I'm posting the highlights of my post-aquablation experience in case it helps anyone wondering how it's like after almost 5 years. Here we go:
~Early 2021, I experienced full blockage and had to go to the ER twice
~Told my urologist I need a long-term fix without removal ("prostatectomy")
~Urologist recommended aquablation based on my prostate size of around 140 grams. Smaller size calls for other procedures
~I agreed and had the procedure Sep 2021 after a cystoscopy confirmed no cancer
~General anesthesia and overnight hospital stay for continuous bladder irrigation meant to prevent clotting
~After post-surgery catheter was removed, some feeling of rawness and pinkish urine but both went away after about 10 days
~While urinating during this period, experienced blockage again. Strong pushing expelled a big blood clot and all was good
~Sometime 2023, I had blood in urine. Urologist prescribed an MRI w/c didn't happen because my insurer delayed approval and the bleeding had stopped
~I had bleeding ("hematuria") once every quarter from 2023 to 2025 but it would come and go within a day
~Wanting to resolve the bleeding, saw my urologist again in late 2025. He performed a cystoscopy but let me know my "4Kscore Test" was 54%, way above the safe upper limit of 7%
~A 4Kscore Test is a regular PSA test x 4 as a cancer predictor. However, I wasn't instructed to stay away from multivitamins 3 days before the test. I learned later that continuing MVs up to the day of the 4Kscore Test can produce a false positive, which happened in my case
~Based on my above test result, urologist - not aware of the multivitamin's false positive effect - ordered an MRI which this time was quickly approved
~MRI results showed negative risk of cancer, a big relief
~Urologist's opinion is that my oversized prostate, while non-cancerous, can be causing the occasional hematuria
~Cleared of the cancer risk, urologist recommended an annual checkup

Hope these insights will ease some people's anxieties or at least answer some questions!