THE JURY IS STILL OUT

My name is Vern and my initial dilemma was a choice between the HoLEP method of BPH treatment and REZUM. The doctor that would have performed the HoLEP moved from one medical facility to the Mayo Clinic and unfortunately, the Mayo Clinic would not accept Medicare. I suppose I could have searched for another doctor that performed the HoLEP treatment but I was in a hurry to get some relief, plus, the REZUM treatment seemed less invasive and tissue traumatic. Therefore, I went with the REZUM.

I had the REZUM performed on 10/15/2019. Contrary to the advertisements, the procedure itself was not exactly a walk in the park. Besides being very uncomfortable (to be expected) the pain of the needle and injection of water vapor into the prostate through the urethra was quite painful. I did not enjoy it at all and afterward thought I would not choose to go through that again. I honestly think that the level of pain one experiences from the procedure justifies at least a twilight sleep, if not general anesthesia. The procedure lasts only about five to ten minutes so putting someone under for that period of time would not be that harmful, in my opinion. After the procedure, my urologist put a catheter in place. I was instructed to remove it the third day post surgery and revisit the urology office for a flow test.

On the third day post surgery, I removed the catheter at home and drove to the urologist who was about an hour and a half away. On the way, I developed an urge to urinate that was so strong that I pulled off to the side of the road but could not urinate even a drop. I got back in my car and continued my journey to the urologist. I felt like I was going to explode. I was torn between getting off the road again but the thought of loosing more time and not being able to urinate anyway kept me moving forward. When I arrived at the office of my urologist, I skipped the check in procedure and walked into the back room without being called. They took me right in but unfortunately, the doctor was in surgery and I had to wait in what turned from significant urgency to significant pelvic pain. Luckily, the doctor was not too far away and he eventually arrived to reinsert the catheter. What a relief. For that reason, I would not advise anyone to remove the catheter themselves after RESUM, unless you are very close to the office of your urologist and very close to your appointment time.

My doctor said the lack of ability to urinate was normal and that I should not be worried or lose patience. We set yet another appointment for a flow test in another four days but this time, I waited to remove the catheter until I was at the office of the urologist. I wasn't about to go through the discomfort I went through the last time I removed it myself at home. It was now a full week post REZUM surgery and I was again at the office of my urologist. I removed the catheter in the waiting room lavatory and waited for my appointment time, which was in about an hour. During that wait, I drank a sixteen ounce of bottled water and by the time I was called in, I was in distress again because I could still not expel urine from my bladder. Once again, my urologist inserted a catheter and once again I left the office disappointed that I could not urinate on my own.

This time, I made another appointment a week out, which will be exactly two weeks from the date of my REZUM surgery. I am crossing my fingers that I will be able to urinate on my own by then. My urologist is hopeful and encouraging that this will be the case. He continues to say that my inability to urinate on my own, at this point, is normal. That's not what all the REZUM advertisements said.

Having a catheter is quite uncomfortable to say the least. I experience a constant urge to urinate and I have bladder spasms that are very painful, lasting anywhere from 30 to 45 seconds. When the spasms occur, urine pushes past the catheter and out the penis so I have to hold a paper towel over the tip to catch the urine, unless I happen to be at a toilet when the spasms happen. Additionally, urethral itching ensues, after the spasms and lasts for sometimes hours afterward. A heat pack gives me some relief. In the mean time, more spasms and continued itching can occur. I asked my urologist about self catheterization but my urologist did not want me to do that at this juncture. It would have made it so much easier than having a catheter in place but what's a little bit more inconvenience and discomfort, right?

I will be returning to have the catheter removed in another week (two weeks post REZUM treatment). After that, I will report on whether or not I can urinate on my own, two weeks post treatment. Until then I will suck up the discomfort, pain and inconvenience of the constant urge to urinate, the urethral itching, the bladder spasms and the leaking past the catheter. I will keep you posted on the long term outcome but for now I can say that I probably should have found someone who could do the HoLEP and left the REZUM treatment to the guinea pigs. The saving grace is that the REZUM treatment is so benign that it still allows for other treatments like TURP and HoLEP to be performed. Therefore I am hopeful that one day, I will be able to urinate on my own again.

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