Post aquablation & an overactive bladder

@wadaman01
Thank you for reaching out. When it comes to urgency issues after aqua it can vary quite a lot I know. Fortunately that was not a big issue for me, but early on during the first few weeks I would experience it off and on. I think it was more likely after drinking coffee and pop which no doubt irritated the raw tissue. A relative just had it done and his dr recommends all aqua patients take one oxybutynin tablet three times a day for the first week or so to prevent/reduce overactive bladder symptoms. You might discuss that with your doctor. It takes a long time to heal. Six weeks in i did a little yard work picking up small branches etc and still experienced soreness and bleeding. Now going on four months and things are great but even now i will sometimes feel a bit of urgency for fairly small voids. But at this point its like one step back two steps forward so looking forward to continued improvements although probably smaller ones at this stage. Much better stream and less getting up at night. Much better than before. I wanted to add that I too had a very large median lobe that needed to be treated. Ive read that can be tricky especially when it is protruding into the bladder like mine was. I assumed that means a greater likelihood of the aqua stream affecting bladder tissue and likely a greater chance of causing urgency issues. Eventually healing should take care of that but like i mentioned medication can help calm the bladder and make it less susceptible to spasms and feelings of urgency.

@wadaman01
AI seems to agree with the advice I shared.

@connect4321 Thank you for your reply. It seems like recovery varies a lot from person to person. It's encouraging to hear that you're still improving after four months.

Yes as a matter of fact, speaking of improvements, just this week i have noticed a significant improvement in my flow rates. I use an app called proudP that can measure flow volume and rate on my iphone. It’s pretty cool. I will probably use it for a year since there is a significant cost to use it. $20/month.

@steven112
Your doctor’s claim that Medicare requires a biopsy after Aquablation is completely untrue. That is not required for Medicare to cover Aquablation. I was not present for your interactions with your urologist but if I was you I would look for a new urologist. I might also share that story with someone at Medicare.

@steven112 . I had both PHI, PSA, MRI and biopsy before aquablation.

I had some flow testing and ultrasound and that was it. But as already posted, my Aquablation wasn't done right, they sneaked in a resident to do it. Medicare did reject some of the facilities payment that things were done wrong. Medicare also said they were not to bill me for that either.
I think they should have done more testing as things have got worse and they ordered an MRI of prostate (a year later). It was not good results, got news today said:
1. The prostate gland measures 5.7 x 5.0 x 4.9 cm with volume of 68.75 cc. PSA density is 0.06 NG/mL/CC. 2. Lesion # 1: PI-
RADS 5 lesion in the left posterior peripheral zone extending from the base to the apex measures 5.83 cc. No frank extracapsular
extension. 3. No pelvic lymphadenopathy.
PI-RADS Category 5: Very high (clinically significant prostate cancer is highly likely to be present)

I don't understand much, but that last sentence sounds like I am in deep trouble. Then the KUMC won't answer my calls or MyChart messages, What started out as simple Aquablation has turned into what may be the end. Seems this all should had been done back in Feb 2024 and done by my real surgeon and not a resident.

Finely talked to a patient advocate and doctor called, but the still won't do the MRI guided fusion biopsy until Feb 18 and then it will be done by a PA. Doctor said the PA actually does more of them than he does. Fusion biopsy uses merges detailed MRI images (the one I had done on 14th) with real-time ultrasound to create a 3D map to guide needle. I said, why can't get it sooner, but they said best they could do., very busy. I went over his head, but didn't help. Told doctor that according to report everything is confined to one area and no lymph nodes involved that they could see. Doctor said, oh don't worry prostate cancer grows slow. Got to tell you that didn't make me feel any better. Would like to get the biopsy done ASAP and treatment like cut the darn thing out before it infects lymph nodes and escapes from what they called Prostatic Capsule. Well will try next week, there clinics are closed Monday.

@rolfwi I had aquablation 6 days ago, so I'm now where you were at on November 23, 2025. I am also a very active 70 year old who normally swims 2000 meters 4 days a week and hikes or bikes on the other days of the week. I agree the catheter was awful to contend with but thank goodness that part is over, and although it is disconcerting to continue to see blood and blood clots in my urine, I am fortunate enough to otherwise be healing fast. My number one, biggest concern now is not to be stupid and sabotage my recovery by re-engaging in any of the forgoing physical activities before it is really safe to do so. I want to be very disciplined about it, but I've read a lot of different advice about waiting 2 to 4 to 8 weeks before doing so. What was your experience and how did it turn out? Do you think you could have started up again sooner or should you have waited longer? I think good vigorous exercise is key to a good old age so I want to spend as little time as is prudent being so inactive.

@hobari
I had aquablation at the Mayo Clinic in mid August. The week after the procedure I avoided strenuous activity, but started walking several miles a day. Prior to the procedure I was doing a lot of long-distance bicycling. Since I was told not to bike for at least six weeks I thought walking would be a good alternative to help me stay fit. But I think I over did the walking. About a week post aquablation my urine went from clear to dark red and sometimes syrupy. I also passed some small blood clots. My urine stayed dark red for almost three weeks and then gradually cleared up and has been clear since. From my experience I would recommend to other men having aquablation to not be too active for three to four weeks afterward, drink lots of water to help clear up your urine, and don't get discourage if you have blood in your urine. It will hopefully clear up after a few weeks. The good news is that several months after the procedure my urine flow is usually strong and I wake up less frequently from the need to urinate during the night. I have no issues with erections or ejaculation. I experienced some urgency to pee for a couple of months after the procedure, but now that has almost totally stopped. So take it easy for the next three to four weeks. There will be plenty of time to get back into shape, and if your experience is like mine, aquablation will greatly improve your quality of life.