Rezum Treatment.

[bmcgonig]

The catheter definitely seems like the least fun part of it

I had an interesting experience. I’ve been on finasteride since August and quite frankly flow was still slow. In December I had to go into hospital for an ablation and for that they needed to put in a Foley catheter just until a few hours after the procedure. After they took the catheter out flow improved dramatically, and has been ever since. Very weird whether coincidental or not.

 

[REWahoo]

I had an interesting experience. I’ve been on finasteride since August and quite frankly flow was still slow. In December I had to go into hospital for an ablation and for that they needed to put in a Foley catheter just until a few hours after the procedure. After they took the catheter out flow improved dramatically, and has been ever since. Very weird whether coincidental or not.

Simple explanation:

 

[Spokane2303]

Day 6 - Post Procedure

Same as day 4, nothing new.

I do have a comment on bmcgonig's observation of a better flow after being catheterized.
I had two urethra strictures, from a childhood motorcycle accident, that I had surgically "cut" (urethrotomy) in my mid 40's. They were reducing my urinary flow just like a large prostate does. As part of the aftercare for this procedure, my urologist had me self catheterize myself with a dialation catheter monthly. I did this for almost 20 yrs. After each dialation, besides painful urination for a day, my flow improved markedly. Over the years I started to note that the dilations had less and less impact on my flow. I originally went to my urologist expecting that the strictures had grown back (which is common); but, a cystoscopic examination of my urethra showed that the strictures were in fact healed and not a concern. The cystoscopic evaluation confirmed that my prostate was long and large, putting pressure on my urethra, reducing my flow and causing residual urine in my bladder. My last biopsy, 4/14/21, had first revealed my prostates current size, which was a surprise to me.

So, my guess is that the Foley catheter, because they are rather large, could have dilated a unknown stricture?

 

[bmcgonig]

Day 6 - Post Procedure

Same as day 4, nothing new.

I do have a comment on bmcgonig's observation of a better flow after being catheterized.
I had two urethra strictures, from a childhood motorcycle accident, that I had surgically "cut" (urethrotomy) in my mid 40's. They were reducing my urinary flow just like a large prostate does. As part of the aftercare for this procedure, my urologist had me self catheterize myself with a dialation catheter monthly. I did this for almost 20 yrs. After each dialation, besides painful urination for a day, my flow improved markedly. Over the years I started to note that the dilations had less and less impact on my flow. I originally went to my urologist expecting that the strictures had grown back (which is common); but, a cystoscopic examination of my urethra showed that the strictures were in fact healed and not a concern. The cystoscopic evaluation confirmed that my prostate was long and large, putting pressure on my urethra, reducing my flow and causing residual urine in my bladder. My last biopsy, 4/14/21, had first revealed my prostates current size, which was a surprise to me.

So, my guess is that the Foley catheter, because they are rather large, could have dilated a unknown stricture?

Fascinating..thanks for the explanation !

How do you catheterize yourself? Sound harsh. Not sure I could do it.

 

[Spokane2303]

Slowly with a lot of KY lubrication and controlled breathing. The worst part is inflating the catheter, with a syringe, once it is inserted into your bladder. This expands the catheter along its entire length and stretches your urethra. The stretching enlarges the stricture opening each time..

You actually get use to doing it and it becomes easier once you know what to expect.

Always hurts though!

 

[bmcgonig]

Slowly with a lot of KY lubrication and controlled breathing. The worst part is inflating the catheter, with a syringe, once it is inserted into your bladder. This expands the catheter along its entire length and stretches your urethra. The stretching enlarges the stricture opening each time..

You actually get use to doing it and it becomes easier once you know what to expect.

Always hurts though!

This procedure is really a piece of cake for you after all that [emoji15]

 

[Spokane2303]

Day 9 - Post Procedure

Foley catheter out! No big deal removing it while in a hot shower.
Was able to empty a full bladder 1 1/2 hours after removing the catheter without pain.
Flow not as strong as before; but, a steady stream. This was expected as the treatment area should still be swollen.
Little amount of clots and sloughing tissue. I was warned ahead of time that this will increase/decrease on-and-off for the next 8-12 weeks.
No UTI!

So far, so good!

Much better than anticipated and much less painful than the horror stories I've read; but, a little more uncomfortable than the "cake walk" descriptions in the provider and manufacturer related sites/forums.

