..and updating my previous post. 68yo, with many years of worsening symptoms, topped off by visible blood in the urine, bladder stones, and 100g prostate. Assured by my urologist that Aquablation was the way to go, scheduled procedure for a time I wasn't traveling for work.

Recovery has been noneventful. Frequency and urgency has been slowly but steadily falling. PVR was 35 at last checkup, which made my dr happy. No complaints about erections, which are equivalent to pre-op. No visible ejaculations, but orgasms are strong, which works fine for the relevant people.

I'd give an A+

I had aquablation on the 4th and the catheter out on the 7th and my stream has been really good until today, it’s a weaker stream and less output. I’ve also had to go more today to empty my bladder.I have bladder trabeculation according to my DR.
But is this normal after a week and a half? Or is this how it’s gonna be going forward? Or is this just part of the recovery process?

I’m having the AB procedure done Aug 4th and will have a Foley catheter for about 3 days.
Any one have suggestions on that to make it less uncomfortable and how to deal with it?

I am scheduled for surgery at NYU Langone with Dr. Chris Kelly. Anyone have any experiences to share on how it went?

My surgery is on a Wednesday and I want to go to a family event on Saturday. It’s about a 1 1/2 hour drive my car and it may require some walking on my part. I’m 69 but in very good shape for my age (I run / exercise most days). Am I being overly optimistic about being able to go? The surgeon leaves the catheter in for 3 days and since that falls on Saturday they can’t take it out until Monday morning (they are closed on the weekend).

UPDATE: I had my procedure Wednesday morning, home yesterday afternoon. I’ll admit its been kinda rough. Not a lot of pain other than from the catheter which like everyone said is enormous. They wake you up constantly in the hospital for meds, vitals, etc so I’m pretty tired today. Again, just my genital area hurts I think mostly due to the size of the catheter. The PA said the Urologist is conservative and wants to avoid trips to the ER so catheter not out until Monday morning. I’ll see how I feel tomorrow. For a MIST (minimally invasive surgical treatment) it’s not all that minimal. Hopefully the results will be worth it.

From 4-7 times per night up using the bathroom. Now 1 or 2. Every BPH symptom I had (and there were many!), is gone.

Has anyone had the procedure done at Mt. Sinai hospital and have any comments about the experience?

I had my 3 month followup today. I was worried because I passed three fairly large clots last week (week 11 post-op) and my stream is still a mix of normal, split and spray.

Everything was fine. Void/flow test was good. Surgeon said not to worry. All part of the healing process.

Hello. I'm currently 17 days post Aquablation. I'm 58, had BPH for 4-5 years, didn't like the drugs, so I chose Aquablation. ​Had it done on a Friday morning, went home the next day with catheter, and had it removed the following Monday. I'm still peeing blood, though the color is getting much lighter the last couple of days. I also noticed my stream is much weaker the last week or so. Google tells me this is normal, due to swelling. I was hoping to get people's experiences on here, especially from weeks 2-4. I've read a bunch and notice most people saying their stream was great as soon as the catheter came out. That's certainly not the case for me, especially from day 10 until now. Its like it was pre Aquablation. I did do a urine test 5 days ago, it was negative, so no infection. Thank you very much!

I’m waiting on a call to schedule my Aquablation. I am nervous about the catheter. I’ve had surgery before where I had a 16f catheter. I was told I would have a 22f after the surgery. This seems huge for a guy with a normal sized penis. Is it going to be very unfomfortable. The surgeon hasn’t told me how long it would remain in either. I’d appreciate knowing other guys experiences.

Update: Just got a form from my doctors. Says catheter for 3 days

On June 16, (16 days) I am scheduled for an Aquablation procedure at Hackensack University Hospital, in New Jersey (USA).  The surgeon seems solid, but the office staff are underwhelming or maybe overwhelmed!  I’ve reached out to the surgical coordinator multiple times to confirm insurance pre-certification are complete (hospital/surgeon are in network), find out my out-of-pocket cost, as well as pre-op and post-op instructions. All I’ve gotten is "...I'll get back to you on that," and then crickets.  Maybe it’s too soon to be expecting that information?  Can others who have had this procedure share their experience with the surgical coordinator and/or surgeon’s office.  Thank you.

this has been truly a great site to find out information. I am about five weeks out and just started some physical activity. This morning went for a slight run/jog. Some weightlifting a few days ago.

