rest better once I get used to it and some of the pain of the procedures goes down. It also will help the healing process so it may be some pain/discomfort now and better recovery later. I had a small bowel movement and noticed some blood in the stool and paper. I’m sure this is from the shots and procedure itself. I am to have the cath on for 3 days before I can remove it – we’ll see how that goes.

My recollectioin from last time, is that I had an ejaculation at 7-10 days but it was way too soon for that. It was painful and I plan on not repeating that mistake. I plan to go a full 4 weeks before sexual activity. Anyway, the Rezum takes much of the sex interest away and the stumped organism isn’t worth the risk of an infection or bleeding or it impeding the healing process.

On my first procedure I was given the blue Urogesic pill samples which I took right away since I didn’t have a cath. Round 2, the Dr. advised that I am not to take these until after I get the Cath out – but I may try taking them. I still feel burning when peeing even w/the cath – so I am hopeful the blue pill will help with some of the discomfort. Also, I took some ibuprofen and just got my pain prescription Ibuprofen 600 mg, hopefully this will help me out w/the discomfort and sleeping tonight.

My first night wasn’t too bad. I got my prescriptions filled and took both of them immediately. This made a noticeable difference in my pain/discomfort. I took it easy that night and slept pretty good, continued to drink a lot of water so got up 3 times to empty the cath bag. I do feel like the blue pill is needed even w/the cath on as this has caused my ‘burning’ sensation to get significantly reduced when urine passes.

Lastly, since the procedure I have felt urine pass, it’s not something I can really control but it happens or felt most when my body is moving - sitting up or down etc.

Day2, 12/14/2019

I have continued w/the medications, comfort and mobility is much more improved. Overall, I feel fine it’s mainly my penis that feels tenderness. It’s awkward to walk w/the cath on so you can get around with a slow gait. I don’t know that I’d enjoy shopping or going to the range but there is nothing that stops me from doing that.

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  • Posted

    I believe that you were given nitrous oxide, a gas that is also used by some dentists in place of an injected anesthetic.

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  • Posted

    Ask your doc to show you how to self cath. Its much better than a foley - no pain , no restrictions and until you can pee again, you'll have an almost 100% normal life.

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    • Posted

      Thanks! Yes, I considered that and did self-cath the first time around. I decided to do the cath bag because the doctor indicated that I'd see better results, healing and reduce infections. It's a drag but I'm hoping it speeds up my recovery. I'm with you on the 100% - and do feel like Rezum is a near perfect treatment. The only downside is that it seems at some point, I had urgency but the doctor indicated it was my age, not the treatment. I'm never going to pee like was 19 years old - but Rezum was a drastic and noticeable improvement nearly a wonder treatment for me. For this reason, I decided to have it again - even if I have to do this again in another 3-4 years; well worth the results pain and trouble. It gave me my life back and that was enough for me. The green light was not an option given my age and desire to have a fulfilled sexual life.

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  • Posted

    Good luck on rezum number 2. Had mine jan 31 2019. ipss 22 to 8. will have a cystoscopy in january to observe the results. My symptom relief in the leaking and urgency area are greatly improved. still get up 3 times a night. Have a slight delay when beginning to urinate but no straining. 150 prostate, 15 injections. overall flow is better than before and the procedure was a complete success for me. Finesteride 14 days prior to procedure for bleeding which i had none. 2 pain shots to the prostate only. Procedure was uncomfortable but not painful. foley 3.5 days. No pain at all day 2 which totally surprised me. Felt immediate mass reduction in the prostate area and healing went textbook. my psa was reduced from 29.8 to 19.8 have another one this month. mri last month said aggresive prostate cancer was highly unlikely. Just have a xl prostate. would consider round 2 to further reduce the mass of the prostate and to tighten up the area outside the bladder. Would do it again and might later this year. Love my results. Most surprising was the final increase in the leaking area around month 8 and 9. went from improved in that area to no leaking at all. feel very solid. good luck to everyone with BPH. This procedure will help you

