Aquablation: Post-surgery expectations

Had the surgery 12/24. The surgery was a non-event and went home with a catheter for 5 days. The catheter was difficult and happy when it was removed. Had bleeding issues for multiple months when exercising; even though I waited the prescribed 4-6 weeks of minimal exercise. The results of the surgery were noticeable and positive; less urgency, less bathroom trips, and strong stream, normal sexual activity. Had a setback after four months as painful urination, blood, and slowed stream came back which was the result of either calcified prostate tissue or perhaps bladder stones. Once removed all systems go.

Used Tamsulosin for nearly two years; seemed to work but in the end had to do both artery embolization that failed and then aquablation. Tamsulosin is a muscle relaxer and does nothing to shrink the prostate; eventually it comes down to how comfortable or uncomfortable you are with the effects of BPH. I have heard from the radiologist who did the artery embolization that some form of dementia is connected to Tamsulosin. Did not check that out as I am no longer on the med.
Hope this helps.

I had aquablation last December (2024). About an hour long procedure. I stayed overnight in hospital (standard procedure I was told), during which time a complex catheter-like instrument was put up my urethra that both had distilled water fed into my bladder, and a drain into a catheter bag, during which a lot of debris came out.
I couldn’t pee at discharge time, so had a catheter for several days. My first issue was a blocked catheter tube that took me to ER, where the catheter was removed (it was scheduled to come out the next day). I had noticed debris in my catheter bag while at home, and a piece of the debris had blocked the catheter tube. Wouldn’t have been a big issue in hospital, but as an out-patient at ER it took around 1.5 hours to get seen, and I was starting to feel very anxious with an extremely full bladder.
Blood in urine for another 4 weeks. Urinary incontinence for about 2 months when I walked, had to wear pads, especially while there was still blood in my urine. I now have some minimal urine leakage, not when I walked any more but when my bladder gets full. I can manage that by regular trips to the bathroom during the day, but I need to still wear a pad at night.
Urinating is amazing, and I am totally voiding my bladder, the issue that triggered the procedure.

I posted this quite some time ago. I had Aquablation in Middletown, CT last September. I had been completely asymptomatic until my prostate shut me down and put me on a catheter for 4 months. I'm 55, in good shape, and my prostate was 110 grams. I stayed in the hospital for two days because of bleeding. I had a catheter at home for a week, which was the worst part. It was larger than they catheter I had been wearing and meds did nothing to control the spasms.

As soon as the catheter came out I was peeing like a racehorse. It took two full weeks for the bleeding to completely subside. At the end of three weeks I went back to work. I had no incontinence and no retrograde shooting. It's now 8 months later and I'm still peeing like a racehorse. I get up once per night...but I've been doing that for 30 years. I now eat plenty of pumpkin seeds, broccoli and tomato sauce...I never want to go through this again. But if my prostate should grow back, I would do another aquablation.

In Connecticut there is only one surgeon who does the procedure and he is very good. I think surgeon makes a world of difference. I've read plenty of accounts where guys didn't do so well...but I've read those about TURP and HOLEP as well.

I have suffered with Prostatitis for more than 20 years. The size of my prostate has grown over the years to 90 grams. I have been getting up a
from 3 to 6 times at night. I have been miserable and have decided to go through the Aquablation procedure.
I am two and a half post the procedure, the urine flow is significantly better but I am not fully cured yet.
Since the procedure, I have been having tremendous pain right after urinating.
I spoke to my doctor, he said not to worry. I have to allow some time for the prostate to heal.
I have done some urinalysis test, the result came back with white blood cells, proteins in the urine and an increase of Leukocyte Esterase.
They have given me antibiotics for possible UTI.
After taking the antibiotic for 3 days, I am now peeing blood.
I was told that I might have some serious inflammation and suggested that I take 600 of ibuprofen and turmeric to help lower the swelling.
Any advice is greatly appreciated.
Paul

Paul, did they give you Azo or the prescription equivalent? I had the burning/pain after peeing for ~ 2 weeks post surgery and that meds significantly reduced those symptoms. I also found that if I kept my water consumption high it helped. YRMV. Hope you can find some relief.

