Rezum Treatment Details

Men's health
1

I hope this is helpful to you all.  My age is age 51, prostate size was a 57 (3 times what it should be) and overall in good health doing resistance training and a jogger prior to BPH Diagnosis.

I had the Rezum procedure done this week (Wednesday, 12/14/16). I had to see a Urologist because of frequent UTI’s and ended up in the hospital with prostatitis on top of that.  It was a scare and was encouraged to see a Urologist.  I was diagnosed with BPH, the Doctor put me on Tamosulin .4MG which took about 45 days before I saw a noticeable improvement.  I had all the classic symptoms of BPH; urgency, dysuria and nocturia etc.  On the International Prostate Symptom Score (I-PSS), I was like a 33 out of 35 possible.  My doc. said I was in a serious condition and that medical intervention was required for me to improve.

I first heard of Rezum and was immediately interested.  The doctor completed a number of test to confirm the needed treatment.  I had a urine and blood test, DRE, Flow Test, Cystoscopy, Biopsy of the prostate.  My biopsy was negative but I did have chronic inflammation.  At this point, my Flomax was working pretty good but I still didn’t like taking all these chemicals but it also caused retrograde ejaculation.  Of all the test, the Cystoscopy was the most uncomfortable mostly the tube working through the uretha past the enlarged prostate.  Knowing what to expect, I could do it again.  I got rather worked up over the biopsy and in the end it was nothing.  I hardly felt anything – at most a mosquito bite type sensation on the first sample tissue taken out of the 12 overall.

At this point, Rezum and Greenlight were my only two options I considered.  Since retrograde ejaculate was an issue for greenlight, I decided against that.  Plus, Rezum gave me the option to consider other options if it did not work.

I am now on my 3rd day and I feel great.  On the day of the procedure, I got a pain shot and 4 nerve block injections, then got lidocaine in my uretha to prepare for the final step.  The nerve block shots are similar to the biopsy – but you get an additional 2 shots that go deeper into the Prostate. The doctor visit lasted about 2 hours, but the actual Rezum procedure was less than 4 minutes, the injections less than 1 minute.  Despite the local anesthesia, it did hurt but one can endure it.  I would say it was a 6 out of a 10.  For me, it felt like a needle going into your skin.  However, it is really just the last half of the injection you feel because of the accumulated steam.  Peeing when you have UTI is about the same level of pain as the injections.  So, if you can take that, you can take the steam.  Immediately after the procedure, my worst pain was from the urgent need of having to go and void.  I returned home and soaked in a warm bath for about 30 minutes.  I was out of the doctor’s office around 11:00 a.m. and by 1:00 p.m. I didn’t feel any pain.  In the day following, I felt a numbness or slight sensation down there but no pain.  Since I was not voiding as much as expected, I went ahead and did a trial run with a self-catheter.  I opted for that versus having to wear a catheter for a few days.  I’ve not had to use one again, 3 days from the procedure date.

The doctor did say it would hurt for about 5 minutes after the procedure which was uncomfortable but he hold me that I’d be pleased w/the procedure results in 30 days.

The procedure will cause inflammation of the prostate tissue.  This causes you to actually get a little worse off than where I was, but by day 2, I was back to where I was prior to the procedure.  I am continuing my Flomax until my next follow up.  The doctor gave me a prescription for the inflammation and also prescribed Urogesic blue.  This little pill I think shaved off much of my discomfort.  I took it immediately after the procedure from a sample they gave me.  Again, after a few hours I was fine and surprised that I was hurting or in pain like I had expected. 

I felt the need to post here because I think most folks will put bad experiences.  Mine was a good one and I’d have this procedure again in a heartbeat – even if I only see the mild improvements I’ve had to date.  That I know only 1 patient (out of 100’s) had returned to the office and it might just have been his prostate was too large or there was something wrong w/the Rezum tool.  I want to ditch the pill and get back on w/living.  I would recommend this to anyone w/suffering w/BPH.  The worst that can happen is that you spend money and it didn’t work – but the doctor said nearly all his patients don’t come back after the monthly follow up visit.

I will update after 7 days and then again after 30 days.   No sex yet and don't plan on it until a couple of weeks from now.  When I had prostatitis sometime back, it was very uncomfortable and since I possibly have swelling I don't want to try that just yet.

