One of the best things about this forum, for me, is when people share their first-hand experiences with procedures and treatments, and the purpose of this post is to share my experience with Rezum. I had the surgery done 3 days ago, on July 15, 2020, in the doctor's office.
I did a lot of research before choosing Rezum over Urolift, especially considering that there is a longer recovery period for Rezum and the procedure itself involves more physical discomfort since it is done with local anesthetic, vs. Urolift, which is done with twilight anesthesia.
I chose Rezum in the end for two reasons:
(1) It has a 5 years success rate of 90% vs. 67% for Urolift (the patient education portal of the American Urological Association states with regard to Urolift: "There are concerns that this may not be a durable treatment as 33% of men need additional surgeries or go back on medications", link: https://www.urologyhealth.org/urologic-conditions/benign-prostatic-hyperplasia-(bph)#Minimally_Invasive_Surgeries)
(2) Urolift's permanent implants can interfere with MRI's that could be needed to diagnose prostate cancer, unfortunately a common condition in aging men, and the implants can be associated with stone formation or can migrate into the bladder, requiring surgical removal. Some people might not be put off by these issues, for me they, together with the durability issue, tilted the scale towards Rezum
I tried to have Rezum done with twilight anesthesia (propofol) but was unsuccessful, my health insurance (the best offered by my employer, but not gold standard) will not cover it. This is common, the patient education portal of the American Urological Association states with regard to Rezum: "The treatment is done in the doctor’s office with local anesthesia..."
Here is what the surgery was like:
I took Xanax tablets two hours and one hour before the procedure as prescribed
At the office, the urologist administered a single Ultrasound-guided injection of 10cc of lidocaine, not as bad as I thought it might be
The urologist injected four jets of steam on each side, eight in total. This was a surprise, I was expecting one on each side. These treatments, especially after the third or fourth, cause discomfort
I was at the doctor's office for less than an hour and left with an indwelling catheter (made of a material less uncomfortable than the ones used for urodynamic testing) and instructed to return in two days
**Day of Surgery**: In the first few hours after surgery, I had strong feeling of needing to urinate, despite the presence of the catheter. I took a walk to distract myself from the discomfort. Medication: I took two caplets of azo once, which helped reduce irritation, and used ibuprofen 600 mg 3 times and 1000 mg acetaminophen before bed. Sleeping: I took half a sleeping pill and set an alarm for 4 hours in order to empty the bag, then went back to sleep
**Day 2**: Took day off from work. Some discomfort but didn't need medication. Getting used to the catheter
**Day 3**: Went to doctor's office for 7:30 am appointment to remove catheter. It's Friday and doctor wants to be sure I don't block, instructs PA to fill my bladder four times with sterile water to be sure there is good flow. Uncomfortable and messy process, and I'm completely blocked (not a surprise, I could barely urinate pre-surgery and I've had four shots of steam to cause swelling on both sides) Catheter reinserted, new appointment made for four days later. I work from home, running meetings while sitting on a recliner with laptop on my lap
That's where things stand, I'll update this and I'm happy to answer questions.
Hi Mark, good description of your experience. Hoping you have a good outcome.
Do you know why the Dr only only gave you one lidocaine injection? I’d always read that they give two whether it’s for Rezum or a biopsy – one on each side of the prostate since that’s where the nerve bundles are.
Also, do you know what size your prostate was?
I’m assuming you did not have a median lobe issue since all the injections were “on the sides.”
Good luck!
Hi Russ,
Thanks for your reply.
The doctor’s approach is to give a single 10 cc shot of lidocaine, he said he watches via ultrasound image to ensure it spreads to both sides.
This video sponsored by Boston Scientific recommends two shots of lidocaine, each 10 cc, also ultrasound guided:
I’m no expert, but having been treated with 4 shots of vapor on each side, I think pain control could have been better.
My prostate size was 39g, no ML.
Day 7 update.
Catheter removed this morning. Requested to be trained in self-catheterization in case needed, up till it hasn’t been.
Suggestion: When you go for urodynamics or anything catheter-related, remove your trousers, underwear and socks and put them somewhere out of range to avoid splashing urine. It happened to me once and I’ve been taking that precaution ever since.