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 dfwcraig @dfwcraig

@psblin99 I remember that day vividly! I couldn’t wait to get the cath out, and that first void after it was out was amazing! Good luck to you and sounds like things are going well so far.

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@dfwcraig Its done. Voided at the doctor and now again at home. Feeling good. Thanks for the well wishes!!!!!1

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Profile picture for albiet @albiet

@202006 did the second surgeon comment at all about the Acquablation ? Was turp the only option he suggested?

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@albiet
2nd Doctor commented on the Aquablation in the tissue exam they do for cancer screening, "Quite a bit of tissue after the Aquablation treatment." His assisting surgeon also told me post surgery that in addition to removing the 13mm median lobe bulge, additional tissue was removed from the urethra channel.
2nd Doctor recommended TURP and I agreed. Never discussed any other options.

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Profile picture for 202006 @202006

@202006
Continuation from my fist post.
On July 28th I had another Surgery with a different Doctor. TURP surgery was successful in removing the median lobe bulge. This is all about the Doctors. I got a second opinion and the 2nd doctor took a look the same day with a TRUS (Transurethral Ultrasound) and immediately identified a large median lobe bulging into the bladder. after 4 months of despair I am finally fixed.
The first Doctor never identified the median lobe issue, even though he did a pre TRUS and a Cystoscopy. Another cystoscopy 5 weeks after the Aquablation and he did still did not identify the issue. 2 months later and a trip to the ER for a UTI and the ER doctor did a CT scan with contrast. Radiologist noted "Median Lobe Bulging into the Bladder with Bladder Wall thickening Likely due to Bladder Outlet Obstruction." I showed this to my first urologist and he blew it off saying that wasn't the issue and he couldn't do anything about it any way. His fix for me was keep self cathing 3 times and day and then keep reducing to get to 1 catheter a day.
Just before this and after my third UTI in 6 weeks, my infectious disease doctor wanted to talk to me about suppression antibiotics which, if you don't know, is a road to a shortened lifespan. Thankfully, I have avoided this.

The first Doctor I had came highly recommended. He works at an office where the Doctors own the business. HE is the senior doctor. He has so many patients he can't keep up with them. More patients, more money. Seems like a conflict of interest. I have made another appt with him just tell him how horrible he is. I was lucky. I feel bad for his other patients who just take him at his word. I'd sue him, but very hard in Texas.
I got some bad vibes from the doctor early on-he actually told me during a visit about a patient who said he was going to get another doctor and the Doc told him "go ahead." I thought it was incredulous he told me that. But I was so far into this doctor, I didn't want to start the clock over with another one. It cost me dearly for those 4 months post surgery.

Again, don't hesitate to get a 2nd or even a 3rd opinion. I really did my homework for the second opinion and went to the top guy at UT Southwestern. I'll forever be grateful. I know he was just doing his job, but he gave me my life back.

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@202006
Correction for TRUS abreviation TRUS=transrectal ultrasound

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Day 5. Up 2 times last night. Bathroom is normal. I must remember I had surgery. I feel like I can do more than I should. Must force myself to take it easy. Today is the last day for meds that turn my urine orange. Looking forward to normal color.

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has anyone here continued to improve after 3 months or are you at your max improvement by then?

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Profile picture for albiet @albiet

has anyone here continued to improve after 3 months or are you at your max improvement by then?

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@albiet

For me the urgency and frequency continued to improve beyond 3 months. I’m at 8 months now and it’s been wonderful.

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Profile picture for albiet @albiet

has anyone here continued to improve after 3 months or are you at your max improvement by then?

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@albiet Two months after my TURP procedure I am slowly getting to the racehorse volume and flow. The first 5 to 6 weeks showed slow improvement but after 6 weeks it is improving day by day. I had Aquablation prior and recovered within 2 to 3 weeks. However, after TURP ejaculation changed by losing power and volume but at least some semen does come out. Disappointed but it is what it is. Hopefully you will begin to see improvement soon.

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Profile picture for pc75 @pc75

@albiet Two months after my TURP procedure I am slowly getting to the racehorse volume and flow. The first 5 to 6 weeks showed slow improvement but after 6 weeks it is improving day by day. I had Aquablation prior and recovered within 2 to 3 weeks. However, after TURP ejaculation changed by losing power and volume but at least some semen does come out. Disappointed but it is what it is. Hopefully you will begin to see improvement soon.

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@pc75
I’m curious, why did you have to have a turp if you already had aquablation? Did the aquablation not work?

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Profile picture for alfonse @alfonse

@pc75
I’m curious, why did you have to have a turp if you already had aquablation? Did the aquablation not work?

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@alfonse After the aquablation I started having the same symptoms recurring 3 to 4 months after the procedure. They did a cystoscopy and found that there were 5 nodules that formed basically because of leftover chips from the aquablation and had to go in and cut them out. But they also found a small mass at the opening of the bladder during the procedure which could have caused some symptoms but luckily it is benign and slow grow but needs to be monitored as a finger is growing close to the bladder opening. I now have to get a cystoscopy every year to monitor. UGH!!

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Wow. Well I’m glad you are better now. I thought about aquablation but chose HoLEP instead. So far so good.

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