I am taking Phenazopyridine to minimize bladder/urethra pain and ibuprofen to reduce inflammation.

 

[Spokane2303]

Day 14 - Post Procedure

Three days after removing the Foley catheter I started to see more blood clots and prostate tissue when I pee. It was expected and does not cause pain.

Flow during the day is almost back to the pre procedure rate. Nite time flow is slow to start and weak.

I have to go every 1-2 hours and have a little drippings just before I go. I'm getting up 4-5 times a nite to go and it still takes awhile to complete. Prior to the Rezum procedure I was up only 1-2 times a nite. Again, this experience seems to be normal.

Stopped taking the Phenazopyridine 48 hrs after removing the catheter.

Have started exercising again without any issues.

Next appointment with my urologist is 4 weeks out.

So far, so good!

 

[Spokane2303]

3 weeks - Post Procedure

Blood in urine, clots and small traces of tissue increased this week.

My urologist called to checkin on my progress and assured me that this is normal.

Burning on urination and some afterwards increased vs week 2.

Still getting up 4-5 times each nite with a delayed and slow flow.

Daytime flow in close to normal in start, flow rate and stop. Some blood drips afterwards.

Urine sample submitted Monday as part of annual physical work up..

Still taking pre procedure tamsulosin and finasteride. This to be discontinued at 6 weeks assuming my recovery proceeds on schedule.

 

[Trooper]

Thanks for your progress reports!! Glad things are getting somewhat better. My urologist is pushing me towards UroLift, and he seems to poo-poo other options like TURP and Rezum...almost to the point where I feel he gets a kickback on Urolift.

Thanks again for sharing your research and experiences.

 

[braumeister]

FWIW, I had the old traditional TURP. Recovery was easy and not painful at all after the first few days. I was completely back to normal within about three weeks. That was over two years ago and I'm still happy with the results.

 

[razztazz]

Thanks for your progress reports!! Glad things are getting somewhat better. My urologist is pushing me towards UroLift, and he seems to poo-poo other options like TURP and Rezum...almost to the point where I feel he gets a kickback on Urolift.

Thanks again for sharing your research and experiences.

Urolift, even tho it's the least complicated procedure, is the most expensive non surgical option. Might be a driver there.

There are a ton of interviews with Urologists and seminars (Doctors talking to doctors) on youtube and other medical sites. Probably every procedure has some "economic incentives" behind it. Also, doctors like anybody else will have their own interests, biases, preferences and just see this or that procedure as the better one. And some actually are better but only under conditions ideal for that procedure and would be 6 of one 1/2 dozen of the other in about 90% of circumstances.

 

[MRG]

Thanks for your progress reports!! Glad things are getting somewhat better. My urologist is pushing me towards UroLift, and he seems to poo-poo other options like TURP and Rezum...almost to the point where I feel he gets a kickback on Urolift.

Thanks again for sharing your research and experiences.

I had a urolift done a couple years ago. Easy , did I say easy , recovery. I do take two Flomax daily as the neck of the bladder isn't impacted by the urolift and I was constrained there. For me it was a very good choice.

 

[Spokane2303]

4 Weeks - Post Procedure

Urine sample, submitted a week ago, clear of any infection!

Daytime flow rate now exceeds pre procedure. Strong and quick! Bladder feels empty.
Nighttime flow not equal to day; but, much quicker and bladder feels more empty.

Now only getting up 1-2 times a night!

Some diluted blood at beginning of flow and after completion. Little pain, more like a deep itch. Still throwing small clots and small pieces of tissue almost each time. This does appear to be decreasing and mid-flow urine is clean and light yellow.

Stopped taking the finasteride!

Wow, things are looking positive......

 

[Time2]

4 Weeks - Post Procedure

Urine sample, submitted a week ago, clear of any infection!

Daytime flow rate now exceeds pre procedure. Strong and quick! Bladder feels empty.
Nighttime flow not equal to day; but, much quicker and bladder feels more empty.

Now only getting up 1-2 times a night!

Some diluted blood at beginning of flow and after completion. Little pain, more like a deep itch. Still throwing small clots and small pieces of tissue almost each time. This does appear to be decreasing and mid-flow urine is clean and light yellow.

Stopped taking the finasteride!

Wow, things are looking positive......

