Aquablation: Post-surgery expectations

Exactly 1 month since my aquablation. I was catheterized for 6 months prior. My prostate was 94 grams. During that time, cystoscopy ruled out cancer, and I chose the AB after researching and interviewing the doc who would perform the procedure. He's been doing prostate surgeries for some 35-40 years and told me he prefers the AB, he feels he has more precise control over what he does. Had the procedure, stayed 1 night in the hospital as a precaution, and went home the next day without a catheter. I quickly realized that when my body signaled I had to urinate, I had only seconds before starting to void; this was expected, those pelvic muscles had not been used in 6 months, so I got some Depends. Within 48 hours that changed and I had a little more time between the urge to urinate and actually peeing, so I didn't need them anymore. I passed some minor blood clots, but it wasn't painful, just an odd sensation. Passing blood clots stopped within 72 hours. I have no residual pain at this point. I have more time to urinate, the muscles are gradually being retrained (I do try and hold it back a little to exercise the Kegel muscles, and to figure out what that feels like - it's not easy, I clench the wrong muscles!). I wake up at night once or twice, I think more out of habit, as it's the same time every night. I do urinate when I wake up. I was starting to get leg cramps, so I started taking magnesium/potassium supplements, upped my water intake, and make sure to add electrolyte powders to it. I noticed I do have retrograde ejaculation, have to research that, but I'm 65 and not planning on any more kids (my doc did question me about that, and my expectations). Orgasms feel fine, just not as much volume, but it's only been 1 month. After 6 months of wearing a catheter, and being in some discomfort, I'm happy to be pain free. My urination continues to improve, as far as being able to hold it longer as the days go by. Overall I'm very pleased I chose the AB, it seems to have corrected the situation.

Thought I would provide an update to my aquablation surgery from March of 2025. As you can see, it's been almost a year since surgery, and I have to tell you it's been a great success for me. Planning my day outside the home depended on having bathroom stops should they be needed was a pain. I kept a bottle in the car for those situations that I couldn't find a bathroom. Those days are gone. I can even sleep through the night (7 hours) without getting up to urinate. I take a flight from Nashville to the west coast often and it's usually a 5-hour flight. Usually don't even have to get up to urinate on those flights either. Full flow and from tests performed post-surgery, I'm able to completely empty my bladder.

I was 68 at the time of the surgery and my prostate was 120mm in size. I'm told that is quite large. I went home the day of, with a Cath in tow. Had the Cath in for 5 days. After removal I didn't have a problem at all with urinating, holding it if I had to until the next bathroom stop, or emptying my bladder completely. I had the usual bleeding for about 3 to 4 weeks and some bladder pain from time to time but overall, it was an easy recovery. Orgasms have been just as before; however, I did end up with RE. Based on everything I've experienced so far, it is a worthwhile trade off. My doctor told me, chances of RE with Aquablation is about 6%. I think it's much higher based on what I've read on this forum. However, some of the other options I was given, was 100% you will end up with RE.

One thing that has been different/amusing is the old trick of turn on running water they tell you to do when you have to give a urine sample at the doctor's office and can't seem to muster up the ability to fill the cup? Yeah, well, when I hear running water now, I have to go and I have to go now. ha. I have to be careful filling up the tank on my pickup at the pump.

So, other than a few little inconveniences and a few amusing changes, my procedure was a great success for me. I know that hasn't' been the case for everyone but there are success stories. Surgery performed in Nashville.

Joined the forum today after last night reading through others experiences all the way back to 2024. While some experiences shared by forum members have been eye opening, ultimately spending time further educating myself on what to possibly expect seems time well spent.

I'm 65 and have been dealing with BPH since 2017. In 2017 I learned of a possible issue after an annual physical gave my general MD a slight concern during a digit exam. PSA tests have for the past 10 years been less than 1.0 and continue the same to this day. Urologist in 2017 did a cystoscopy and discovered hypervascular bladder neck w/ a large obstructing intravesical median lobe of the prostate which was acting as a ball valve causing urine retainment post void of 200+cc. Didn't feel comfortable with the Dr. at the time as he immediately wanted me to undergo TURP. Rx Uroxatral was not helpful and discontinued. I chose to put issue on the back burner as it was just not affecting lifestyle at the time...sleep wise or even in any noticeable voiding. After my first hernia surgery in 2019, anesthesia apparently caused my first inability to void post surgery and a catheter was used...painful experience. A few weeks later made an appointment with different highly recommended Urologist in here in AZ did some testing and another cysto. Found that my prostate had trilobar hyperplasia and agin the median lobe ball valving into the bladder. Estimated total protate tissue resectable as no more than 30 g. Bladder showed early trabeculation with cellule formation. Again, this was 2019. I was scheduled for TURP surgery and prescribed Tamsulosin to see if helpful. Well, it was very helpful to a point I and the surgeon thought ok to cancel surgery. He did think I'd eventually be back at that time. In 2021 and 2022 I had a couple more hernia surgeries...each time leading to the need for a catheter for a day or two. Anesthesia also does a number on me when it comes to bowel movement post surgery.

