Aquablation: Post-surgery expectations

Hi,
I’m going to see a uro that has done alot of aquablations. I had a rezum about 6 years ago that worked great for 2 years then started slowing down my flow. I have a large medium lobe.
Some days my flow is decent but never empty ( was told l was about 200 ml stays in) I only wake up once during the night. There are some mornings when I try to go, only a little comes out , and start to worry about larger retention only to be able to pee a decent amount an hour later.

I am going to ask if a redo of the rezum makes sense or is acquablation a better option.

I am also going to ask if there are any stats on doing an acquablation after a rezum.

Was wondering what other questions do you think I should ask. All help appreciated.

Update. At the end of week 2 of my PAE/Aquablation combo therapy things seem to be progressing on schedule. The combo therapy is used by my URO because it supposedly reduces bleeding and complications of the Aqua, speeds healing time and helps the procedure results last longer. Only time will tell all that stuff. There's a study out there for anyone interested. After a pretty optimal first week, bleeding picked up at the beginning of the second week along with more discomfort in the area of my pereneum. The pain was similar to that following the PAE. I wasn't too concerned though since I had seen many of you posted similar set backs in week 2 or after, but my hopes of being done kind of super healer were dashed:-). Doctors were pretty specific about not taking NSAIDs, but they had prescribed Naproxen which is also an NSAID. I hadn't needed it, but started using it for a couple of days and the pain subsided as did the increased bleeding. As of today, bleeding is pretty minimal and flow still much improved. Still getting up at night 2-3 times, but bathroom visits very productive. I have drastically increased my fluid intake last procedure per directions which I think is partly to blame. I'll provide an update at one month for those interested in the results of this combo therapy.

It's been almost 6 months since my surgery and thought I would post my post op journey. To recap, I was 68 at the time and been dealing with an ever increasing number symptoms expressed in this discussion. Urgent need to urinate, weak flow, not emptying my bladder fully, etc. My doctor told me years ago to let him know when I had a belly full of it and we would get it taken care of. The size of my prostate ruled out Turp in his opinion as he thought I would be back in a few years needing more surgery. I opted for Aquablation as the side effects as explained to me seemed few compared to laser surgery.

Same day release from hospital with a cath in tow. Removed 5 days later. Heavy bleeding at times over the next 3 weeks but most likely due to the large amount of tissue removed. I was told my prostate was 120mm in size. Some burning sensation and dull pain for the first two weeks but quickly subsided. I was on a drug Finasteride for 3 months prior to surgery and several months after. There has been no need for it since.

Prior to surgery I used to plan my drives away from home with bathroom stops and kept a bottle in the car for those situations where I ended up somewhere without a bathroom. Most of you know what I'm talking about. ha I don't have that problem any longer and would consider my surgery a complete success. The only side effect has been RE to some degree. Not complete but a very minimal amount of semen compared to before. All in all, a great trade off in my opinion. I know in reading some of the stories, not all have had the same results I have experienced, but I think it's important to share the fact that Aquablasion does have some good outcomes as well. I would recommend this surgery without hesitation.

Just a quick update...foley catheter was removed yesterday (thank you very much!). Some blood in the urine for the first 8 hrs. then turned tea colored. Today urine is yellow and no trace of any red blood. Able to pee with ease but more frequently than I'd like but just being able to urinate is GREAT after 12 weeks of catherization. No noticeable pain (slight burning sensation on occasion). No drips or urine leakage...lets hope it only gets better as time goes on! Doc said he was aggressive with the amount of tissue he removed. Will let the blog know if anything changes for the worse.

Hi. Thank you for sharing your experience. I have a large prostate 80 plus grams with a large median lobe that’s growing into my bladder causing obstruction. Because aquablation was not available to me then, two years ago i had a rezum treatment that helped for about a year. I had a second rezum that also lasted about a year. My symptoms are again back. Excessive retention and lack of capacity are my main problem plus the fact if i let too much time pass between voids the large median lobe in my bladder will press down and prevent me from going at all. Not a good situation. It requires putting in a catheter to drain my bladder. I am now going to have aquablation done. It’s a great option for those with large to very large prostates and those with a median lobe growing into their bladder. It might very well be a good option for you.