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Pleased to hear that things look good and thanks for the positive posting. Plese keep us updated and hope that you manage to come off the meds soon.

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Great post. Thanks for sharing your experience. My biopsy was slightly more painful. I would describe it as like being snapped by a rubber band. Still not intolerable. I know some men (I think it has to do more with the doctor and pain meds givien) have much more pain during this procedure.). My cystoscopy was almost totally painless except passing the prostate (mine was 98cc) and even that was pretty mild. The cystoscopy was the procedure that psychologically bothered me the most. Thinking about a tube being shoved up my urethra. But with the numbing jelly it wasn't all that bad.

Glad you had a good experience and look forward to your updates.

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I hope all goes the way your hope  Let us know  Ken

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Thanks for rezum play by play Outtatoone. I wish you the best with your recovery

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Good luck on your recovery.  A month after my REZUM 6/27/16 I thought REZUM was wonderful.  A couple of months later the pain I had before the procedure began to return.  The doc had me do a MRI which was negative and then a systosopy which showed that REZUME procedure was only about 50% effective so I still have blockage.  He put me on a nerve med, Gabapentin, to see if reduces the pain.  Gabapentin makes me feel like I am stoned.  So after 6 months he and his practice partners have not been able to find the source of the pain.  I had a easier time than you with the REZUM because they put me to sleep.  I will follow your posts and progress to see how you do.  Hopefully you will return to 100%

7

Thanks.  It's strange - but the day of my procedure was my last day of using Gabapentin.  After my hospital stay in September, my immune system was down and ended up with Shingles.  I was diagnosed with Shingles the first week of October.  Even though my blisters were gone and most of my redness I think had pain and itchyness 2 months later.  The doctor put me on a low dosage Gabapentin which has helped and hope that I am on my final days w/the Shingles.  I'll keep you posted.  What kind of pain are you experiencing and what was the size of the prostate?

8

I am feeling great, still absolutely no pain.  I’ve noticed more of a split stream and active bladder which I can attribute to chocolate and spicy foods though doctors indicate urgency and frequency up to 7-10 days.  Since I had improved rather quickly the fact these symptoms came back may be because of the chocolate/spicy food, I think.  In fact, the last couple of days I cut these two things from my diet and I felt a noticeable improvement.

As far as meds, I am still taking Ibuprofen Tab 600 MG to help w/the inflammation, Urogesic Blue for any pain association to urination and still on Flomax at least until my next visit.  I’m also still taking the 500 mg Cipro for inflammation (chronic prostatitis) discovered during my biopsy.

I am voiding about 3-4 times a night.  Still, no pain whatsoever since the procedure.

A bit nervously and hesitantly about sex, I did have an orgasm on day 6.  It was anti-climactic since I felt the climax but it was very short lived and also completely dry, quite unusual.  It’s almost as if it didn’t happen.  Retrograde ejaculation (RE) is common with Flomax – but usually there is at least a little semen.  For me, RE makes me feel like I only get about 85-90% of the orgasm, it could do but I’ll be glad when I can get back to a normal one. Anyway, this was way too soon and probably not giving myself time to heal.

Also, rather interestingly, I have noticed small pieces of scar tissue in my urine the last 3 or 4 days, with a slight tinge of blood on it.  It is about the size of a sunflower seed and a big sticky, which leads to believe it might actually be pieces of my prostrate that flow out with my urine.  I think it’s a good sign that my body is making progress to remove these denatured cells as a result of Rezum.

I am thinking about cutting the Urogesic Blue to determine if in fact I need it and maybe in another week I may just take Flomax every other day to see how I am doing by week 4, thinking most of these meds will clear my body for the follow up.

I will report again in a week to let you all know my progress.  Also, a couple more reasons why I don't want to stay on Flomax.  Although I was urinating much better, I was still getting up 2-3 times at night and would still get urgency.  It helped, but wasn't a magic pill for me.  Besides I understand that after time, the medication may no longer work and stronger doses don't necessarily mean it continues to work.

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Glad to hear you're doing well outtaboone

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Thanks.  Which Dr. did your REZUM procedure?

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OK.  I am two weeks out from the Rezum treatment.  Here is a quick update.