I have been on both Azo and Phenazopyridine 200mg. I get a little relief when talking 600mg ibuprofen but I do not want to stay on it for too long. Yesterday out of nowhere I noticed a good amount of blood while peeing.
I was able to flush it out by drinking a couple of gallons of water.
I know my prostate is still healing but it’s been almost 3 months post Aquablation and I’d like to resume my normal life.
Could my condition be a sign of blood clot?
If that is the case, is there anything I can take to help alleviate my pain or get rid of the clot?
Please advise.
Thanks in advance.

Aged 65. Had surgery 16th May 2025, so 17 days in.

Previously had Urolift in 2019, results of which were mixed. Prostate continued to grow from 35cc to 60/65cc. Had quite problematic discomfort and prostatitis flare ups. Chose Aquablation after a lot of research, like the way is produced TURP like outcomes without the risks associated with heat and prolonged surgery on a large prostate.

Had surgery in London. Went fine. Used cauterisation loop to tidy up the fluffy residue after the water jet passes and seal off bleeds. Only one of 4 Urolift implants recovered, no idea where the rest have migrated to, but only one discovered near the bladder neck. Woke up in a lot of pain, but that was brought under control quickly. Think my bladder neck had taken a bit of a beating. Settled down in a few hours. Lots of saline on drip to fill bladder for flushing.

Discharged with catheter following day. So far pretty much as expected, uncomfortable, but bearably so. Trial without catheter three days later. Managed 250cc then 400cc of pink urine, 10cc PvR, but not scary amounts of blood. Stung a lot, but pleased with myself and was driven home. Flow then started to decline, by 11.30pm was in almost total retention. Finally got back to clinic 8.00am and used a catheter to empty nearly a litre. Not a fun night.

Did self catheterisation for a day, but still unable to pee, then put indwelling catheter in for a week. It was so inflamed inside that they could only squeeze a 4mm catheter in. Second TWoC was fine, but flow not great. PvR 90/100cc. Very happy to lose catheter.

Not experiencing urgency or much discomfort, but urination is a dribble of blood followed by a thin stream. Hurts to initiate and at end, but it is definitely improving. Had review with surgeon yesterday who prescribed Ciprofloxacin (2 weeks) as thought chance of infection - partly from a week of catheter and blood in urine providing good conditions for bacteria. Urine sample gone for test - but looked suspect.

Flow today seemed improved for the first time. Not great, but felt better. Pain slightly less, so maybe I have been unlucky and infection has slowed the process?

So, tough first two weeks - I envy those who seemed to recover in a few days - but definite hints of light at the end of the tunnel. Getting up 4+ times a night, now down to 3x and feel 2x beckons. No urgency during day, able to leave reasonable gaps between toilet trips. Can sit on harder office chair for a few hours without too much discomfort.

I have heard it said that the transition from being uncomfortable to suddenly thinking, 'Hey, this is working' is quite sudden, so fingers crossed this is me turning the corner.

I am 70 and have low-grade prostate cancer. A uriflow test indicated a blockage so a urologist did aquablation 8 weeks ago (4/3).

My stream is better but I have to urinate every 45-60 minutes during the day all day long with great urgency. I have 10-15 seconds to get to the bathroom or pull off the road. At night I get up twice over 7-8 hours. Erections are strong but ejaculation is always retrograde and not satisfying. I had none of these particular issues prior to aquablation (only low flow), but was taking Alfuzosin to help with this.

The aquablation procedure was in preparation for brachytherapy (targeted radioactive seeding) but the surgeon will not do this until the above issues resolve, if ever. My urologist said this sometimes happens but had not resolution. I have an MRI scheduled next week.

I had similar after Urolift. Took about 2 years, but the slight dampness eventually went away. Just have to keep active to improve muscle tone.