Aquablation: Post-surgery expectations

@grahamh
Did you aspirate the baloon with a syringe before you pull the catheter out or you cut the baloon arm?
If you pull the air with the syringe balloon does not go to its original shape. Since it is stretched, if you pull all the air out it makes sharp edges. That might put cuts to your urethra all the way out. Urine spray makes me think of that.
Same thing happened to me. An untrained orderly pulled my catheter out after deflating the balloon with a syringe, I had fresh bleeding and spray urine several days. Now on second month, flow keeps decreasing probably as a result of scar tissue formation and scar shrinking. It does not matter how good the Pilot is if he has one bad mechanic result is disaster! I wish us best luck. We need a Real Doctor taking care of his patients.

@luferfish, I just cut the tube, waited for the liquid to empty and pulled it out.
I meet with my urologist next week and will certainly address my continued incontinence. Leaking more now than before the surgery. But I am still optimistic and the doc said I would be a few months before full healing.
For anyone dealing with leaking or sudden urgency I have found the men’s guards to be effective. CVS has them, their brand, maximum absorbancy. You must wear them inside briefs, not boxers. My wife keeps one in her purse for me and I have a few in my glovebox. ( to remove the catheter I just cut the tube, waited for the liquid to empty and pulled.)
I meet with my urologist next week and will certainly address my continued incontinence. Leaking more now than before the surgery. But I am still optimistic and the doc said I would be a few months before full healing.
For anyone dealing with leaking or sudden urgency I have found the men’s guards to be effective. CVS has them, their brand, maximum absorbancy. You must wear them inside briefs, not boxers. My wife keeps one in her purse for me and I have a few in my glovebox.

@techee I am 3 yrs after Urolift and 2 months after the Aquablation. I was better off before I started BPH treatment and 3 different Urologists care. Could you please tell me the name and the location of your urologist? Thank you.

@luferfish for what it's worth my doctors practice was in Northern Virginia at Potomac Urology, Dr Lim, but I don't know that my recovery is perfect either. At times encouraging and at other times not, but i don't blame the surgeon. The damage one has done to their bladder while delaying treatment plays a big role I think. As my doctor explained your bladder has been blocked by your prostate obstruction and depending on how damaged it was your urgency and frequency will now be impacted. Even at 64 I wish I had the surgery many years earlier in hindsight, but I had a poor Utologist who never even did a cystoscopy and when I brought up surgeries said I didn't need it. He was wrong, but I didn't find that out until he retired and I sought out a new Urologist practice who promptly informed me otherwise. The way I see it now I've traded not being able to go for a little more frequency, but I was eventually going to need surgery so putting it off only hurt me. I think that's my one bit of advice to people with BPH, don't delay surgery too long, it's only going to get worse and your success post surgery will be impacted. Don't get me wrong, my surgery was pretty painless, recovery quick, I get up only once a night most nights instead of 3 or 4, improved flow, no sexual side effects other than some occasional RE and when I want to go i just go, but if I drink something I'm probably going to need to find a bathroom in a couple of hours.

@luferfish for what it's worth my doctors practice was in Northern Virginia at Potomac Urology, Dr Lim, but I don't know that my recovery is perfect either. At times encouraging and at other times not, but i don't blame the surgeon. The damage one has done to their bladder while delaying treatment plays a big role I think. As my doctor explained your bladder has been blocked by your prostate obstruction and depending on how damaged it was your urgency and frequency will now be impacted. Even at 64 I wish I had the surgery many years earlier in hindsight, but I had a poor Utologist who never even did a cystoscopy and when I brought up surgeries said I didn't need it. He was wrong, but I didn't find that out until he retired and I sought out a new Urologist practice who promptly informed me otherwise. The way I see it now I've traded not being able to go for a little more frequency, but I was eventually going to need surgery so putting it off only hurt me. I think that's my one bit of advice to people with BPH, don't delay surgery too long, it's only going to get worse and your success post surgery will be impacted. Don't get me wrong, my surgery was pretty painless, recovery quick, I get up only once a night most nights instead of 3 or 4, improved flow, no sexual side effects other than some occasional RE and when I want to go i just go, but if I drink something I'm probably going to need to find a bathroom in a couple of hours.

