Aquablation: Post-surgery expectations

@vtredwolf I'm a little hesitant about PAE, although I know someone who only had PAE, no Aquablation, and it went all right. My urologist had concerns about possible negative outcomes with PAE, so he basically steered me away from that.

Thanks a lot @joseflesh, I assume it the Dr. Kalpesh Patel at Arizon Urology Specialists, just south of Arizona?

@diverjer

Great post! My experience aligns with your description.

Had the procedure on Nov 4th, 2025. I have been through "living hell". I have visited the ER five times and once to urgent care.

My symptoms have been improving at a snail pace. Frequency, urgency, burning, and pain that are accompanied with the strong need to defecate after urinating. A urine culture cameback without "growth". Meaning that no infection found. Nevertheless, I had been under several courses of antibiotics.

The positive side? My stream is strong and ejaculations are more voluminous than before the surgery. I had three CT scans (one w contrast) and found a small kidney stone going it's way down. I suspect this had exasperated my recuperation.

I strongly recommend to have physical and emotional support post op. I live by myself and having this procedure during the holidays have taken a toll.

I have an appointment with my Urologist at the end of Jan. Hopefully, he will do an ultrasound for my kidney stone; and perhaps order an MRI. I will insist to get those exams nevertheless.

For those reading this post: "please take an active role on your health" and stay motivated. I would still recommending this procedure even with the nightmare experience post op. The long term benefits are worth the misery.

Background:
I am 57, prostate was 65cc. Spent one overnight and had the catheter for 7 days.

@mkaften this is the biggest problem, but also the biggest reason for success with aquablation. Because there is no heat compared to other methods there is less risk to successful outcome, but it also means more bleeding because the procedure itself doesn't cauterize vessels. Here's my guess. So the doctor has to manually do it which is not a effective. The bigger the gland perhaps the more opportunity to miss something. Maybe luck plays a part. I believe this is why the practice that did my procedure does PAE just before the aquablation, studies have shown or to be a very effective way to reduce bleeding and quicken recovery. I'm not advocating for the procedure, i had my concerns, including the additional risk of the PAE procedure, but my recovery was only 24 hours with the catheter and I had very minimal bleeding after. However, the PAE wasn't a breeze either. The procedure was easy, but there is a lot of initial inflammation which was painful and because I had a large median lobe I nearly lost the ability to urinate before the aquablation which was 5 days after PAE. Certainly there are horror stories, but most regular aquablation seem to have minimal bleeding and a catheter for only 2 to 3 days. I looked at it this way, my enlarged prostate want going away, it was only going to get worse, so it's a risk I had to take. Delaying only increases the risk and worsens the outcome of the procedure. Just one guys opinion.

@vtredwolf
I agree with your advice men pursue aquablation as soon as they can. Yes, you may be able to struggle by on medications etc but getting rid of the obstructive tissue asap is the goal. The obstruction makes the bladder work harder, thickening it. Eventually it loses elasticity and then you are really screwed you will have perm retention issues that threaten kidney function, more likely to have kidney stones and infections. If you have bph, get the obstructing tissue removed. Aquablation is a good way to do that.

@joseflesh
Hang in there. Sounds like after this stone things may improve. I hope so.

@connect4321 I am that cautionary tale which is why I am so vocal. My Uro did nothing for years except feed me meds and do flow tests. Never a cystoscospy, and when I asked about procedures he dismissed them as not necessary. When he finally retired my new Uro as much as told me i had not received a standard of care, did a cystoscospy and showed me my large median lobe causing my problems. He also made sure to explain thing's like urolift and PAE some would not work for and referred me to another uro in his practice who did the aquablation, which went well. However the moderate damage done to my bladder has reduced its effectiveness so I want people to understand the impacts of delaying. Truth is I allowed myself to be mislead because I wanted to believe I didn't need surgery, so I let myself be silenced because I was afraid of the procedure which turned out to be quiet simple and relatively painless. I don't want others to make the mistake I did.

Today is four weeks after aquablation procedure. I must say I’m very lucky in that my recovery has been going extremely well. Urine is pretty much clear by now with occasional drop of blood once in a while. Still some discomfort at times, slight aching like someone kicked me between the legs, but not all the time. Flow is still great. I do not wake up at all during the night. I still have urgency sometimes, but have found that I can get ahead of any surprises by going before I leave the house and proactively going when I’m out and about.

Very satisfied with the results so far.