Aquablation: Post-surgery expectations

Hello, This is my first post. So I had Aquablation procedure back on Jan 7, 2025. So far it has not been what I had expected. I stll have pain urinating, going to the bathroom double what I use to, get up three to four times a night, uncontrollable surges to go to the bathroom and on top of that retrograde ejaculation. I thought I was having only a Aquablation procedure but on the day of my surgery and in my post op report it stated Aquablation and Turp. So are the combine procedure or is turp separate process or is it used to remove tissue from after Aquablation, Right now total a bit confused with what was done, As I had idea what Turp was and had to look it up after my surgery as we never discussed it during office appointments nor prior to surgery.

I’m 6 months out from surgery. Within 2 months I was enjoying very good urine flow and bladder control. No major problems. But after the four month mark, things started going in the wrong direction. My urine stream gradually weakened and it was taking longer to empty my bladder. So, just this month my urologist put me back on the Emano Flow urine strength test app. It showed that I had gone from averaging 22 ml sec max flow rate (or 12 ml mean flow) four months ago to about 14 ml sec average max or 7 ml average mean today at the end of latest round of tests. The Emano Flow tests urination over two week periods. That’s a pretty significant drop.

I have an appointment with my urologist next week to discuss my urine flow results and determine why I am regressing.
Has this happened to anyone else at this stage of Awuablation recovery?

I had the Aquablation procedure two weeks ago. I had a median lobe and a size of 90 cc before the procedure. Everything went well although I almost fainted when the nurse removed the catheter on the third day after the procedure. The flow is excellent and no blood after the fourth day. My problem is UTI. I got it again. I would like to go back to the gym soon. Just work the upper body with 50% of the weight I used before. I'd love to use the recliner bike at the gym for exercise. It concerns me that people have problems resuming biking. Love to hear anyone's comments.

Yes. My urine flow has regressed in the past month (had the procedure on 12/24. Also have bleeding in my urine when I exercise hard (running primarily). The recovery has not gone as quickly and smooth as I was led to believe. Have an appt. with surgeon on the 27th of this month. Will post what I learn.

Hello. 66 year old in good shape, work out etc. Had enlarged prostate for about 15 years, 2 biopsies back at beginning due to high PSA score and both negative. (NOTE: Follow ups of PSA's and Free PSA's along with 4K indicate no cancer). Watchful waiting over the years with frequency and stream problems worsening slowly. In December of 2023, got to point that something needed to be done. Prostate size 110 cc. My urologist suggested simple prostatectomy and it seemed extreme. I asked him about aquablation and he said few do it, but seems to be a good option. Went to Mt. Sinai in Manhattan to a Dr. Kaplan, who is said to be one of the best at this procedure. My urologist advised that Mt. Sinai has great uro staff.
Scheduled aquablation for 2/28/24. On 1/8/24, had a urodynamic flow test by a nurse at Mt. Sinai. Seemed to be tough to get to done and there was bleeding. This is to check if bladder emptying. Within 36 hours I was in emergency room with complete blockage and a catheter had to be put in. I had never had a catheter before. Advised Dr. Kaplan and we spoke by phone and a scheduled rectal ultrasound was for 1/22/24. Went to my original uro approximately 1/17 to take out catheter. Within hours back to ER for another catheter.
After the rectal ultrasound on 1/22/24, Dr. Kaplan advised that there was a medial lobe extension into the bladder that would be addressed during the aquablation. I asked (begged) to fit me in sooner as he advised that I would need to keep the catheter in until then. No avail.
Pre-op tesgting for surgery clearance indicated uti (light staph infection only) and took antibiotics.) Aquablation on 2/28/24 that took about 1 hr. and 15 minutes. Apparently went well. 1 night in hospital and home with catheter, which was removed three days later and stream was good, no blood (other than in the hospital where clots and blood were cleaned out with heavy irrigation.)
On 4/8/24, had pain in the lower abdomen right side and went to Urgent Care and CT scan indicated no problems with bladder or prostate area or any where for that matter. Staph infection diagnosed and treated.
Moved along and saw Dr. Kaplan in May '24 and seemed to be going well, good flow, getting up once maybe twice a night, but somewhat still limiting fluid intake. Fast forward to Dec. '24 and starting to have more problems with urgency and frequency, feel like I have to pee throughout the day more times than not.
Seen Kaplan on 12/16/24 and he did a rectal ultrasound indicating that the aquablation had reduced the size of the prosate to 80 cc and he would have liked it to be smaller (40% reduction). I advised him of the urgency and frequency issues and he quoted that " you wouldn't want to do another aquablation". Very little questioning allowed with this Dr. So here I am in March '25 and I am now going through bouts of having to pee many times throughout the day, even though really have limited my fluid intake, some pain in lower left abdomen area and in the perineum (area between anus and scrotum). From some research, I think I need to actually take in more water and it may help. I have appointment with my regular uro on 3/25 as he is on vacation. I still work and have to drive moderate distances when on road. This doesn't help. Not sure where to go from here. Hope this helps those in similar predicament and appreciate hlep from anyone who has successfully gotten through something lke this. Thanks, Joe

Had surgery March 26th, 2025, )6 days ago). Surgery done at Centennial Hospital in Nashville. Great hospital by the way, everyone there takes wonderful care of you. Surgery performed about mid-day, and I was released to go home by midafternoon. I was in recovery for an extended period of time for adequate flushing and monitoring for blood loss. My progress seemed satisfactory to the nurses in charge, and I was released with a catheter in tow. My follow up was in 5 days to remove the catheter. My 5 days passed quickly and the whole process was bearable but not pleasant. I'm 68 and very active and hard for me to sit around tied to a hose if you know what I mean. My appointment yesterday to remove the catheter was pretty painless and I was out of the office in 20 minutes with a one-month appointment scheduled to check my progress. To say I was nervous about my first urination was an understatement. They scared me a bit with the, (if you can't pee, head to the ER). It was an hour drive home from the Dr. office and by the time I got home I started to feel the urge to pee. I went to the bathroom and to my surprise, it was the best pee I'd had in years. Full flow and it felt like I emptied my bladder fully. Prior to the surgery I had many urinations that left you with the thought of "that was a total waste of time". It's now the second day and I got up once during the night to relieve myself. The usual stand there and watch it dribble out was replaced by a full stream and back to bed feeling like I had totally emptied my bladder. I still have blood in my urine and the burning sensation while I urinate that most have reported, but other than that I feel like the surgery has been a total success so far. Too early to test if RE will be an issue but I seem to have sidestepped the other complications that can happen. If I can keep improving from where I am currently, I will be ecstatic. I was told my prostrate size was 120mm which is very large, and the Dr. had to remove a large amount of the prostate and bleeding will continue for a time but hopefully that is not a long-term issue. I'll report back after my one-month appointment.