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    • Posted

      Thanks for the update raygar13! My IPSS has varied 25-32 and I'm hoping I'll get back to 5 which is my best score after Rezum #1. Since the removal of the tissue is from w/in the Prostate, I don't believe size changes. Mine changed but only because of my 60 pound weight loss. Let me know if your prostate did shrink as a result of the procedure. My understanding is that the prostate size doesn't matter as much as the obstruction or blockage that it creates. This morning I was researching on Laser Enucleation which is a new technique for BPH. There is a doctor here in town (San Antonio) that trains other doctors on the technique. It seems you can still keep most of your sexual capabilities but there is some retrograde ejaculation. Anyway, it may be an option I consider next time around and a worthwhile tradeoff. The doc was trying a different technique on me in hopes he can get it to last longer. He has done many other people but none of them have returned for a redo - so perhaps it does depend on the person and on the prostate shape and/or procedure itself.

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    • Posted

      most reading indicates a 30 percent reduction. my psa is down 35 percent which seems to correlate. for a prostate to grow from under 30 to 150 and im only 62, it would be foolish to think it wouldnt continue to grow after rezum. the nice thing about the procedure is it kills the cells on the outside of the urethra, if done in an overlapping pattern (of injections) it should free men up for more than 3 years. rezum statistics at the 3 year mark show the improvement holding at the 3 year mark. I recently caught an infection near the bladder neck or the bladder and i had trouble urinating until gone (8 days antibiodics) it is the one area that might need touch up. I told the urologist that i was sold on rezum despite no clinical trials of 80 to 150 prostates, and if we had to do 2 rezums, i still wanted this procedure. lastly, my urologist said she could clearly see the area that causes retro and stayed away from it, if you inject that area it will kill the cells and retro is possible

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  • Posted

    Raygar,

    Glad to hear about your improvements.

    Do you know the theory behind why Finisteride should slow bleeding ?

    THomas

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    • Posted

      I know my urologist had a rezum patient and there was a lot of bleeding during the procedure. She shared that with me prior to me picking the procedure. When I went in 2 weeks before, she immediately put me on finesteride and later antibiodics before the procedure. I, like you was not sure why and I didnt ask but later at home I googled in finesteride bleeding and operations and found that finesteride aids in stopping bleeding. I was to take an oral relaxer prior to rezum and prostate block, same as biopsy. I wanted to drive myself home, so I asked to eliminiate the oral meds and just had prostate block....2 shots. Didnt find the procedure painful 4 out of 10 but the shots do get warm around 7 seconds out of 9.

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  • Posted

    Day 3 (Sunday) 12/15/2019

    Aside from the Cath, I can say that I feel much better. Yesterday, I had to walk gingerly, sitting up or down had to be done slowly. It wasn’t necessarily because of pain, but just getting used to having the cath in me. Today, I feel much less of it and am walking a bit more normal. I also showered yesterday w/the cath on so that wasn’t so bad and made me feel a little better. I have one more day to go. There were a 3-4 instances yesterday where I felt a ‘burning’ sensation – similar to that burning when urinating w/a UTI though not as intense. I thought I’d be urinating, checked the bag and nothing was coming out. I’ve not had that sensation today.

    Absent the ‘Cath’, I’d say I’m almost back to normal. I will continue taking the Flomax until I finish my prescription since it will take 3-4 weeks before I really notice Rezum do it’s thing.

    I’m still drinking lots of water. Tomorrow I’ll post on how I feel w/the Cath off. Thus, far I felt my first time around was easier; maybe I just didn’t know what to expect. However, w/the cath off it may help w/my overall recovery timeline, we’ll see.

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  • Posted

    Day 4 (Monday) 12/16/2019

    I took the Cath off this morning! Oh, what a feeling to be free again. Once I urinated naturally, I felt comfortable enough to go to work – but still packed a self-cath w/me in case I needed it, for an emergency.