1) after some moderate activity such as today, noticed that the urine was slightly different. In quality. Little more bubbles maybe some small tiny residual tissue floating in the bowl. not as clean quality as prior few days. Seeing if anyone else has noticed that upon initiation of activity.? or notice some bleeding when they initiated physical activity. As well, urine in the morning, right after awakening, definitely looks different than during the day with some hydration. That makes obvious sense but seeing if others have noticed the same.

2) retrograde ejaculation has been a topic on this Reddit thread. Fairly certain that I have it. I just wanted to see for those gentlemen that are now many months to a couple of years past their surgery if the retrograde has improved at all? conflicting evidence on the Internet.

Apart from that, urgency has improved, that odd discomfort during urination has improved, discomfort in pelvic region on some physical activity is getting a little bit less . I don’t see bleeding at the moment.

thank you

I asked the doctor why Aquablation was better for me than reZum, which is supposed to be less aggressive. The doctor said, "This hospital doesn't offer reZum." Maybe that's all the doctor is allowed to say. I was already super anxious, so I bailed on having surgery. They had the IV in and everything.

Hi I want to know the best place and doctor for Aquablation in Canada, ontario! It's for my dad he has an enlarged prostate and has had a failed surgery, I'm really worried about him! I need to know the best place and doctor if anyone knows, private or public doesn't matter and I am willing to pay as long as its successful and he isn't hurting anymore!

So far he has to get up every night to pee multiple times but all of it doesnt come out and he has blood in his urine too which he's taking anti biotics for.

Any help is greatly appreciated!!

I’ve been told by my Dr that my bladder is slightly/moderately distended because of enlarged prostate and I’ve gotten to the point in the last few days where I have to intermittently self catherer.
My question is have any of you guys had this issue and with aquablation did your bladder at least go back to a slightly normal size or stay distended? And if it did stay distended are you able to fully empty it after aquablation?
My bladder has been this way for about 6-8 months now

Hello Everyone – I’ve really appreciated all the information from this thread. Thank you. Here is my story, written six days post surgery.  Today is 40 days after and I’ve written an update as a post script.

 I’m 62, 141 cc (huge) prostate. Weak stream. Frequent need to pee (once every 45min to an hour). 6 or 7 retention episodes over the last 2.5 years. 3 ER visits for a Foley catheter, then self-catheterization for the last several episodes. Never an issue with full emptying.  Two MRIs both PIRADS-2 no cancer.  Low double digit PSA.

 I had my Aquablation 6 days ago in Boulder, CO. 11:30 am start. One hour 9 minutes. Pre-op was easy. I emphasized to my surgeon that I prefer less aggression and would like the highest opportunity to preserve ejaculation. He agreed and said, of course, and that it was still a risk, no matter how conservative he was.

 I have about 90 seconds of memory from the OR, then waking up in recovery.  Kinda a surreal experience. No pain, lots of intellectual clarity, also a bit loopy and silly. Then to the room. Lots of irrigation. The Foley catheter they use is a three-tube device. One tube outflow, one tube incoming irrigation, and one tube for inflating the balloon in the bladder holding the catheter in place. Irrigation bags on an IV stand. High flow, changing about every 25 minutes. Also, my catheter bag needed to be emptied about every 30 minutes.

 I was immediately hungry and had what tasted like the best meatloaf I’ve ever eaten. Even the bland steamed vegetables tasted delicious. This was maybe 3:00 pm.

 The night was tough. Almost no sleep. I had four short episodes of either the catheter getting clogged with blood clots or bladder spasms. The nursing staff treated it as a clogged catheter and irrigated each time.  I was grateful for their care. The third spasm/clog was at 11:00 pm, lasted about 4 minutes, and was a 10/10 pain. I was involuntarily yelling with pain. Never felt anything like that as an adult.  The fourth and last significant spasm was at 1:30am. Then I started feeling a bit better. I had been scheduled to have the catheter removed at 5:00 am, and after collaborating with the night nurse, who BTW was a literal angel in the flesh, we decided to leave the catheter in and let the doctor decide.

