aquablation and retro ejaculation

drmccabe, I'm sorry you've had all these complications as a result of your AQB. I too had concerns over the potential infection. I did a lot of "patient experience" reading ahead of time so I understood that the "expected recovery" info from the urologist was the "better" end of the spectrum. I am thankful that I was able to leave the hospital within 24 hours with no catheter and limited pain (some of that rectal, which had zero mention from the urology team). Thankful that resolved, but it took several weeks. Earlier in this thread I'd mentioned some pain/burning with RE. I can report that the next time "around the block" was much better. I'm a cyclist and am back to riding again, building back my mileage (time in the saddle) slowly. I am also a runner and that activity seems to have less impact on my lingering AQB symptoms. (Running before the surgery was as bad as, if not worse, than cycling.) Based on my "patient experience" reading I think I fell somewhere between best and worst case, but closer to best case. Had I not done the sleuthing ahead of time, I would have been disappointed/concerned how things went.

I had prostate aquablation done close to 6 months ago. My only issue was a blocked catheter after discharge from an overnight stay, due to the debris still coming oiut where I peed, and I had blood in my urine for about 4 weeks afterwards (no ill effects since that I know of).
My groin area has undergone significant issues over my lifetime, prior to aquablation. I have one undescended testicle (although fathered two amazing children), then got a hydrocell (sp?) in my one descended testicle that made it much larger due to the build-up of harmless fluid- I had that fixed surgically.

Then a TURP procedure due to enlarged prostate 10 years ago, followed by another TURP 3 months after as the first didn’t work (prostate collapsed in on itself, according to the urologist). He was pretty mad the second time and so gave me a “super-TURP”, after which he told me I most likely now would have ED, which I do, on Viagra now.
All of the above made my descended testicle smaller than the undescended one, gave me retro ejaculation, ED and lack of orgasm (I feel the build-up but then it just suddenly quits). In 2023 I have some UroLift implants which made me pee better, then the aquablation in December of 2025.
So, when I say “no ill effects”, there were not many ill effects left to have- but luckily no infections or major pain in any of this.

I had a TURP some years ago, then had to have another to fix the first one and have had similar problems with ED and orgasm. I'm pretty old and am reluctant to use Viagra etc. But also I'm too old to get upset about it (anymore).

Interesting that your story is similar to mine. I’m almost 74 and also don’t worry too much anymore. I had the aquablation as my prostate protruded into my bladder, so there was always a sizable well around my intrusion that never got drained ( not even with a catheter). My urologist was concerned about a UTI.

I had Aquablation surgery on March 26th so I'm now about 10 weeks post op. I'm 68, good health but got to the point that it was a problem to travel to town or other trips without planning bathroom breaks. Went through all the options with my Urologist and Turp he felt was a bad option since my prostrate was so large. He thought I would have to have the surgery again in 5 years or so. I chose Aquablation as it seemed to have the least amount of side effects. The other option he wanted me to consider and forgive my ignorance as I can't remember the procedures name, but it would be performed by laser and require several incision points in the stomach. It also came with a 100% chance of RE which I wanted to avoid if possible. He told me Aquablation came with a less than 10% chance of RE.

I had visible bleeding for the first 4 weeks but went away at that point and haven't had a problem since. All the other reported issues such as pain, almost a stinging feeling when done urinated was there for several weeks but it too went away. I went home same day from the hospital and had a cath. in for 5 days. After removal I had no problems with leaking or incontinence. My month follow up appointment went well. After going to the bathroom, I was checked to see if I had completely emptied my bladder. They performed an Ultrasound, and I had. Stream is good and I even make it through the night without having to get up now.

After about 3 weeks I was curious about RE so gave it a go and to my horror, orgasm but no ejaculate. I was disappointed for sure but since I had such good luck with the surgery so far, I tried to stay upbeat. Several weeks later I tried again with no luck. Yesterday was my third attempt and to my surprise, I was able to muster up a few (3) weak shots. Maybe a 1/4 of what was the norm before but at least something. I'm hoping as time goes by that function with continue to improve.

I would encourage patience for those having the same issue I did. My doctor did say it sometimes takes months for everything to settle down and get working again, especially if you had to have a large portion of the prostrate removed like I did. So far, I'm glad I chose the Aqua route, and hopeful things continue to improve. Best of luck men.

I’m deeply sorry for any man experiencing complications after any prostate surgery. I tried to call an Aqua doctor but the waitlist was as long as turp. I’m 123day out from holep ( neck preserved median lobe)
I’m 100 recovered. It’s like I was never sick or my urethra wasn’t completely blocked for months -years. I saw Dr Austen Slade in Boise. He’s the best there is I could find.

I am soo glad that it helped your husband. How long after surgery was he able to go back to his normal routine ?

He had lifting restrictions for 1 month, and was not allowed to mow the grass for 4 to 6 weeks. He is very active, goes to the gym ( free weights and treadmill), returned to that routine at 4 weeks. He felt wonderful, but I wanted him to follow instructions to the letter.

I can't comment on aquablation. Just for reference, which is not helpful either, I had a TURP and Urolift the last week of May 2025. It was a median lobe TURP ONLY. Not all procedures are created equally. So when people say they had prostate surgery it could mean a ton of different things. The key, as I understand it, is to stay away from the front and the back of the prostate to preserve ejaculation and urinary function. He told me that 5-10% of patients still have issues after the procedure so I went with those odds. Besides, it wasn't going to fix itself and I would forever have retrograde. Not to mention peeing all over myself. I was maxxed out on Flomax so I had no other recourse. So I had less to lose if it didn't work.
After a week of pain, wearing a diaper and bleeding- I thought I recovered quickly and it fixed my retrograde ejaculation and my urinary issues. After 2 months of not peeing any blood, last week I suddenly did. I'm not real concerned since it hasn't happened again. Plus they said it could be up to 4 months of sporadic issues. I feel like I'm ahead of the curve. The retrograde is gone but I can tell I still have a little ways to go, it gets better each time. The point there is, just when I thought I was 100% healed, it appears I was wrong.
I get that aquablation and HOLEP are the new sexy procedures but as I understand it, TURP is still the gold standard. I read more about those procedures having issues than the old school TURP. Not to mention if they got sloppy in their work - it is a small organ after all. I got photos of before and after so I know he did a good job. Well, it appeared he did a good job.

I really hope you continue to heal and your symptoms disappear. I feel as though this is a long process. Hang in there, I'm not sure you've reached the end of the process. I may give it a rest on the sex part and not push that issue for another few weeks or so. While it's not a long procedure and there's no external scars, internally your body needs more time than you think.

Thank you for your post. I am considering aquablation to fix the same problem you had. I too have a large median lobe intruding into my bladder and causing problems, including the inability to fully void. I have substantial post voiding retention pvr. Has your aquablation fixed the problems you were having.