What are the other Names for the Procedure?
- Convective Water Vapor Ablation (Rezūm System) for Benign Prostatic Hyperplasia
- Rezūm Therapy for Benign Prostatic Hyperplasia
- Rezum Treatment for Benign Prostatic Hyperplasia
What is Rezum Procedure for BPH?
- Rezum Procedure for Benign Prostatic Hyperplasia is a cutting-edge procedure to treat Benign Prostatic Hyperplasia in men, using water vapor ablation. It is a minimally-invasive procedure
- Benign prostatic hyperplasia (BPH) occurs when the prostate gland is swollen and its size increases. It is a relatively common condition in men over 50 years of age
- The symptoms of an enlarged prostate include frequent urination (including at night), urgency to urinate, pain during urination, incontinence, and changes in the color or smell of urine
- In Rezūm Procedure for BPH, water vapor or steam is directed to the enlarged prostate gland resulting in the removal of extra prostate tissue, thereby improving the symptoms
What part of the Body does the Procedure involve?
Rezum Procedure for Benign Prostatic Hyperplasia involves the prostate gland, urethra, and the male genitalia.
Why is the Rezum Procedure for BPH Performed?
The Rezum Procedure for Benign Prostatic Hyperplasia is performed chiefly to treat benign prostatic hyperplasia (BPH), which is a condition of enlarged prostate. The procedure is performed for the following reasons:
- To address chronic issues of urine flow obstruction
- To decrease or treat urination problems that include low urine output, difficult urination or unable to urinate, frequent night-time urination, and dripping of urine after completing urination
- When medications and other surgical procedures to treat BPH have not resulted in a cure
What are some Alternative Choices for the Procedure?
Some of the alternatives to Rezum Procedure for Benign Prostatic Hyperplasia include the following measures:
- Bringing about lifestyle changes and managing stress (early in BPH)
- Administration of medications, such as alpha blockers and phosphodiesterase-5 inhibitors, to help relax the muscles of the urinary bladder
- Surgical procedures that may include trans-urethral microwave thermotherapy, trans-urethral needle ablation, and insertion of prostatic stent
- Trans-urethral resection of the prostate and open prostatectomy to treat severe cases of BPH
However, some of the surgical procedures can result in complications, such as infection, loss of bladder function, erectile dysfunction, and rarely, recurrence of the condition.
What are the Recent Advances in the Procedure?
Rezum Procedure for Benign Prostatic Hyperplasia is an emerging technique in urology to treat enlarged prostate gland in men.
What is the Cost of performing Rezum Procedure for BPH?
The cost of Rezum Procedure for Benign Prostatic Hyperplasia depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.
In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.
When do you need a Second Opinion, prior to the Procedure?
- It is normal for a patient to feel uncomfortable and confused by the information regarding Rezum Procedure for Benign Prostatic Hyperplasia and on what needs to be done
- If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
- Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently
What are some Helpful Resources?
Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006
https://www.urologysanantonio.com/bph-enlarged-prostate/rezum (accessed on 03/08/2018)
http://www.rezum.com/ (accessed on 03/08/2018)
Prior to Rezum Procedure for BPH:
How is the Rezum Procedure for BPH Performed?
Rezum Procedure for Benign Prostatic Hyperplasia may be undertaken in the following manner:
- The procedure is performed under conscious sedation or suitable nerve block
- The urologist directs tiny streams of water vapor (steam) via the urethra to the targeted region of enlarged prostate gland causing the symptoms
- Using the stored energy in steam, the excess cells are destroyed and the extra tissues are slowly removed from the prostate by the body
- This results in an overall decrease in the size of the prostate gland. This technique is also known as water vapor ablation therapy
Where is the Procedure Performed?
Rezum Procedure for Benign Prostatic Hyperplasia is usually performed in an out-patient (surgery) facility, a physician’s clinic/office, or a hospital.
Who Performs the Procedure?
An urologist usually performs the Rezum Procedure for Benign Prostatic Hyperplasia.
How long will the Procedure take?
The time taken for the Rezum Procedure for Benign Prostatic Hyperplasia can range from 30-60 minutes. However, the actual procedure may take around 3-5 minutes.
What do you need to tell your Physician before the Procedure?
It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Rezum Procedure for Benign Prostatic Hyperplasia and helps avoid unnecessary complications.
- Provide a complete list of medications you are currently taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
- If you are allergic to any specific medication or food items
- If you are taking blood thinners such as aspirin, warfarin, herbal supplements, or any other such medications
- If you or your family members have a history of bleeding disorders, or if there is a tendency to bleed more than normal
- If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
- If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
- If you have a history of frequent bone fractures (this may affect bone-healing if bones are involved as part of your procedure)
- A list of all previous surgical procedures you have undergone, for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.
What Preparations are needed, prior to the Procedure?
- The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are currently being taken
- Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time before the procedure is performed
- Inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
- Avoid application of any cosmetics, deodorant, or topical medicines on the area prior to the procedure
- It is advisable to quit smoking and the use of any nicotine based products for a while before the surgery
- Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
- The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
- For individuals suffering from diabetes, it is important that the blood sugar stays within the normal range; if not, their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
What is the Consent Process before the Procedure?