Overall, I feel like I am making small progress.  Here is why I think that:

  The volume of urine output has increased by a few/couple of ounces from my first week, now can pee up to about 15 ounces.

 The time between bathroom visits is also up – can go up to about 1.5 - 3 hours now.  This varies depending on my intake.  But, initially days after the procedure I was going probably every hour.

  Improved Nocturia. I am making it a point to monitor my fluid intake late at night.  This has helped a lot.  I am probably now doing 2-3 bathroom trips vs. 3-5 in my first week.

  I have less of the split stream or revisits to the bathroom.  On the first week, I'd urinate and about 2-5 minutes later I'd be back again - getting much less of this now.

I still see small pieces of scar tissue.  I cut the Urogesic blue and have had no effects as a result of that.  However, on one occasion I had a large piece of tissue going through my uretha and I felt it travelling as I voided.  I hadn’t had that sensation until I got off of the blue (pain) pill.

I have also complete my Cipro 500 as well as the Ibuprofen scripted for inflammation.  Thus, the only pill I am taking now is Flomax.

During week one, I just had stumped orgasms and completely dry.  However, right at week 2 I got my first full orgasm with ejaculate. This doesn’t usually happen especially if you are on Flomax because it causes the Retro Ejaculate.  At this point, I am at least back to where I was prior to the procedure so enjoying about 80% of an orgasm.

The only thing I am still experiencing is urgency.  I don’t get much notice when I have to go, I hope this improves.  Lastly, I've not had to cather since that 'trial' run I did on day one.  Overall, getting back to life but still think or worry about where the restrooms are when I go someplace.

If I don't see much change this week, I might just update you all at the monthly intervals.                 

12

Dear Outtatoone and all of those posting on their experience about their Rezum procedure lol

I have been following this blog prior to having the procedure and found it quite helpful. Like many have stated, it does not seem like our physicians provide full disclosure on what to expect post procedure.

I had my procedure under general anesthesia on 08-Dec-2016 and wore a  foley catheter for 4 days. It has been 3 weeks today since my procedure, and would like to also share my experience to date.

Foley removed 12-Dec-2016: experienced some pain and heaviness and tenderness in the groin area later that day and was prescribed TMP/Bactrim DS (a/b for possible UTI) and Mobic (anti-inflammatory) - symptoms resolved within a day or two.

Week 1 (15-Dec-2016): I have seen some improvements in flow with some blood in urine which eventually turns clear, however, there was discomfort and irritation in the urethral/prostate area after voiding, which subsides after 2-3 minutes.

Frequent and urgent urination during the day (5-9 times/day)

Week 2 (22-Dec-2016): Similar to week 1, same issues with some additional improvement in flow.

Week 3 (29-Dec-2016): Similar to week 2, again some improvements in flow, still some blood and discomfort/irritation after voiding.  However, not frequenting the bathroom as much during the day (3-4 times/day)

Has anyone experienced the discomfort/irritation after voiding 3 weeks after the procedure? I have been on antibiotics and would rule out a UTI. I am assuming that this will eventually go away in time.

As mentioned, earlier, it seems as though the doctors really don't tell you what to expect post procedure.

I am still taking alfuzosin ER for BPH at this time until my doctor tells me to discontinue.  I see him again on 18-Jan-2017.

I hope everyone finds this information helpful, and will update again in January.

Happy New Year all.

13

Thanks Dave.

Hank

14

Thanks.

Hank

15

thanks dave

16

Thanks for the update outtatoone

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Great synopsis Dave.  I wish you the best.  I've not seen any blood since day 1 and also no pain whatsoever.  As mentioned, my first day, I felt a numbness or slight sensation in the groin area but it went away after a hot bath.  Even before that, I felt something there but it was barely noticeable. Your tenderness after the procedure is probably from wearing the cathey. I have experienced a slight pain (in week 1) once after voiding - like someone kicks you in the rear (acute pain like peeing w/a UTI) but less intense.  However, I did get that once or twice during my prostatitis before the procedure.  Of course, at that time I felt like was peeing through an IV line and now more like a straw thanks to Flomax.  My guess is 2-3 minute pain is from inflammation. I am anxious to get off my last drug so I can better guage my progress (unvarnished from meds).

