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Clinical History:
Case 1
74 years old.
TRUS prostate volume: 70cc with a median lobe.
PSA: 4 ng/mL
Qmax: 7 mL/sec
IPSS: 22
Case 2
50 years old.
TRUS prostate volume: 40 cc and no median lobe.
Cystoscopy: ruled out urethral strictures.
PSA: 2 ng/mL
Qmax: 9 mL/sec
IPSS: 20
Other History:
Case 1
High-risk patient. History of arterial hypertension and anticoagulant treatment.
The patient has a permanent catheter due to a urinary retention 2 months ago and 3 failed attempts to remove the catheter.
He is on dual medical treatment with alpha blockers and finasteride.
The patient stopped taking his oral anticoagulant treatment 7 days before the procedure and is now taking enoxaparin.
Case 2
He had taken alpha blockers for a few months, but stopped the treatment because of retrograde ejaculation.
Technique description:
Case 1
Rezum OR procedure under IV sedation.
4 treatments on the right, 3 treatments on the left and 2 treatments into the middle lobe.
Total operative time: 4 minutes and 55 seconds.
Case 2
Rezum Office procedure under local anesthesia.
2 treatments on the right, 2 treatments on the left.
Total operative time: 3 minutes and 2 seconds.
Procedure steps:
Enter very gently and be careful with the urethra and the prostatic lobes mucosa to avoid bleeding.
Identify anatomical landmarks
Treating lateral lobes.
Treating the median lobe.
Trainings Objectives:
Case 1: Treating a large prostate with a median lobe.
Case 2: Treating a small prostate with no median lobe.
Part 3: Take a look at some images of the outcomes from a few cases. Cystoscopy and ultrasound view after Rezum procedure.
