The prostate aqua ablation left this 72 year old patient who is also a primary care provider utterly disturbed. The procedure itself was not bad other than extreme rectal pain , bladder spasms, urinary incontinence, and normal painful hematuria. Assuming that this would be gone in 2 to 3 weeks, I had total acceptance. After two weeks after taking Macrobid, I developed high fever ,hard shaking chills which indicated cystitis and orchitis diagnosed with a ultrasound of the scrotum and pelvic CT. with a 10 cm right testicle with E. coli culture positive. Several antibiotics were tried but only intramuscular ceftriaxone partially benefited. Multiple antibiotics were tried including Keflex and ciprofloxacin , then levofloxacin and Ceftin, then Bactrim DS ( allergy) , and starting back on Macrobid. After the third-fourth week of therapy of cefdinir and doxycycline, the testicular pain lessened and normal size reoccurred. During all this time, the rectal pain continued along with stooling urgency with a loose stool and occasional incontinence. My urologist did not address the rectal pain said everything was normal and it may take as much is 6 months to fully resolve. My primary care provider ordered a CT scan with IV contrast finding that I had both a severe colitis and diverticulitis adjacent to the prostate. His rectal exam did not show any pain of the prostate gland. Cefdinir and metronidazole resolved the rectal pain . 12-week postsurgical symptoms of retrograde ejaculation and extreme urinary urgency are the only negatives with a good urinary stream as a positive. Seeing patients daily now indicating a pattern of seeing a patient and then go to the toilet during business hours. It would be a hard decision to decide to do the surgery again or recommend it to my patients. The surgery was performed in Tulsa Oklahoma at Oklahoma surgical Hospital. I too feel that the side effects of this is aqua ablation procedure are vastly under reported. Thank you