Technical question about Rezum

Posted , 12 users are following.

I've read or seen a video by NxThera explaining in "dumbed-down" terms how the Rezum process works to kill cells in the target tissue. I recall some remark about it being inherently safe because the steam could not pass from one zone of the prostate to another.

My question is if by "zone" they meant transition zone, central zone, or peripheral zone, does a steam injection in the transition zone (lateral lobe) not risk damaging ejaculatory ducts or other vital parts needed to retain full sexual function that exist in that zone? When injury does occur in areas not intended to be necrotized, what is the mechanism or cause? Did the urologist get too close with the injection point?

Asked another way, when the urologist injects the 9 second blast of steam, how does he/she control or limit the region of tissue through which it penetrates and subsequently causes cell death when it releases the heat of condensation? Do they really know how far it will propagate from any given injection point?

This is the only thing that spooks me about Rezum...imprecise control over the tissue that is necrotized.

I would appreciate any insight that anyone has on this question.

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8 Replies

  • Posted

    I went with HDR Brachy in March of 2018..after reading its effectiveness on Prostate Cancer Foundation

    I have radiation cystitis as a result .....I said today at a doctor's appointment if I had known I would be seeing blood and pain when I urinate and risk developing bladder cancer from the radiation I would have gone with surgery........The Dr responded we just started using HDR Brachy in 2014 ...most side effects like RC and BC do not appear for 3 to 5 years ...Point being it is just not the cure when doing research but also what may happen as a result of the cure

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    • Posted

      I also had HD Brachytherapy - in 2014. Now, my bladder is hyper sensitive and mimics OAB symptoms. I also had a PAE in 2017. I have made the point on this forum several times that had I know about all of the side effects of the radiation, I would have had my prostate removed. Also, I have gone through five years of BPH torment, and for the past couple of years sleep issues. However, had I gone for the prostate removal, I might be having incontinence issues and wishing I had gone with the radiation. There is an element of uncertainty about any prostate treatment, whether for cancer or BPH symptoms. On a positive note, my PSA is now 0.2 and tissue samples taken in April after a bipolar TURP shower no cancer cells, so as far as I know I am 100% cancer free. Sorry to hear you are having blood and pain issues. My "radiation cystitis" is only minor but the disturbance of my sleep as a result is a very big deal.

      It's possible that your issues will improve over time. My bladder is feeling less sensitive as the months pass.

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  • Posted

    Russ,

    .

    At the end of November 2018, I had a Rezum consisting of 10 injections (4 per lateral lobe, and 2 median lobe) that was successful. I was on catheters for over 10 months before that which gave me the time to research the various BPH procedures available and also research the urologists available too.

    .

    It is important to carefully chose the urologist who will do your Rezum as it is such a new procedure. The 1st urologist that I saw had only done 12 which is not enough so I moved on to another urologist who was recommended to me on this forum and had been doing Rezums for about 2 years.

    .

    From her notes: "The verumontanum, sphincter complex were spared." which means that a good urologist with sufficient experienced with Rezum can as you wrote "not risk damaging ejaculatory ducts or other vital parts needed to retain full sexual function".

    .

    The bottom line is that Rezum works and but carefully chose your urologist who does it.

    .

    Steve

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  • Posted

    I would like some recommendations for a urologist to do the Rezum procedure. May I ask who did yours?

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    • Posted

      I presume you meant to direct that at Steven and not me since I haven't had the procedure.

      I'd also be interested in any recommendations for urologists who've performed Rezum in the Southeast US (NC, SC, GA, FL mainly).

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  • Posted

    I had my Rezum procedure done June 28 this year at Loyola University in Chicago. I traveled there from San Francisco to have it done by Dr Kevin McVary. Dr McVary helped with the original design of the procedure. He was the principal investigator for the clinical trials, and as far as I can determine, he's done more of the procedures than anyone else. I had a 93 gram prostate with a median lobe and had been doing CIC for 3 years. I can now urinate, and no nasty side effects. You can PM me for more info. Best of luck.

    Fred

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  • Posted

    I had the procedure done in October 2017 in Houston. The urologist warned that there is a chance of RE and I accepted the risk. It turned out that it was a total success. Almost no bleeding, catheter in for the first night and then it worked. Of course, it took a few months to see the full benefits, but it came through. Every human being is different and so it must be new every time for an urologist to do surgery, even though all men are alike. Dr G in H is superb, I fully trusted him.

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  • Posted

    To answer your question, the spray is quite narrow, so there isn't any real risk it going where it wasn't intended. The risk is from an inexperienced (with the procedure) urologist aiming it at the wrong place. That's how ED is avoided - the doc can see where they're spraying and can avoid where damage could cause problems.

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