Aquablation: Post-surgery expectations

Aquablation Surgery: My Experience (2 Days Post-Surgery)

I wanted to share my experience with Aquablation surgery, so here’s a summary:

My prostate was 45cc and had become a major disruption to my daily life. I had to carefully plan bathroom trips, such as peeing before boarding a plane and again 20–30 minutes before landing. At night, I was waking up around five times to urinate.

My surgery began at 10:00 AM January 24 / 2025, and I woke up in the recovery room around 12:00 PM. Here are some things I didn’t anticipate or found noteworthy:

Hospital Stay
• Overnight Stay: My doctor required me to stay in the hospital overnight, and I highly recommend this. I can’t imagine going home the same day given how I felt after waking up from surgery.

The 3-Way Catheter
• Flushing Process: A 3-way catheter was used to flush my bladder. This created a constant sensation of needing to urinate or have a bowel movement, which was uncomfortable but no too bad.
• Discomfort: The catheter was as uncomfortable as I had feared. My penis was very sore and sensitive—just touching the catheter tubes hurt. The two most painful moments were being moved from the gurney to the bed and having the catheter removed.
• Nurse Interactions: Nurses regularly checked the color and clarity of the flushed fluids. Sometimes, they lifted the discharge bag too quickly, causing a slight back pressure that could be felt in my bladder. Letting them know to lift the bag slowly helped a lot.
• Sleeping Challenges: Sleeping in the hospital was difficult with the catheter. Rolling to one side strained the catheter tubes and woke me up.

First Night at Home
• Leakage: Be prepared for some leakage and blood. I recommend having Depends or similar products on hand.
• Improved nighttime Urination: Before surgery, I had to urinate five or six times a night. On my first night home, I only woke up twice—at midnight and 3:00 AM. This is already a significant improvement for me.

Pain and Recovery
• Burning Sensation: Two days post-surgery, urinating remains painful, with a burning sensation in my penis. However, the intensity is starting to subside.

I related to your experience so well, I wanted to share my experience with you.
Aquablation Surgery: My Experience (2 Days Post-Surgery)

@wxman38 , I related to your experience so well that I wanted to share my experience with Aquablation surgery, so here’s a summary:

My prostate was 45cc and had become a major disruption to my daily life. I had to carefully plan bathroom trips, such as peeing before boarding a plane and again 20–30 minutes before landing. At night, I was waking up around five times to urinate.

My surgery began at 10:00 AM January 24 / 2025, and I woke up in the recovery room around 12:00 PM. Here are some things I didn’t anticipate or found noteworthy:

Hospital Stay
• Overnight Stay: My doctor required me to stay in the hospital overnight, and I highly recommend this. I can’t imagine going home the same day given how I felt after waking up from surgery.

The 3-Way Catheter
• Flushing Process: A 3-way catheter was used to flush my bladder. This created a constant sensation of needing to urinate or have a bowel movement, which was uncomfortable but no too bad. The flushing process coninued all night.
• Discomfort: The catheter was as uncomfortable as I had feared. My penis was very sore and sensitive—just touching the catheter tubes hurt. The two most painful moments were being moved from the gurney to the bed and having the catheter removed. After returning home, urination cause alot of pain at the tip of my penis.
• Nurse Interactions: Nurses regularly checked the color and clarity of the flushed fluids. Sometimes, they lifted the discharge bag too quickly, causing a slight back pressure that could be felt in my bladder. Letting them know to lift the bag slowly helped a lot. The fluids in my “flushing bag” were a light pink and quite translucent.
• Sleeping Challenges: Sleeping in the hospital was difficult with the catheter. Rolling to one side strained the catheter tubes and woke me up.

First Night at Home
• Leakage: Be prepared for some leakage and blood. I recommend having Depends or similar products on hand.
• Improved Nighttime Urination: Before surgery, I had to urinate five or six times a night. On my first night home, I only woke up twice—at midnight and 3:00 AM. This is already a significant improvement for me.

Pain and Recovery
• Burning Sensation: Two days post-surgery, urinating remains painful, with a burning sensation in my penis. However, the intensity is starting to subside.

77 years old, a 130 gram prostate.
I'm five months in from my aqua surgery. frequency and urgency are just starting to go away.. So is the burning.. Still having reverse ejack. Still, getting up two to three times a night. I'm hoping a few more months, and it may be totally healed. Who knows?
At least my flow has improved. and I'm urinating more volume, and I don't. have to wait to urinate. And I'm off the damn Flomax. and proscar. . So I think it was worth it.

I'm 66 and am considering the Aquablation therapy. Here is the background:
Starting in about 2022 and into 2023, my urinary stream was weak, and seemed to be getting weaker. In mid-2023, I started having occasional incontinence at night. I did not wake up, and had no urge at all to go to the bathroom. I had no problems during the day. I finally needed to get some absorbent underwear to use at night.

