Rezum

The Procedure

Rezum is a transurethral procedure in which your doctor uses the energy stored in water vapor, or steam to relieve the symptoms of benign prostatic hyperplasia, or BPH. During each 9 second treatment, sterile water vapor is released throughout the targeted prostate tissue. When the steam cools and turns back into water, all the stored energy (heat) is released, causing the prostate cells to die.

The number of water vapour treatments varies depending on the size of the prostate, usually between 2-8 vapour treatments.

Over time, your body’s healing response removes the dead cells, shrinking the prostate. With the extra tissue removed, the urethra opens, reducing symptoms related to the enlarged prostate.

Rezum Procedure Urologist Sydney

Most patients begin to experience symptom relief in as soon as two weeks and maximum benefit will occur within three months.

This is a minimally invasive procedure which preserves urinary and sexual function. Erections and are not affected and generally ejaculation is preserved in 95% of the men. There is a very low percentage of men (approx. 5%) who experience retrograde ejaculation. This is when the semen enters the bladder instead of the penis causing very little or no semen to be ejaculated.

Pre operative preparation

You may be asked to stop anticoagulants (blood thinners) like aspirin/cartia, warfarin, plavix, xarelto, eliquis and Pradaxa a few days to a week before your procedure.

Post operative expectations

Do not drive a car or operate machinery for the first 24 hours post anaesthetic.

You will have an indwelling catheter in your bladder to drain urine for a number of days (5-7 days) until the inflammation/swelling in the prostate has settled.

While having a catheter in place it is important to drink adequate volumes of water, at least 1-2L water/day.

The catheter may cause you to experience bladder spasms, which can cause intermittent discomfort/pain in the bladder and some leakage of urine past the catheter.

Avoid strenuous activity (climbing ladders, biking, extensive walking up and down stairs) while the catheter is in place.

You may be on a course of oral antibiotics. Please complete the full course.

Post catheter removal

Take URAL (you can buy this over the counter at the chemist) one sachet 3 times per day, to alleviate burning when passing urine (burning/stinging normally lasts up to 72 hours). Take Panadol for pain relief.

You may experience blood in the urine, this will resolve quickly with increased fluid intake.

If the bleeding is heavy, with bright fresh blood, and/or with clots, and/or continues for more than 48 hours, please contact your surgeon

You may experience discomfort, frequency and urgency in urinating. This is not unusual with the swelling of the prostate causing restrictive slow flow and can last from 24-48 hours. A small percentage of men have these symptoms continue for 2-3 weeks.

If you have any difficulty urinating, present back to the Emergency department and contact Dr Rasiah’s office.

Symptom improvement is gradual. Response to treatment varies between men depending on the size of their prostate, the number of treatments, the location of treatment within their prostate and their bladder function. During the first 1-2 months following your procedure you may have frequency of urination and/or urgency and perhaps even more getting up at night. Symptoms usually get worse before they get better. Generally, at 2 weeks symptoms tend to stabilize, at 4 weeks they are back to where they were before the procedure and at 6 weeks men start to enjoy the benefits of the procedure and can come off their medication. Therefore, expect slow improvement over 1-2 months.

It is recommended to avoid (or have in moderation) alcohol, spicy food and drinks with caffeine, as these may cause irritation when passing urine.

It is important to keep your bowels regular during the post-operative period. Straining with bowel movements may cause bleeding. You can take a stool softener or a mild laxative if needed (like movicol).

Your physical activity does not need to be restricted.

No sexual activity for the first 2 weeks post catheter removal. Expect some burning and blood in the ejaculate/semen for up to 3 months after the procedure.

Continue taking Flomaxtra until Dr Rasiah takes you off the drug. Check with your surgeon when to restart your blood thinning medication (aspirin/cartia, warfarin, plavix, xarelto, eliquis and pradaxa).

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