Aquablation while on blood thinning?

I’ve read in these forums concerning Aquablation that some practices are combining PAE with Aquablation. Having PAE and then about 5 days later having Aquablation. I am not sure about getting PAE done when the patient is on blood thinners or how long they must wait after stopping the blood thinners. That would be a good question for an interventional radiologist.

In most prostate procedures, they want you off blood thinners at least a week before the procedure. If your health is poor, then they probably won't want you to stop the thinners and that in itself will prohibit most of these types of procedures. I had a relatively simple P.A.E. with very little blood loss and the first question they asked me in a pre-interview with the nurse was, " are you on blood thinners?" For a lot of these surgeons, it's not worth the risk.

OK - thanks, - any comments on aquablation and blood thinners?

You may be better off having an HoLEP surgery. They use a laser and there is more controlled hemostasis. Ask your doctor about it. But it is highly dependent on the skill of the Surgeon. So do your homework. Also, there’s a 90% chance and probably more like 100% chance that you will have great ejaculation. You have to weigh your risks against your benefits.

Thanks @alfonse, I will check out the HoLEP procedure!

@alfonse when I read about the HoLEP procedure most state that you will loose your ejaculation ability, - how come you are sure about the opposite?

I’m not sure what you mean by “ejaculation ability”. You still have an erection, you still have an orgasm and you still have this sensation. But there’s no more prostatic tissue blocking your bladder neck when you orgasm. So the ejaculate goes to the area of less resistance. Backwards, into your bladder. This is harmless. The next time you urinate, it comes out in you urine. But it’s most likely not going to be like the feeling with the drug Flomax (tamsulosin). For me, I basically didn’t have a full orgasm at all with Flomax . It was muted as soon as it started. Tamsulosin causes ejaculatory dysfunction primarily by abolishing the smooth muscle contractions required for the emission phase. By blocking alpha-1A adrenergic receptors on the seminal vesicles, prostate ducts, and epididymal duct, tamsulosin prevents the noradrenaline-induced contractions that propel seminal fluid into the prostatic urethra. Everybody has a different sensation and I get it most men wanna see it coming out. Including me. And was not an easy decision. But for me , my long-term goal is making sure I don’t have permanent bladder failure. I already had thickening of my bladder wall and mild to moderate damage to me bladder. I was also developing bladder stones causing damage. I don’t want to be on medications for the rest of my life. And I don’t want to have repeat surgical procedure in the future. Now there are other procedures that leave some prosthetic tissue there and there is a lot less of a chance a retro ejaculation. It is also a larger chance of tissue growing back and retreatment needed in the future. You have to make your decision based on what your long-term goals are. And what you feel comfortable with. HoLEP has long time studies with a very low retreatment rate. Long-term studies indicate that the rate of needing another procedure after HoLEP is just 0.7% to 1.4%. This is significantly lower than the retreatment rates for other methods You just have to have a skilled surgeon. But if retrograde ejaculation is something that’s going to bother you, pick a different procedure.

Thanks @alfonse, I was not aware of the side effect of tamsulosin, but thanks for that information also.