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

AUA is offering a class, Surgery Management of BPH (2021) that is virtual and free. 7/14/2021, 7pm EDT.
https://auau.auanet.org/content/surgical-management-bph-2021#group-tabs-node-course-default5

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Thanks for posting this link. Glad to see there is more and more information available to us. We’ll beat this one way or another.

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The latest literature review on Rezum has recently been published at "Rezum: a novel minimally invasive treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia a review article," International Urology and Nephrology https://doi.org/10.1007/s11255-021-02878-8. The publisher of the journal charges $39 for the article, which you can download after paying. The review shows this treatment to be very attractive. I am very glad to I read this review. It supports my inclination to choose this treatment.

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I noticed the followiing in the May 2020 AUA guidelines for surgery for BPH:

"PROSTATE ARTERY EMBOLIZATION (PAE)
23. PAE for the treatment of LUTS secondary to BPH is not supported by current data and trial designs, and benefit over risk remains unclear; therefore, PAE is not recommended outside the context of clinical trials. (Expert Opinion)"

That sentence is consistent with the view SC at Mayo Rochester gave me about PAE on July 7.

Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA GUIDELINE

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@bruce1sparkle

I noticed the followiing in the May 2020 AUA guidelines for surgery for BPH:

"PROSTATE ARTERY EMBOLIZATION (PAE)
23. PAE for the treatment of LUTS secondary to BPH is not supported by current data and trial designs, and benefit over risk remains unclear; therefore, PAE is not recommended outside the context of clinical trials. (Expert Opinion)"

That sentence is consistent with the view SC at Mayo Rochester gave me about PAE on July 7.

Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA GUIDELINE

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@bruce1sparkle Thanks for this Bruce,
I did read about this last week and was very disappointed. At least I have some time for my eventual decision. I talked to a guy who did Rezum and he said it took six months to get full relief and now he is happy to have done it. My Uro did mention the procedure does take time to show benefits. Good luck on your procedure, looking forward to hearing your updates.
Best,
Bill

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@bill5letsfixthis

@bruce1sparkle Thanks for this Bruce,
I did read about this last week and was very disappointed. At least I have some time for my eventual decision. I talked to a guy who did Rezum and he said it took six months to get full relief and now he is happy to have done it. My Uro did mention the procedure does take time to show benefits. Good luck on your procedure, looking forward to hearing your updates.
Best,
Bill

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I thought I'd note where I've come down on treatment for BPH, having had several back-to-back episodes of acute urinary retention, having had the benefit of a long visit with SC at Mayo Rochester to discuss treatment options and then having done a lot of web research on my own. My plan, viewed as reasonable by SC, is to do the medical route—2x/day tamsulosin and dutasteride—for 4-6 months, while I continue with 2x/day self-catheterizations; if my nightly bathroom trips fall from 4-5 or more to 2-3, I'll try stopping the self-catheterizations and see if I'm 'done' with treatment (continuing with dutasreride at least). If not, I'll ask SC to schedule Rezum for me.

Everyone's situation is different, but I thought I'd note where I am on my situation.

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@bruce1sparkle

I thought I'd note where I've come down on treatment for BPH, having had several back-to-back episodes of acute urinary retention, having had the benefit of a long visit with SC at Mayo Rochester to discuss treatment options and then having done a lot of web research on my own. My plan, viewed as reasonable by SC, is to do the medical route—2x/day tamsulosin and dutasteride—for 4-6 months, while I continue with 2x/day self-catheterizations; if my nightly bathroom trips fall from 4-5 or more to 2-3, I'll try stopping the self-catheterizations and see if I'm 'done' with treatment (continuing with dutasreride at least). If not, I'll ask SC to schedule Rezum for me.

Everyone's situation is different, but I thought I'd note where I am on my situation.

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All the best to you Bruce @bruce1sparkle

Your research and perseverance will prevail. Thanks for this update.

Everyone’s situation being different is not only puzzling but finding the right course makes us proactive in our own cases. And you have done a great job and give us inspiration to do the same.

Good luck,
Bill

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@bill5letsfixthis

Thanks for posting this link. Glad to see there is more and more information available to us. We’ll beat this one way or another.

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The program, "Surgical Management of BPH Webcast (2021)" (2:02:37) is available on Youtube at:

You can skip the first four minutes. After that it begins with a multiple choice Q&A that gives a patient's specific condition, provides four possible solutions, then the audience votes. Later the responders give recommendations and explanations.
The "audience" is apparently meant to be Urologists who are seeking the latest information. Doctor words are plentiful.

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@rfherald

The program, "Surgical Management of BPH Webcast (2021)" (2:02:37) is available on Youtube at:

You can skip the first four minutes. After that it begins with a multiple choice Q&A that gives a patient's specific condition, provides four possible solutions, then the audience votes. Later the responders give recommendations and explanations.
The "audience" is apparently meant to be Urologists who are seeking the latest information. Doctor words are plentiful.

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Thanks Bruce @bruce1sparkle. I will be watching this. I watched a quick Youtube video by a Dr. at Loyola on Rezum. Makes it look so easy, I will be considering this when my time comes. Thanks again.

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@bill5letsfixthis

Thanks Bruce @bruce1sparkle. I will be watching this. I watched a quick Youtube video by a Dr. at Loyola on Rezum. Makes it look so easy, I will be considering this when my time comes. Thanks again.

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There was a post here a few weeks ago by a man who had the Rezum procedure done. He complained LOUDLY about the pain. It was pulled, probably because he mentioned the doctor's name and called him a "butcher." I don't remember if he had a local anesthetic or not, but other posters have said the pain was manageable and had a local and/or the "dreamy" drug. Ask questions.

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@rfherald

There was a post here a few weeks ago by a man who had the Rezum procedure done. He complained LOUDLY about the pain. It was pulled, probably because he mentioned the doctor's name and called him a "butcher." I don't remember if he had a local anesthetic or not, but other posters have said the pain was manageable and had a local and/or the "dreamy" drug. Ask questions.

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@rfherald Yes, I remember that post, he was really upset. I may have mentioned before that I spoke to someone that had Rezum and he said it took about 6 months to finally work. My Uro did say it takes time. You’re so right about asking questions. I go in with an index card with my list. I think doctors appreciate that because both of us get quality time not forgetting anything.

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