Urolift vs. rezum for patients with obstructed median lobe
Posted , 4 users are following.
Carl here, anyone out there with these issues? Enlarged obstructed median lobe prostate patient on medication myrbetriq 50mg, and tamusolin 4-8 mg. Visiting bathroom 2-4 times a night regardless of fluid intake. Horror stories of Foley catheters and poor post surgery recovery of rezum and some urolift patients. Has anyone had urolift with these issues? 70 year old
1 like, 8 replies
carl29026
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Head is spinning with research and arguments for and against medicines, BPH procedure options, AND mfg as Boston (scientific) data tells one side of the story. Here on MB, we find troubled patient post because they are p****d (literally), and are very troubling. What about the success stories, we do not here about..few will look in the rear view mirror or post in public forum. I had never even thought of second opinion, as everyone is different, BUT the anatomy is the same for male. Is there a golden unicorn for every patient with OAB, BPH and assorted afflictions. When doctors come off like 'used car salesman' YOU are in trouble. Doctor's bottom line rules! WHAT is 'normal' for post rezum, urolift with CIC, UTI ?? Is this just what to expect in autumn of life? Is this male doom, in search for medicines, relief in procedure options AND CATHETER HELL? Appreciate comments
hank1953 carl29026
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Hi Carl, from what I've read on this forum in the last 6 years, Urolift is not very successful and Rezum is not much better. Your chance of success is much better if you go through much tested methods like Turp or Holep. The only downside is retrograde ejaculation almost guaranteed. Between the two, Holep is a little better.
I am currently doing self catherization cic. If I start having problem with this method I probably will go with Holep. Hank
carl29026 hank1953
Posted
Howdy Hank, thanks for info. Will look at Holep.. Am also thinking of PAE (Prostatic Artery Embolization) sounds dangerous, and/or Medlift (Eurolift). Shopping list keeps getting longer but these above seem to work for males (me) with obstructive enlarged median lobe with around 40 cc prostate size and my symptoms with OAB; BPH. Now, finding uro competent, trained and certified for latest available procedure IN MY home base of middle tn. Asking alot. As Interventional radiologist (IR) as it lower risk : of urinary incontinence; retrograde ejaculation or dysfunction. ?Irritative voiding issues. Paramount is avoiding CIC.
hank1953 carl29026
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40 cc is a small prostate. Holep might be an overkill. It's small even for PAE as an IR told me. Hank
WilliamUSA carl29026
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Carl, I was in your position looking for options a little over 4 years ago when I was almost 62. My prostate was 54cm3 with a small median lobe. I opted for Rezum. I had 7 steam injections, 3 left, 3 right, and 1 in central lobe.
The doctor showed me how to self-cath afterwards. However, I only had to do this once at home. I was able to urinate enough to get by after this one time. So no Foley horrors.
It took about 2 weeks to get back to my normal sleep pattern, which is getting up twice a night. It took 2 months to return to normal sexual function with 100% satisfaction.
I still get up twice a night. I know that I don't urinate "normally", but it's good enough that it doesn't affect my life. I don't doubt that there will be another Rezum procedure in my future. The ability to have Rezum multiple times is a plus to this procedure.
My advice would be to see someone skilled in the Rezum procedure and see if you are a good candidate. When I had mine done, Rezum was fairly new. I live in Pittsburgh and had to go to the Baltimore area (Towson) to find a doctor I felt comfortable with. If you are anywhere close to Baltimore, I'd recommend seeing Dr. Richard Levin. He was involved with the initial Rezum trials and has a great feel for what's possible. He has some Youtube videos that are pretty descriptive.
I agree to a point that the basic male anatomy is consistent. However, the details are different enough from man to man that the treatment of BPH is art as well as science. Find a good urologist/artist and you can enjoy your golden years, avoiding catheter hell.
All the best,
Bill
carl29026 WilliamUSA
Posted
@WilliamUSA thanks for sharing. I was told I was a good candidate for Rezum as I have 40cc lateral lobes, with obstructing median lobe protruding into bladder neck. The OAB/BPH takes over and you look for therapy. The life changes lose some weight, exercise, reduce or stop caffeine and alcohol. Eat your veggies. Presently, studying the latest info 12 months study of (PUL) Prostatic Urethral Lift. Very impressive for those like me hav ing done cysto and ultrasound. I do not know the IPP (intravescial prostatic protrusion) number. The high grade IPP have significant obstruction! The ultrasound should have told the story, as I see pain in any kind of recovery unless all implants. Several implants for lateral lobes (both sides) and carefully as to avoid neurovascular bundles when deploy the implants for middle lobe. This creates the channel for urethra. I see doc this week, hope to have some news.
andrew23481 carl29026
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I had similar with 40g prostate. Tried Urolift/Medlift but it has been a nightmare. I am still in pain 3 years later and it only improved things for 3 months. Have since had a TURP but still problems urinating and still constant pain from the Urolift. Rezum would be the way to go imho. Don't worry about foley cath; nothing to it; I had one for a week after TURP.
andrew23481 carl29026
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Also consider self-cathetering if you are worried about retro-ejaculation