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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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Profile picture for rcwjrstreet
rcwjrstreet | @rcwjrstreet | Sep 3 9:02am
In reply to @kocour "@rcwjrstreet I had aquablation done one year ago. I too was discouraged the first several weeks...." + (show)
Profile picture for kocour @kocour

@rcwjrstreet I had aquablation done one year ago. I too was discouraged the first several weeks. But after about 4 weeks my urine was clear and I had pretty good control of when I urinated. I did experience urgency for a few more weeks, but as time progressed that lessened, and I awoke less and less during the night with the need to pee. So from my experience I can tell you that things will get better. One suggestion that I have for you is that you could probably increase the amount of time that you are walking. Perhaps do two or three different sessions per day when you walk 15 to 20 minutes.

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@kocour There have certainly been days when I have walked quite a lot but I have been self-limiting due to some apprehension about experiencing urgency when I am not near a toilet. I do find I become rather tired, too.

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rcwjrstreet | @rcwjrstreet | Sep 3 9:04am
In reply to @duckhunter "I am currently 72 and had an aquablation done 5 years ago. Although the results are..." + (show)
Profile picture for duckhunter @duckhunter

I am currently 72 and had an aquablation done 5 years ago. Although the results are not perfect the procedure resolved a lot of my issues. I too feel fairly healthy (even though I’ve had 2 stents implanted in my LAD in the last 8 months). I am active outside, I lift weights on an U / L split 4 days a week, I’ve lost 12 pounds with a goal of losing 10 or 12 more (tirzepitide) and I eat healthy. My blood pressure is now controlled and the only serious struggle now is sleep. (I have to use gummies and or trazadone to get over 5 hours a night). I also fight with a CPAP. My weight loss goal is an attempt to resolve sleep apnea in order to nix the machine.)
I gave that rundown because I think my attempt at a comprehensive health improvement program is part of the reason the aquablation has been successful. My PSA is normal, I am no longer on tamsulosin, and wake up only twice a night to pee (most of that is due to my significant intake of water during the day to improve hydration) Although it’s not like it was in my 30’s I mostly wake in the morning hard and have normal ejaculation (less semen however) and normal sex drive. (I actively work on that part of my physiology too because I feel like if you don’t then you lose it.
Overall I’m happy with the results of the proceedure. Good Luck!!! Lift weights!! If I can do it you can too!

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@duckhunter I do lift weights and can hardly wait to get back to the gym after, I hope, a couple more weeks.

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albiet | @albiet | Sep 3 9:22am

i am happy to see so many positive results. however i am 4 month post aquablation. My flow never got real strong and has slowed down. in addition its been hard to start urination. pee is usually short, stop and go sessions and never feel like really emptying. i have a cyctocopy next week. hopefully it will give some clarity. any advice from someone who has been in similar circumstances will be helpful. thank you.

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psblin99 | @psblin99 | Sep 10 10:00am
In reply to @psblin99 "@psblin99 I an now just shy of 4 weeks. No more blood or skin tissue. Still..." + (show)
Profile picture for psblin99 @psblin99

@psblin99 I an now just shy of 4 weeks. No more blood or skin tissue. Still a little tired but all looks good!

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@psblin99 Just an update. Today is 5 weeks since the procedure. All is well and a lot of my strength has returned. Am I peeing like when I was 15? Cannot tell you, I cannot remember when I was 15. I do have RE but did prior to the procedure. I will be quitting the meds in two weeks when I see the doc. Has anyone had any experience with RE when thew meds are done?

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2 replies
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dfwcraig | @dfwcraig | Sep 10 6:16pm
In reply to @psblin99 "@psblin99 Just an update. Today is 5 weeks since the procedure. All is well and a..." + (show)
Profile picture for psblin99 @psblin99

@psblin99 Just an update. Today is 5 weeks since the procedure. All is well and a lot of my strength has returned. Am I peeing like when I was 15? Cannot tell you, I cannot remember when I was 15. I do have RE but did prior to the procedure. I will be quitting the meds in two weeks when I see the doc. Has anyone had any experience with RE when thew meds are done?

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@psblin99

The first prescription my dr gave me was Tamsulosin and it immediately gave me RE. I switched to alfuzosin and tadalafil daily and that was better as far as no more RE, but none of the meds helped with the BPH. After the aquablation procedure I stopped taking both meds right away. While I wouldn’t say I have RE after the procedure, it isn't the same as before the procedure, but I’ll take it.

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547beachcomber | @547beachcomber | Sep 13 6:53pm
In reply to @psblin99 "@psblin99 Just an update. Today is 5 weeks since the procedure. All is well and a..." + (show)
Profile picture for psblin99 @psblin99

@psblin99 Just an update. Today is 5 weeks since the procedure. All is well and a lot of my strength has returned. Am I peeing like when I was 15? Cannot tell you, I cannot remember when I was 15. I do have RE but did prior to the procedure. I will be quitting the meds in two weeks when I see the doc. Has anyone had any experience with RE when thew meds are done?

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@psblin99

What is "RE" ???

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psblin99 | @psblin99 | Sep 14 6:26am
In reply to @547beachcomber "@psblin99 What is "RE" ???" + (show)
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@psblin99

What is "RE" ???

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@547beachcomber RE means retrograde ejaculation ... With RE, when you reach the point of ... enters the bladder instead of being ejaculated ... unaffected though there is little/no actual ejaculate

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547beachcomber | @547beachcomber | Sep 14 3:15pm
In reply to @psblin99 "@547beachcomber RE means retrograde ejaculation ... With RE, when you reach the point of ... enters..." + (show)
Profile picture for psblin99 @psblin99

@547beachcomber RE means retrograde ejaculation ... With RE, when you reach the point of ... enters the bladder instead of being ejaculated ... unaffected though there is little/no actual ejaculate

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@psblin99
Thanks

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rstephenb | @rstephenb | 1 day ago

Day 6 after the Aquablation procedure done at Swedish Hospital in Seattle. 18 months ago had the UroLift which was unsuccessful, although was put off for almost a year with the "It takes time to heal" messaging. It never worked, never improved symptoms and wasted time and money. So Aquablation was the next step. But after almost a week, my flow is as bad or worse than ever with absolutely no improvement. Am I being impatient? Will the swelling and healing allow me to pee freely at some point in the next few weeks? Anyone with a similar experience. Right now, I'm feeling very, very disheartened, especially after reading all the success stories about the procedure.

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arbytee | @arbytee | 9 hours ago

I do think it’s a little early to worry. Everything was out of whack for me for awhile. Hang in there a bit longer. Best wishes!

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