The Rezum procedure and BPH
Posted , 28 users are following.
Hello;
I represent a large Urology practice in New Jersey.
I have been notified that there has been a lot of interest in new procedures for the treatment of symptoms caused by an enlarged procedure.
My group has substantial experienced with many procedures for this condition, including the "Rezum" procedure (we have done over 100 cases at this point and are one of the most experienced groups in the world at this point.) I wanted to offer any information and answer any questions anyone here might have about this (or any other) procedure for BPH (Benign Prostatic Hypertrophy.)
Thank you.
4 likes, 305 replies
kenneth1955 JerseyUrology
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derek76 JerseyUrology
Posted
JerseyUrology derek76
Posted
I did read about the difference in a book somewhere once. Unfortunately, it appears that autocorrect didn't
mike36864 JerseyUrology
Posted
I forgot to mention- I'm referring to Rezum.
derek76 JerseyUrology
Posted
The Moderator said that the spellchecker could mot cope with names of medical conditions or drugs.
jimjames derek76
Posted
@derek: The Moderator said that the spellchecker could mot cope...
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What's the name of your spell checker. I'm looking for a good one
Jim
kenneth1955 jimjames
Posted
Jim and Derek. I don't think there is a spell check on here I wish there was I could use bigger words. Most of the time all the procedure go together in some way so we are on the same subject. Been out of school for a long time. Spelling was never my thing. Take care you guys and have a great day Ken
mike36864 JerseyUrology
Posted
What is the rate of success at your NJ practice as a whole?
Thanks
JerseyUrology mike36864
Posted
While it is a relatively simple procedure for experienced urologists, I believe that number of cases never hurts; the Rezum procedure is new, but fairly similar to a procedure that urologists have performed for well over a decade (Prostiva.)
The vast majority of our patients have been delighted by month 6 after the procedure; most of those who aren't have underlying bladder dysfunction (which is why I generally recommend bladder testing prior to the procedure.)
Greg123 JerseyUrology
Posted
I've already had a PAE procedure and it was unsuccessful because my large median lobe is still blocking the neck of the bladder. As a result I'm self cathing 4-5 times a day.
Does the Nezum shrink the median lobe?
JerseyUrology Greg123
Posted
If the median lobe is treated, it will shrink as well after the Rezum procedure.
We have had success in using this treatment for very large (>100 gram) prostates
Greg123 JerseyUrology
Posted
1. Can the median lobe always be reached and treated?
2. What are the potential side effects and percentages of those side effects?
3. Out of the 100 patients that your practice has treated, how many reported what they themselves defined as success?
Thanks.
JerseyUrology Greg123
Posted
1- I will never say "always"; technically, Rezum is generally recommended for glands less than 80 g; we have had some success treating as large as 130g so far. However, If you can "see" tissue, you can technically "treat it".
2- Virtually all men will have some irritation with voiding for the first few weeks; some will continue for 2-3 months. I cannot give exact percentages, but somewhat fewer than 1/4 will likely have retrograde ejaculation; erectile dysfunction is a risk, but we have not seen this yet; urethral stricture would be another risk that we have not seen yet.
3- Most will be defined as "success" that their AUA symptoms score will improve by at least 5, and their flow will increase by at least 5 cc/sec. I don't think that we are unique in this aspect compared to other high volume Rezum practices.
uncklefester JerseyUrology
Posted
kenneth1955 uncklefester
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JerseyUrology uncklefester
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There is currently a "large gland" trial for glands larger than 80g.
That being said, if a urologist feels comfortable, he is free to treat a larger (or smaller) gland. We have had good success, but I would not consider that the "gold standard" at this time; as my professors always used to tell me, "the plural of anecdotes is not "clinical guideline", (meaning, just because a few people have had success, doesn't mean it's the definitive treatment for you.)
ross73654 uncklefester
Posted
unckle, I also investigated Rezum last year and my uro said the same. He measured my prostate by ultrasound at 125g (3T MRI measured me at 98) with a large median lobe. After a (quite bloody) cystoscopy, he said my propensity to bleed would impair his ability to see during the procedure, particularly since I would require a large number of 'sticks'. The company itself recommended 5mg finasteride for a month to reduce the bleeding. But after reading some forum accounts on some of the Rezum failures and experiencing the horrendous sexual side effects of finasteride, I went back into watchful waiting mode with a keen interest in MRI guided FLA.
JerseyUrology ross73654
Posted
We will obviously need to perform this on more larger glands, but early results seem promising thus far.