Aquablation: Post-surgery expectations

@stevedc1 I think it depends a little on how much you delayed treatment and how much damage you may have done to your bladder as a result, but in general you should expect an immediate improvement in your urination and how much you have to get up at night. The biggest variance among us appears to be retention, frequency and retrograde ejaculation post procedure. The recovery for most is pretty rapid and very little pain. The catheter seems to be the biggest annoyance for most. My urologist offered PAE followed almost immediately by the aquablation so i only had the catheter for 24 hours, but i can understand the irritation. You have good reason to be very positive, even those who have had poorer results are generally better off. There are some, very few, with bad results but I think that is often a result of delaying treatment or age. My own recovery over the last 4 months has not been perfect, but I'm still tremendously better off and I feel lucky that this technology is now available compared to other procedures.

@stevedc1 From my experience I would say Aquablation is very successful. Five months after the procedure I have good control over my bladder and urine. I have had no issues with ejaculation. But my bladder control results were not immediate. They seemed to improve with time, so stay optimistic. I still have to get up one or two times some nights to pee, but it comes easier. I do not have to strain, so I am able to get back to sleep. On occasion I still have to rush to a toilet, but is much rarer than pre-procedure and something I can live with. Behavioral changes have also helped. I avoid carbonated beverages, including sparkling water, and I try to avoid liquids about 4 hours before bedtime. I do Kegel exercises for the pelvic floor, but they should not be started until a few months after the procedure. Good luck.

@stevedc1 I had the catheter in for 6 days and its been out for 11 days now. My prostate was quite large at 140cc, which apparently affects how long recovery will be. Smaller gland procedures heal more quickly. Since the first day the catheter was removed, urination came very easily with a good stream. Burning was fairly substantial and I still have it, but each day is getting better. Same with urgency and frequency. Each day is getting better and I'm very optimistic that a few weeks from now symptoms will hopefully be 100% resolved. Good luck!

@joez26 I had a weak and even non-ejaculation issue before and after aquablation. Before the procedure, I place the blame on tamsulosin, which relaxes all muscles including the sphincter muscles essential for ejaculation. Even my sneezes were weak. Seems to me that medication takes away almost all of life's pleasures.

Post-aquablation, ejaculation started weakly then gradually got better. Aquablation can affect the sphincter muscle surrounding the neck of the bladder. Practice makes perfect or at least a noticeable improvement (pardon the humor).

Nonetheless it's reasonable to expect an improvement. Best of luck.

@vtredwolf
Good day. I just saw your kind response. Sorry not thanking you earlier. My last situation is: I found out that my last urologist took only 33 cc out of 187 cc prostate. Which is only % 17.8 of the whole prostate. I think he fell into sleep with his Robot during the surgery. He told me he wants to do a TURP. I cannot believe it. I made an appointment with Jacksonville Mayo Clinique I will see what happens. Have a pleasant day.

Aquablation Recovery Saga!

I am 57 years old. Prostate size 65cc. Had Aquablation on Nov. 4th, 2025. Spent a night in hospital and catheter for 7 days.

My recovery has been a real roller coaster. I have been to the ER 4 times and 1 time to urgent care.

I am still having pain and burning at 7 weeks. Frequency have been crazy with some good days (every 2 or 3 hours) to many trips to the bathroom. Urgency have been constant. I struggle to not urinate before reaching the bathroom. Stream has been good and relatively strong. I ejaculated at 4.5 weeks. Had pain on my stomach that felt like a strained muscle. Ejaculations (2 more times) have been more voluminous than prior to surgery. I wake up once or twice per night.

My complain? Is the lack of tangible recovery. There are days that felt like my bladder and prostate were irritated or swollen. I have pain on my penis even with movement. I am afraid that prostatitis is the issue. The pain when urinating goes from bothersome to UTI like. Bladder spams are notable when the urgency appears. I have to literally run to the bathroom. I do not have incontinence issues. Urinating with pain and burning are together with the urgency to poop. My bowel movements have not been normal since the procedure. All of these have taken an emotional toll. I want to see progress in order to start living a relatively normal life. I am anxious and depressed. I hope this is temporary.

I am calling the Urologist to rescheduled my appointment to an earlier date. I want reassurance that all of these symptoms are part of the journey to recovery.

That's my story. There are more details, but it would take a lot of writing.

@joseflesh by all means see your urologist, but to calm some of your fears i had the stomach pain during orgasm too. It went away at about 3 months just like my Urologist said it would. Still probably a lot of healing left to do at 7 weeks, but talk to your urologist.

@luferfish sorry to hear about your experience. I dont what happened but from your brief description you may want to consult with a different urologist at a different network. Aquablation is becoming the procedure of choice for very large prostates as they can just do as many passes as needed and adjusting the equipment between passes.

@luferfish
Here is a video by dr mehan at a Banner Health hospital in mesa az showing him using aquablation to treat a prostate over 200 grams.

@connect4321 Thanks for this! I advanced to 20:20 where Dr Mehan started stripping the obstructive prostate tissue. He then sees the urolift pins from the previous procedure, an alarming discovery because urolift is best for smaller BPH, not for patients like this whose prostate size was 280 grams. The casual conversation among the MDs in what sounds like an operating theater was amusing. Great video!