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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Profile picture for albiet @albiet

i am about 25 days from the date of my operation. I am noticed some positive and negatives. each week has been better but im nowhere near perfect. Since i was in full retention for the month prior to surgey, anything is better than that. when i get up in the morning the most i can pee is about 225. I know there s a lot still left in me, I usually pee 2 more time in the next hour to get around 400mo out of me. i also notice i have to push. nothing comes too easy. im aslo very sore esprcially after i pee. at what point is it what you are doing is your best? is this as good as it gets?
would be reat to hear from others. thanks

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@albiet -- Are you drinking sufficient amounts of water? I drank extra water for the first several weeks after aquablation. I think that helped flush out my system. I noticed improvements over time. I am now 10 months past the date of my procedure and am very happy with the results. (I was told to avoid carbonated beverages because they can irritated the bladder.).

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Profile picture for kocour @kocour

@albiet -- Are you drinking sufficient amounts of water? I drank extra water for the first several weeks after aquablation. I think that helped flush out my system. I noticed improvements over time. I am now 10 months past the date of my procedure and am very happy with the results. (I was told to avoid carbonated beverages because they can irritated the bladder.).

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@kocour im not sure what is enough. my dr said "if im thirsty drink, no need to go overboard." i have no been peeing blood out since the first week. Also only had 1 huge clot come out and that was on day 4, the day after the cath came out. when did you see your flow really improve?

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Profile picture for albiet @albiet

i am about 25 days from the date of my operation. I am noticed some positive and negatives. each week has been better but im nowhere near perfect. Since i was in full retention for the month prior to surgey, anything is better than that. when i get up in the morning the most i can pee is about 225. I know there s a lot still left in me, I usually pee 2 more time in the next hour to get around 400mo out of me. i also notice i have to push. nothing comes too easy. im aslo very sore esprcially after i pee. at what point is it what you are doing is your best? is this as good as it gets?
would be reat to hear from others. thanks

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@albiet My experience has been very good. I checked into the hospital on April 16, had the aquablation done that afternoon, stayed the night and had the catheter removed then next morning and drove myself home. It did burn a little for a few days, but I had some meds to help with that, along with about 3 days of antibiotics. By the end of the first week, no more blood in urine and I was peeing like I was 18 again! I don't measure the amount I pee, but I do pee completely empty. If I pee before I go to bed I no longer get up at night. I used to get up 6 or so times a night. Other than RE, I am more than satisfied with this procedure. I had a TURP 10 years ago, and a PAE 1.5 years ago. This has given the best results for it's intended purpose.

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Profile picture for fireman123 @fireman123

@albiet My experience has been very good. I checked into the hospital on April 16, had the aquablation done that afternoon, stayed the night and had the catheter removed then next morning and drove myself home. It did burn a little for a few days, but I had some meds to help with that, along with about 3 days of antibiotics. By the end of the first week, no more blood in urine and I was peeing like I was 18 again! I don't measure the amount I pee, but I do pee completely empty. If I pee before I go to bed I no longer get up at night. I used to get up 6 or so times a night. Other than RE, I am more than satisfied with this procedure. I had a TURP 10 years ago, and a PAE 1.5 years ago. This has given the best results for it's intended purpose.

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@fireman123 great to hear that its working great. do you still feel urgency at times?

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Has anyone tried the med Imipramine for retrograde ejaculation caused by Aquablation and if so , can you provide some feedback

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Profile picture for ken224 @ken224

Has anyone tried the med Imipramine for retrograde ejaculation caused by Aquablation and if so , can you provide some feedback

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@ken224

I’d love to hear that answer as well. I’m not really sure why, except the orgasms do feel different, but really would like my RE to get fixed, too.

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Profile picture for albiet @albiet

@fireman123 great to hear that its working great. do you still feel urgency at times?

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@albiet I never felt any urgency after the aquablation at all. The only thing is I am having RE. Maybe I am jumping the gun on that, I have read that it is still healing and it may come back, but either way, I am very pleased with being able to urinate normally again.

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Profile picture for fireman123 @fireman123

@albiet I never felt any urgency after the aquablation at all. The only thing is I am having RE. Maybe I am jumping the gun on that, I have read that it is still healing and it may come back, but either way, I am very pleased with being able to urinate normally again.

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@fireman123 thanks fireman. as i said prior, i was in retention prior and now i can pee so i should not complain but would really be great if i can improve to where i can be like an 18 year old agin. my surgery was on april 27 so i need another 10 ays to catch up to you.

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Profile picture for Success1234 @art12

Prostate size: 145cc
Age: 60
Very large median lobe pressing into my bladder obstructing bladder neck
Had Rezum done a few years ago. Did not want RE so TURP and other similar procedures not considered.
Rezum failed 100%. Recovery was dreadful. Had to self-catheterize for 3 weeks until swelling went down and bladder returned to normal.
Decided no more surgery. I would just stay on the drugs.
1.5 years later, had a large bladder stone that had to be removed by robotic surgery. Waiting makes things worse.
3 months after bladder stone surgery, I had aquablation done.
Approaching 4 weeks:
Pros:
*no hesitancy, large powerful stream almost immediately
*urgency that I had in the first few weeks is now gone
*no leakage
*get up one time a night
*no RE. my ejaculate volume is 4X what is used to be. Apparently my prostate was blocking more than just my bladder.
Cons:
*don't always get the feeling that I'm done urinating, so have to double void.
*soreness when urinating - 1 to 2 on a scale of 10
*will take time to mentally get to normal state. I still use every bathroom that I come across just in case. If I'm going on a longer trip, I still will use the bathroom a few times right before I get into the car. I still use the stalls as it use to be a long process to urinate.
*I still get a clot expelled in my urine now and then
Summary: So far - life changing.
Note: I asked my surgeon how much of my prostate was removed. He said most of it.

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@art12 7 months later
Pros:
bladder is almost empty when I urinate
No RE
urine stream is 20% less forceful now compared to right after the surgery. Still far far better than it was before the surgery.
I get up at most once per night during the work week. Without the stress of the work week, I don't get up at all.
Cons:
None
Summary:
In my case, life changing. I don't worry about a bathroom being nearby. Sometimes 4 -5 hours pass and I realize I didn't have any urge to go to the bathroom. When the train is delayed or I'm stuck in traffic, I don't stress. Life is good.

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Profile picture for Success1234 @art12

@art12 7 months later
Pros:
bladder is almost empty when I urinate
No RE
urine stream is 20% less forceful now compared to right after the surgery. Still far far better than it was before the surgery.
I get up at most once per night during the work week. Without the stress of the work week, I don't get up at all.
Cons:
None
Summary:
In my case, life changing. I don't worry about a bathroom being nearby. Sometimes 4 -5 hours pass and I realize I didn't have any urge to go to the bathroom. When the train is delayed or I'm stuck in traffic, I don't stress. Life is good.

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@art12 At any point after surgery did you ever have RE and if so since your procedure was 7 months ago, did time heal it

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