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Aquablation: Post-surgery expectations

Posted by Phil, Volunteer Mentor @upstatephil, Jan 26 8:05am

After decades of pills to (partially) manage BPH, I am scheduled for aquablation at Mayo JAX in mid-Feb. Has anyone had that procedure done? What was post-surgery like? What were your experiences regarding regular vs. retrograde ejaculation?

My expectations are high. My general health is good+ (71 yo), my prostate is enlarged but not massive, my PSA's suggest no cancer concerns. The surgeon expects a low-risk procedure (no incisions I believe) and a quick recovery (unless something unexpected pops up). I appreciate it's impossible to predict surgical outcomes with certainty - I would like to hear of others' experiences to help set my expectations.

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Phil, Volunteer Mentor | @upstatephil | Feb 21 1:45pm

New Question: I am nine days post-aquablation and I have developed a significant hematoma located in the lower right abdominal area. Not particularly painful but I an "fee'" the blood under the skin and don't want to just leave it go. I've reached out to the urology folks but they have yet to respond. Anyone else have that? What did you do?

REPLY
wxman38 | @wxman38 | Feb 26 9:44am
In reply to @wxman38 "I had aquablation 1/30/2024 at the HCA Florida Northwest Hospital. I was taken into the operating..." + (show)
@wxman38

I had aquablation 1/30/2024 at the HCA Florida Northwest Hospital. I was taken into the operating room a few minutes after 9AM and was in recovery by about 1040AM. The actual waterjet lasted about 4 minutes. I was kept overnight for observation. During this time they ran big bags of fluid through my catheter. However, at one point the bag had run out and before it was replaced they had to flush out the catheter which was not fun. The whole time my urine bag was filled with a red color which had lighten somewhat by the time I was discharged. The time I experienced the most pain was when I had to urinate with the catheter in me. On Friday 2/2/2024, I went to the doctor to have the catheter removed. My urine was still red, but she said it was old 'blood' and that was fine. The tech then filled by bladder with fluid until I needed to urinate at which point she pulled out the catheter and I had to finish in a bowl that measured how much came out. The catheter removal was essentially painless.
I did need to use depends after the catheter since on at least 3 occasions when I got a strong urge I didn't make it to the toilet in time. Also it was only on the first of these that I ever saw anything like 'clots' in my urine.
Today is 2/7/2024 and my urine is basically clear. I've had no other pain other than with the catheter. I haven't had any morning erections as I've seen in other reviews. The doctor's report showed an 80gm prostate. I'm 80 years old and that might be the age limit for these procedures. Good luck with your procedure.

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Coming up on 4 weeks since procedure. One thing that has occurred is often after I finish peeing I experience a noticeable pain at the tip of my penis. In addition for a couple of weeks after the procedure my stools were real dark. So I assume there was some blood in them. No problem with the stools now. Also not many cases of urgency now either.

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1 reply
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Phil, Volunteer Mentor | @upstatephil | Feb 26 1:38pm

UPDATE: I am exactly two weeks post-aquablation. Two more weeks of activity restrictions to endure. Otherwise - I feel great and better than my expectations. No pain. Rare small episodes of blood in my urine. The urge to go is very reduced. Flow is easy to start and is strong. When done, I am really done w/o any quick need to return to the bathroom. I wake up much less often. I am excited for the ultimate results.

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1 reply
ndclayt41 | @ndclayt41 | Feb 27 10:12pm
In reply to @wxman38 "Coming up on 4 weeks since procedure. One thing that has occurred is often after I..." + (show)
@wxman38

Coming up on 4 weeks since procedure. One thing that has occurred is often after I finish peeing I experience a noticeable pain at the tip of my penis. In addition for a couple of weeks after the procedure my stools were real dark. So I assume there was some blood in them. No problem with the stools now. Also not many cases of urgency now either.

Jump to this post

I had the same pain it took awhile to stop I’m 3 months out and everything feels good

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uniform8 | @uniform8 | Feb 28 3:13pm

Thanks for your posting; I am 70 and had an aquablation procedure in Arlington VA Mid January 2024. I was one night in the hospital and then had a Foley Catheter for 4 days. I am now in the 6th week of recovery. I had blood in the urine for the first 4 weeks and urination burned toward the end of voiding. The hematuria is gone, but I still have pain (bladder spasms) that result in an urgent need to urinate. I also now have retrograde ejaculation which after reading the surgery report realize it was due to the area of the prostate, the only issue I have with RE is it is also painful again I assume due to spasms. In the literature I received I thought the expectation was that after 4 weeks all would be great... but I seem worse off than before I had the procedure. I assume that the spasms will eventually go away - does anyone have similar experiences?

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1 reply
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Phil, Volunteer Mentor | @upstatephil | Feb 29 7:09am
In reply to @uniform8 "Thanks for your posting; I am 70 and had an aquablation procedure in Arlington VA Mid..." + (show)
@uniform8

Thanks for your posting; I am 70 and had an aquablation procedure in Arlington VA Mid January 2024. I was one night in the hospital and then had a Foley Catheter for 4 days. I am now in the 6th week of recovery. I had blood in the urine for the first 4 weeks and urination burned toward the end of voiding. The hematuria is gone, but I still have pain (bladder spasms) that result in an urgent need to urinate. I also now have retrograde ejaculation which after reading the surgery report realize it was due to the area of the prostate, the only issue I have with RE is it is also painful again I assume due to spasms. In the literature I received I thought the expectation was that after 4 weeks all would be great... but I seem worse off than before I had the procedure. I assume that the spasms will eventually go away - does anyone have similar experiences?

