Rezum Water Vapor Therapy - Dr. Jo Schoeman

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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: a weak stream, nightly urination, frequent urination, inability to urinate, (LUTS) 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.
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 80-100 cc even mid lobe are acceptable

Patients will receive general anaesthesia, 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 cystoscopic sheath.
Prostate lobes are injected with water vapour, 2-6 injections 10 seconds each
Prophylactic antibiotics will be given to prevent any infections.
Any anaesthesia has its risks and the anaesthetist will explain this to you.
You may in extreme cases experience some blood loss.
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.

· NB! Each person is unique and for this reason, symptoms vary!

Ejaculation will not be affected as with medication, TURP and TUVP, therefore no retrograde ejaculation, thus preserving sexual function
Infertility should not be an issue as there is no retrograde ejaculation. Don’t do it if you still want children.
No Stress incontinence especially in the elderly and the diabetic patients
May experience a slower stream initially due to swelling
Some urgency and dysuria for 6 weeks
Possible infection due to avascular tissue
May require resection of infected tissue
Further enlargement of prostate lobes within 3-5 years requiring a definite procedure.
NB! Each person is unique and for this reason, symptoms vary!
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
Suprapubic pain will improve over the next 7 days.
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.