Post aquablation & an overactive bladder

@sorentj Regarding your questions: In the first few weeks after the procedure I did pee in my pants on four or five occasions before I was able to get to a toilet. I also experienced strong urges to urinate on several occasions and had to rush to find a restroom. But as more time passes since the procedure I have experienced less and less of those issues. I have had no RE. My ejaculations are better than before the procedure. Prior to the procedure I was getting up 3 or 4 times per night to pee. Now it is one or two times a night, and on rare occasions none. I use a plastic urinal to measure the amount that I pee during the night. It has dropped from around 28 ounces pre producer to as little as 4, sometimes 16, sometimes 20, and on rare occasions 0. I recently stopped drinking sparkling water and other carbonated beverages and that has helped cut down on night time urination. I have also been doing Kegel exercise and I that may be giving me better daytime control.

Hi! I had the Aquablation on November 4th. I spent a night in the hospital and left with a catheter that was to be removed in a week. I ended up in the ER the night of my discharge. The medical staff forgot to retrieve my foreskin to its normal position (not circumcised). The swelling was cutting blood flow to the head of my penis. I can assure the pain to get this rectified was out of this world. The next day I ended up in the ER again. My catheter got blocked. The catheter was removed and a new one installed (another pain moment). I visited the ER a 3rd time 2 days after that last episode due to the catheter being blocked. CT scan, blood work and urine exams all came back normal. Finally, my catheter was removed after a week.

Recuperation seemed to be on schedule. A burning sensation when urinating and the occasional blood with bladder spasms and pain. My bowel movements have been disrupted and has not been the same since the procedure. Erections returned but have not attempted to have any sexual activity. About the 3rd week post procedure, I carried a 50 pounds bag of salt for my water softener. I started to feel unwell for about 3 days until one morning I urinated blood. I freaked out and ended in the ER for the 4th time. A CT scan with contrast this time, blood work and urine sample (w blood) were analyzed, and everything came back normal. I pissed 2 huge blood clots before leaving the ER and the urine cleared after that. I went back to work the next day. I carried my backpack as usual. I started to piss blood at work. Again, 2 huge blood clots were pissed out and the urine cleared after that. I am afraid that a vein popped open because of the strain. My abdominal area is tender and feels bloated. I feel pressure and a dull pain in my testicles, perineum and anal area.

I finally called my urologist to get an appointment before the post operative follow-up. I am anxious, depressed and full of doubt about getting better. I am trying my hardest to stay positive. Hopefully this was just a setback due to my own doing when carrying the 50 pounds bag of salt. I am even afraid of sneezing and coughing. My symptoms are bothersome. I have the appointment today. Thanks for reading my experience.

I noticed there is not a standard guide on the Aquablation post operative. I have read many posts, articles blogs, but different guidance. For example:

1. Not a timeline to resume sexual activity. Some states 2 weeks and others 6 weeks or 2 months.
2. There is not guidance on taking care of the catheter if leaving the hospital with one. Like irrigation with saline water to prevent blood clogs.
3. My doctor or staff did not call me the following days to check on me and perhaps answer questions. Thus, providing an emotional comfort to the patient.

My recuperation has not been a smooth sailing. I just pray the procedure final result is positive to include the ability to ejaculate. I am only 57 years old and not ready yet to say goodbye to this important part of intimacy with my girlfriend. I hope my posts help others in the same situation.

@joseflesh sounds like you got off to a rough start with some complications I've not heard of, but most of what you've experienced after that was experienced by most of us. I only had the catheter for 24 hours, but even then I was instructed to flush it, so I'm surprised you had so many blockages. Also when the doctor says no heavy lifting he means it, but many of us over exerted ourselves anyway which dislodged scabs and clots and increased bleeding. My visible bleeding pretty much stopped at 3 weeks, but even now at 3 months I see the occasional dark flecks in my urine usually after heavier activity. You didn't mention your current success with urination, but I recommend you be patient, I think we all get there at our own pace. Mine's not perfect either, but it's easy to forget how miserable i was just a few months ago when I was getting up all night and struggling to urinate at times. Hang in there and good luck.

