HoLEP vs Aquablation, which is better?

Posted by cardscrazysteve @cardscrazysteve, May 10, 2025

I’m schedule for a HoLEP in July in Rochester Mayo and am wondering if I made the right choice vs Aquablation. I am 67 and don’t care about ejaculation but worry about side effects, incontinence, pelvic exercises and getting quick results. I forgot is Aquablation an overnight stay?
I do want permanent results. I don’t want to go through this again. Thanks for your responses.

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Profile picture for joseinsd @joseinsd

I am schedule for aquablation 22nd of this September 2026. I did extensive research on different procedures and decided to go with Aquablation. 120cc prostate. Yep, pretty large. Just tired of planning my life on where is a restroom. I want to sleep without needing to get up 3 times everynight. Exahusted. Wish me luck!

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@joseinsd Had Holep 13 weeks ago. It has been a breeze and very uneventful. The 4 weeks following procedure is the main recovery period. My urologist said my recovery is perfect textbook recovery. He uses my recovery as a case study in teaching his medical students. There is absolutely no pain involved!

I did my research of the many procedures before deciding on Holep. Why?It is the only procedure that totally removes all prostate tissue inside the capsule. That is the culprit that keeps growing and causes blockage. So, it won’t bother me again unless I live to 150!😛 All the other procedures leave varying amounts of prostate tissue behind in the prostate capsule. That will grow back and cause the same problem, I had Greenlight 14 years ago but as expected it grew back, and was causing blood in the urine. My running was causing the regrown prostate tissue to slam into the bladder neck during running, triggering blood in urine.

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Profile picture for TommyG @tdgillett

@jimcha Glad to hear your good report. Do you know your "updated" prostate size? I'm considering ho-lep for my 114 cc prostate so that I have more, better treatment options for my PCa.

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@tdgillett Had Holep 13 weeks ago. Recovery has been a breeze, and totally uneventful. I researched all the various procedures and decided on Holep - the only procedure that empties out the prostate capsule, leaving no tissue behind to grow back! So unless I live to 150 years, I won’t need another Holep!😛

My catheter was removed at the 36 hr mark post Holep, then I went home. A key reason I chose Holep was the short catheter period and Idon’t have to go home with it!

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Profile picture for soor @soor

I just heard a radio advertisement for Aquablation.com. It was basically saying how superior it is and touting the procedure. This may or may not be the case, every individual has different needs. Medical device companies are like the wild west and not highly regulated. It may be a great way to treat BPH, I just hate to see corporations pushing procedures for profit.

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@soor YES , I hear those ads to. It is the only procedure advertised regularly. I had Holep 13 weeks ago. It has been an uneventful recovery..I considered Aquablation but decided on Holep.. One reason - Holep removes the catheter the quickest post procedure. I did not want to go home with it. The other reason - it is the most complete procedure totally removing all prostate tissue inside prostate capsule. That is the culprit that keeps growing back as long as you live! I am absolutely glad to choose Holep!

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Had Holep 13 weeks ago. Recovery has been so easy it is unbelievable. Absolutely no pain. I could excuse myself for forgetting that I had Holep for no pain, discomfort, and minimal incontinence. Totally glad I had Holep. I considered Aquablation too but the longer catheter period put me off it!

I stopped wearing Depends during daytime by day 36.At week 13, the bladder incontinence is 99% gone!👍👍👍

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