Rezum Procedure for BPH - Done!

[ElbowRoom]

I had the Rezum procedure done with Dr. Hakky in Atlanta on Thursday, 10/15/2026. The procedure involves injecting high temperature steam into the tissue to kill and shrink sections of the prostate gland, reducing symptoms of BPH such as frequency, urgency, weak/intermittent stream, etc.

Rezum is favorable compared to other procedures such as TURP, laser ablation, etc. because of lower chances of side effects such as induced ED, loss of ejaculatory function, and faster recovery with low rates of required retreatment (about 4.5% of men require a second treatment within five years). In my investigation of options this seemed like the best, and Dr. Hakky’s recommendation sealed the deal because I trust him. It’s also a big advantage to have the same surgeon that did my implant doing this procedure.

In addition to Rezum, Hakky also injected 80 units of Botox into the bladder lining, to help with frequency and urgency during the first 3-6 months following the procedure as things heal up (maximum benefit of the procedure occurs at 8-12 weeks). Hakky kept the Botox away from the right side of the bladder closest to the implant reservoir.

Țhe Procedure:

I started a course of 500mg of Cipro twice a day the day before the procedure, and continued for five days afterwards.

I was given Versed, Ketamine, and Propophol as anesthetic instead of general, so no intubation was required unless there were complications (which there were not). I obviously don’t remember much and was quite loopy afterward (from the Ketamine I suspect). I woke with a foley catheter in place — the procedure causes initial swelling that can cause urine retention so a cath is placed for a few days until things calm down. My cath is scheduled to be removed Monday the 19th by me at home.

I was also sent home with a six day taper course of Methylpredisolone (steroids) to help manage the tissue swelling and inflammation.

Recovery - Day 1-4:

The worst part of this so far is the catheter. It’s irritating when you move, and just generally hurts. Some blood leaked around it the first couple of days, but that has almost entirely stopped. I had a stub tube with a cap instead of a bag, Hakky prefers that as it puts less stress on implants components. He also mentioned that no implantee should be catheterized longer than two weeks, as it risks urethral erosion against the implant cylinders. There was some blood in my urine the first day and a half, then it just about completely stopped. hakky said to expect more blood and clots when the catheter comes out.

I have managed the pain with hydrocodone. There is constant stinging urethral pain when off the meds, which almost vanishes with them. So I’ll take the pills and taper off of them once the cath comes out tomorrow morning.

I expect there to be blood, pain, and very painful urination when the cath is removed. The worst case is if I can’t pee, then I’ll have to drive to Hakky’s office or an urgent care/ER to get re-cathed. Hakky gave be a cath to do it myself if needed, but I don’t think I could do it if it hurst the way I suspect it will. Hopefully it won’t be necessary…I’ll post again tomorrow once the cath is out with the results of that.

[SWorks17]

I'm glad you're doing well Elbow.

Yes, that Cath was a pain in the ass.

It sounds like Hakky has got this down to a science, I didn't get any botox in my bladder, I'm sure that would have helped a lot.

Heal up brother and get back into the saddle as soon as you can.

Your Bionic Brother in Texas
SWorks

[1sfman]

I had the Rezum procedure Jun 30th this year, and the results were outstanding. It was performed in-office. The anesthesia used was Nitrous Oxide. The tech got me started on the nitrous with deep breathing and holding it for 5 seconds. Did that several times and I vaguely remember the doctor saying he was getting started. I could have cared less as I was high as a kite. The next thing I knew was the tech telling me to release the breathing tube as the doctor was finished. My though was we just got started.

I did have a catheter for 5 days post-procedure. Normally he leaves the catheter in for 2 or 3 days, but I've had problems with early catheter removals in other non-urological surgeries (couldn't pee), so I requested the 5 days. There was just slight discomfort when the catheter was removed and once my bladder filled up I was surprised to have a flow like I hadn't had for 20 years. Little to no discomfort. Other than the discomfort of the catheter exiting my dick, which I used Lidocaine on, I didn't need any pain pills throughout the recovery.

