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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kocour | @kocour | 17 hours ago

In reply to @dfwcraig "I’m 59 and just had aquablation on Dec 18th after having PAE in July this year..." + (show)

@dfwcraig

I’m 59 and just had aquablation on Dec 18th after having PAE in July this year and it not improving conditions after five months. I was originally scheduled for aquablation in April of this year but my insurance (BCBS) would not approve, as it was considered “experimental” and not a typical first recommended procedure. So after going through all the appeals and third party review and BCBS still saying no, my urologist said try PAE and maybe that would help for a few years or more, and by then my insurance would approve. Well that didn’t work and luckily insurance did finally approve since the PAE did not help.

So Thursday I went in for 3:15 scheduled procedure, that actually happened closer to 4:00. They said I was done around 6:00pm but I don’t remember waking up until 7:00pm. My Dr spoke to my wife and said that he was shocked how much prostate was still there having had the PAE, so I guess it was easy to see why that did not help. The Interventional Radiologist that did my PAE has done close to 8,000 of them so I was pretty sure he did things right, but for some reason it didn’t help.

Like many, this started with my PCP suggesting flomax which didn’t help and also gave me retrograde ejaculation. So he sent me to urologist. Dr Hyder in Fort Worth is who he recommended because he is a younger guy that was up on all the best new procedures and things.

So urologist recommended alfuzosin instead of flomax. I tried that and no longer had RE but it really wasn’t helping either. So he added tadalafil to it. Even with both of these, bph symptoms remained but at least things worked well sex related.

So fast forward to today, third day after procedure and still have cath. Miserable few days so far.

Dr said procedure went very well. I stayed overnight while they flushed at least 8 large bags through me. Always looked good color wise with no clots or anything. Had a rough time coming out of anesthesia, ended up going home around 5:30pm the following day.

Having this catheter has not been fun at all. Feels like someone is cutting the end of my penis with a razor every time I move. Dr gave me meds for bladder spasms but not sure it’s helping.

I go tomorrow at 10:00 to get cath removed. Hopefully everything goes well there. Will continue to post here as things progress.

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@dfwcraig My experience with insurance coverage was similar to yours. I had Blue Cross Blue Shield. After a urologist at the Mayo Clinic recommended Aquablation, and the procedure was scheduled for April, I got a call from the business office telling me that Blue Cross was one of the few major insurance companies that did not cover the procedure. Mayo advised me to put the procedure off for several months till I was eligible for Medicare, which does coverage the procedure. Otherwise I would have considerable medical bills. I had the procedure done in August, the same month that I turned 65 and signed up for Medicare.
The catheter was a bit of a bother, but in retrospect, well worth it for the improvement in my quality of life after Aquablation. Take it easy for the next weeks. No strenuous exercise. After the first three weeks post procedure I noticed continued improvement in my urinary function. So hang it there.