I only got 4 steam injections (related to the size of the prostate) maybe that makes a difference on pain and blood afterwards??  I was also very careful I didn't take aspirin or anti-coagulants.  I got a laundry list of all meds prescribed or OTC to avoid for at least 2 weeks before the procedure.

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Week 3 Update.  No meds other than Flomax which now just take every other day.  With this change, On Saturday(12/31/2016) and today (1/4/2016), I started to get a slight burn in the morning (when meds skipped) when urinating followed by a slight burning sensation for a few hours – a feeling that I had to go or wasn’t finished voiding.  The urine was mixed with some tint of blood – something I hadn’t seen except the first couple of days.  Oddly, this is something reported by Dave96087 reported in week 3 of his recovery, not exact symptoms but similar discomfort.  This has really been my first instance of any pain since the original procedure.

At the start of the new year I took 3.5 hour drive comfortably.  Driving through rural country is usually a nervous time for me because I find myself constantly thinking about where the next restroom might be but felt more relaxed about it this time. I’m seeing less to none of the denatured cells in my urine.  It might be there but can’t see it anymore with the naked eye.

Last week, I was in a meeting that lasted 1.5 hours.  I went almost 2.5 hours w/o voiding.  What was interesting is that I needed to go at the hour but was able to hold it for another 30 minutes or so.  There have been a few other instances this week where I am voiding when I want to rather than when by body demands it.  Usually, I get the urge and I barely make it to the toilet.  Overall, still good with Rezum.  

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Dear Outtatoone,

Thanks for your update.

Today is week 4 (05-Jan-2017) since my procedure. Urine flow has improved, however, still seeing a tinge of blood in the initial output but then turns normal. There is still some minor irritation/burning after voiding but subsides within a few minutes. This usually only happens first thing in the morning.  During the day I don't experience most of these symptoms, so I assuming that the urethra is still healing in the prostate region. I have a follow-up appointment in two-weeks, but will give another update at week 5. 

All the best,

Dave

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I am now at 4 weeks.  I had failed to mentioned in my week 3 that I had a few nights where I only got up to void once overnight.  Yes, I am being more careful on my fluid intake at least 2 hours before bedtime.  However, I tried this before Rezum and didn’t make a difference so I quit monitoring fluid intake.

I am still taking Flomax.  Pain (discomfort) of any kind is completely gone.

Theoretically the expectation is that I will see changes at 30 days – buy I noticed slight improvement as early as week two.  There is noticeable change as well with respect to my ‘urgency’, I have much better control and postponement.  It typically comes on urgent for a few seconds but I control it and before long another hour passes before I actually go (some days better than others, but improvement).  I started doing Kegel exercises to see this helps me.

I cut caffeine out for the most part and again, I think it’s really helped me.  The intermittent burning sensation after voiding from last week is now gone.

Finally, I wanted to add a word about Prostate Artery Embolization (PAE) which is a procedure that I had considered in lieu of Rezum.  I had actually talked w/one of the Doctors in San Antonio, TX.  Urologist do not do this procedure but rather an Interventional Radiologist.  The IR DR had mentioned that they do these all the time on other parts of the body/organs – but Prostate is something new and he did probably 1 or 2 a month.  This is a whole other subject and there is plenty of documentation on this but my decision to not take it as my first option is that it can’t be undone and had a lessor success rate than Rezum.  It’s a permanent solution and essentially killing parts of the prostate by cutting off blood supply.  It could be a second option for me if Rezum does not provide the desired benefits.  It would be unrealistic to expect my urological health to be like it was when I was 20 but I’d be glad to avoid dependency on meds and not have to pee every 60 minutes.  I’d still pause before considering PAE only because that just isn’t a part of the medical protocol for Urology.  Maybe it should, but doctors who work with this disease (BPH) don’t think this treatment is appropriate. There again, there are Urologist who don’t do think Rezum is a recommendable option either.  For this reason, I considered Green Light as a secondary option but decided against it due to the Retro Ejaculation it would cause.  Overall, I made an informed decision that Rezum gave me the best chances of success and still allowed me to keep other options if it didn’t.  Thus far, it is proving to be the right decision.

This week, there were a few nights were I had 0 voids.  Man, I got up so refreshed, it was great to have that.  At most, I am now just getting up once per night.  Sexual activity is limited since I hate what Flomax does to my sexual health (RE and stumped orgasms).