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What happens if I decide to have Rezum? 

We will offer you a date for the 

procedure, and an appointment for the pre-assessment clinic. If you have not already had a urine flow test, we will arrange this. If you are currently taking blood-thinning medication (such as warfarin), we may ask you to stop taking it for a few days before your treatment. 
 

On the day of surgery 

We will ask you to come in on the day of your operation. Although the procedure only takes a few minutes, you should expect to be at the hospital for a few hours, longer if you are having a general anaesthetic. It is very likely that you will be able to go home the same day. We will discuss the procedure with you in detail and ask you to sign a consent form. In theatre before the operation, we will give you some strong painkillers as well as antibiotics which you will need to continue at home. You will then be given a general anaesthetic if you are having one. We recommend to keep the bowel motions soft after the procedure for 3-5 days. 

The prostrate is measured with the use of an ultrasound probe via your back passage. This may feel a bit uncomfortable, but the more relaxed you are, the easier it will be. 

We will then pass the Rezum equipment through your urethra (water pipe) using plenty of anaesthetic gel, which may momentarily sting. After a quick inspection of the bladder, we will start the Rezum treatment. 

At the end of the procedure, we will insert antibiotics and pain killers (this may include a pain killing suppository into your rectum). You will have a catheter left within your bladder for a few days to drain the urine away without the need for you to pass urine yourself and also allow the prostate to adjust to the treatment and for any swelling to go down. You may be given a tap or valve to attach to the catheter. 
 

When can I go home? 

After the procedure, a member of the urology team will discuss the operation with you. They will give you a date to return to hospital for removal of your urinary catheter, as well as advise you on how to look after yourself at home. You are usually in the hospital for less than 6 hours. 

You should be discharged home with at least 5 days of antibiotics as well as some painkillers. You are unlikely to have any pain once the catheter has been removed. 

Is there anything I need to watch for at home? 

It is normal to have some pain and discomfort after surgery, and we will advise you on the most appropriate pain killers to use. 

If you have a temperature after the procedure with shivers and shakes you may require antibiotics and so we would advise you to contact the hospital where you had the procedure. If there is bleeding and blood clots we would also ask you to seek help. 

 

When can I get back to normal? 

You can return to work as soon as you feel comfortable to do. If you need a sick certificate or have any queries about this, please speak to your surgeon before we discharge you home. Some patients have returned to work within a few days. Most will take 1 week off, some longer. 

You should be able to resume most of your usual activities within a few days. It is normal to see a small amount of blood in the urine after this procedure for 4-6 weeks. Burning when passing urine can come and go. This responds well to anti-inflammatory painkillers. 

You can resume sexual activity 4 weeks after the catheter has been removed and you feel comfortable to do so. Please do not worry if you see blood in your semen which may also be visible for a long as 3 months. 

 
 

Will I need to return to hospital? 

Yes, we will ask you to return to have your catheter removed. This appointment will be arranged when you come in for your procedure. Please try to have a full bladder when you come for this appointment, so that your stay will be as short as possible. 

Once we have removed the catheter, we will ask you to empty your bladder. We monitor how much you void and then do a bladder scan to detect any urine remaining in your bladder. If the nurse is happy with the results, we will discharge you from the ward. 

However, if there are any problems, we may need to recatheterize you for a further period. 

We will be asking you to complete some questionnaires before and after the procedure. 

 

What to expect following the catheter removal (Trial WithOut Catheter - TWOC) 

After catheter removal once you have been discharged home it is important to be aware of the following; 

 

For 24-48 hours the flow may deteriorate before it starts to improve 

• Blood in the urine is normal particularly for the first few days 

• Increasing fluid intake can help the urine to clear 

• Avoiding heavy lifting or straining is sensible 

• Burning when passing urine is not uncommon and this can occur at any time in the first 6 weeks – this responds well to anti-inflammatory painkillers and avoiding drinks which irritate the bladder such as fruit juices and caffeine containing drinks 

• Please try not to get constipated – straining to open the bowels can trigger bleeding and the passage of blood clots 

 
 

Blood at the start of the urinary stream is normal particularly in the first few weeks. This can last as long as 6 weeks. If the urine becomes a dark rose colour or red with clots it is important to rest and take fluids, and if this doesn’t settle within 24 hours please contact the ward. 

It is normal to pass some debris in the first few weeks – 1/3 of men will pass small bits of  prostate tissue in the urine. This is more common if the median lobe has been treated (not all men have a median prostate lobe). 

It is possible that pads may be required to absorb any potentially embarrassing leakage particularly in the first 2-3 weeks. This is something that will settle over time. 
 

Continue to look out for the following; 

 
 

• If you are unable to pass urine and it becomes painful at any time in the first week you may need another catheter for a few days. This doesn’t happen very often. 

• If you get a ever (high temperature) in the first few weeks – please consult the ward or contact your local GP. Further antibiotics may be required to treat a urinary tract infection. 

• If there is dark blood passing from the urethra with clots and it is uncomfortable you may require urgent review if it is not settling. 
   

After 4 weeks 

You no longer need to avoid heavy lifting or sexual intercourse. 

It is normal for the improvement in the urinary symptoms to be quite slow but usually some improvement in the flow has occurred by this stage. ¼ of men will still be having some difficulties with increased urinary urgency and frequency at 6 weeks. To get the full benefit of Rezum can take as long as 6 months. 
 

Frequently asked questions 

When should I stop my prostate medication? 

It is sensible to stop the medication 4 weeks after the procedure. If the prostate is very large then this may be extended to up to 3 months. 

 

Is it normal to have blood in the ejaculation fluid? 

Yes this is normal and can take several weeks for ejaculations to settle. 
 

Is it likely to be a slower recovery if my prostate was large before the procedure? 

The bigger the prostate the longer it can take to see an improvement and it can be a bit more uncomfortable in the first week or two. As additional injections of steam are required for a bigger gland it will be more swollen to start with. 

 

What happens if my symptoms initially improve and then deteriorate within the first 3-6 months? 

Occasionally this can happen in the first few months following the Rezum procedure. This can be due to the healing process and sometimes a piece of dead prostate tissue can cause a partial blockage. This is not difficult to deal with but it is important to notify your Urologist if this occurs. 

 

Is there a limit to the size of gland treated? 

We would recommend gland volumes are less than 100mls in size ideally. The data would suggest that the best results are for those with a gland volume of less than 80 mls. This will be assessed before your procedure. We can treat larger glands but there are usually other options which may be superior for very large prostates. 

 

How much time will I need off work? 

This does depend on the type of work. If there is quite a lot of travelling and exercise we would recommend 2 weeks from the time of surgery. Some men are able to return to a desk job within 2-3 days of the procedure whilst others will prefer to wait until after the catheter has been removed. 

 

Your feedback is important to us 

Comments, concerns, compliments and complaints 

If you have any comments, concerns, compliments or complaints about your care, please let us know as soon as possible. Please speak to the urology specialist nurse so that we can help to resolve your concerns quickly.