What you need to know before Rezum - Preoperative information
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- Опубліковано 24 лип 2021
- prostates.com.au
#BPH #watervapour #Rezum #menshealth #TURP #urology
The following video highlights preoperative information for men thinking about or about to have water vapour treatment for the management of their urinary symptoms related to BPH. Not all men nor all prostates are suitable for this treatment. Some will be better suited to different forms of cavitating surgery such as a greenlight laser prostatectomy. If you have any question or are looking for more information regarding prostate treatments have a look at our other videos...
I hope this helps and good luck with your journey!
Dr Chabert is a board certified urologist specialising in diseases of the prostate, including BPH and prostate cancer.
Dr Chabert consults form the following offices:
Suite 501, Level 5
Pindara Specialist Suites
29 Carrara St
Benowa QLD 4217
Phone: 07 5597 6293
Fax: 07 5539 6879
Email: contact@prostates.com.au
instagram: prostates.com.au
/ theprostateclinic
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THANK YOU for talking about "how it goes", day to day, and monthly expectations. Well done!
Very informative. I appreciate the simplicity of your talk given what is probably a complex subject-thank’ you for taking time to post & upload.
Hi John thx for your positive feedback🙏🏻
Really appreciate you taking the time to post this!!!!
My pleasure!
Excellent video, very informative, the best I've see so far. Thanks very much.
Thx for the feedback Charles, Glad you enjoyed it👌🏻
I guess I'm in that 5% as I had & have retrograde ejaculation. When I mentioned it to my doctor after the procedure he said that was almost always the case. He kinda forgot to tell me this before hand. I was to wear the catheter for 3-5 days. Because of the weekend I went in to have it removed after 5 days. The next day I could not pee & was drinking lots of water. I made an emergency trip back to the doctor's office & they reinserted the catheter again. I still couldn't pee so they used a high pressure water treatment that blew a large blood clot out & I filled the container all the way to the brim with urine. I had to wear the catheter for two weeks & developed an infection so I had to take antibiotics & had a lot of problems with blood clots. I bled badly for 9 weeks before finally a blood clot took & I healed up. Other than all this it was great! Go with the least invasive treatment. If I had to do it again I would look at the Urolift treatment. Then Rezum treatment. The TURP is the roto-rooter treatment that I would stay away from. A tip if you bleed. Women's panty liners are great! Sticky on one side & absorbent on the other. They really saved my underwear. I'm doing well now even though I had a lot of problems. A tip not mention. Dribbling is very common after the Rezum. You pee & think you are through but then you can dribble 12-20 drops afterwards. Expect that.
Thank You doctor, also you replied to all comments. You answered what I need to ask. Thank You again
You’re welcome. Good luck👌🏻
This is a much better explanation both pre and post treatment than I ever received when I had this treatment at a local hospital. Excellent and well communicated.
Thx for the feedback👌🏻
my treatment came 9 months after I had started intermittent fasting ... I had greater success because of this ... however, coffee and alcohol did lead to slightly more painful urination ... I treated this with ibuprofen, 2 tablets before bedtime
I had noticeable blood in my urine for 3-4 weeks after the procedure ...
I was able to stop using tambulosum as well as dutasuride and now have full urine flow as well as have eliminated retrograde ejaculation 3-4 weeks post procedure
Thx for sharing. Great to hear of your experience!👍🏻
Had it done 12 months ago……..excellent result
Glad to hear that you had a great outcome John!
Very informative, thank you Doc!
Glad u found it helpful👌🏻
Really clear explanation,thanks. I’m in Perth so now I know this procedure is available in Australia.
Thx for your feedback and good luck👌🏻
My friend had local anesthesia for his first REZUM, and general anesthesia for his second REZUM three years later.
Great explanation! Very thorough
Thx for ur feedback Tommy👍🏻
Thank you Doc….. Yes I am waiting and scared because of the horrible storeys coming out from NHS , Uk 🇬🇧
Good luck👌🏻
Great video thanks
Thx for your feedback👍🏻
This is a highly informative and an extremely patient-friendly video. Dr. Chabert seems to have a extraordinary bedside manner, and he appears reassuring yet candid about the Rezum procedure. One quick question: My urologist in the U.S. recommends Rezum for pain and obstruction, although my prostate is relatively small. One complicating factor is that I also have prostate cancer; I am practicing active surveillance. Would I be a good candidate for the Rezum procedure? Thank you profoundly, and keep up the amazing work. You are a gift to urologic medicine, and mankind is grateful for your expertise, as well as for your pleasant demeanor. Cheers!