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One challenge in reading patient experiences online in hopes of gaining persepctive on what YOU will experience...is that everyone is different and Patient X's experience may/will be different from Patient Y and so on. People are different. Doctors are different. Procedures vary a bit. Aquablation is even harder to predict due to its newness as a procedure.

Have you returned to the urologist for a follow-up opinion?

REPLY
clark1949 | @clark1949 | Mar 1 1:31pm

I went through Aquablation on Wednesday 2/14. I stayed in the hospital overnight afterwards for prostate flushing and observation. Went home 2/15. I did not go home with a catheter. I tried to drink as much water as possible but found it extremely difficult to urinate. I also considered going to emergency because of the need to urinate. I was given a stool softener in the hospital to loosen my bowels; however, I was extremely constipated after the procedure. The night of the 16th I took a laxative and the morning of the 17th I had a strong bowel movement. I was then able to urinate, not a strong flow but enough to relieve the pressure. Because I was concerned about constipation, I would drink prune juice before bedtime.

As stated in previous post, the procedure was straight forward and without any pain. Urinating after the procedure was very painful and the urge to urinate was sudden and without warning. It is now day 16 and my flow is still not as strong as I would like it to be. I still see blood in my urine but very little. Most of the time color is clear.

I wasn’t given any restrictions at discharge, but I decided to wait until day 14 to resume my workout activities which included golf and an elliptical workout.

I am an active 74-year-old and in reasonably good health. I would say that I am about 70%. I am scheduled to see my urologist on the March 7. I am hoping he will tell me things are going to get better as time goes on.

The first week of recovery was pure hell. As I mentioned above, the burning sensation, constipation, the pressure of not being able to urinate was a major concern. There was also the immediate need to urinate without much warning. By day 10th day, I would say burning sensation and the immediate need to urinate has subsided.

It's day 16. If my flow increases and I am able to sleep through the night with maybe getting up once, I would consider the Aquablation procedure a success.

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2 replies
gottodosomething | @gottodosomething | Mar 4 9:11am
In reply to @fredunger "No surgery to recover from. Making the prostate shrink instead of a roto rooter surgery was..." + (show)
@fredunger

No surgery to recover from. Making the prostate shrink instead of a roto rooter surgery was an easy choice for me. Urologists don't suggest this since it competes with their surgery. You need to go the physicians that do stents.

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I never heard about prostate artery embolization. Which doctor type do I look for? Can you be a little more specific. Would I need to find a heart doctor. Appreciate any help. Before I read this blog I was all set to do aquablation but this prostate artery embolization sounds better.

One question : by apparently "plugging" artery blood flow to prostate to strave growth....can you speak to the risk of blood clots should a clot piece break free or am I just misunderstanding something
thank you
got to do something

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2 replies
Mentor
Phil, Volunteer Mentor | @upstatephil | Mar 4 9:33am
In reply to @clark1949 "I went through Aquablation on Wednesday 2/14. I stayed in the hospital overnight afterwards for prostate..." + (show)
@clark1949

I went through Aquablation on Wednesday 2/14. I stayed in the hospital overnight afterwards for prostate flushing and observation. Went home 2/15. I did not go home with a catheter. I tried to drink as much water as possible but found it extremely difficult to urinate. I also considered going to emergency because of the need to urinate. I was given a stool softener in the hospital to loosen my bowels; however, I was extremely constipated after the procedure. The night of the 16th I took a laxative and the morning of the 17th I had a strong bowel movement. I was then able to urinate, not a strong flow but enough to relieve the pressure. Because I was concerned about constipation, I would drink prune juice before bedtime.

As stated in previous post, the procedure was straight forward and without any pain. Urinating after the procedure was very painful and the urge to urinate was sudden and without warning. It is now day 16 and my flow is still not as strong as I would like it to be. I still see blood in my urine but very little. Most of the time color is clear.

I wasn’t given any restrictions at discharge, but I decided to wait until day 14 to resume my workout activities which included golf and an elliptical workout.

I am an active 74-year-old and in reasonably good health. I would say that I am about 70%. I am scheduled to see my urologist on the March 7. I am hoping he will tell me things are going to get better as time goes on.

The first week of recovery was pure hell. As I mentioned above, the burning sensation, constipation, the pressure of not being able to urinate was a major concern. There was also the immediate need to urinate without much warning. By day 10th day, I would say burning sensation and the immediate need to urinate has subsided.

It's day 16. If my flow increases and I am able to sleep through the night with maybe getting up once, I would consider the Aquablation procedure a success.

Jump to this post

So sorry you experienced such negative early outcomes! I never experienced "pure hell" but I can imagine how that would be...Maybe this is encouraging: I am exactly three weeks post-aquablation today and I feel great. 90% of the way back w/o any of the previous BPH symptoms. Good luck with your urologist on March 7th.

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Mentor
Phil, Volunteer Mentor | @upstatephil | Mar 4 9:34am
In reply to @gottodosomething "I never heard about prostate artery embolization. Which doctor type do I look for? Can you..." + (show)
@gottodosomething

I never heard about prostate artery embolization. Which doctor type do I look for? Can you be a little more specific. Would I need to find a heart doctor. Appreciate any help. Before I read this blog I was all set to do aquablation but this prostate artery embolization sounds better.

One question : by apparently "plugging" artery blood flow to prostate to strave growth....can you speak to the risk of blood clots should a clot piece break free or am I just misunderstanding something
thank you
got to do something

Jump to this post

I would imagine a urologist is the best person to ask?

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