I see a lot of people talking about getting up multiple times in the night to urinate. I would urinate, but without sensing the urge.

Finally, in 10/2024, I went to see a urologist (actually worked with his technician). He determined that I had a lot of urine retention in my bladder and used a catheter to empty it. He offered either a Foley catheter or a self-catheter. I opted for the latter. He prescribed an antibiotic. He also prescribed Tamsulosin to possibly help shrink the prostate. He said it doesn't always work (After later doing my own research on this I decided to not take it).

My PSA was over 7 (it had been as high as 11 in previous years). He recommended a biopsy to check for cancer. I had already looked into this, and didn't want them taking random shots and poking holes in my prostate in case they happened to find something. He then recommended a non-invasive CT Scan and MRI to see if there was anything suspicious. This made a lot more sense!

I was very careful with the self-catheter, but within a day I started having symptoms that turned out to be a UTI. I first went to urgent care and they gave me an antibiotic. That helped for a week or so, but then the symptoms returned.

In early November I went to the ER and they admitted me to treat the UTI. I was there for 3 nights. Lots of IV antibiotics and a CT scan. This confirmed the enlarged prostate and also kidney issues.

12/2/2024 - MRI summary: PSA 7.8, prostate volume 66.3 ml. Impression: No MR suspicious focal prostate lesion identified - enlarged prostate. PI_RADS 2: Clinically significant cancer unlikely to be present. I was glad to see that!

1/24/2025: Finally met the urologist. He did a cystoscopy to get a visual on what's going on. He recommended Aquablation.

It was my research on this that led me to this website. I have learned a lot and now have more realistic expectations. I have a consult with him on 1/31 so he can answer my questions and then schedule the procedure. I'll make sure my calendar is relatively clear for a month or so after the procedure just in case. I'm optimistic there won't be any serious issues, but I'm also a realist!

After reading many of the reports of people using Tamsulosin, Flowmax, and other medications, I'm glad I decided to not start on them.

Before all of this, I was sleeping through the night (with the absorbent underwear). I hoped to be able to eliminate this and be able to just sleep through the night like I did up until a few years ago. It sounds like with this procedure I will likely be resuming the absorbent underwear - at least for a little while.

It will be nice to be done with the Foley catheter. I've had it since early November. I've had it changed out twice (roughly 30 days) and, fortunately, that process was only slightly uncomfortable - and no pain! Because I have some things that are already scheduled, I probably won't do the Aquablation until early April.

I really appreciate the information provided here, and people willing to talk straight about their experiences. It is really helpful.

Any suggestions on things I should ask at the consultation?

Have faith and try and calm down. You can work your body and its healing system into a frenzy that I think can affect recovery. Things take a while to straighten out after the procedure. I’m 8 months out and frankly don’t think about it anymore. Everything works. Not like it did 50 years ago but that was 50 years ago. At 71 I couldn’t be happier. My thickened bladder walls finally have some relief and have agreed to continue working. At least for the present. Hang in there.

I wrote a post detailing my husbands experience with Aqua Blation, please read it. Only regret is that he didn’t do it sooner.

My symptoms were not as yours. The urge to urinate was intense and too constant. My prostate was impacting the ability to urinate as it was constricting/growing into the bladder. The prostate measured 80 grams My PSA numbers were never over 5 and did have an MRI/Sonogram done looking for lesions but showed negative. In short I had an enlarged prostate and tried to work through it with Tamsulosin but at the end of the day this ran its course. First attempt to address was via artery embolization, where crystals are injected into arteries feeding blood to the prostate with the objective being the slowing of blood and hence shrinking or atrophying of the prostate. This procedure did not achieve the needed results - still high urgency to urinate, weak stream, multiple trips to the bathroom, etc. Moved onto next more intrusive step of some sort of surgery - after research chose aquablation vice TURP. The reason for choosing Aq was the low probability of ED or issues with ejaculation. The Aq statistics are quite good for not suffering these drawbacks. Surgery was done on 4 December 2025, no hospital stay and went home with catheter for 5 days. It was an angry period as the catheter was a challenge. Once removed things got better and was told to take 4-6 weeks to recover before starting activities (exercise (run, lift weights, spin), sex). I waited the prescribed time and began to exercise and engage in sex and all functions a go. However, I did experience some blood in the urine in week 7 and after a consultation with the surgeon last week he recommended stopped spin for a while as this is most likely traumatizing the area; but am doing the running, lifting, and sex. Also I have stopped taking the Tamsulosin which my understanding is a muscle relaxer and does not shrink the prostate. Finally the surgeon said I am on track and it can take 6 mos. to a year for all the dust to settle and see where one ends up. Hope this helps.

My Aquablation Journey: What to Expect After Surgery

Hey there! If you’re reading this, you’re probably considering aquablation or preparing for your own procedure. First off, you’ve got this! I’m sharing my experience to give you an idea of what recovery might look like. Everyone’s journey is a little different, but here’s how mine went.