Thx for your kind feedback🙏🏻 yes if your local urologist feels that your urinary symptoms are due to prostatic obstruction then Rezum is an option. Good luck
Very nice 🙂
Thx Mohammad👌🏻
How long would I have to wait before resuming moderate weight training?
Hi doctor. Thank you for this great explanation of Resume Treatment for prostate.Would like to know what are the Costs for this Treatment?
This will depend on many factors including which country you are in. Best to contact your local urologist for more details. If you are in Australia please contact the Prostate Clinic for more info
I was diagnosed with BPH and put on meds. Some days I can pee like a race horse, other days I have typical symptoms. Prostate is either enlarged or not. Why would my situation vary from day to day? I am starting to doubt my diagnosis.
thank you Dr Chabert . i am surprised to hear you say this procedure is done under general anesthesia . i have heard ALL other urologists ( in Canada and USA ) say otherwise , that Rezūm procedure is done with local anesthesia . Which is the correct way ? Thank you for clarifying
Hello and thx for your comment. In Canada and USA Rezum as you say is done under local anaesthetic in the office as the remuneration is better for in office procedures. In Australia there is no such difference and as such most urologists here perform the majority of their work under anaesthesia in the operating room.
Can Resume be used on a prostate that is cancerous?
Great presentation doctor and you have a very nice took about you by the way I was just wondering I've had a turp it didn't work out for a while would I still be able to have this procedure even though I've already had a turp? I sure hope so as I am really looking forward to getting this come on local great urologist
Thx for your feedback🙏🏻 it really depends on why the procedure didn’t work. The possibilities include scar tissue formation, persistent BPH or issues with bladder contractility. The first thing would be an assessment of flow and a cystoscopy. Good luck👌🏻
@@TheProstateClinicTPC thank you very much I think you are correct in one of those at least
Does have this treatment lower the PSA reading in the blood test? Very good video.
Yes it should. By 30-50%
I was diagnosed at 30 with BPH but my symptoms started at 25... I still want to have the ability to have kids. Should I hold off on treatment for risk of retrograde ejaculation?
Thanks a million for your video and replies, a 83 yrs old cardiac man ( not feasible for anaesthesia) with urine obstruction led to suprapubic catheterization due to inablity to insert a penil catheter, TRUS revealed central adenoma and also heterogenous hypoechoic area in peripheral zone , last PSA 15. What is your recommendation?. Can he just perform rezum for obstruction relief? Can he rely on PSMA plus pelvic MRI to tell if he has also cancer and start hormonal treatment without bx? What is your recommendation management plz?. Thanks alot
Hi San. I don’t recommend over the internet. All that u discuss is reasonable but should be discussed with your local urologist. By the very nature of your question it appears that you understand the potential options. Good luck
Excellent presentation. I have PBNO aka High Neck Bar. Why, I do not know. Perhaps from traumatic injuries in my younger years. My PSA is good as of less than a year ago. I do not have BPH. I have read a lot about PBNO aka High Neck Bar and watched some videos but have not found gentle, accurate and concise specific treatment. Some I watched were brutal. Do you know if Rezum would be an option? Some doctors want to do TURP. I do NOT want that. Any advice you have would be welcome. Thank you.
Hi thx for your comment. Rezum is not an ideal option for those with high bladder necks. Medication or a bladder neck incision potentially with UroLift are options. Good luck👍🏻
Do you consider the PSA ratio in differentiating the BPH and prostate cancer? Or only the value of PSA?. Thanks
Several aspects to PSA are reviewed including absolute value, relationship to the median, free total ratio, and kinetics. If we are concerned the next step is a multiparametric MRI
Thanks for all your help and replies, can it be done if suspected malignancy in the periferal zone along the central hypertrophy and urine obstruction?.
Thx
If there coexists prostate cancer and BPH both need to be managed on their own merits. Indolent prostate cancers are best managed with surveillance so don’t require active treatment. Rezum does not and is not a treatment for prostate cancer. Significant cancers require treatment with either surgery or radiotherapy or sometimes a combination of both. Surgery to remove the prostate treats both cancer and BPH.
Hope this helps
And plz what is the definition of " indolent" cancer?
This is a non aggressive cancer which would be defined as a small volume Gleason grade 6 cancer
what is your recommendation when you had the Rezum procedure and it appears symptoms have gotten worse?
Things usually settle with time. Good luck
Are there any natural supplements that will work before considering surgery?
Hi thx for your question. You can trial Saw Palmetto which is a herb that has been used for years to manage urinary symptoms due to an enlarged prostate. Good luck👌🏻
Does Rezum work if there is no restrictive symptoms but just frequent urination due to over active bladder?.
