Rezum Water Vapor Therapy

Minimal invasive management for the relief of LUTS (lower urinary tract symptoms)

This procedure is performed when the prostate gland is causing LUTS and you want an alternative to medication without the complications of a permanent procedure.
Symptoms include (LUTS):
- a weak stream,
- nightly urination,
- frequent urination,
- inability to urinate,
- kidney failure due to the obstruction,
- bladder stones,
- recurrent bladder infections.
Medication such as Flomaxtra, Urorec Minipress etc. should always be given as a first resort. All have side effects that you may not like.
This is alternative to medication where the ejaculatory function is to be preserved.
Prostate cancer first needs to be ruled out by doing a PSA, and when indicated, with a 3T MRI scan of the prostate with an abnormal PSA with a possible prostate biopsy of any suspicious lesions. Prostate sizes up to 80 cc, even mid lobe are acceptable

Patients will receive general anesthesia, unless contra-indicated.
A cystoscopy is performed by placing a camera in the urethra with the help of a lubricant jelly and an irrigant (fluid).
The inside of the bladder is viewed for pathology. If any suspicious lesions are seen, a biopsy will be taken.
The device is placed through the cystoscopy sheath.
Prostate lobes are injected with water vapor, 2-6 injections 10 seconds each
Prophylactic antibiotics will be given to prevent any infections.
Any anesthesia has its risks, and the anesthetist will explain this to you.
You will require an indwelling urinary catheter for 5-10 days depending on the size of your prostate
Lower abdominal discomfort for a few days
Could have an inflammatory response requiring antibiotics.
Discomfort in urination can last 6 weeks.
Full results will be experienced at 3 months

NB! Hang in there, it is worth it! Each person is unique and for this reason, symptoms vary!

Ejaculation will mostly not be affected as is the case with medication, TURP and TUVP, therefore no retrograde ejaculation, thus preserving sexual function,
In a small % of cases the bladder neck is treated, there may be retrograde ejaculation, this will be discussed with you.
Infertility should not be an issue as there is no retrograde ejaculation. Don’t do it if you still want children.
You will be discharged with a catheter.
A trial of void (removal catheter) will be scheduled 5-10 later as soon as the major swelling has gone down
Larger prostates may fail and require the catheter for a further 5 days.
Suprapubic pain will improve over the next 7 days.
No Stress incontinence especially in the elderly and the diabetic patients
You may experience a slower stream initially due to swelling
Some urgency and dysuria for 6 weeks
Possible infection due to avascular / necrotic tissue
You will pass the hemolyzed dead tissue in the form of brown discolored fluid at the 14-day mark.
Allow for 6 weeks for stabilization of symptoms thereafter.
There may be some blood in your urine. You can remedy this by drinking plenty of fluids until it clears.
A follow-up appointment will be scheduled for 6 weeks.
The full extent of this procedure will only appreciated at 3 months.