Aged 65, had aquablation (in London) 14 weeks ago, just had to have TURP to fix complication due to a band of tissue blocking urethra.

So mine is a story of what can go wrong. Recover from aquablation was slow (extra 10 days on catheter as went into retention) and from around 4/5 weeks it was obvious that I was way off the recovery curve and there was a problem. Things were going backwards. Painful to pee, weak flow. Surgeon kept kicking ball down road with talk of 'time to heal', 'Let's give it a few more weeks', 'I'll give you some different antibiotics'.

At round 11 weeks did another flow and PVR which showed the Qmax the same as before surgery and residual urine also at pre-surgery levels. The flow rate pattern looked obstructive to me (or rather Google), but surgeon didn't mention his view. He just said it was below average.

More surgeon chasing and updates - Flexible cystoscopy organised and above sphincter in prostate apex, tissue had grown and blocked the channel like a curtain with two smallish holes in it. I'd say it was an 80% blockage. TURP procedure required to remove tissue. That was 2 days ago. I'm back home.

Despite being only 2 days post op, feels better already. The point here is that the surgeon's confidence (hope?) in a complication free procedure meant that I had to spend 3 months in discomfort while he issued scrips for antibiotics that did nothing and played 'wait and see'. My symptoms 6 weeks after surgery were probably enough to merit further investigation without me having to push.

My own (not a doctor) theory is that heavy bruising of the bladder neck (mentioned by surgeon) cause a swelling that caused retention 24 hours after original catheter removed. They couldn't get a normal sized catheter through the swollen tissue and had to scale down to a 3mm foley. Even that was hard to get in. This was left in place for 10 days (because of national holidays). I suspect this acted as a scaffold for the tissue to grow across the urethra. I think one hole was the original channel and the second hole was the catheter pushing a channel through sheets of newly forming tissue - possibly pushing a strand across to start the bridge. Trapped by the catheter and not moved by urine flow, the tissue grew.

The catheter came out and from that point the flow and discomfort just got worse as time passed and the tissue filled in the gap.

Unlike TURP which cauterises the urethral wall, aquablation leaves a rough, raw, living surface with a lot of 'candy floss' debris and ribbons of live tissue. Many surgeons use a TURP tool to clear out this debris surface and cauterise bleeds. I wonder if this difference in the nature of the surface left after surgery makes aquablation a bit more prone to these adhesions across the urethra?

Anyhow, two surgeries, lot of expense and frustration, plus a lost year of discomfort. Fingers crossed that this time, we are where we need to be. My point is that if your recovery is way off what is expected and you have clear symptoms, you may have to decide at what point you start to push for investigation to save yourself a very long wait for the surgeon to come to the conclusion that things have not gone as hoped.