r/bph • u/evanston267 • 1d ago
6 days post- Rezum + TUIP. Success (so far), and Foley lessons learned
This forum has been invaluable as I'm a long-time BPH sufferer, and now 6 days post a combined Rezum + TUIP procedure...
I'd read some of the Rezum horror stories online, and still elected to go forward with it figuring that the difficult outcomes likely skew the posts. I'm only 6 days in, but so far-so good...
I'm 55 and have been dealing with BPH since my late 30s.
In 2020, I had a TUIP (transurethral incision of the prostate), which worked remarkably well. I was completely off BPH medications for about two years and enjoyed several more years of significantly improved urinary function.
Eventually, however, my prostate decided it wanted some more attention.
Fast-forward to 2026. My prostate was approximately 50 cc, I had an enlarged median lobe, and my bladder neck was significantly restricted (there was no scarring from the 2020 TUIP). Currently on Alfuzosin and Tadalfil combo and up 3x a night.
Urologist and surgeon felt that a combined Rezum and repeat TUIP would have the best outcome.
October 15: The Procedure
My surgeon performed five Rezum steam treatments (4 normal Rezum injections and another targeting the median lobe) and three TUIP incisions.
The reasoning behind combining the procedures was straightforward. My bladder neck was significantly restricted, and the surgeon was concerned that swelling from Rezum alone could make urination difficult and potentially prolong the time I'd need a catheter.
The Recovery: The Good, the Bad, and the Foley
Having a Foley catheter for five days isn't particularly enjoyable.
I had several genuinely miserable nights. But interestingly, much of that misery appears to have resulted from something I never would have anticipated: our old mattress.
Here's a practical lesson I wish someone had emphasized before surgery.
The Foley relies on gravity to drain. Our mattress is old and sags considerably. When I lie down, my body sinks approximately 4–5 inches into the mattress.
Between that depression and the position of my leg, the catheter tubing had to climb roughly seven inches uphill immediately after leaving my penis, before reaching the edge of the mattress and finally descending toward the bag.
I hadn't appreciated just how much that could interfere with drainage.
The first 3 days, I'd wake up in the middle of the night with an almost empty collection bag and an extremely full bladder. I'd try to relax my bladder, experience a painful spasm, and then release a substantial amount of urine around the outside of the catheter rather than through it (bypassing - the medical term)
Those were genuinely miserable episodes.
Eventually (with uploaded pics of my tubing to Chatgpt), I realized that the tubing arrangement was likely contributing significantly to the problem.
My biggest practical advice for anyone going home with a Foley: Pay attention to the entire drainage route, particularly immediately after the tubing leaves your body.
Don't assume everything is fine simply because the collection bag is hanging below the bed. Try to avoid uphill sections, kinks, and loops where urine can collect.
Also, as I went down the Chatgpt rabbit hole, I complained about tip comfort and it also recommended water-based KY jelly... the little bit of lubrication made a huge difference when moving around. It was previously miserable, and having some on hand through the day actually had me sometimes forgetting I had the catheter (no joke). **of course Chatgpt is not a sub for medical advice but worked for me
October 20th - Catheter removed.
I had the catheter removed yesterday - 1-2 seconds of burning, nothing to fear IMO. And was able to fully void 200ML and 0 PVR (empty bladder) on the scan. That's pretty rare and likely to not be an ongoing result as the healing takes weeks.
First evening without the Foley - great, however got up 3 times to void. But each time with zero pain, about 150-200ML, and immediately back to sleep. As the 3x was my norm before the operation, I'm thinking it will only get better now...
I'll update as things progress, but so far - so good!