Yes it can if ur symptoms are due to underlying obstruction. Good luck👌🏻
Can someone tell me please, what is the fr. size (diameter) of the instrument inserted during the procedure? Any reason someone who is already self cathing (sterile intermittent catheterization) cannot continue that rather than submit to a foley catheter placement during recovery? Thank you.
Hi Richard it is around 20Fr. If already doing self Cath then yes this can be continued afterwards instead of having an IDC. Good luck👌🏻
I haven't read any of the comments so I have no idea if anyone addressed this already, but what is the long-term outlook for this REZUM procedure (Will this give me another 10 years of pseudo-normalized urinary function)?
The truth is that we don’t know about 10 year data. The procedure has only been around for approx 5 years. Retreatment rates around 15%
Hi doctor..can I use a flip-flop valve on the catheter after my Rezum procedure. Thanks Corey
Yes you sure can👌🏻
Hello dear doctor Chabert ! I was suffering from benign prostatic hypertrophy. An intervention with the Rezum technique performed in Belgium on April 11, 2022 at the hospital of Libramont by Dr. Vaesen relieved me somewhat from the most negative symptoms. However, I wore a catheter for 10 days and suffered from hematuria for +/- 40 days and I notice that now no more sperm comes out of the urethra, only liquid as clear as water. It looks like the semen is going to the bladder and not coming out at all through the normal way! So, I think I am a victim of retrograde ejaculation. Is it irreversible? And if there is a chance to recover the normal ejaculatory function, how many months could it take? It has been 2 months to the day since I underwent this operation and my fear of permanently losing my ejaculatory sexual function with sperm emission is particularly important. Can you please advise me on this subject ? Thank you in advance.
Hi Alain. If retrograde ejaculation occurs it is a permanent fixture I’m afraid. The risk of this occurring with Rezum is approximately 5%.
Hello, doctor. Thank you for this as it is very helpful. How long does the Rezum remain effective? I have read that 5 years is common. If so, would I then need to have it done again?
U could have another treatment but only if u we’re having recurrent issues
can rezum be done for a large median lobe protruding into the bladder? also, if prostate is 50cc will rezum shrink it by 5,10, 20 pct?
Yes it can be effective for a median lobe. Probably around 20% reduction
Hi, is it possible to do it with local anaesthesia for a cardiac patient ?. Thx
Great question! Yes it’s absolutely possible to perform Rezum this way.
Can rezum be done on a patient who has (in addition to BPH) untreated prostate cancer?
Hi Charles great question. Rezum treats the central overgrown prostate tissue causing an obstruction. Prostate cancer tend to be located in the periphery of the gland. Rezum therefore is not a treatment for cancer but can be used to treat the enlargement in those who also have a low grade cancer which is being monitored. Hope this helps and good luck👌🏻
I was suprised to be told at a clinic that my Prostate is too large for a Rezum procedure
My question is are people happy with their results including the healing process.
Yes they are. For the majority they experience big improvements in quality of life related to their urinary symptoms👌🏻
Do patients need to stay on BPH medications after Rezūm procedure?
No the aim is to cease BPH medication
Hi, does it work for prostate bacterial inflammation?
No it’s a treatment for symptomatic BPH
My prostate size or rather weight is about 90 and I also have several 1 cm. bladder stones and burning symptoms while peeing, am I entitled to have a Rezum?
Your best bet is to have a procedure which creates a cavity such as a GreenLight. Your stones can be treated at the same time
How does the water (steam) injected into the prostate gland come out?
It doesn’t. The body reabsorbs the tissue treated by the stream over time
How about if i dont wanna use catheter because i dont want the bacteria to go inside... ? Can bph still be treated without using catheter?
Hi Albert thx for your question. The challenge is that the prostate swells after this treatment making voiding harder to begin with. Options include self catheterisation IDC or a suprapubic tube
Help! I had REZUM. My Dr. had me where a catheter for 11 days. Then I got it removed. within 2 weeks I was in retention. Very Painful. I could not pee. Only trickle. I went back to Dr. and now I'm in a catheter for another 3 weeks. He said its either an infection or some ppl just take longer to recover. Is that correct? Or is this something else?? FYI I'm only 36yrs... Also when I have spasms with catheter no urine comes out... Is that normal? Thank you!
Yes everyone recovers at a different rate. Usually related to size of prostate and the number of injection sites that are used. Good luck👍🏻
Reason I had PAE. My urologist is still not happy with me.
You are only 36? Hard to believe your prostae was actually hypertrophied at such a young age
Impressive. Do you have any contact in Uganda for this treatment.
