An update on my REZUM procedure and Apixiban cessation.

[RoyM]

The procedure went ok with no surprises. My concern was around the cessation of Apixiban prior to and following the surgery. My last Apixiban was taken Tuesday evening last. My procedure was at 10.am Friday morning. After surgery I was advised to restart Apixiban on Monday morning that is a total of 5 days without stroke protection and bearing in mind I have been in Permenent AF since May 2016. I feel 5 days is to long and am tempted to restart Apixiban tomorrow morning (Sunday) one day before the surgeon advised me to. I have no bleeding now but the possibility of a stroke or TIA does rather concern me. Regards Roy

[BobD Volunteer]

Fully understand Roy though we can't condone going agianst doctors instructions.

[RoyM in reply to BobD]

I understand that Bob but sometimes we need to take control and for me it's now. I was also just updating everyone who was kind enough to reply to my first post. Kind regards Roy

[Lynnsj63]

Hi Roy, Perhapa take half a dose tomorrow evening for peace of mind or call 111 for advice re your concerns for reassurance. Wishing you a good recovery. Take care. Fiona

[RoyM]

Thanks Fiona for your reply, perhaps that may be a compromise. Kind regards Roy

[dedeottie in reply to RoyM]

That is what I did but obviously I am not recommending that you do the same. I agree that sometimes we have to take control but then I guess we have to accept responsibility for any unwanted outcome. X

[Ppiman]

I have read that the major complication of any prostate surgery is post-op bleeding, sometimes requiring transfusion and new surgery. The REZUM procedure seems far less likely to cause this. At Leicester, it seems they still prefer the TURPS procedure, which is what I'll be having if the tablets don't do the trick.

I couldn't imagine myself not following my doctor's advice, myself, but I can understand your fears. Maybe phone his secretary to discuss these?

Steve

[RoyM in reply to Ppiman]

Thanks for your input Steve. I tried tablets(Tamalosin) but unfortunately they had side effects for me and didn't help anyway but did bless me with Floppy Iris Syndrome that resulted in difficult surgery for a cataract replacement I needed and that was a while after coming off them. I looked at TURPS too and didn't fancy the possible side effects of that procedure. I then found a hospital that carry out the REZUM procedure and referred myself...good luck with your journey. Regards Roy

[Ppiman in reply to RoyM]

I was fine of doxazosin, even if not brilliant with too many night-time loo visits, but my cardiologist wanted me to stop that as it affected the heart too much. That was maybe six weeks ago. I then had major issues switching to first tamsulosin which worked but only at double the dose (allowed in the US but not here), then to alfuzosin once-a-day which had me completely unable to wee for half the day and awful discomfort; now, I'm on the same but not slow-release, i.e. four times a day and at last things have stabilised, thank the Lord. I paid privately to see a urologist at the Spire in Leicester such was my discomfort and fear of urinary retention and he said TURPS was the best choice but would require my coming off rivaroxaban. I fear Leicester is traditional but maybe for the best, I just can't tell. I did read that surgeons like TURPS as it provides unique evidence (from the biopsies) of a healthy prostate, which I had never thought of at all.

I gather Rezum is only useful with a small prostate, which excludes me. I asked also about the Urolift procedure but was told that my urologist spends his days rescuing failed attempts at that.

Steve

[RoyM]

Hi Steve...thanks for your reply and info. It's all a journey and we all choose the path that feels right for us as individuals. Hopefully, we all end up at the same place, eventually. Take care, good luck and have a very Merry Christmas and a peaceful 2022.

[MarkS]

Hi Roy, Many thanks for the info. I think the surgeon was being very cautious, given the half life of apixaban is 12 hours. It would have negligible effect after 1 day, let along 2.5 days. On restarting, I see there is actually quite a lot of blood involved in the Rezum procedure, so I think a bit of a delay is justified.

I looked up the Rezum procedure and it does appear more complicated than I had believed - although my urologist had warned me that it was. I found this site with a lot of comments:

patient.info//forums/discus...

Can I ask whether you have a catheter inserted now, either a Foley or a self-cath? Also, was the procedure painful?

Best wishes for a good recovery, Mark

[RoyM in reply to MarkS]

Hi Mark. Thanks for your message, yes catheter fitted in theater and will be removed on Thursday all being well, no pain at all during the surgery i had full anaesthetic. It's now Sunday evening only taken 2 codine since Friday so it's discomfort not painful at all. Still small amounts of blood still showing and had 2 blood clots since Friday. I went into theater at 10.30 back in bed at 11.15. allowed home at 4.45pm with instruction not to drive for 48 hrs. Feel free to ask any question. Regards Roy

[MarkS in reply to RoyM]

Thanks, Roy, that's very helpful. I'll follow up with you personally in a few weeks to see how you are, if that's OK. Best wishes, Mark

[RoyM in reply to MarkS]

No problem Mark. Stay save. Roy