@joseflesh I agree with you on the standard time for returning to sex. My doctor gave me the okay at my 4 week flow up, but i too had heard 2 weeks to 2 months on the boards. It was a bit painful until recently (3 months), but seems pretty close to normal now. As I mentioned earlier I received instruction on back flushing the catheter but I only did it once since I only had it 24 hours but I also hydrated heavily for the first few weeks which I think is very important. I agree about the followed up from the doctors office, I would have really appreciated an opportunity to ask the doctor if all the things I was experiencing were normal instead of waiting until the 1 month follow up. On ejaculation, for me it's been off and on, but I had RE when I was taking the tamulosin so I don't think it's that big a deal, there are certainly worse things. Not to be too graphic but there were some things the wife would do when I had RE that she was reluctant about before, so that's a positive. I just try to keep it in perspective, but I certainly understand hoping everything would return to "normal" and the disappointment if it didn't. I'm just happy aquablation was an option. 10 years ago there were fewer options for men with large prostates and/or large median lobes and at least now there's a large chance you don't have RE.

@diverjer Sounds like an outrageous level of incompetence on the part of KUMC.

@mkaften I agree KUMC made some errors before the surgery even was done. It's interesting to look up some of those codes in the letter I got from the Medicare comtractor, can learn a little more about Aquablation procedures and payment procedures.
They say in the denial "that a resident under direction of a teaching procedure code 0421T-GC". I was never told I was getting a surgery under direction of a Teaching Procedure!!

Then they use this term for payment denial "Local Coverage Determination (LCD) L38682"

The whole thing was a painful mess and ended up not working and a little worse off now.

A lot to deal with as locally they do nothing but TURP. Had to travel about 90 miles to get to KUMC. Not sure what I am going to do, so much going on now with family issues and my own stuff. Might just stay on Flomax until it don't work, not what I want, but not a lot of choices.

Then now I just finished 1st cataract surgery on 2nd of Dec and things still blurry, hope that clears up. At least I know real surgeon did that procedure as I was awake.

@vtredwolf
Thank you for sharing. I would just add something to echo your advice on adding activities. I waited until 5 weeks to start doing some yard work. Spent seversl hours hours trimming branches off two pine trees that had blown over. That night quite a bit of blood in my urine. Then at 8 weeks there was still just a tinge of red following a long walk that included some hills so my advice is just monitor for the first few months after the procedure.

@vtredwolf

Thanks for the words of encouragement. I tested the "plumbing" at 4 weeks. I was happy when ejaculation happened. However, I developed a sudden sharp pain on my stomach. I used cold presses on my belly for a night. It seems that a muscle got torn. I started to urinate with more pain and urgently. I ended up in urgent care. My urinalysis showed negative for nitrite, but positive for leukocytes (white cells). There was also protein and traces of blood. Therefore an inflammation or an infection is present. I do not know if it is the bladder overacting or my kidneys are imflamated. This is week 5 from the procedure.

My urine stream is good and strong. I have not developed fever. What's frustrating is the rocky recuperation. I have good and bad days. It has affected me emotionally for sure. It had a great impact on my very active lifestyle. I am trying to stay positive and let the body heal accordingly. I won't try to "test drive" until this pain goes away. I am afraid it will tear an abdominal muscle. Had anybody been through the same struggles?

I am waiting a day or two to see if this overactive bladder gets better before another doctors visit.

@joseflesh You're only 5 weeks post aquablation, way too early to be panicking. You're experiencing many of the same issues that many of us faced and you'll continue to have ups and downs until you get to 3 or 4 months with continued lesser improvement to follow. The pain during orgasm is not uncommon and should get better, mine felt like a spasm in my lower groin. I had the same problem which took about month 3 to go away just like my doctor told me it would. I had a great recovery other than that until about 8 weeks when my urgency and frequency suddenly increased. I thought I had a urinary tract infection at 10 weeks, but my urine tests showed leukocytes and no nitrites exactly like you. The leukocytes can be just due to the inflammation in your prostate not necessarily infection, but a simple urinalysis will answer that question. It also showed red and white blood cells even though I could see no visual indications of blood. I don't think any of that is uncommon or a reason for major concern, but check in with your doctor. I'm at 3.5 months now, the pain during orgasm is gone. I still have some minor burning in my perineum area and a little irritation in my urethra some times, but I think that will continue to get better over time. You just had major surgery on your prostate, at 5 weeks don't expect too much, but by all means check in with your doctor. If it helps your experiences are very similar to my own. We all are own journey and I think how old you are, how long you delayed treatment (and damaged your bladder) and of course a little luck all play a factor. You'll read here cases where guys have had poor recoveries and others where they were complication free and never looked back after 6 or 8 weeks. Keep the faith, I think you're going to do great, but it's going to take a little more time.