No I’m sorry I don’t. Good luck
I did the rezum September 2021, my psa was 1, now we are February and my psa is 2.31. What does that mean?
Hi Raoul best to touch base with your urologist to discuss as they will know your situation the best.
I think bph is from growth hormones in beef. I had the pae and it didnt work.
Is it common to have any urinary tract infection due to the catheter after the treatment? I mean the first days.Is it possible to have symptoms of fever as well?
Thx for your question… yes it is very common. Most catheters are colonised with bacteria within a few days so infections are not uncommon.
@@TheProstateClinicTPC Thank you very much doctor you answered. I did rezum last Thursday and i am still with the catheter. At Saturday started the fever initially low 37,2 C 37,5 C and at Sunday 38.5C the maximum. Doctor gave me additional 5 injections called AMIKACIN. Since Monday evening i am OK and to day i did the last injection. For information i did rezume in Greece because i live there. My question is the following. Is it possible this fact to affect the normal progress of the operation? Is it possible to do any damage to the prostate or to kidneys ? Thank you very much in advance.
Hi So sorry I didn’t reply to your question earlier, I only found this reply🙄. Infection in the urinary tract are not uncommon following prostate surgery and rarely produce a longer term issue. Sounds as if things have been managed as they should. Take care and again sorry for the delayed response
Is this procedure dangerous if there is a family history of prostate cancer? In other words, is there a relationship between this procedure and prostate cancer? If there is a genetic factor, does it stimulate the formation of cancerous tumors?
No it’s not dangerous and doesn’t increase the risk of prostate cancer
I am 58 yrs old and been taking flowmax for over 5 years. My Urologist recommended Rezume. Its been 8 weeks. The flow is great like a millk shake straw.
I do experience a side effect though. When I need to pi, the pressure is intense and sometimes I leake before I get to the bathroom. This is the only side effect I have so far.
I watched many videos from different Urologists, no one talks about post procedure complications.
I suggest have a good discussion with your Urologist about risks.
How good! Glad to hear u have had a great outcome👌🏻
How long on average does the procedure last before a repeat at age 55?
Approx 15-20% retreatment rate at 5 years post treatment
I saw another video on Rezum, where the practitioner did the procedure without any anaesthetic at all. Why do you need your patients to be under general anaesthetic?
Hi Victor it really depends on which country u r in. In the USA most procedures are done in the office under local anaesthetic whilst here in Australia we do most of our surgeries in the OR. Clearly both are feasible.
Will the bladder wall thickening reverse, back to a normal thickness after the Rezum treatment?
Hi David. It’s appearance doesn’t change but the pressure with which it operates does change which results in fewer irritative urinary symptoms.
Is there a limit to the size of one's prostate for this type of treatment?
Hi Chris the larger the gland the greater the umber of injections of steam which are required and the slower the recover as a general rule. I usually recommend for gland size < 80cc but have performed it on other prostates. Good luck
can it be used for chronic prostatitis/cpps?
No it’s for BPH only
@@TheProstateClinicTPC thanks for the quick answer
The rezume treatment, well it did not work for me. On the forum, most people had a very negative opinion of the procedure. I took the chance and failed.
Sorry to hear ur story but thx for sharing. Good outcomes depend on several factors including size and shape of prostate
Hi doctor! Can you provide your opinion in a choice of Rezum or Aquablation for 75 cc prostate with trilobar? Thank you for your input.
Both would be options for the profile you give. Depends on local availability expertise severity of symptoms as well as which pathway you would prefer. Good luck
@@TheProstateClinicTPC You don't think 75 cc prostate is too larger for the Rezum but Aquablation therapy is better?
it rezum work for prostatitis doctor?
No it’s a treatment specifically for prostate enlargement
how often do u see patients with an average size prostate suffer from urinary symptoms that we typically relate to BPH? i'm 55 and for unrelated reasons (trying to hold onto my hair) am already taking propecia & saw palmetto daily. symptoms started about a year ago. i can void 100% (3 separate tests confirmed this), no have "urgency" symptoms, have an average size prostate, don't feel like i struggle to urinate...... but my bladder aches all the time which gets worse with any volume. from all the research i've done, my very unprofessional opinion is that it falls more into the IC category than BPH. the local urologists are quick to offer rezum/urolift but none have made a convincing argument as to why those procedures would help my bladder stop aching all the time. any thoughts much appreciated.
Hi D B it’s always very difficult to comment specially without knowing all the information at hand. It is very possible thought to have symptoms related to a prostate without significant enlargement. Some of the most obstructed bladders can be due to “stiff” rigid prostates even though minimal or no enlargement
I had rezum done almost 2 years ago it destroyed the best part of my life it gave me retrograde ejaculation and narrowed my bladder neck leading to a very painful bladder neck surgery now i living with depression from the choice i made i wish my doctor was more forthcoming about the risks involved... be very careful with the choice you make. ..
