Post aquablation & an overactive bladder

I am five weeks out from having had aquablation procedure. I am writing a detailed account of my experience to give other men who are considering the procedure an idea of what you might experience, and to encourage those who are now going through the early recovery process.
I am 65 years old and my prostate was 114 CC before the procedure. I experienced frequent urgency to urinate. At other times I had had to stain to empty my bladder. My stream was often weak and some times split into two or more. I woke up about three or four times per night needing to urinate.
I had the aquablation procedure in mid-August. I spent the night in the hospital and was released the next day with a catheter. I had the catheter for three days and returned to the hospital to have it removed on day four after the procedure. I experienced very little pain as a result of the process, but did find the catheter slightly irritating. The worst part was the bladder spasms when I felt the urge to urinate while the catheter was still in. I had been prescribed a med to minimize spasms, but I avoided taking. I highly recommend taking the prescription.
After the catheter removal I had a slight stinging sensation when urinating the first few days, but that soon subsided. I had a forceful urine stream. I was advised to drink lots of water so I was drinking at least 12 to 20 oz every hour. My urine did have blood usually just at the beginning of the stream. Urine color was a light cranberry color.
By day six after the procedure I felt great, so I became more active and walked 5 to 6 miles that day. Then the blood in the urine intensified and I saw a few blood clots 1/4 inch to 1/2 inch in diameter. Urine color became a dark red and thicker, but never got to the ketchup thickness that I was warned about. I increased my intake in of water and rested. I walked no more than 1 to 1.5 miles per day (I think over doing the walking early after the procedure may have set me back). My urine remained dark red for a few days, but gradually lightened. At day 21 after the procedure my urine was clear and has stayed clear.
My advice from the experience is not to over do any activity the first week after having the catheter out. I also recommend taking the MiraLax that had been prescribed for easier bowl movements for the first week or two after the procedure. Straining may put pressure on a healing prostate and may have lead to the increased bleeding that I experienced.
During the first three weeks after the procedure I had a few involuntary erections, but abstained form any form of sex. My written hospital release instructions said to abstain from sex for four weeks. At week three and six days I took maters into my own hand and had successful orgasm. The semen seemed a bit lighter in viscosity than prior to the procedure, but there was plenty of it and I was satisfied. I did notice for a day or two after my orgasm there was slight stinging sensation in my urethra when I urinated. This might have been my imagination.
Most of the time I have found it easy to empty my bladder and my stream is strong, but there have been a few occasions where I have had to strain to urinate, but that has been rare. I have experienced some urgency to urinate (probably less then 15% of the time) and have lightly urinated in my pants a couple of times before reaching the toilet. I have learned that while I am away from home I should use public restrooms when I seem them available, or before setting out for a long walk. I have been waking 1 or 2 times at night needing to urinate. An improvement to prior to the procedure, but I am hoping that night time urination will get even less necessary. I have put a reminder on my calendar to stop drinking liquids after 8:00 PM.
I have gone into all of this detail to make the point that there may be ups and downs during recovery. I was really worried when blood in the urine had increased, but after a week or two of worry my urine cleared up and I feel great. I have much more control than I did before the procedure and am hoping that daytime urgency and the need to urinate during the night deceases a bit more with time.

I am seven weeks out of Aquablation. I am having an intermittent overactive bladder situation as well, sometimes I can go two to three hours without peeing at other times it's much sooner. I had a follow up appointment this week and I was prescribed Solifenacin 10 Mg. I haven't taken it yet. I don't want the confounding of healing naturally or due to the medication. UR said it's expected and that I am healing well.

Another updated report from my August 2025 scoping to see why Aquablation didn't work. One line stuck out; "Does have persistent obstructive tissue at apical gland in veru preserveration zone. No stricture/BNC.

Looked this sentence up 3 different places and basically all say the same thing- a complication that can occur after surgical treatment for BPH when not all the tissue is removed, particularly in area near verumontanum.

So this makes me even more upset at my surgeon or whoever schedules, let a resident practice surgery on me- not the doctor I had seen and selected. Actually according to what I signed when woke up during surgery said my surgeon could be off on another procedure, but would be available. However, I never got to read what I signed until months later when trouble started. Just got woke up with a tablet and signature block over my head and told to sign and then knocked back out.

Complained to their patient advocacy section and got a letter that they were looking into it with urology staff and would get back in 45 day. It could take longer than 45 days and I could call if I had questions or more information.

Really disappointed in KUMC.

@jaemiami thank you for sharing. Did the procedure improve your flow rates and urine retention? Ive heard that urgency issues can take time to resolve.

@connect4321
For some reason my flow was always good. But now it's like a fire hose. The urine retention hasn't resolved completely. I was told and read that it could take up to three months or more to optimize.