Orgasms after Aquablation

I agree with everything you said.
Worst part now is the recurring UTIs.
Among other things.

60yo, 214 lbs, 16% body fat and in gym 6 days or about 14 hours per week.

Today is May 24, 2024. I had aqua ablation on Monday, May 13. Less than two weeks from surgery of removing about 2/3 of my prostate. All was tested and negative for the Big Casino. Spent one night in hospital where they used over 18 liters to maintain a continuous flush of my bladder while in hospital. Release on Tuesday with a, what I was told was a 3-way catheter. All was going as expected with bloody urine and blood clots. Thursday, May 16, the catheter was removed. They backfilled my bladder and I was able to urinate with no issues other than some burning. Was sent home.
At midnight that same day, I got up and tried to urinate. Nothing would come out. I tried for about 3 hours and I was now having contraction lasting 1 1/2 minutes coming every 3 minutes. I was unable to stand up to walk to cart, so we called an ambulance to transport me. Once at the hospital I went in the restroom try to go. Now my pain level is at a 9 or 10 and I’m screaming out in pain during the contraction. God bless the nurse, who demanded me to get to my room so she can help me. Unable to lay down, she used a syringe of lidocaine into my urethra. She said I must lay down to insert the foley. Once that was accomplished, over 40 ounces of blood and urine filled the bag. She started an IV and gave me some morphine.

On May 22, I had that foley removed and was again able to urinate. I was told I will see blood for a minimum of 2 weeks, but could be up to 2 months. However, I asked my doctor when I could resume sexual activity and he told me 1 week. He said when I do, I will still have orgasms, but will not ejaculate because the semen goes into the bladder. Wife isn’t ready for Mr Wiggly, because of what I’ve been through and is afraid I’m can hurt myself.

Exactly two weeks out from aquablation today. Doctor sent me home the same day but with a Foley. No pain at all, which was surprising, although the cath was slightly uncomfortable with movement. Six days after procedure, doctor removed cathether, but that day had trouble peeing so he had me return to his office. Unfortunately, he re-installed the Foley for one more week (yesterday). So yesterday I was sweating a bit about whether or not I could urinate, but he did a test where he inserted fluid through the catheter, then removed the catheter and asked me to urinate in a container. Happily all went well. No pain, just a joyous sense of relief. Since yesterday I have been peeing well, no blood or discoloration, and this morning I peed all the way across the shower stall. WooHoo!!!!
To your question, my doctor said I'm okay for the hot tub but he wants me to wait on orgasm two more weeks. Mainly so as not to irritate the urethra through the activity leading to orgasm, not the orgasm itself. Erections are strong. Hang in there.

To the OP:

My urologist told me to avoid sexual intercourse and orgasms for 4 weeks after the procedure. The first 2 weeks didn’t matter as I was still having recovery discomfort, blood in urine, etc. I wished I could have sex during the second 2 weeks of the 4 weeks, but abstained. Cold showers.
But you need to take your own urologist’s advice, this is just my experience.

@mike5450 , you’re welcome.

I started seeing a urologist after 40, and the only test was the PSA level- which was continually high, and triggered a biopsy procedure and one “atypical” sample.

Then a new urologist, and a previously unknown test- an ultrasound for urine retention, apparently more important than the PSA (and I get it that a UTI can be very painful and potentially dangerous).

In the process of pursuing minimal urine retention, I had two TURPs, the second one only 2 months after the first due to the first not working (where I got RE). In the second procedure, but only after it, I was told by the urologist that he wanted to make sure this second TURP didn’t fail, so he has ablated everything he could, short of a prostatectomy, and I would have ED from then onwards- and with a bunch of complementary viagra in my hand I left. Yep, since then I do need help with ED drugs. But the urine retention didn’t go away. Just the erections. And the orgasms.

Another new urologist, that I like and is much more up to discussing options. With the same goal of minimizing urine retention, some UroLift implants, and when that that didn’t work to minimize urine retention, the aquablation finally did. My biggest issue has been mild urological incontinence. It’s getting much better now.

The orgasms are not what they used to be, and are much more subtle- more like a relaxation of sexual urge. I take whatever I can from all of this. And the important point is to keep smiling- even when there’s nothing to smile about!

I don't know if people also look at other prostate surgery threads, but theres to be a common issue with many of the procedures - the quality of orgasms definitely changes. I don't care at all about retrograde ejaculation (except for the first couple times, when it felt distinctly uncomfortable), but there's something up with the actual pleasure part of it. I asked my surgeon about that (I had a very successful HOLEP). He shrugged it off, but my urologist explained that it's commonly understood that there are pleasure centers in the area of the anatomy that actually releases semen, which makes some biological sense. When those are removed, there's a feeling of incompletion that interferes with the feeling of orgasm. I wish my surgeon had mentioned that, but he's very much "that's not my department" about it and I'm sure that guys might not run to get life-saving surgery that also messes with such a primal and important part of life.
Something that seems to be less understood is what neale360 says above - about the build up being more intense. Boy howdy. Yeah, same here. It feels more body-based than before and it's kind of interesting. My wife suggested that maybe it's closer to what women feel when orgasming, and I've always been a little curious about that difference, so I'll just keep exploring the feeling.

Thank you for sharing your experience. Can you provide a link to the comment from neale360 that you mention? I cant find it. Thank you.