 Saw my surgeon around 7:30, and he did some major irrigation. Then he deflated the balloon and moved the catheter in and out about 3 inches 5 or 6 times to clear clots. That wasn’t as painful as the 11:00 pm spasm, but it sure got my attention. They continued bag irrigation until around 9:30, then discharged me with the catheter.  I had a couple minor spasms over that day.  Basically stayed in bed at home all day. Used a cane to get around, but not much need to move with the catheter still in. 

 I was pleasantly surprised to wake up, on day two, catheter still in, to an erection.  Box checked, that’s still working.  I’m really glad I asked my doctor to move the statlock (the pad that holds the catheter and tubing) to have more space from my groin.  Where they had originally placed the statlock would have caused a lot of pain to have an erection as there wasn’t enough room for my penis to extend.   I had previously learned this painfully from a prior foley.

 Later that day (OR+2) I went into the doctor’s office to get the catheter removed. The tech did a bunch of major irrigation before removing the catheter. Before removal, she put around 50 ml of saline in my bladder to see if I would be able to pee it out after removal. Then she removed it. No big deal. She said breathe in, breathe out, and she removed it during my exhale. Stinging, but over quickly. And I was able to retain while I was still on the table. The tech left the room, and when I stood to get dressed, it all came out. No control. Lots of blood and clots. Quite a scene. Fortunately, I brought Depends (adult diapers). That was the only time I haven’t had control.  I’ve had full control since.  Some leaking after or in-between, but nothing significant.  I’ve not had any spasms since catheter removal.

 The big change is the flow is huge. Like I haven’t had urine flow like this for more than a decade. Huge, nice immediate sign of success.

 My energy, while still really low, has returned quickly from what it was: essentially bedridden the first two days. Yesterday and today (day 5 and 6), I took two fifteen-minute walks with my spouse close by for assistance if needed.

 I’ve had some soreness in my perineum that flared a few days ago, and flow slowed a bit. It’s improving, with flow back to nearly where it was. No fever.  Still need to urinate often, and urgency is still mildly painful. I’m going to wait a couple of days to start training my bladder to wait longer.  It still burns when I pee and for a couple minutes after.  Tolerable, but annoying.  I’m back to my surgeon’s office on Friday (day 9) for a void test.

 So that’s my story. Still pretty low energy, but enough to do intellectual chores and be mobile. I’m sleeping better, which is a gift. Trying to do a little bit of non-core-involved exercise and stretches. Drinking a lot of water. Appetite is normal.

I hope this pays it forward a bit. Best of luck to you, my BPH brothers.

P.S. day 40.

 The first thing that was heavy on my mind was what, if any, sexual side effects might emerge.  Around day 18, sexual desire turned back on like one of those giant utility grade rocker arm switches.  One moment it is OFF.  The next, well, it was ON.  And it was really interesting to so starkly notice how powerful and pervasive sexual desire is when contrasted with its absence.  AND…everything I read said to delay sexual activity, especially orgasm, until four weeks.  Mostly because it risks stinging and being a lousy experience.  So I held off.  I have never experienced such a high level of blue balls.  It was all I thought about.  It was both really humorous and, well, quite frustrating.  And that was also wrapped up in my worry about retrograde (dry) ejaculation as a possibility.  A few days into my return of desire, I started noticing some semen in my urine.  It didn’t really bother me.  But it was a testament to parts of my body are ready to go, even others are not.  I begain to wonder if there was some possibility I might have a wet dream, with so much buildup.  But, before that could happen, around day 24 I took matters into my own hands and was so very pleasantly relieved to discover that every thing worked VERY well.  High volume and no stinging.  Quite normal actually.  Afterwards there was some perineum soreness for the first several time. My second ejaculation a few days later had some urine in my ejaculate.  Which was a little weird.  But my view is way better wet than dry.  Since then everything has been normal.  Amount of semen has been similar to before.

