You should have the following investigations:
a cystoscopy by your urologist to assess prostate anatomy (length of prostatic urethra, presence of a median lobe)
a transrectal US or pelvic US to document prostate volume
a uroflowmeter and ultrasound to assess urine flow and residual urine
PSA to assess prostate volume and check for prostate cancer
creatinine to check kidney function
urinalysis and culture to check for bladder infection
Our surgical facility is staffed by tertiary care anesthetists who will discuss anesthetic options with you. Because of the minimally invasive nature of Rezum, often a light IV sedation is all that is needed.
Procedure time can vary depending on prostate size and anatomy. You should expect to spend 90 to 120 minutes from checking in, to being discharged from the surgical centre. Procedure time is about 15 minutes.
Depending on your condition which requires you to be on blood thinners, you may still qualify for Rezum®. Please mention this to your surgeon for your consultation.
You will be going home with a catheter which is a tube that drains the bladder into a bag. The nurses will show you how to empty the bag and how to switch between the leg bag during the day and night bag at night. The surgeon will decide on how long the catheter will remain in.
Blood and urine can sometimes escape at the tip of the penis even with the catheter in. You may have sudden urge to void. This may be a bladder spasm. If this happens, stop activity, sit or lie down until spasm resolves.
You will also be on an antibiotic until the catheter comes out plus an additional 1-2 days.
You may have burning when voiding for a variable period when the catheter is removed. Drink enough fluids to keep the urine clear. Expect some blood and occasional tissue like materials to be found in the urine. As a minimum, try and void every 2 hours. Avoid streneous activities that involving lifting, pushing or pulling (keep less than 20 lbs) for the first 4 weeks.
Urination may initially be slow. Do not be discouraged, your voiding will improve with time as the tissue from the treatment is resorbed by the body.
If you are unable to void after 4-6 hours and/or you have significant discomfort over the bladder area, contact your surgeon or go to the closest urgent care centre or emergency department. A catheter can be placed. Some patient need longer catheter time for the postoperative swelling to settle.
If you have a high temperature (>39 degrees celcius or 100 degree farenheit) you should contact your surgeon or go to the closest urgent care centre or emergency department.
As a minimally invasive procedure, Rezum® has demonstrated fewer side effects compared to those typically seen with surgical therapies, but as with any interventional procedure, some of the following side effects may temporarily occur:
Blood in urine
Blood in semen
Inability to urinate or completely empty the bladder
Need for short-term catheterization
Most of these events resolve within three weeks of the procedure, but there is a possibility some of these effects may be prolonged. Please talk with your physician about ways to potentially minimize the effects of these risks. Patients have found that the following options may help relieve discomfort during the short-term healing process:
Take a mild pain medication such as Tylenol®.
Try a warm bath or sitting on a hot water bottle.
Eliminate caffeine, chocolate, and alcohol from your diet
Results are variable, but studies have shown as early as 2 weeks. patient will notice improvement in their flow.
You should speak to your urologist when you can returns to regular activities. For most, once the catheter is out and urination returns, they can return to light duties (ie no straining, no lifting <10lbs) with in a week. We encourage drinking enough fluids to keep the urine clear.
Studies have shown that patients that had Rezum did not have an increased risk of erectile dysfunction.
Studies have shown that patients that had Rezum did not have an increased risk of ejaculatory dysfunction.
Studies have that that patients that had Rezum did not have an increased risk of urinary incontinence.
OHIP does not cover the cost of Rezum. Please contact us for further information.