Rezum Treatment with Nitrous for BPH

Technique Description:

• Case 1) discuss staking technique, but need not to overtreat
• Case 2) how to treat the median lobe
• Case 3) treating the difficult patient with vocal anesthesia and "veru first" technique
• Case 4) smaller prostate, do not overtreat!
• Case 5) typical patient - streamlined approach

Case Record:

• Case 1) treating a tall prostate and discuss Spanner stent
• Case 2) treating a UroLift failure with median lobe
• Case 3) difficult patient who doesn't tolerate cystoscopy
• Case 4) treating a smaller prostate
• Case 5) discuss my streamlined work-up and aftercare

Clinical History:

• Case 1) 76-year-old with urinary retention and a 60-gram prostate
• Case 2) 59-year-old with prior Urolift procedure and large median lobe
• Case 3) 80 y/o with a 40-gram prostate, typical patient
• Case 4 85 y/o with an elevated PVR and smaller prostate
• Case 5) 65 y/o with a 30-gram prostate, streamline approach

Procedure Steps:

• 1. Prostate block
• 2. Nitrous administration
• 3. Rezum

Learning Points:

• Case 1) - discuss protocol after the procedure and role of Spanner stent
• Case 2) - treating UoLift failures and addressing the median lobe
• Case 3) - the role of vocal anesthesia and "veru first" technique
• Case 4) - don't overtreat!
• Case 5) - streamlined approach for work-up and recovery