I followed this forum prior to my aquablation surgery so I thought I would share my experience. Had the surgery on 8/28 at UPENN in Philadelphia.

Background: 60 years old, relatively good health (except for BPH). First started experiencing issues about 10 years ago. First urologist put me on tamsulosin, which worked for a little while. Had an episode where I could not pee at all, went to the emergency room and got my first catheter. Not fun. Decided to switch urologists. At first, maintained the drug treatment. But experienced multiple UTI's due to incomplete emptying. In 2021, elected to have Urolift. I was borderline due to the size of my prostate, but thought I'd give it a go anyway. At first, surgery worked great! Awesome flow, no more UTIs. In 2024, old symptoms started to return. Weak flow, UTIs, etc. Urologist doubled up on the tamsulosin and added 5 mg of cialus at beginning of 2025. Also put me on methenamine to prevent further UTIs. Memorial Day weekend had another incident where I could not pee at all and ended up in the emergency room again. Visited urologist and got a complete scan and we decided best option was for surgical intervention via aquablation. Prostate size is roughly 100 g, with "significant intravesical median lobe."

As I said, surgery was 8/28 in the morning. In reading the notes in my chart, the doctor took two passes. First one was 4:09 and the second one was 4:01. Dr. then went in and resected residual fluffy tissue at the bladder neck and residual lateral and anterior tissue. Per the notes, the channel was notably wide open. And, the bilateral ureteral orifices, verumontanum and sphincter were all noted to be intact. Bottom line: doctor thinks the surgery went well.

I stayed overnight at the hospital with a foley catheter. Lots of irrigation going on. So, no real pain or discomfort on 8/28. The next day, 8/29, catheter was removed in the morning and needed to do a void trial to see if I had to go home with a catheter or not. Was not able to fully empty my bladder, but I was able to pee. So, they let me go home without the catheter. 8/29 was not a fun day. Drank a lot of water, peed a lot of blood, rested. Definite burning sensation when I peed. Tried to walk some to help with healing. Also, doctor had me resume all meds and added Finasteride for 2 weeks to help with bleeding.

On 8/30, felt much better. Still drinking a lot of water. But, blood in urine has gone down. Used to look like fruit punch. Now, only noticeable at start of urination. Still burns a little when I pee. But very tolerable. Also, stream is much improved! Got up twice at night to pee. But, part of that is because I am continuously drinking water (even at night).

On 8/31 felt better still. Remaining hydrated. Taking meds. Still some blood at start of urination. But, feel like bladder is emptying and good stream. Took a couple of longer walks and, while tired, felt good.

Today is 9/1, roughly 4 days post-procedure. Took a two plus mile walk this morning. Feel like things are still improving. I imagine blood will be present for at least a couple of weeks. But, so far, marked improvement from where I was a week ago!