Benign prostatic hyperplasia (BPH) Surgery Options

Posted by wpasternak @wpasternak, Aug 4, 2020

I had a Urolift procedure last February for my BPH symptoms and it was a total failure. The implants are still in position though. I am looking for a different procedure to alleviate my BPH problem and Rezum seems to be a good alternative. Can it be done considering my prior Urolift procedure. If not, what would be your recommendation.

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@rfherald

Will do. The procedure was painful even with Valium. But the pain subsided quickly and completely gone in two days. The catheter caused great pain until I was able to limit tubing movement by taping it to my leg. On the third night after, I slept eight hours! It's been years since I've had eight hours sleep! I almost asked for a permanent catheter - the two liter bladder let me sleep through the night. The procedure bothered the prostate so it grew making urinating slow, frequent and painful. The pain was caused by the catheter. The urine remaining in the bladder was 260 ml, 60 ml over the limit. So I have to recathiterize, self-catheterize, or hope I'm below 200ml this morning. More next time.

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How are you doing 5 days after Rezum? Is cath still in? I am 80 years old and started with BPH symptoms about 6 years ago. I am taking tamsulosin in am and pm before bed along with 400 MG Ibuprofen. Up once a night. I was set to do REZUM months back but urologist lost access to equipment because of change in ownership. I oscillate back and forth. I see a urologist in NYC which is about 100 miles away..

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@pablo81

How are you doing 5 days after Rezum? Is cath still in? I am 80 years old and started with BPH symptoms about 6 years ago. I am taking tamsulosin in am and pm before bed along with 400 MG Ibuprofen. Up once a night. I was set to do REZUM months back but urologist lost access to equipment because of change in ownership. I oscillate back and forth. I see a urologist in NYC which is about 100 miles away..

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Pablo, the catheter was in for three days and then fell out the morning it was to be removed. Tamsulosin sounds like it's working for you. They put me on that and took me off Myrbetriq. I will try Oxybutynin before going back to Myrbetriq for co$t reasons. Getting up only once at night sounds pretty much good to me. The PA said "the two weeks after the REZUM procedure sucks." It might not be worth going through the Vicodin, REZUM, catheterization, two weeks of serious discomfort, self-catheterization (which I am now doing) to get rid of one nighttime biffy-visit. Think about it.

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@rfherald

Pablo, the catheter was in for three days and then fell out the morning it was to be removed. Tamsulosin sounds like it's working for you. They put me on that and took me off Myrbetriq. I will try Oxybutynin before going back to Myrbetriq for co$t reasons. Getting up only once at night sounds pretty much good to me. The PA said "the two weeks after the REZUM procedure sucks." It might not be worth going through the Vicodin, REZUM, catheterization, two weeks of serious discomfort, self-catheterization (which I am now doing) to get rid of one nighttime biffy-visit. Think about it.

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I forgot one step: Multiple ultrasound scans of the bladder. Not painful, but a hassle to go in to get smeared with jelly and told you have too much urine in the bladder and need to be re-catheterized or learn how to self-catheterize.

The best part of the whole week was when I was wearing a 2 liter cath bag and slept non-stop for eight hours for the first time in YEARS!

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@wallyworld

I'm 64 and had the HoLEP procedure this past July and went from a garden hose trickle to a firehose concerning flow. I highly recommend this procedure. One night in the hospital to monitor bleeding then you go home and almost no pain. I've been doing great ever sense and don't have to take the med's anymore. No issue with ED. I did have to exercise my Kegel muscles to strengthen my pelvic floor which supports the urinary system. I'll be happy to answer any questions y'all have on my experience with this procedure. Like joenfl2017, I sleep through the night and the BPH is gone.

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Did you consider Rezum procedure. If so, how did you choose?

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There's another procedure called P.A.E., Prostate Arterial Embolization.

https://www.yalemedicine.org/conditions/prostate-artery-embolization

This procedure uses an x-ray guided catheter that enters either through the wrist or the efemeral artery in the groin. The catheter is guided to the blood supply of the prostate and is embolized or blocked with an agent that stays there. The prostate reduces in size. This procedure is being used for larger prostates and doesn't affect the prostate, sexual or urinary function. They don't use the urethra to do this. I have read that there is about a week of residual perineal pain and some urinary burn. They do this in radiology under conscious sedation, such as Sublimaze (fentanyl) and Versed or Valium sub-lingual. It takes anywhere between one to two hours, or less.

This is what I, myself would choose over all of the current roto rooter, steam, water and laser options via urethra. It's worth a look-see. I would like to avoid a lifetime of self-cath if possible. I will ask about it.

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I had a Plasma Button procedure back in 2017 and I am still sleeping through the night.
The Plasma procedure goes through the urethra using a plasma burst to burn the excess prostate tissue to reduce the size of the prostate. I only had the catheter in over night and pain lasted 4 to 5 days. There was blood in the urine for 2 months. I had this done at the VA in St. Cloud MN. I Hope this helps.

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Looks like I am headed for the GREEN LIGHT LASER surgery. Doc explained the procedure would remove tissue of prostrate, etc. Having an issue with basic hospital bureaucracy. Scheduling nurse just called after last weeks visit, and explained that the hospital needed to co-ordinate vendor/surgeon before I can get a scheduled date for surgery. Looks like 6 to 8 weeks out from this date before we can have a definite date. Not good news, as I am still with the Foley catheter causing pain/irritation. Seems like an inordinate amount of time to have the surgery done. Any thoughts, etc. Confusing......

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Going to have the Green Light Laser surgery in a few weeks. I am wondering if those that have had this procedure can give me some insight, suggestions, and general comments on the process. Particularly worried about ability to Urinate after completion....Can you immediately "go", what about pain and how long before life gets back to normal. What about a return to sex life ( Asking for wife ( ha ha)) Any comments appreciated.

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I had Rezum 2.5 months ago. Right now, I would seek out other alternatives. When they say minimally evasive...boloney...it's evasive. First off, I did not do enough research on other treatments and put way too much trust in my URO. Make sure you go to someone that measures the size of the prostate so you know what you are dealing with, that was my first mistake. I had some complications after the catheter came out 5 days later. I could not void and had to use a catheter daily for 2 weeks, then my voiding got down to <200 ml. I also had a wicked UTI, Now at 2.5 months I am still not peeing any better, I had to cath the other night. Maybe Maybe (praying here) that in 2-3 months from now it will get better, otherwise this was a total fail and looking at other options, all have their possible complications. Hope this helps!

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@markbph

I had Rezum 2.5 months ago. Right now, I would seek out other alternatives. When they say minimally evasive...boloney...it's evasive. First off, I did not do enough research on other treatments and put way too much trust in my URO. Make sure you go to someone that measures the size of the prostate so you know what you are dealing with, that was my first mistake. I had some complications after the catheter came out 5 days later. I could not void and had to use a catheter daily for 2 weeks, then my voiding got down to <200 ml. I also had a wicked UTI, Now at 2.5 months I am still not peeing any better, I had to cath the other night. Maybe Maybe (praying here) that in 2-3 months from now it will get better, otherwise this was a total fail and looking at other options, all have their possible complications. Hope this helps!

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People considering a surgical procedure would benefit tremendously in my opinion if they could read hundreds of post surgery results like yours Mark before they decided to choose a particular surgical procedure. Having read many dozens of after surgery Rezum reports I tend to agree with you that in spite of it being a short in office procedure, after surgery tissue trauma and healing might take longer than some doctors suggest. "All have possible complications." So at least I'd want a prognosis and options tailored to my particular medical case from a team of doctor specialists like might be found at the Mayo Clinic.

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