Thx for sharing. Sorry to hear of your experience.
I had this procedure and now I can't control my flow,I have to wear a pull up!! Plus when they did this procedure,it hurts badly!!
Hi Jim sorry to hear that you have had difficulties. After all BPH procedures an increase in irritable bladder symptoms including urgency and frequency can be experienced. These settle with time. Sometimes bladder medication can be used to help expedite the situation. Good luck👌🏻
My BPH size is 48 and no post void residue. My problem is the frequent urination around every 2 hours or so and might be even shorter with drinking liquids. I noticed that I have ED, is it a result of enlarged prostate or could be due to other factors. My testosterone is normal.
Regards,
Separate factors
Donde esta localizado
Gold Coast Australia
What can go wrong? What becomes of the dead tissue that was cooked with the steam? What are the chances of success with a 72 year old man? Are there specific consequences for the elderly? Is there a possibility of permanent damage? Thank you for your response.
Outcome is not dependent on age other with prolonged obstruction improvement in bladder symptoms can take longer
Is this treatment possible for a man who has a stricture in the urethra, very close to the bladder area?
That's the first I've heard that this procedure requires general anesthesia
They should find solution for retrograde ejaculation after rezum... Rate is not %5, close to % 80. Otherwise not better than holep..
Does the procedure have to be repeated every few years?
Hi Alister no it doesn’t. Around 15% of men may require retreatment at around 4-5 years after initial treatment. Hope this helps
Does Rezum cure or at least alleviate ED?
Hi Rudy no it doesn’t. It is purely a treatment for the management of urinary symptoms related to an enlarged prostate
I am 73, can I have rezum treatment ?
You sure can! 👍🏻
Doctor, does rezum cause ED after the operation, please reply?
Hi Farouk no it doesn’t. Good luck
Thanks dr. Does it have side effects on the rectum? Can it cause prochtitis ?. And what is the common side effects in general. Thanks
Hi San this treatment is exceptionally unlikely to have any effect on the rectum. For most men there is some prostate swelling which results in a slower stream with increased frequency of urination to begin with. There is no improvement in flow until around 3 weeks post op then a gradual improvement. Infections and blood in urine are possible. There is a low risk of retrograde ejaculation but it is possible. Hope this helps👍🏻
Hi San this treatment is exceptionally unlikely to have any effect on the rectum. For most men there is some prostate swelling which results in a slower stream with increased frequency of urination to begin with. There is no improvement in flow until around 3 weeks post op then a gradual improvement. Infections and blood in urine are possible. There is a low risk of retrograde ejaculation but it is possible. Hope this helps👍🏻
Where are you located
The Gold Coast Queensland Australia
I have an enlarged prostate that's killing me
Sorry to hear that. U should get it checked out👌🏻
I just had the procedure done 48 hours ago. If I understand correctly the steam will continue to kill and remove the enlarged prostate?
Or has the enlarged part been removed and I'm just waiting on healing?
I'm still with the catheter.
What is the average time until the catheter comes out?
You can't really try to urinate until catheter is removed.
I.I'm anxious to see if the procedure worked.
Just a matter of time
Catheter usually for 3-4 days
No improvement for 3 weeks then gradual steady improvement
Hi Dave. I just had the procedure 2 days ago. How has your result been?
Show me this video clip in urdu or hindi
Sorry I don’t have this translation
Id rather never pee again. How can they even say its not very invasive.This is extremely invasive l. I dont understand why they cant go through the stomach.
It’s is in fact one of the least invasive options out there. Going through the stomach adds another layer of complexity but is performed for those with massive prostates which can be managed robotically.
Reszum is very painful and has a very low success rate . It should no be done under local anesthesia. I had it done so I know
Always done under GA at The Prostate Clinic
Hello what about sex after how long do you have to wait ?
I recommend leaving things for a couple of weeks
If you are being honest, you should advise that in some cases, this procedure makes symptoms worse and leads to urinary incontinence!
Hi Dennis with any BPH related treatment there is always the potential for things to deteriorate in the short term whilst the bladder is adjusting to the treatment. This is followed by improvements in both obstructive and irritate each symptoms. This procedure does not make urinary symptoms worse in the long term. That has not been my experience nor is that position supported by the clinical literature. Good luck👌🏻
The whole lecture about bPH wasn't necessary. If someone is interested in RESUME therapy, they know all this.