Aquablation: Post-surgery expectations

@psblin99
Well met with the doc yesterday and Aquablation is scheduled for 3 weeks from now. The doctor asked me if I had any requests and I said only one. Asked him to get a good nights sleep before my procedure!!

@psblin99 You'll be fine. He doesn't need a good nights sleep, it's all done by a robot. He just has to put in the correct numbers. I am completely pleased with mine I had done around 4 months ago. I have read all sorts of issues folks have had, but I have not experienced any problems. I still can pee several feet off my back patio after a few beers(I live in the country). I did get RE, and I wonder if he had been more cautious with the numbers entered, and sacrificed the entirety of the job, if he could have left the part that diverts the ejaculate away from the bladder, if that would have helped. I'd say discuss that with him ahead of time.

@fireman123 Thanks for the words of encouragement. I am pretty relaxed, but still a little apprehensive at the same time. Odds are heavy in my favor.

I think all will go well for you. I had problems, but I found out later the doctor with experience didn't do the surgery, not sure he was even in room?? I was at Kansas Univ Medical Center which is also a training hospital. It ended up a resident did the surgery and things didn't work out well, basically very little relief. Later the "real doctor" said I needed a redo, some stuff left that shouldn't be there. I said- NO. Then year later found I had prostate cancer and had it removed. Also, whatever the resident took out was sent to lab and they said no cancer at that time.

@fireman123

Agree for sure. I don’t think urologists understand that ejaculation can still be important to old guys. (60 here). Told nurse practitioner to tell dr to be careful of that particular area. Don’t think she took me seriously. I’ve heard/read many time that orgasm feels the same. It doesn’t for me. Still good. Just not as much so.

So yeah if it’s important to you to be able to ejaculate normally, make sure they understand that, though I’m not sure it would be 100% anyhow.

Best wishes.

i'm about 2 3/4 months since the aquablation. since i stopped being able to pee prior to the surgury, i will consider it a win, but i did expect more. I had a rezum back in 2019 and i pee'd like a fire hose after that for almost 2 years. this is not like that at all. lots of stops and starts. peeing takes a but to start. morning pee which used to be good, starts small. have to come back a few times to get enough out. i do have full ejactulation. when i saw my dr after a month he told me there will be lots of ups and downs and will doarectal scan in september. does any of this sound similiar to anyone that has had aquablation and if so did everything start working perfectly later on?.

I had TURP cleanup at end of June of some chips left from original procedure 1.5 years ago that became nodules in my urethra. I was having some of the same symptoms before the first procedure. Everything is fine so far other than having some bleeding, mild pinkish in color after almost 4 weeks. After researching it sounds normal through maybe 4 to 6 weeks. I am not peeing like a racehorse yet (like after my first procedure) but it is getting stronger week by week and hoping for the best after full recovery. After first procedure I had developed delayed ejaculation but no RE but still waiting to find out after last procedure if RE will develop as I was told no sex or masturbation until a full 4 to 5 weeks after procedure. Dr. was fairly confident that my delayed ejaculation would go away but they always give the caveat about RE developing.

Here is my plug for Holep. I had Holep on 19 June. Today, Tues 21 July, is day 32 post Holep, and recovery has been totally UNEVENTFUL (which is great!). Why uneventful?

Days 2 -catheter removed; clear urine within an hour, then discharged.
Day 18 - clear urine since day 2
Day 19-22 - rusty red color at start of stream, then clear (expected "scabbing stage" of healing prostate)
Day 23 - day 32 - completely clear urine, gushing like Niagara Falls!!
PAIN: zero pain from the moment I woke up from anaesthetic. No panadol required after Holep.
BLADDER INCONTINENCE: Days 2- day 27 : Depends Level 3 @ 2 per day
Day 28 to now: Depend Level ONE, 2 per day.
Bladder incontinence is gradually returning to normal which means soon I will no longer need Depends.
Went out for a run on day 28 - no problems, no bleeding in urine, no urge to void during run!
NOTE: No running or any exercise for 4 weeks post Holep.

I did have an "EINSTEIN" urologist who performed my Holep: Dr Kapil Sethi.

NOTE There is a huge difference between Holep and the other prostate reduction procedures. In Holep, the prostate capsule is entirely hollowed out - no prostate tissue left in there to regrow again, thus requiring further prostate reduction, in a few years time. All other procedures leave prostate tissue behind to regrow back over the years. I know that because I had Greenlioght in 2012, and sure enough what was left behind grew back, and eventually was mechanically hitting the bladder neck, when I run, triggering heavy bleeding in the urine.

NOTE: when prostate tissue regrows back, it isn't in the same form as the original prostate tissue. The regrown tissue is fibrous and BLEEDS easily. If you had seen a REGROWN prostate years after a green light, TURP etc, during a CYSTOCOPY, you will be horrified - the prostate tissue grows back in random blood flushed lobes - like a horror cave! I saw my cystoscopy live 2 years ago after a visit to ER due to bleeding and clotting after a run.

Enjoy the photos I took from the window. On the morning after Holep, after I showered, I was ordered out of bed, and told to "do something". Since I couldn't go for a run, I sat by the window, and watched the city skyline, from the "North"!

My insurance company just denied the pre auth my doctor sent it to have the Aquablation procedure. He has appealed. Has any others experienced this?

@psblin99

I did. BCBS denied several attempts and appeals. So I went with PAE instead, which didn’t produce any results for me at all. After paying for that and it not helping, my insurance did approve aquablation.

My insurance said that aquablation was not a typical first recommended option for BPH and that it was still considered experimental. They wanted me to do TURP, which in my 50’s I was not about to do due to likelihood of RE.

It took time, but eventually got approved after the failed PAE.