I had combination PAE/aquablation and am just completing 3 weeks post aquablation. My URO does PAE first to reduce post aquablation bleeding and speed up recovery. Supposedly it helps the results last longer too. I had the PAE followed 5 days later by the aqua. I had a catheter for one night and the recovery has been very little pain or discomfort, slight blood in the urine. The meds weren't working for me anymore and with a 94g prostate with a large median lobe some of the less invasive procedures wouldn't work. I can only say this has worked great for me so far and wish I had done it several years earlier.