I'm 55 years old. Back in August of this year, I ended up in the hospital for four days. Results, 104 temp, E.coli, sepsis, UTI, and enlarged prostate. Since there is so much free time in the hospital, I made an appointment with an urologist. I had my "after hospital stay" appointment with my PCP. My PSA was 25.2. I have always been under 4. Called the urologist and was able to get in sooner. They assured me it was from the UTI. Five weeks of antibiotics and PSA dropped to 5.2.
On Monday, Nov 3, I had a cystoscopy and ultrasound. Result, 72 cc prostate. I met with my urologist on Nov 5 and am scheduled for Aquablation on Nov 20. I'm told that I will have a catheter for 5 days, have it removed, with no straining, lifting, exercising, all of that jazz, for 4 weeks. I'm going to take it to the end of the year just to be on the safe side.
I don't have a lot of massive urgency to urinate, sometimes some dribble or if I don't make it to the bathroom in time have peed just a bit in my clothes. I hate using the urinal as I don't seem to empty everything out and inevitably will leak into my clothes. I wear dark color clothes for that reason. 99% of the time I sit to urinate and it feels like I'm going for a month. It's a bit painful and very slow. I urinate all under the bottom of me and end up having to wipe myself off. No issues with being woken up at night to pee, thankfully. I do have the feeling like I need to go but I really don't.
I read up on the Aquablation way before even having the cystoscopy. I always like to review my options. No way was I going to have a TURP. My testosterone level is already on the low end of things (had a benign cyst in my left breast a couple of years ago and had a painful drain line for two weeks). Not looking forward to a cath but I figure if I can deal with an infected drain line I should be ok (fingers crossed). I have been on Flowmax and Tamsulosin since my hospital stay in Aug.

I have been following this board for a few weeks in anticipation of my aquablation procedure on 10-15. It was really helpful to learn about the experiences of others. So, now that I’ve gone through it, for what it’s worth here is my story.

My procedure was a little different…I am part of a trial to use aquablation to both reduce the prostate and remove tumors. I had a biopsy in July that indicated two prostate tumors with the lowest possible Gleason score of 6 (3 +3). Initially the recommended treatment was aquablation for BPH (my prostate was about 80 grams) and surveillance for the cancer. But a genomic test indicated the cancer cells were aggressive and this trial was just beginning, so I hoped to be included to have a chance of removing the cancer, reducing my prostate, and having the best chance of normal function afterwards. I am 54 years old.

The surgery was done 10-15. It was basically the same as aquablation for BPH, except 95% of my prostate was removed (all but the capsule which is where the essential parts are located). The surgery was delayed about an hour because an instrument had broken, but once started it lasted about two hours. I was in the hospital one night afterwards.

At first there was no blood in the urine which surprised the nurses, but eventually it started. Through the catheter they washed out my bladder with saline all night, as others have reported.

I had an erection the very next morning, which was a pleasant surprise. I went home with the catheter for six days, which was not pleasant. I would have liked to have been more active, as I felt like I was physically able to the next day, but when I tried to walk the catheter pulled against the tip of my penis, which was very irritating and painful. I finally decided to just wait until it was taken out. It was frustrating to just sit around for that long, feeling like you could do a lot more. Being patient was maybe the hardest thing.

They removed the catheter this morning. It was maybe the greatest feeling of relief I have ever experienced. It came right out without any pain or discomfort, and I passed the voiding test with flying colors. My urine was still pretty red. I went by my office afterwards just to check in, but didn’t stay as I wanted to gauge my urinary function before spending a full day at work. I didn’t want to spend the day at the office peeing down my leg.

Not to worry. My urinary function is almost 100%. It’s a little difficult to hold it for a long time, it burns some to pee and there is still a little blood and tissue coming out, but not too much. The flow is much improved, it comes out like a firehose and then doesn’t last long because of the volume. When I’m done it shuts off immediately and doesn’t keep dribbling out like before. I wore a pad all day and there are traces of urine in it, but not much. I am very surprised.

I must say, so far so good. Tomorrow, one week after surgery, I plan to spend a full day at the office. Over the past couple of years, at least a half dozen times a day I’ve walked the length of our floor, about 100 yards one way, to go to the men’s room. I am very curious to see how that goes tomorrow.

The big test comes in December, with another PSA to see if the cancer is gone. But for now the relief of the BPH symptoms is much appreciated. I may sleep the night through tonight for the first time in years.

My restrictions are light activity for three weeks after surgery, i.e. no lifting of anything over 15 lbs, no pressure on the prostate region from cycling, riding a mower, golf cart, UTV, tractor or the like. Basically walking and other gentle low-impact exercise is okay. After that, the activity level is based on tolerance, with blood in the urine as the gauge for tolerance level. They said I can drink alcohol in moderation, but I think I will abstain for that three-week period.

As I was finishing up this post, my wife came over to see what I was doing. As a test, we messed around for a bit and I got an almost instant, full erection. I don’t think I’m quite ready to follow through on that, it’s still pretty sore down there, but it seems promising.

Sorry if any of this is TMI, but the reason I was interested in this board was to learn about such things. Inquiring minds want to know.

More to come as the weeks go by….