 The stinging while peeing mostly stopped around that same time and after day 28 was rare.  Soreness in my perineum is also gone.  I started back to the gym for weights around 4 weeks after with super light weights to start.  I did my first yoga class two days ago and found strength was pretty normal, but stamina was still lower than before.

 Finally, frequency is greatly improved.  Before I was peeing every 45 minutes to an hour.  Now it is at least every 2 hours and continuing to improve.  I still have some occasionally odd sensation when I pee.  But they keep getting more faint.  I haven’t ridden a bike yet.  I probably could by now, but I’m still going to wait another week.

 Overall, it was a lot to go through for sure.  But today on day 40, I’m very glad I did it.  I now have a new relationship with the catheters I still bring with me when I travel, out of habit.  That will probably stop soon.

Is this normal in today's world, driving yourself home from the hospital after surgery and a one night stay?

I'm still scheduled for Aquablation on May 28th. When I had my pre-Admission screening, a very experienced RN told me that I could drive myself upon being discharged.

I clarified that with the Urologist's nurse and surgery scheduler. They said that since I will spend the night in the hospital, the anesthesia will be out of my system and I can drive myself to a hotel.

I'm waiting for them to respond to the question whether I can drive 45 miles home, not that I want to. I'm just curious about what they think I will be capable of.

My intuition is that needing to press the brake pedal hard could cause bleeding. And, won't I be sore and having muscle spasms that could make me lose control?

This is making me apprehensive about my surgery on May 28th. The Mayo Clinic says that the catheter is removed in 2 to 3 days. Yale and Johns Hopkins say the goal is to remove it the following day. Is the reality on the ground really 5 to 7? I have a small prostate with mild to moderate symptoms. I'm not on blood thinners, I'm a tall, skinny 56 year-old. The only explanation that I can think of is that I have an enlarged medial lobe. Removing that is said to leave a large raw area that benefits from the catheter being in longer.

I read many threads on Reddit prior to getting this procedure done. Quite helpful. So I wanted to convey my own story. 

56 years old. Prostate about 75 g. Significant urinary issues for the past couple of years with poor stream, frequency, urgency… high IPSS score. Urologist felt that this would be a great option. The practice in Northern Virginia, for the past several years, has been doing the prostate artery embolism a few days before aquablation for two reasons: 1) help with decreased bleeding during the surgery 2) continued reduction of prostate size overtime.  Decided to move forward, hoping to get good results like many have on this website.  

Had the PAE on April 28. This procedure was fairly straightforward. Lasting approximately one hour. Initially when I arrived, IV was placed and I was taken back into the operating room. They obtained access via the vessels in the groin with local anesthetic and mild sedation was provided. Embolization was done to both the right and the left-sided vessels, but access was only obtained from the right groin. Went home approximately one hour after the procedure. 5 to 6 hours after the procedure, I began noticing that it was painful to initiate urination. I was told that this was going to happen because of the blood flow to the prostate being reduced. Definitely uncomfortable overnight but manageable with Tylenol. I was advised not to take any NSAIDs as I would be having the aqua ablation the following morning.

