Aquablation: Post-surgery expectations

Posted by Phil, Alumni 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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@jojo99


Ten weeks after Aquabilation surgery it is worse than before the surgery. Except I can urinate with no problem compared to before when I had to go to emergency get a catheter for urination. But now I have the following problems. 77 year old male with a prostate 140 CC'. This is a note I sent to my doctor. Said he will answer questions on next weeks visit but it could take another 3 months to become normal. Almost 6 months, really! Anyone care to chime in with answers if you have had these problems 10 weeks or longer after Aquabilation surgery thanks.
One,
In chat rooms that I have read most men after 2 to 8 weeks, now are normal in the areas of no urgency of urination, once or twice a night urination and no burning at the end of urination. Yet I still have all those symptoms of urgency, incontinence, frequency, burning, is this normal? What is the average time you see that your patients become normal?
Assuming it's not a urinary tract infection what can be done?
Two,
I’m in my ninth week since surgery. If the urine culture test keeps showing no growth of bacteria. Then to cover all my bases to make sure that it's not an UTI, do you have any experience with DNA-based testing methods for UTI? Such as PCR or NGS. From my research it said they are more accurate. Or anything else you can suggest?
Three,
My wife and I started having sex 4 weeks after surgery approximately three to four times a week, In the approximately 14 times we had sex I had a good erection but only ejaculated fluid 3x very lightly few weeks in between each time. The other 11 orgasms I assume were reverse ejaculations, although I never see anything else in my urine afterward. But I still had good orgasms. Am I the unlucky 10% that will have a reverse ejaculation? Or if it will come back how long does it take?
Four.
My penis when erect now bends to the right since the
Aquabation. Before it was always straight out. I read in my research after prostate surgery, I could come down with a condition called Peyronie's disease. Will it stay like this or get worse and become painful. Can it be fixed if it becomes painful or worse?
Five,
I've only had four clots of various size weeks apart since the aquibation surgery, come out when urinating. The last one very small two days ago. Is this normal, shouldn't I have had a lot more? The reason I asked because when I had my Cystoscope, I had a couple of toilet bowels full of large clots.
Thank You.

Jump to this post

I am now about 5 or 5and a half months post aquablation.
As a 74 years old, I was not having a big problem with urination, but the doctor warned me that my prostate was huge and action was necessary.
I was miserable with the results until just very recently.
I had to wear depends, urination was too frequent, and urgency cropped up frequently.
I couldn't urinate standing, because the flow sometimes became a spray (messy ). So I sat. There was some burning prior to the flow getting started, which sometimes didn't get going real well.
Some nights I had to urinate 4 or 5 times.
In other words, procedure made me worse, not better.
The first time I reached out to my urologist, a few months ago, he told me to be patient, that things would settle down.
That became somewhat true, but only very recently. I have stopped with the depends, but I make sure to always be close to a toilet, or to be sure to empty my bladder before leaving the house. If careful, I can stand up to pee.
The amount of time I can wait between toilet visits varies from just under an hour to more than 2 hours. I make sure to not take chances, and urinate at even a small urge.
I any case, last time I saw the Urologist, he claims I had signs of a UTI, (some mucous noticeable in urine) so I am taking Cipro. Some relief, so I refilled and will try another dose.
I am definitely more comfortable without Depends, and the burning/discomfort has reduced somewhat. Without the depends I do get some seepage, which I usually don't notice until I feel a little dampness in under wear or pajamas.
Sex has been non existent. Surely the fact that my wife was diagnosed with stage zero breast cancer 3 months ago has not helped with intimacy. The most we manage in that part of life is to show affection, like gentle cuddling or hand holding.
To summarize, I was very unhappy with the whole thing until very recently when I noticed a flicker of light at the end of the runnel.
If I'm not measurably better in 3 months the doctor has threatened me with a cystoscopy. I had that procedure once years back and dread it. I cant understand why patients are not sedated when they do that.
Best of luck to you. Be a patient patient, and surely things will settle down, albeit a lot slower than you were told,

REPLY
@dm2473

I am now about 5 or 5and a half months post aquablation.
As a 74 years old, I was not having a big problem with urination, but the doctor warned me that my prostate was huge and action was necessary.
I was miserable with the results until just very recently.
I had to wear depends, urination was too frequent, and urgency cropped up frequently.
I couldn't urinate standing, because the flow sometimes became a spray (messy ). So I sat. There was some burning prior to the flow getting started, which sometimes didn't get going real well.
Some nights I had to urinate 4 or 5 times.
In other words, procedure made me worse, not better.
The first time I reached out to my urologist, a few months ago, he told me to be patient, that things would settle down.
That became somewhat true, but only very recently. I have stopped with the depends, but I make sure to always be close to a toilet, or to be sure to empty my bladder before leaving the house. If careful, I can stand up to pee.
The amount of time I can wait between toilet visits varies from just under an hour to more than 2 hours. I make sure to not take chances, and urinate at even a small urge.
I any case, last time I saw the Urologist, he claims I had signs of a UTI, (some mucous noticeable in urine) so I am taking Cipro. Some relief, so I refilled and will try another dose.
I am definitely more comfortable without Depends, and the burning/discomfort has reduced somewhat. Without the depends I do get some seepage, which I usually don't notice until I feel a little dampness in under wear or pajamas.
Sex has been non existent. Surely the fact that my wife was diagnosed with stage zero breast cancer 3 months ago has not helped with intimacy. The most we manage in that part of life is to show affection, like gentle cuddling or hand holding.
To summarize, I was very unhappy with the whole thing until very recently when I noticed a flicker of light at the end of the runnel.
If I'm not measurably better in 3 months the doctor has threatened me with a cystoscopy. I had that procedure once years back and dread it. I cant understand why patients are not sedated when they do that.
Best of luck to you. Be a patient patient, and surely things will settle down, albeit a lot slower than you were told,

Jump to this post

Thank you for your reply.
My bleeding slowely stopped after about 6 weeks. Now in my 10th week for the last few days off and on.
I'll bleed for a few urinations with or without clots.
Then go back to a light yellow urination, the first time since the surgery. Dr said it was normal? Have you experienced this?
I thought I was the only one going this long with problems after aquibation now in my 10th week. They advertise it and you read most men are fine after 5 weeks. Are we just the unlucky ones, or there are other guys out there who have suffered as long. Let's hope we get some more replies to see that we're not the only ones.

REPLY

I know a few men who had aquablation, and they are generally satisfied after a few months.
One fellow I know had to have the procedure repeated within a week or two, because the first effort left him unable to pee at all. But after the 2nd procedure, he recovered quickly.
I know several men who had TURP. One of them is not fully recovered over a year after. He urinates better than prior, but he can't control the direction, so he sits to urinate.
A lesson to be learned, don't rely on doctor google for a post surgery analysis.

REPLY
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