A physician will request your consent for Rezum Procedure for Benign Prostatic Hyperplasia using an Informed Consent Form.
Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.
You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.
What Tests are needed, before the Rezum Procedure for BPH?
The following exams and tests may be recommended prior to the Rezum Procedure for Benign Prostatic Hyperplasia:
- Routine blood and urine analysis
- Chest and kidney X-ray
- Kidney function study
- Electrocardiography (ECG)
- Ultrasound imaging of the pelvic region
- Intravenous pyelogram (IVP)
- Cystoscopy with uroflow, may be performed
- Prostate gland tissue biopsy, if needed
What are some Questions for your Physician?
Some of the basic questions that you might ask your physician are as follows:
- What is Rezum Procedure for Benign Prostatic Hyperplasia?
- Why is this procedure necessary? How will it help?
- How soon should I get it done? Is it an emergency?
- Who are the medical personnel involved in this procedure?
- Where is the procedure performed?
- What are the risks while performing the procedure?
- What are the complications that might take place during recovery?
- How long will it take to recover? When can I resume normal work?
- How many such procedures have you (the physician) performed?
- Are there any follow-up tests or periodic visits to the healthcare facility required, after the procedure?
- What are the costs involved?
During the Rezum Procedure for BPH:
What kind of Anesthesia is given, during the Procedure?
In a majority of cases, no general anesthesia is administered during the procedure. However, the patient is placed under conscious sedation. The procedure may also be performed under a prostate block (such as periprostatic block anesthesia or periprostatic nerve block).
How much Blood will you lose, during the Procedure?
There may be minimal blood loss involved during the Rezum Procedure for Benign Prostatic Hyperplasia.
What are the possible Risks and Complications during the Rezum Procedure for BPH?
There are general factors that increase the risk of complications during the procedure and they include:
- Obesity: Generally, the greater the degree of obesity, the greater the surgical risk
- Smoking: The longer the smoking history (in pack years smoked), the greater the surgical risk
- Advancing age
- Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
- Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
- Poorly functioning liver, as evidenced by increased blood liver function tests
- Hypertension (increased blood pressure), especially if it is poorly controlled
- Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
- Poor lung function, as evidenced by abnormal lung function tests
- History of bleeding disorders
- Longstanding illness, such as autoimmune disorders and chronic infections
- Poor immune system due to a variety of causes
The possible complications that may arise during the surgery are:
- Accidental injury to the neighboring tissue, blood vessel, nerve, or bone
- Excessive bleeding
What Post-Operative Care is needed at the Healthcare Facility after the Rezum Procedure for BPH?
At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise.
After the Rezum Procedure for BPH:
What are the possible Risks and Complications after the Rezum Procedure for BPH?
Significant risks and complications are generally not noted after a Rezum Procedure for Benign Prostatic Hyperplasia.
What is the Prognosis after the Procedure?
The prognosis after a Rezum Procedure for Benign Prostatic Hyperplasia is usually excellent for a majority of individuals. The individuals are able to recover within a few days of the procedure.
When do you need to call your Physician?
Do contact your physician if you notice any of the following symptoms:
- Worsening pain and swelling around the surgical wound
- Bleeding or fluid drainage from the surgical wound
- The occurrence of any symptom that causes uneasiness such as nausea, vomiting, or constipation
- Experiencing difficultly or pain while urinating
- Presence of blood in urine
- Prolonged erectile dysfunction (ED)
- Signs of an infection
- Headache, muscle aches
- Fever, feeling sick
- Complications associated with prescription medications used in treatment
What Post-Operative Care is needed at Home after the Rezum Procedure for BPH?
At home, the following post-operative care is recommended after a Rezum Procedure for Benign Prostatic Hyperplasia:
- Follow instructions and take medications prescribed by the urologist
- Take stool softeners to prevent constipation, under advice of the physician; have soft foods for a few days
- Avoid all activities that are physically strenuous for about 2 weeks after the surgery (per physician’s advice)
- Avoid sex till a complete healing has taken place (as advised by your physician)
- Avoid taking nonprescription medications
- Avoid smoking or chewing tobacco
- Eat healthy food rich in vegetables and whole grains
How long does it normally take to fully recover, from the Procedure?
In a majority of cases, individuals are able to fully recover from the procedure within a few days to a week. They often note an improvement of the BPH symptoms within 2 weeks; after 3 months, most individuals are able to feel a complete relief from the symptoms.
What happens to tissue (if any), taken out during the Procedure?
Generally, the procedure does not involve the surgical removal of any tissue.
When should you expect results from the pathologist regarding tissue taken out, during the Procedure?
Usually, no tissue is sent for a pathological analysis.
Who will you receive a Bill from, after the Rezum Procedure for BPH?
It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.
Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:
- An outpatient surgery center facility, the dentist or oral surgeon’s clinic/office, or a hospital
- An anesthesiologist
- An urologist
The patient is advised to inquire and confirm the type of billing, before the Rezum Therapy for Benign Prostatic Hyperplasia is performed.