Aquablation: Post-surgery expectations

Posted by Phil, Alumni Mentor @upstatephil, Jan 26, 2024

After decades of pills to (partially) manage BPH, I am scheduled for aquablation at Mayo JAX in mid-Feb. Has anyone had that procedure done? What was post-surgery like? What were your experiences regarding regular vs. retrograde ejaculation?

My expectations are high. My general health is good+ (71 yo), my prostate is enlarged but not massive, my PSA's suggest no cancer concerns. The surgeon expects a low-risk procedure (no incisions I believe) and a quick recovery (unless something unexpected pops up). I appreciate it's impossible to predict surgical outcomes with certainty - I would like to hear of others' experiences to help set my expectations.

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I believe my prostate was 81.
They stopped the flushing this morning but are now seeing red blood. They are going to flush manually pans see if all Is good before I leave

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Profile picture for albiet @albiet

I had my Acquablation done today.
The process was fairly straight forward. Got there early. Signed in. Blood taken. Waited then for surgeon and team. Very organized. I believe they preformed the surgery using a Hydros machine.

When I woke up I was in recovery with a high Foley catheter. This foley hurts more than the foley I had in me for the prior 3 weeks waiting for the surgery.
I believe it a larger size . Could that the pain in the head.

I’m staying over night in the hospital as the flush out the bladder with a liquid solution. Was told it’s basically clear right now.

I will
Continue to update
My questions
1- have others here had pain due to the foley ? does the pain stop once it’s removed?

2-I’ve read that it’s common to have blood and clots for the next few weeks. The fact that there is no blood in my flushing mean that I won’t bleed once it’s stopped and the

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@albiet 1. For me the catheter was not very painful, but it was an irritation. My urethra burned a little after it was taken out but that soon subsided.
2. My urine was clear when I was released from the hospital. It stayed clear for a few days, but then I overdid exercising and my urine turned dark red and sometimes included small clots. To held flush out the blood I drank lots of water and after about three weeks my urine cleared up. I experience urgency and wet my pants a few times over the next few weeks. If that happens to you, don't worry too much. It took about 3 to 4 months for me to realize the full benefits of aquablation. You should take it easy over the next three weeks to let your body heal. I over did exercising (going on long walks) and I think that prolonged my bleeding. After three weeks post procedure I suggest stepping up exercise gradually. Avoiding or at least limiting intake of carbonated beverages, caffein, and alcohol helped me to get urgency under control. I am now totally happy with the outcome of aquablation.

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Profile picture for kocour @kocour

@albiet 1. For me the catheter was not very painful, but it was an irritation. My urethra burned a little after it was taken out but that soon subsided.
2. My urine was clear when I was released from the hospital. It stayed clear for a few days, but then I overdid exercising and my urine turned dark red and sometimes included small clots. To held flush out the blood I drank lots of water and after about three weeks my urine cleared up. I experience urgency and wet my pants a few times over the next few weeks. If that happens to you, don't worry too much. It took about 3 to 4 months for me to realize the full benefits of aquablation. You should take it easy over the next three weeks to let your body heal. I over did exercising (going on long walks) and I think that prolonged my bleeding. After three weeks post procedure I suggest stepping up exercise gradually. Avoiding or at least limiting intake of carbonated beverages, caffein, and alcohol helped me to get urgency under control. I am now totally happy with the outcome of aquablation.

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@kocour thank you for you quick reply.i was just told , even though there is some blood , it’s become a light color and they feel I can leave shortly. They mentioned id get an anti spasm med , Tylenol and an antibiotic.
I will then need to call my drs offer to see when they will take out the foley.

What were people’s experience after the foley is taken out?

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Profile picture for billrtx @billrtx

@mirdad22
I realized that I had a urethral stricture at the position of the fossa navicularis (about 1 inch from tip of penis). At about 10 days post surgery my stream became very narrow. Cystoscopy confirmed this. I was given a few options for treatment, including more surgery. Instead I decided on weekly self catheterization using Fr14-16 catheters to keep the stricture from reforming.

More than likely the stricture occurred due to the tools used for this transurethral procedure. Good luck.

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@billrtx You mentioned that you opted to use the catheters to keep the stricture from "reforming." What did they do to remove the stricture in the first place?
Thanks,

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Profile picture for mirdad22 @mirdad22

@billrtx You mentioned that you opted to use the catheters to keep the stricture from "reforming." What did they do to remove the stricture in the first place?
Thanks,

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@mirdad22
They dilated my urethral stricture with some metal rods called "sounds" up to a 20 Fr diameter (slightly less than 7 mm). I continued self catheterization (14 -16 Fr) a few times daily at first, and slowly increased to once weekly. Seems to be working, as I've been doing it for over a year.

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Profile picture for albiet @albiet

@kocour thank you for you quick reply.i was just told , even though there is some blood , it’s become a light color and they feel I can leave shortly. They mentioned id get an anti spasm med , Tylenol and an antibiotic.
I will then need to call my drs offer to see when they will take out the foley.

What were people’s experience after the foley is taken out?

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@albiet stopped bleeding after 3 weeks went back to normal activity 4 weeks. 9 weeks still having urgency and leakage, not happy so far, Doctor put me on gemtesa (Vibergon) takes 2-3 weeks to work. Stream has definitely improved only thing though and that was never my main problem as urgency was, so Aquablation is not too impressive so far for me. Hope you have better results.

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Profile picture for billrtx @billrtx

@mirdad22
They dilated my urethral stricture with some metal rods called "sounds" up to a 20 Fr diameter (slightly less than 7 mm). I continued self catheterization (14 -16 Fr) a few times daily at first, and slowly increased to once weekly. Seems to be working, as I've been doing it for over a year.

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@billrtx So despite having the "sounds" procedure, you still have to self catheterization for over a year?

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Profile picture for mirdad22 @mirdad22

@billrtx So despite having the "sounds" procedure, you still have to self catheterization for over a year?

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@mirdad22
Only doing it weekly. Afraid to completely stop. Dr said that some patients doing this only self catheterize monthly.

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thanks for all the comments. i had foley taken out yesterday. was at drs office for about 4 hours. drank lots of water. while pee came out it was slow and spraying all over the place. i would have to pee every ten minutes the whole time i was there.. the good thing was pee was coming out. the bad thing was i was pushing it out which the dr said i have to stop. my pvr was over 200 but since my pee had stopped 100% a month before the operation, i took that as a plus. he said he could either put another foley in me for a week or i could try and go without it and if complications come, either go back to them or the emergency room. I decided to try without it. this morning the spraying today is not bad and the pee is coming out but i do know there is a decent amount left in. have peed some multiple times im hoping i get enough out each day so that i dont have to go to the er but will take each day, 1 at a time. he feels it could be the swelling. has another else had similar expererences the first week or 2 following foley removal only to improve?

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It’s now 3 days since my catheter has been removed. The day after my first real clot came out and seemed to make a difference. Since then the flow has been slow and I feel full. Since waking up I peed 3 times and only about 250ml total came out. The current pee does not look bloody. I’m not sure if I have another clot or if it’s just swelling. I have started drinking more water hoping it’s a clot that needs to come out but realize if this continues will most likely have to be in emergency room by tomorrow.
Has anyone here had similar experience. I have a 14 Frnch cath I could try on my self but worry about damaging my prostate if I try. If anyone has had similar experiences please lmk what you did

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