Fast forward to 2025 and after an appointment for a yearly testing for voiding/retention...it became clear that I had slowly over the past 3-4 years reached a new phase. Prior to testing I had for 5 days started taking (2) 0.4 Tamsolosin daily to help facilitate better voiding than I'd been experiencing. The nurse practitioner had recommended (2) a day a year prior but dizziness seemed to come along with taking...so I stayed with (1). The voiding test was done and I was holding 650cc with no pain and no real urge after the test. (10 minutes after testing I was able to void 50cc further). I was released until the following week for a set appointment with the nurse practioner. The day prior to that appointment...I woke and could not void at all. Back to the clinic that day where I was given the choice of a foley or self catheter 2 times daily. Reluctantly chose the self catheter. I'm currently using (4) self catheters daily and pretty tired of the daily planning involved in making that possible. Developed a UTI at some point recently and was placed on Cipro for 7 days. Then an issue w/ a need for a dental abstraction put me on another 7 day course of Cipro for precautionary reasons after that abstraction. In the meantime, because my surgeon was unable to get me into surgery until the end of April, a different surgeon has been recommended to me in Austin. I will travel there on 2/25 and I will be under his care for aquablation surgery. Planning to likely be in Austin for 3 weeks and have been advised that a catheter will remain the first 7 days.

After reading of the others experiences on the forum, I'll have to admit a bit of fear when it comes to post surgery issues...the first of which would be catheter blockages. Maybe since I have a smaller prostate possibly requiring less ablation...hopefully less chance of catheter blockage. I'll post again once surgery is complete. Any advice or insight from those who have similar size prostates and your experiences with post surgery healing and outcome is surely welcome. Sorry for the book...future posts much shorter.

Joined the forum today after last night reading through others experiences all the way back to 2024. While some experiences shared by forum members have been eye opening, ultimately spending time further educating myself on what to possibly expect seems time well spent.

I'm 65 and have been dealing with BPH since 2017. In 2017 I learned of a possible issue after an annual physical gave my general MD a slight concern during a digit exam. PSA tests have for the past 10 years been less than 1.0 and continue the same to this day. Urologist in 2017 did a cystoscopy and discovered hypervascular bladder neck w/ a large obstructing intravesical median lobe of the prostate which was acting as a ball valve causing urine retainment post void of 200+cc. Didn't feel comfortable with the Dr. at the time as he immediately wanted me to undergo TURP. Rx Uroxatral was not helpful and discontinued. I chose to put issue on the back burner as it was just not affecting lifestyle at the time...sleep wise or even in any noticeable voiding. After my first hernia surgery in 2019, anesthesia apparently caused my first inability to void post surgery and a catheter was used...painful experience. A few weeks later made an appointment with different highly recommended Urologist in here in AZ did some testing and another cysto. Found that my prostate had trilobar hyperplasia and agin the median lobe ball valving into the bladder. Estimated total protate tissue resectable as no more than 30 g. Bladder showed early trabeculation with cellule formation. Again, this was 2019. I was scheduled for TURP surgery and prescribed Tamsulosin to see if helpful. Well, it was very helpful to a point I and the surgeon thought ok to cancel surgery. He did think I'd eventually be back at that time. In 2021 and 2022 I had a couple more hernia surgeries...each time leading to the need for a catheter for a day or two. Anesthesia also does a number on me when it comes to bowel movement post surgery.

Fast forward to 2025 and after an appointment for a yearly testing for voiding/retention...it became clear that I had slowly over the past 3-4 years reached a new phase. Prior to testing I had for 5 days started taking (2) 0.4 Tamsolosin daily to help facilitate better voiding than I'd been experiencing. The nurse practitioner had recommended (2) a day a year prior but dizziness seemed to come along with taking...so I stayed with (1). The voiding test was done and I was holding 650cc with no pain and no real urge after the test. (10 minutes after testing I was able to void 50cc further). I was released until the following week for a set appointment with the nurse practioner. The day prior to that appointment...I woke and could not void at all. Back to the clinic that day where I was given the choice of a foley or self catheter 2 times daily. Reluctantly chose the self catheter. I'm currently using (4) self catheters daily and pretty tired of the daily planning involved in making that possible. Developed a UTI at some point recently and was placed on Cipro for 7 days. Then an issue w/ a need for a dental abstraction put me on another 7 day course of Cipro for precautionary reasons after that abstraction. In the meantime, because my surgeon was unable to get me into surgery until the end of April, a different surgeon has been recommended to me in Austin. I will travel there on 2/25 and I will be under his care for aquablation surgery. Planning to likely be in Austin for 3 weeks and have been advised that a catheter will remain the first 7 days.

After reading of the others experiences on the forum, I'll have to admit a bit of fear when it comes to post surgery issues...the first of which would be catheter blockages. Maybe since I have a smaller prostate possibly requiring less ablation...hopefully less chance of catheter blockage. I'll post again once surgery is complete. Any advice or insight from those who have similar size prostates and your experiences with post surgery healing and outcome is surely welcome. Sorry for the book...future posts much shorter.

@b140
I am glad you are having aquablation. It’s definitely time to get that large median lobe out of your bladder. Hopefully your bladder will get better and your retention will go way down. Let us know how it goes.