Hello. 66 year old in good shape, work out etc. Had enlarged prostate for about 15 years, 2 biopsies back at beginning due to high PSA score and both negative. (NOTE: Follow ups of PSA's and Free PSA's along with 4K indicate no cancer). Watchful waiting over the years with frequency and stream problems worsening slowly. In December of 2023, got to point that something needed to be done. Prostate size 110 cc. My urologist suggested simple prostatectomy and it seemed extreme. I asked him about aquablation and he said few do it, but seems to be a good option. Went to Mt. Sinai in Manhattan to a Dr. Kaplan, who is said to be one of the best at this procedure. My urologist advised that Mt. Sinai has great uro staff.
Scheduled aquablation for 2/28/24. On 1/8/24, had a urodynamic flow test by a nurse at Mt. Sinai. Seemed to be tough to get to done and there was bleeding. This is to check if bladder emptying. Within 36 hours I was in emergency room with complete blockage and a catheter had to be put in. I had never had a catheter before. Advised Dr. Kaplan and we spoke by phone and a scheduled rectal ultrasound was for 1/22/24. Went to my original uro approximately 1/17 to take out catheter. Within hours back to ER for another catheter.
After the rectal ultrasound on 1/22/24, Dr. Kaplan advised that there was a medial lobe extension into the bladder that would be addressed during the aquablation. I asked (begged) to fit me in sooner as he advised that I would need to keep the catheter in until then. No avail.
Pre-op tesgting for surgery clearance indicated uti (light staph infection only) and took antibiotics.) Aquablation on 2/28/24 that took about 1 hr. and 15 minutes. Apparently went well. 1 night in hospital and home with catheter, which was removed three days later and stream was good, no blood (other than in the hospital where clots and blood were cleaned out with heavy irrigation.)
On 4/8/24, had pain in the lower abdomen right side and went to Urgent Care and CT scan indicated no problems with bladder or prostate area or any where for that matter. Staph infection diagnosed and treated.
Moved along and saw Dr. Kaplan in May '24 and seemed to be going well, good flow, getting up once maybe twice a night, but somewhat still limiting fluid intake. Fast forward to Dec. '24 and starting to have more problems with urgency and frequency, feel like I have to pee throughout the day more times than not.
Seen Kaplan on 12/16/24 and he did a rectal ultrasound indicating that the aquablation had reduced the size of the prosate to 80 cc and he would have liked it to be smaller (40% reduction). I advised him of the urgency and frequency issues and he quoted that " you wouldn't want to do another aquablation". Very little questioning allowed with this Dr. So here I am in March '25 and I am now going through bouts of having to pee many times throughout the day, even though really have limited my fluid intake, some pain in lower left abdomen area and in the perineum (area between anus and scrotum). From some research, I think I need to actually take in more water and it may help. I have appointment with my regular uro on 3/25 as he is on vacation. I still work and have to drive moderate distances when on road. This doesn't help. Not sure where to go from here. Hope this helps those in similar predicament and appreciate hlep from anyone who has successfully gotten through something lke this. Thanks, Joe