Aquablation: Post-surgery expectations

Things looking better after day 20. Much less blood in urine, good flow, 3-4 hours of sleep without waking to void. Minimal and short lived burning after voiding. UA shows blood, ph 7, and protein in urine.

So far, I'd recommend it.

Best of luck Bill!

My procedure is somewhat unique from what I've seen posted here. My experience prior to surgery are very similar though. 64yo, been experiencing issues for roughly 15 years, on Flomax for 10-12 yrs, but began to struggle more and more. My URO retired, thank goodness, and I was referred to a practice in NOVA. In a dozen years my Uro had never done a cytoscope. My new Uro just shook his head, scheduled me for the procedure which revealed 94g prostate with a large median lobe. He described it as a ball valve which made perfect sense. If I delayed urination or had to much to drink to fast, like prepping for a flow test, I would really struggle to go, the Marian line was blocking flow and the back pressure was creating more difficulty. This practice performs PAE followed closely by aquablation. This cuts down on some of the complications and speeds the recovery from aquablation by reducing blood flow to the prostate prior to surgery. Had PAE 28 Aug. Procedure was easy, but I was surprised by the pain after. It wasn't terrible, I just thought there would be none. It wasn't bad just light burning during urination. Had the aquablation 2 Sep so I'm about a week in. Sent home with a catheter post procedure with appt to come back next day for catheter removal. Catheter was ready stuff, but ready to get rid of it by next morning. Went in, they removed catheter and I had to come back that afternoon for testing. Went how and drank lots, peed 4 or 5 times, a little pain during urination, but less than the PAE. My afternoon test went okay, my stream was kind of weak and I was still retaining, the latter more a function of my bladder than my prostate I think. Doc said he would be would let me go home without catheter (He was going to have to fight me to put it back in). Next day urination was even better. So far I've had very little blood in urine, pain is very minor and gets less every day. Stream is meh, but even two days post aqua was better than even a good day before the procedure. Closing out day 6, feeling good and comfortable with my flow improvement with expectation it will get even better. Still up 3 or 4 times a night, but I get up do my business in a few seconds and back to bed. No hovering over the toilet trying to coax it out. Delaying treatment had taken it's toll on my bladder so I expect that will get better over time. Taking it easy, just walking a little, and waiting. Still plenty of time for something to go wrong but currently pretty happy with the procedures. The true test will be when I can have sex which I imagine people like us are very anxious about, I know I am. Whether the combo PAE/Aqua procedure becomes a standard or if the risk of the extra procedure was worth it only time will tell, but so far I would say my recovery has been pretty optimum. I'll keep folks posted on my progress. Fingers crossed.

Sorry for the few auto correct errors. "Marian line" should be median lobe. There are a couple of others i think you'll figure out on your own.

Thank you for sharing youe experience. I also have a large obstructing median lobe. My procedures in a few weeks.

Good luck. Are you doing the PAE/Aquablation or just the aquablation? So far I'm just mad at myself for waiting so long, hope I'm still saying that in a few weeks.

At 66 years of age, and after many years of increasing frequency of urination and taking many of the medications prescribed for BPH to no avail, and, in consultation with my surgeon I decided that Aquablation was the way to go for me. My prostate was 54 grams. I had Aquablation performed at the University of Miami Hospital on August 7th, 2025. was discharged on August 8th with a Foley catheter.

On August 9th I had to go the ER because I was unable to urinate in the catheter, only a bloody discharge squirting out. I was in extreme pain and discomfort. While at the ER the nurse said most likely I had a blood clot blocking the catheter tube. Sure enough as soon as she flushed it, I had immediate relief. After urinating two full bags I was allowed to go home.

On August 12th I had the catheter removed. For the next two to three weeks I had burning, bloody debris that turned darker as the days went on, frequent urination, and urgency. However, five days ago all debris stopped and my urine has cleared up. Now, sometimes I can go two hours without the need to urinate but at other time it is more frequent.

At no time did I experience any kind of pain from the surgery just some discomfort mostly from having the catheter for several days. I did follow my surgeon's orders for care and restrictions in order to maximize my recovery and set myself up for success.

For me, and after consulting several different Urologists who performed different procedures including, Greenlight, HOLEP, PAE, and Aquablation I believe I made the right decision. I know it's too early for a full recovery and I haven't ascertained yet if I can still ejaculate but I had to do SOMETHING because doing nothing was affecting my life in many negative ways.

At this juncture I can honestly say I am glad I went with Aquablation. The precision of the robotic arm combined with the skill of an experienced surgeon made me feel confident in the expected (or hoped) outcome.

I will update this post in a few more weeks.

First two weeks were no fun. Catheter for 3 days then discomfort and bloody urine. On day 20 things really turned around and things got much better. I am almost a month postoperative and my flow is like a teenager, no visible blood, no issues with sexual function. Still getting up at night 3-4 times but have longer periods of sleep like 3-4 hours. Very happy with outcome but I was regretting it for the first two weeks. Had a great doctor and god bless the robot programmer / designer.

Had the Aquablation procedure on the 11th. Went home 5 hours after the surgery with the catheter they inserted during/after surgery while I was still under. My problem with urinating started after having a kidney stone removed the middle of June this yr. From that point until the middle of August I had 4 foley catheters placed as I was unable to urinate. After each of the catheters were removed I was told if I didn't void in 7 hours to go to the ER. I did this 4x's. After they removed the last catheter I opted to self catherize to empty my bladder. Did this 4x's a day (every 6 hours). Finally towards the end of August I started to urinate in drips and dribbles, but not emptying my bladder so I still did the self catheter 2x's a day to empty the bladder. Today is day 2 after procedure and still have the catheter...appt to remove it on day 5. After this surgery I have had a little discomfort (the tubing on this catheter is very big compared to the other catheters I had before which I believe is making it a little uncomfortable). Had the PAE procedure 10 yrs ago and was in a lot of pain for 2 days after it but everything cleared up and I was fine for about 7 years until I started with weak streams, up 3&4 times at night, and knowing where a bathroom was whenever I went out; but still emptying my bladder until I went in for the kidney stone removal, after which I was unable to pass any urine. Got my fingers crossed that I can get back to being able to tinkle and empty my bladder. Before they cut me lose from post op they flushed out my bladder with 5 huge IV bags of sterile water. After I got home, I noticed the catheter collection bag was just plain bloody with clots. By the end of the following day the color of my urine looked like tea with some debris floating around. Today so far my urine is back to yellow in the collection bag. Postscript...6 hours after I went home after surgery I noticed the catheter bag had just a couple of teaspoons of bloody urine in it, even though I was drinking plenty of water. Panicked and went to the ER that night thinking something was wrong. The ER nurse and PA felt a blood clot was clogging the tube and flushed the end of the catheter where the tube was connected and that did the trick. They would not remove the catheter that soon after surgery and decided on trying to flush it out with saline/sterile water. So now I have 3 more days before I can update on whether I can urinate but will get back on here. When I had the PAE procedure in 2015 my prostate was 94cm and for this procedure it was 65cm. I learned that prostate tissue that is not affected by any procedure will continue to grow (hopefully very slowly). BTW, I am 77 yrs. old.