A Little Backstory

For over 10 years, I’ve dealt with frequent urination. By 2022, I was waking up four or five times a night to pee. It got to the point where I had to plan bathroom trips before events—whether boarding a plane or going to a concert.

In 2023, I had my first episode of nighttime incontinence. I brushed it off as a fluke, but when it happened again in 2024, I knew I had to take action. After consulting with a urologist, I discovered medications weren’t an option for me due to my low blood pressure (some prostate meds can lower blood pressure further).

I narrowed my option down to three procedure: TURP, HoLEP, or aquablation. After researching, I chose aquablation. Here’s how my recovery went:

Day of Surgery (Friday)

When I woke up from the surgery, I had a three-way catheter in place (fluid in, fluid out, and a balloon). The nurses regularly checked the retrieval fluid bags, describing the color as "Hawaiian punch," "pink," or "pink lemonade."

The catheter was the most uncomfortable part—it created a constant pressure on my bladder and bowels, making me feel like I needed to use the bathroom. It wasn’t unbearable or painful, just noticeable. Pain meds helped, and the discomfort from the catheter eased quickly.

Day 1 Post-Surgery (Saturday)

By this day, my discharge looked like "pink lemonade," so they removed the catheter. Let me tell you, that was the most painful part of the whole experience! After the catheter came out, urinating burned a lot—like a sharp stinging sensation at the tip of my penis.

They asked me to fill a volume of 300ml, but I only managed 230ml because of the burning sensation at the tip of my penis. To ensure my bladder was emptying properly, they did a post-void residual (PVR) test, which I passed. I was sent home later that day.

That night, I only had to get up a couple of times to pee, which was a huge relief. I’m staying hydrated with about 44 ounces of electrolytes daily.

Day 2 Post-Surgery (Sunday)

Urinating was still painful, but not as intense as the day before. My urine was a fluorescent yellow with a small puddle of iodine-colored liquid at the bottom. (Don’t worry if you see this; it’s normal!)

By now, I’m drinking about 66 ounces of electrolytes daily to keep things flowing smoothly.

Day 3 Post-Surgery (Monday)

The burning sensation started to ease up, and my urine was a lighter yellow. By the end of the day, the blood in my urine had cleared up. I even got follow-up calls from both my urologist’s PA and my primary care physician’s office to check on my progress.

Still sticking with 66 ounces of electrolytes a day. Hydration is key!

Day 4 Post-Surgery (Tuesday)

The stinging at the tip of my penis continued to decrease, and for the first time, I could comfortably stand to pee. Before this, sitting to pee was less painful.

Takeaways

If you’re about to undergo aquablation, here are a few tips from my experience:

Stay Hydrated: Drinking plenty of fluids (especially electrolytes) really helps.

Be Patient: The burning and discomfort will subside. Take it one day at a time.

Communicate: Keep in touch with your medical team. They’re there to help and reassure you.

I hope this gives you a better idea of what to expect. Remember, every recovery is unique, but the end goal is worth it. Good luck—you’ve got this!

There are a few things I left off...
1) My prostrate was around 45ml
2) The procedure was conducted on Friday, Jan 24, 2025.
3) I remained in the hospital overnight for observation
4) I was released to go home the day after the procedure.

It's now about 10 months post aquablation.
Still trying to stop using diapers, with some success. I'm not really wetting my pants, so to speak, but there is some light moisture during the day and at night, whether in the Depends or regular underwear when I wear them. I'm not sure if that's caused by a minor urine dribble, or some sweat.
I have forgotten what life was like pre Depends, so it's hard to compare before and after.

I developed a UTI in December, which caused much increased urgency & frequency. I suspect the UTI went undetected for some months before being noticed. The first two regimens of antibiotics didn't help at all, and matters got worse.
Then I was given a different antibiotic, which finally relieved that issue just at the end of the 10 day regimen. But I am always looking over my shoulder waiting for those symptoms to crop back up.
At that time my MD threatened me with a cystoscopy to examine the situation more thoroughly, but he has not followed through yet, and I'm not going to remind him. He told me he would do it under anesthesia just in case some nips and tucks are necessary.
I did have very uncomfortable cystoscopy about ten years ago, so I'm not excited about another one.
Although the discomfort when peeing is not totally gone, I have much improvement with much easier urination, and an increase in time between pit stops. I can usually last 3 to 4 hours between urgencies. And have occasionally gone 6 hours at night. (and sometimes only 2 hours) I still feel the need to try to empty my bladder before leaving the house, because now and then I do experience an unexpected urgency.
I have to pee in female position, because I have not gained full control of aim.
As to my wife's breast cancer, she is doing well. Surgery and daily radiation seem to have done what we hoped. Now she takes daily hormone tablets that are supposed to reduce the likelihood of a recurrence, but there are no guarantees. I dread a recurrence of that problem more than my own issues.