How many opinions do you get before you decided on an acqablation?

Good luck, and let us know how your result is. I had the Rezum 4 years ago and I am now back to just as bad as ever (get up 5 times a night to urinate and it takes a long time as it is just a trickle.) I have been debating HOLEP or maybe even go for 2nd Rezum? I like the minimally invasive part of the Rezum and the low chances of sexual side effect. My prostate was 100 grams initially then Rezum took it down to about 80. Frustrating to say the least. PAE does not sound that appealling to me (intentionally causing starvation of blood to a part of your body by loading the area with small plastic pellets.) Aquablation sounds pretty crude to me as well (blasting parts of your body with high velocity H2O.) What to do.

It seems to me that most urologists prefer Holep since most of the prostate (inside) is removed so it is a permanent fix to urinary problems. But there are sexual side effects. There is less bleeding than aquablation but they cauterize the arteries. I am still considering PAE since it seems to have the fewest side effects and is considered a very minimal procedure. Urologists don’t seem to recommend it since it is down by radiologists.

I had aquablation and it was a home run. It's not "crude." Least chance of side effects. You want the minimal effective treatment.

Seems like a lot of folks with aquablation suffer from a lot of bleeding for a few weeks.

I am another Holep “survivor.”
I highly recommend the procedure. It is basically one and done.

I have had PVP Selective Vaporization (Green light laser), Rezum (Aquablation) and HOLEP. I started with PVP. This worked for 10 years but was rather uncomfortable to recover from. So, I decided to do a less invasive procedure next and had Rezum. This was not pleasant to have done without anesthesia. It was easier to recover from but only lasted a few years. I decided my next procedure should remove as much tissue as possible and provide as long lasting relief as possible, and opted for HOLEP. I am only a couple of years out, but so far so good. And, the recovery was not much different from PVP (Green light laser), with no significant side effects. I know some people have had HOLEP have had leakage and other significant issues. I have not and made it a point to go to a surgeon and hospital that does a lot and is highly rated in the specialty.

My husband had Aquablation 1 year ago this month, Rezum is not the same as it uses steam, and Aquablation uses no heat source. I documented his recovery on previous post. His surgeon he felt he would be good 15 to 20 years. He is 72 and feels renewed. Sex life is great, never had RE, and every aspect of the urinary process is great. Every patient has a different story, regardless of the process they choose. We found a great surgeon with lots of experience completing the surgery. I’m a nurse and kept meticulous records from beginning to end. Good luck in whatever you choose.

What Dr. and Hosptal did you use for HoLEP?

What Dr. and Hospital did the Aqua?

Dr. Hadley, Soin Hospital in Dayton Ohio.