Taking Finesteride, I'll be curious to know, if you had retrograde ejaculation, has it reversed and if so how long did it take?

 

[Spokane2303]

Finasteride relieved my BPH symptoms after 3-4 months; but, I developed retrograde ejaculation (which actually started with 2x Tamsulosin daily), "NO" sex drive, ED, right nipple tenderness, weight gain and slight headaches.

All the above side effects are the main reason I decided to have the Rezum treatemt, so that I can get off the medications.

I also decided to have the Rezum procedure while my prostate's size was still within the optimum treatment range. I was afraid that if I waited too long, both my age and prostate's increase in size would limit my future treatment options?

My understanding is that, even though the finasteride should be out of my system fairly quickly, it will take a few month for the hormones to replenish.

I'll update on the improvement of my side effects as/if they occur..

While I've been on the tamsulosin for years, I was only on the finasteride for 6 1/2 months.

 

[Spokane2303]

5 weeks - Post Procedure

Flow keeps increasing..
Only getting up 1-2x per nite to pee..
Burning continues to decrease "slowly"
Blood clots and tissue continues to decrease..
Light bleeding before and after peeing has almost totally stopped.

and, ED from finasteride appears to be reversing!

Right breast (nipple area) is still really sensitive and I still have a full head of hair from the finasteride... I'm happy to trade the extra hair to eliminate the ED!

 

[Spokane2303]

6 weeks - Post Procedure

Flow still increasing.. unbelievable!
Only getting up 1-2x per nite to pee..
Burning light, a few odd aches and pains occasionally.
Blood clots and tissue discharge no longer visible.
Light bleeding before and after peeing has stopped.

Today I discontinue the Tamsulosin!

 

[bmcgonig]

6 weeks - Post Procedure

Flow still increasing.. unbelievable!
Only getting up 1-2x per nite to pee..
Burning light, a few odd aches and pains occasionally.
Blood clots and tissue discharge no longer visible.
Light bleeding before and after peeing has stopped.

Today I discontinue the Tamsulosin!

Great news!

 

[Spokane2303]

It's been 2 yrs since my Rezume procedure.

After a 3 month recovery period, I had a full year of great flow, no pain, no problems.

Starting late 2023 I started to experience reduced flow, some burning and it started to interfere with my sleep.

This week I had a cystoscopic exam; and, the Rezum procedure has obviously failed. My urologist gave me a detailed tour of my urethra, prostate and bladder during the exam. Only one small section is still showing benefits from the Rezum procedure. The rest of my prostate has regrown and is now, once again, putting pressure on my urethra.

So I'm being scheduled for a TURP procedure in the next 4-8 weeks.

Oh well, I tried!

 

[Qs Laptop]

It's been 2 yrs since my Rezume procedure.

After a 3 month recovery period, I had a full year of great flow, no pain, no problems.

Starting late 2023 I started to experience reduced flow, some burning and it started to interfere with my sleep.

This week I had a cystoscopic exam; and, the Rezum procedure has obviously failed. My urologist gave me a detailed tour of my urethra, prostate and bladder during the exam. Only one small section is still showing benefits from the Rezum procedure. The rest of my prostate has regrown and is now, once again, putting pressure on my urethra.

So I'm being scheduled for a TURP procedure in the next 4-8 weeks.

Oh well, I tried!

I'm sorry to hear the Rezum didn't work out for you. Hopefully, TURP will be the ticket for you.

This is making me reconsider the Rezum procedure.

 

[braumeister]

I can appreciate your situation, since I'm a guy with a very large prostate. In fact, I was first diagnosed with an enlarged prostate about 35 years ago.

When it got bad enough that the drugs could no longer help me, I had a procedure that was similar to a TURP about 16 years ago. It was called TUNA (TransUrethral Needle Ablation) where they used RF energy to ream out the offending prostate tissue. My urologist said I was a textbook candidate for it.

That worked very well, but eventually that @#$% prostate started growing again, and I got desperate for relief once again. My urologist recommended a traditional TURP and I thought it would most likely be the answer so I agreed and had the TURP done four years ago. Once again, it worked beautifully and I'm still fine, no complications.

My guess is that if I live long enough I might have to go through it all again, but I think they are constantly improving their methods. Most likely I'll want to get a HOLEP next time, but still hoping there won't be a next time.