Aquablation: Post-surgery expectations

@b140 it's going to go great and you will be so happy you had the aquablation, wishing you had done it earlier. My case is very similar to yours and with that large median lobe less invasive options won't be effective. Plus the longer you delay the worse your damage to your bladder and the more likely you'll experience urgency and frequency. You've waited as long as you could, maybe longer than you should have (I and many of us do the same). Aqua is relatively painless and with some great results. Remember you probably get more posters here with issues looking for answers than people with textbook recoveries. There is risk with every procedure, but should be very low with aqua and an experienced surgeon. I was 64.

@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.

@vtredwolf -

"My case is very similar to yours and with that large median lobe less invasive options won't be effective". - I'd noticed your posts as I scrolled through them all and at that time noted the similarities. I'd like to go back to re-review your earlier posts...is there any way to recall just an individuals postings in this group without scrolling through all posts?

Yes - the minute I was told I had a choice of a foley or self catheter...I knew I wanted to move as quick as possible into an appropriate surgery. While the post surgery bleeding and the clogged catheter issues concern me...I still believe this was the best choice to address the issue. Since I'm traveling to Austin, (taking a friend along for assistance for the first few days), and staying in a hotel for the first 3 days then moving to a relatives mostly unoccupied apartment for the anticipated 3 weeks...that's adding a bit more stress and planning. Would have preferred to stay at home...but this surgeon comes very highly recommended, (has done over 2k aquablations I've noted), and I was able to arrange surgery in February as opposed to early April with my local urology surgeon. Seeing some of the comments in the posts suggesting experience is everything, I guess the extra stress is probably worth it. Dr. is telling me to plan on staying in Austin for 2 weeks beyond the catheter coming out...which will be in for 7 days.

Was it ever discussed in your case that your bladder had been damaged (temporarily or permanently) in any way due to longer term retention? This is what concerns me the most since my issues started in 2017. The thing is...I never felt any discomfort due to retention...it was more a weak stream and staccato voiding that bothered me. Most the time I never got up at night...just was not a problem sleeping.

And yes, I agree that the forum likely fields more negative results since those with the best experiences are less likely to join any sort of a support group but instead put the experience behind them.

Thanks again for reaching out and I'll definitely follow up with outcome...likely as I progress.

@b140 the doctor said from my initial cystoscopy that there was some thickening of the bladder wall which could effect my results. He said my results would likely peak around 3 months. My first couple of months everything was great, the third month I had increased frequency and urgency which lasted for a few weeks, but it has settled down somewhat. The doctor recommended i start pelvic floor therapy which i start this week, will see how it goes. My aquablation was in September. I have to urinate once or twice at night and probably go on average 8 or 9 times a day. I can hold it if I have to, sometimes as long as 4-5 hours between bathroom visits, sometimes 1-2 hours. Am I back to normal? Who knows what that even is. I've had symptoms for 15 years and probably should have had surgery 5 years ago, but I had a poor urologist. Wasn't until he retired that my new Uro set me straight. Anyway, every case is different, but don't be discouraged if the first few days are frustrating or you have setbacks, we all have ups and downs during our recoveries. To be honest I felt like I could have gone back to work a few days after my catheter was out. Week 2 bleeding increased. Week 3 things got better right on schedule.

@kocour & @vtredwolf & all
Here is my 21 day progress report for Aqua
**Never any pain after procedure
**No tissue expulsion after procedure
**5 clots total in 1st 10 days..none since
**urination 10 - 20 seconds....I'm leaving the urinal faster than the young guys!!
**Minor amount of blood in urine 50% of the time
** NO bladder control issues...frequency 1.5 - 3 hours. I was always this way....I concluded I have a small bladder
**Getting off tamsulosin & Finasteride immediately after procedure GREATLY improved how I feel
**Walking 3+ miles/day 5 days/week. Stretching 30min/day 3 - 4 days/week. No weight bearing exercises
** I have strictly followed your advice & have been VERY conservative about not overdoing my physical activities...Thanks guys!!

I hope this update helps others with their journery back to good health!!

@techee Here is my latest update:
Aqua 10/15/2025
I am living my best life in many years. I am 83 & & have the gift exceptionally good health.
Results the same as described above.
Resumed weight lifting @ the YMCA.
I encourage anyone having urination issues to get a fix ASAP. I think I was not eliminating toxins from my system for quite a few years. I am a very hi energy person & I just tolerated it because I did not know any better.
My overall well being is MUCH better than prior to Aqua.
I hope this info helps you all in your journey back to goo health!!

I had my one month post-surgery visit with the urologist yesterday so it seems like an appropriate milestone to choose to say something that has been on my mind for a while. For guys like me who researched posts among this support group, it is easy to be scared off by some of the bad outcomes you can ready here. I have no doubt that these complaints are very real, but I suggest that their frequency here may not reflect fully on what the most likely set of outcomes is for most patients. Most patients with successful outcomes and without major setbacks or complications are unlikely to sit down and write a post. After surgery with everything going fine, its natural to have very little motivation to write a post that says just that. People move on to other things. Aquablation is no fun, being catheterized is no fun, and passing blood and blood clots in urine is a an unerving experience. In my case, post-surgery I started reading narratives on Mayo connect from patients who had to be re-catheterized, or suffered incontinence, complete blockages, and/or all kinds of complications which I extrapolated to my own case and worked myself into a frenzy of worrying. But the reality was that the catheter came out on day four as scheduled, a week later the blood and clots slowed and then stopped, I went from having unexpected sudden urges to urinate to a more normal schedule and just this week I'm able to get a full nights sleep without waking up to urinate. I went from retaining 600 ml of urine in my bladder after trying to urinate to 10 ml as of yesterday. I was back in the gym after three weeks and I swam my first mile yesterday. I'm not posting this to gloat; rather I'm posting it because I think it's important to remember that for every tragic story you read here there a lots and lots of men who are saying nothing because when everything transpires on schedule and comes out just fine as it is supposed to, there's no real news in that story.

My doctor is pushing HOLEP procedure.
I am interested in Aquablation for the least side effects.