In any case, I would expect minimal discomfort with the removal of the catheter and excellent flow. I've been really impressed with the Rezum procedure including that I still have cum.

[ElbowRoom]

Hey guys, thanks for sharing your Rezum experiences!

The cath came out this morning without incident. I have peed a few time since, mostly just dribbling but since I completely emptied before removing the cath I think that's okay for now. I definitely feel *way* more comfortable without the cath. No more irritation or pain whenever I shift or move. I'm not having any blood or clots in my urine since the removal, though I was told to expect them.

I'll let you know how things progress, for now it seems proceeding as expected.

[cbinspok]

thanks for sharing Elbow, men's health sharing here is of huge benefit to our site. keep us in the loop, and get well soon.

[ElbowRoom]

Hey all, I haven’t updated this thread in three weeks, mainly because frankly I have been having a very rough time following the Rezum procedure.

After the cath came out on the 19th, my urination slowed to s dribble, in spite of feeling constant need to urinate. The bladder pressure became painfully uncomfortable. At the same time I started having a reaction to the steroids (Methylprednisolone) that Hakky had put me on to manage inflammation. I became anxious, agitated, shaky, and my BP shot over 200/100. Ì called the EMTs and got a ride to the ER.

I spent an awful 45min in the ER before they put another foley cath in and drained over 700ml from my bladder. My pressure started to come down so they checked my troponin levels to make sure I hadn’t had an MI (levels were normal), and then sent me home. I hated having another cath but was thrilled I could at least drain my bladder. Urgency and frequency of needing to drain the cath were still pretty high.

I went in to see Hakky on a day later, and they pulled the foley, and did a flow test and ultrasound (including kidneys) and confirmed I was still retaining urine. Hakky preferred to leave the foley out, he wanted me to continue trying to pee on my own. They sent me home with single use straight caths to use as needed. Hakky’s fantastic nurse Kimberly taught me how to use them. A little weird but doesn’t really hurt.

The next week was honestly pretty miserable. I had to pee about every 30-45min, and usually only 50-150ml would come out. I could tell when my bladder got too full and I’d use a cath, about 3-4 times daily. That would usually drain 250-400ml.

About last Friday I had a telecall with Hakky’s PA Daniel and had started to feel like I was turning the corner. I went from a fast dribble to a real stream, and was getting 150-200ml out each time, and cathing only produced 150-175ml, so I was retaining less. Frequency was still 30-45min. Daniel said I should see if I could stop using caths entirely, and he had me resume the Trospium I was taking before the surgery for overactive bladder symptoms (frequency/urgency).

That was the magic. Over the weekend my stream has improved, and my sense of urgency went way down and volume has stayed up. I can now generally go 1.5-2.5 hours between urinations, which is close to normal for me. I’m hoping over time I can pee less often and the stream will continue improving. Max improvement is generally cited at six months, so I still have a long way to go.

I’m as good as I was before the procedure now, and should continue improving over that. It’s been a long road, so anybody considering a BHP procedure of any type should be aware that it is no cake walk and you will likely be miserable for some period. Mine was on the longer side, but it’s definitely a dice roll as to how bad it will be for you.

[SWorks17]

Dang Elbow, what a rough journey you have went through, but I’m glad you can see the light at the end of the tunnel.

Just reading your post, I was reliving my experience with the Rezum procedure, but thankfully mine didn’t go to that extent!

Hang in there brother!
SWorks

[ElbowRoom]

Dang Elbow, what a rough journey you have went through, but I’m glad you can see the light at the end of the tunnel.

Just reading your post, I was reliving my experience with the Rezum procedure, but thankfully mine didn’t go to that extent!

Hang in there brother!
SWorks

Thanks brother! Yeah, Hakky’s office agreed my recovery was more difficult and longer than typical, but that’s just my luck! I am on the upside of the curve now and peeing normally and at reasonable intervals, so I’m hopeful I won’t have any more setbacks.