    There is some redness and tenderness at the head of the penis which seems to be from the 3 day cath. I don’t recall having that issue last time around.

    I’ve been peeing about every 45 mins. to 60 mins. For my first episode of peeing, w/o the cath, I felt little to no discomfort, no blood, but did see a few pieces of tissue (red) for the first time. The second time urinating, I definitely felt the ‘burn’. Stream has been weaker than before – but I do remember that things will get worst before they get better. I’m also seeing some split stream, something I wasn’t getting before. There is urgency when I need to go so it requires I be more attentive when I first get the urge.

    Returned to the Drs ofc for a follow up visit w/a PA. I was able to clear my bladder via sonogram, so far so good. They suggested no ejaculations until after the urgency and when I no longer pass prostate tissue when urinating – which happens about the 3-4 week point.

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  • Posted

    A few things I failed to mention yesterday. I did not take the prescribed Ibuprofen pill – didn’t feel like I needed it. However, I’m still taking the Urogesic blue and Flomax. Towards, the end of the day, the ‘burn’ was much less – only slight discomfort, 80% less than day 4 morning. Also, the PA suggested that I put some Neosporin on the head of my penis. It was very dry and had lots of redness so we’ll see how this helps.

    Day 5 (Tuesday) 12/17/2019

    The Neosporin did wonders. I’m so much better than yesterday. One day makes a big difference.

    Overnight I got up a total of 3 times, an improvement. I went nearly 5 hours w/o peeing!!

    Overall:

    Hardly any pain, at all – ever so slight burn when I urinate. The blue pill is at work.

    The head of the penis is much better – the rawness is gone.

    I’m going about 1.5 hours in between bathroom visits today, an improvement over yesterday.

    My overflow stream/flow is improved but still weak pressure.

    Still seeing tiny/small pieces of flesh when I pee.

    At this point, I feel like I'm doing as good as or better than my round 1 of Rezum. I'm please thus far - still no exercising.

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  • Posted

    Outtatoone,

    .

    The big unknown with Rezum is how long will it last before the prostate grows back. So far there is only about 4 years of published data and probably an additional year of unpublished data.

    .

    I had a successful Rezum in November 2018 so I am about 1 year out. The procedure went well and the pain was easily tolerated. The recovery followed the standard schedule and I am peeing OK.

    .

    I decided to remain on Finasteride to prevent prostate regrowth and the need for another Rezum. Other than my bald spot filling in, I have seen no side effects from remaining on Finasteride.

    .

    Steve

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    • Posted

      Any procedure including rezum that reduces the prostate is only temporary. When the steam is injected into the prostate it disperses and kills all cells it comes in contact with, within the zone it is injected. At 4 years from rezum original trials the procedure is holding for most men. I was always in the state of mind that a second procedure is a possibility. I too am at the one year mark and some of the improvements from the first happened in month 8 and 9 (symptom relief for leaking got way better) From a leaking and urgency improvement, I can say the procedure was a success and I love being back in control. I have flomax still, sometimes take one at night, but am 95 percent medication free. A lot of men only get up once a night after rezum, i still get up every 2 hours or 3 times a night. 3 of my 8 points on ipss. Have some 3 or 4 hour sleep intervals which are appreciated

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    • Posted

      Raygar13,

      .

      After my Rezum, I did not have leaking and urgency problems. I only get up once a night to pee. My recovery followed the standard progression so by 3 months things were pretty normal. Due to bladder damage (when I was in AUR, they took 2 liters of pee out of me), it took 9 months for my PVR's to get below 100 ml which is normal for guys our age.

      .

      Steve

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    • Posted

      Leaking was a big issue prior to rezum. at 3 months it got noticeably better but still some occurrences. steady improvement to month 8 where leaking was 100 percent gone. Also at 3 months, I noticed i could postpone urination which I could not do before rezum. Confidence and peace of mind.

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