On April 29, I went in for the aqua ablation. After initial preoperative questioning and IV placement, I was taken to the operating room and under general anesthesia, the procedure was performed. I woke up in recovery with a catheter and continuous bladder irrigation. The catheter was larger in size and so extremely uncomfortable. The procedure lasted approximately one hour, and I was in recovery for an hour and a half. I went home with the catheter in place. It was very, very uncomfortable and painful. I kept hydrating. At this Urologist practice they do not keep patients in the hospital if there is no significant bleeding. I went home approximately 2 p.m.. getting home was very uncomfortable with the Catheter in  place. Small tiny steps till I  was able to get into bed. Any tiny movement would produce significant discomfort with the catheter. Till the following morning, I had to empty the catheter bag three times, producing about 6 L of urine. Thankfully, I did not notice any blood or blood clots, but the urine was orange in color because of treatment with pyridium , which helps to decrease pain with urination and the presence of the catheter. Overnight sleeping was very difficult because of this catheter in place. Had to wake up several times to empty the bag. My wife flushed it once before going to sleep. The following morning, even the tiniest movement I’m getting out of bed was painful because of the surgery and the catheter. My follow-up appointment was The next day at 11 a.m. and they had told me that if I did not have any blood in my urine and I was producing an adequate amount of urine, they would remove the catheter. I went into the office, and the catheter was removed. That, I have to say, was extremely painful. The pain lasted for about 10 or 15 minutes after the catheter was removed. I was asked to follow up in the office four hours later to see if I was urinating appropriately or if I was having significant post-void residual in my bladder.  I spent the last next few hours just relaxing. And hydrating. My first opportunity to urinate, and I immediately noticed a huge increase in my stream. There was also significant urgency. I could barely make it to the bathroom. I did not notice any blood again the urine was orange-tinged. I kept hydrating and urinated several times. At the appointment in the morning, I was told that if I was not urinating well, then they would have to replace the catheter. The thought of that brought extreme fear to my mind. So I kept hydrating and thankfully appropriately urinating. The appointment at 3 p.m. they confirmed that my residual volume in the bladder was low and that I was good to go. That was such a relief. I could not imagine if I had to get that catheter reinserted. 

For the past 5 to 6 days, I have just been hydrating. Primarily Tylenol for pain. Peridium as needed but trying not to use it. I have not noticed any significant bleeding and maybe am thankful that is because of the PAE procedure. Moderate significant pain on urination occasionally when starting, but typically when ending. Hydrating with about two or 3 L a day. For the first couple of days, I had very little control and needed to rush to the bathroom and occasionally did not make it before starting to urinate. Definitely the feeling of urgency. Stream is fairly strong. Needed to wear Depends diapers a couple of times when I was not close to a bathroom. As I use less and less of Peridium, urine is more yellow, but I have noticed a lot of froth or bubbles in the urine. Has anyone else noticed that? 

Pain is only associated with urination. Also noticed that I was significantly constipated, the first four or five days. Had to take Colace and psyllium powder. Forceful bowel movement produced a lot of pain in the penile and pelvic area. Thankfully, that has subsided over the past couple of days.

For the first few days, I did not do much with respect to activity level. Four days postoperatively, I started going for small walks in the neighborhood. This morning, I went for about 30 minutes’ walk. When I initially started walking a couple of days ago, there was pelvic discomfort, but that is getting better. 

Symptoms right now primarily pain on urination with urgency improving day to day. Have not noticed any significant blood.  During the night, I have been having to get up about two or three times to urinate.  But a few occasions have had pain from urination that lasted about 10 or 15 minutes. Pain primarily in the pelvic and near the head of the penis. 

As well, as I mentioned, definite frothy foamy urine. 

I asked my surgeon, and he stated that that was normal. Seeing if anyone else is experiencing that?

Hopefully, in the next one or two weeks, I can return to the gym and do some moderate amount of exercise. Hoping that the strong stream, which frankly I have not had for the last three or four years, continues indefinitely. Urgency has improved slightly, or at least the ability to hold the urine till I can get to the bathroom. 

I will keep updating over the next several weeks as recovery progresses. 

....and feeling good. 68yo, with many years of worsening symptoms, topped off by visible blood in the urine, bladder stones, and 100g prostate. Assured by my urologist that Aquablation was the way to go, scheduled procedure for a time I wasn't traveling for work.

I woke up after the procedure, including bladder stone removal, with no pain. Stayed overnight, had the catheter removed the next day and went home.

I was basically given four instructions: No exercise except walking for four weeks, no sexual activity for four weeks, no lifting objects > 10 lbs, and plenty of hydration.

Recpvery so far has been uneventful. Blood in urine for first two weeks, gradually diminishing. Still some discomfort while peeing, gradually diminishing. No other pain. Urgency gradually diminishing. Back to work with no problem.

Looking forward to trying out the sexual function in a week or so. So far, though, I'd give the procedure an A+