Category Archives: BPH
Rezum: What to Expect
REZUM therapy is a minimally invasive, in-office, and non-surgical procedure to shrink an enlarged prostate due to benign prostatic hyperplasia or BPH. Heat generated by radiofrequency waves is delivered to the prostate through a needle that emits water droplets that generate steam. This allows for a rapid treatment that has the ability to expand but will not go beyond the anatomical boundary of the prostate itself. The REZUM starts with a transrectal ultrasound which will be used to take a picture of the prostate, determine its dimensions, and inject lidocaine as local anesthesia. This is a very well-tolerated step akin to numbing before a dental procedure and is very quick. The patient will then be repositioned with legs in stirrups and the REZUM can commence.
Treating Large Prostates (>80g) for BPH
Benign Prostatic Hyperplasia (BPH) or enlarged prostate is a concern that most men will experience as they age. On average, about 50% of men over 50 and 80% of men over 80 will experience the lower urinary tract symptoms associated with prostatic enlargement. Because of the nature of this condition, many novel procedures have tried to address the limitations of their predecessors. Some have succeeded, while others have fallen out of favor. In the absence of more serious medical complications, Dr. Engel always focuses on medical therapy as a first line of treatment for most cases of an enlarged prostate. However, if initial medical therapy does not offer the relief the patient expects, if there are side effects, or if the patient simply does not want to be on chronic medication, we often move on to offering minimally invasive BPH therapies that can be quick, effective, and have minimal side effects. However, some patients will need surgical intervention such as robotic simple prostatectomy or HoLEP (Holmium laser enucleation of the prostate) as the procedure of choice when the prostatic enlargement is extreme. The prostate is measured in grams; we consider a large prostate to be anything over 80g, and Dr. Engel has treated prostates of up to 400g.