@vtredwolf one month update following PAE/Aquablation combo procedure. As noted prior pretty normal recovery, catheter one day, very little discomfort or bleeding first week, little more bleeding second week which cleared up in 3rd week.
Doctor followup at 3 weeks cleared for sex and exercise, but told "don't go crazy". Waited an extra week on sex, no RE but some reddish color in semen which was thinner than normal (like any of us remember what was normal). So passing the occasional small flake of dry blood/scab, but definitely more of that if I overdo the activity. Flow is excellent, bladder still adjusting but typically only up once at night. Frequency is better, but hoping for improvement there over the next couple of months.
I found the combo therapy worked very well for me so far. Doctor said results should last 10-15 years. Discomfort was minimal and I liked only having catheter for one day, the hardest part was the waiting to be cleared for general activity, but I caution that increased activity did mean increased bleeding so recommend you follow doctors orders even though it's hard. At this point I'm wishing I did this several years ago, but I understand anyone's hesitancy. Will update at 3 months for anyone interested.

@vtredwolf happy to hear. where did you get it done?

@vtredwolf
Thank you for sharing your experience with aquablation. Please do continue providing updates. I had aqua done four days ago. After procedure went to hospital room with gravity irrigation through catheter. Stayed a total of two days as drainage was deemed a little too thick/red. Procedure was tuesday. Thursday went home with catheter. Drainage has been getting cleaner every day. Sometimes a little red “sediment” can be seen in the tube but no clots. The day of the procedure my catheter did clog. Because they were sending quite a bit of irrigation through the catheter i very soon began to expetience extreme pain from the pressure building up. The nurses scrambled to find a “flush kit.” It only took them a few minutes but it seemed like an hour. Not good when that happens. I had the nurse show me again how she did it and i ordered a couple to have at home since my catheter would be in seven days. My irrigation rate at home (just from drinking no big bags going in) makes a clog less worrisome but i wanted to be prepared to avoid a possible trip to an er if the catheter clogged. That happened after a rezum treatment a few years ago. Only other issue so far was constipation for four and a half days so i recommend starting to take mild stool softeners right after the procedure. I waited two days. I too will provide updates once my catheter comes out in a couple days. So far i have not experienced any pain following the procedure except for some irritation in the tip of my penis from the catheter.
A little more background. My prostate size prior to procedure was 80 grams with a large median lobe projecting into and obstructing the bladder. If I would go too long without voiding my bladder would fill up and push down on the obstructing median lobe and I wouldnt be able to go. Fortunately when this happened I had a catheter available and I was able to drain my bladder without having to visit the emergency room. Very much looking forward to no longer having to worry about that, or finding a bathroom every hour, getting up many times at night, leaving a large amount of urine in my bladder after every void, etc. Not to mention removing the obstruction will save my bladder muscles from eventually wearing out from dealing with the obstructions causing permanent problems. Aquablation works for all prostate sizes. If you are struggling with urinating issues, seek help from a provider that offers aquablation in their network.

@albiet Potomac Urology in Northern Virginia.

@connect4321 I'm not sure how mine compares sincere I had the PAE 5 days prior to the Aqua which reduced bleeding. The POST PAE days weren't bad but worse than Aqua which wasn't painful either. It also meant less bleeding and less clots, but I did get one the second week that stopped my urine stream for a split second before popping out. That was a
tad scary, but the only problem I had. I'm don't know if the risks of the PAE prior was worth it, but it has helped recovery I think. FYI I did get increased bleeding the second week before it disappeared in week 3 just like they said it would, so don't get discouraged if it looks worse for a few days. Good luck!