Rezum Water Vapour Treament
Benign Prostatic Hypertrophy (BPH) causes a variety of urinary symptoms, including:
- poor urine stream
- difficulty commencing urine flow
- dribbling after finishing
- passing urine frequently
- needing to go urgently
- waking up at night to pass urine
Whilst there are a number of different treatments available, and they all are different in how well they work, how long it takes to get over the procedure, and the side-effects caused by the treatments, Rezum® water vapour therapy is the newest, and shows great promise as a minimally-invasive treatment with good efficacy and a very low risk of side-effects.
How Does Rezum Work?
Rezum uses the natural energy stored in water vapour, or steam. During each 9 second treatment, sterile water vapour is is released within the targeted prostate tissue. When the steam turns back into water, within the prostate, all the stored energy is released, causing the surrounding prostate tissue to die.
Over time the body's natural healing response removes the dead prostate tissue, therefore shrinking the prostate, so that the urethra will open and BPH symptoms will improve.
Most patients begin to experience symptom relief in as soon as two weeks and maximum benefit will occur within 3 months.
How is Rezum Treatment Done?
Under a very light, short, general anaesthetic, the bladder, prostate and urethra (water tube) are inspected.
An assessment of the size and shape of the prostate determines how many 9 second treatments are used.
A specialised instrument allows a needle to be inserted into the enlarged prostate tissue, and steam is applied via this needle. Usually between 2 and 8 steam applications will be used, each taking 9 seconds, with the average being 4.5 application, so the total treatment time is short.
Because the prostate swells following the treatment, making urination difficult initially, a small catheter tube is inserted into the bladder via the lower abdomen (not through the penis).
The patient goes home the same day, and the small tube is removed 1 week after the procedure.
Before The Procedure
Once assessed as being suitable for Rezum®, a day will be organised for the procedure. You will meet with the Urology Nurse to discuss the small catheter tube and how you will manage that after the procedure.
Routine blood tests and a urine test will be done before the procedure.
Blood thinning medications, apart from Aspirin, need to be stopped for a few days before the procedure
After The Rezum Procedure
After your procedure both Dr. Love and the Urology Nurse will see you and answer questions before you leave hospital, almost certainly the same day you are treated.
You will be on antibiotics for a week, and may need mild pain killers because of discomfort from the small drainage catheter.
As urine will drain from the catheter initially, you will not need to pass urine yourself, and when the initial swelling following the treatment has resolved, usually 1 week, the small catheter will be removed by the Urology Nurse, after being sure you can pass urine naturally yourself. It may be possible to remove the catheter earlier, but there is more chance then that it might need to be re-inserted for a few more days.
You can return to any physical activity you like, as soon as you are comfortable after the procedure, within the limitation of having the small catheter tube in place.
If you normally take blood thinning medication, you can start those again 2 days after the procedure.
An appointment will be made for you to see Dr. Love about 6 weeks after the procedure, by which time you should be noticing significant improvement, although it can take 3 months for the bladder to be at its best after Rezum®
What Can Go Wrong?
One of the great things about this minimally-invasive treatment, is the very small risk of any significant complications or side-effects.
About 50% of patients get little or no side-effects.
If the catheter tube is removed too soon, it may be difficult to pass urine, and it is possible another tube would need to be re-inserted.
Very occasionally, even after passing urine when the catheter is first removed, difficulties could develop after a day or two, again necessitating re-inserting a catheter.
It is normal to have a small amount of blood in the urine for a number of days, and some burning when passing urine for a week or so. There is usually blood in the semen for some time after the procedure.
Despite the antibiotics, there is a very small chance, around 2-3%, of a urinary infection.
Sometimes burning and stinging in the urine will persist for more than a week, even with no infection, and some other treatment for that may be required.
There should be no effect on sex drive (libido) from this procedure, and the risk of any reduction in erectile function is very low, <1% only.
Compared to prostate medications, and "re-bore" type procedures, such as TURP, which often cause sexual dysfunction, the risk of backward (retrograde) ejaculation is < 5% with Rezum®
If there are any unexpected issues in the post-operative period, please contact Dr. Love on 96604911, firstname.lastname@example.org, or via the Holmesglen Private Hospital switchboard.