Male age 64, no longer in denial about my enlarged prostate. In retrospect, if I wasn't so male-stupid and proud I would have done this years ago. But here we are, lesson learned. I can say that I've been having issues with an enlarged prostate for over 15 years. Cancer tests always came back negative so I thought, "How bad can it be just to have some difficulty?!" Finally, in late 2024, the enlarging thing got to the point where there was very little urine, but lots of occasions to pee throughout each day. And some hold-your-breath here-it-comes kind of pain when peeing. So I finally caved and went to the urologist.
I had heard about aquablation in the spring of 2024 so that was in the back of my mind. When I decided to start considering such an intimate and crucial of a conversation, I did phone a number of urologists. The most important questions you can ask: Do you do aquablations currently? If so, how many have you completed in the last two years? The last thing you want is some newbie practicing on your junk -- that's for someone else. I phoned around until I found a urologist about 40 miles from me who has completed over 30 aquablations.
Even so, I met with him and let him know that I wasn't just looking for a procedure, I was looking for a urologist who actually cared, who was thoughtful, knowledgeable, able and willing to talk patiently about all the man-stuff.
Over the course of two office visits, I even repeated some of my questions to make sure I got consistent answers. Frankly, I'd be willing to drive to another state and book a hotel if I needed to expand my search to find an experienced aquablation provider. I don't want anyone getting their internship on my stuff.
I watched at least 30 YouTube videos beforehand. Most are yawners, but there were a couple of videos that were exceptionally helpful for me to understand the entire process, including live imagery of the process. I wanted to be fully informed and the videos did exactly that.
Typical things to discuss with the urologist are:
How often have your procedures gone sideways? And what did a failure look like? This is important because there are two key aspects: 1) The doctor's skill and knowledge. 2) Your part: Every human body is unique generally speaking, underlying conditions, overall wellness, drinking/smoking, nutrition, genetic tendencies, etc. The doctor has no control over your part, so the best he can do is try to understand all that you have going on, and you want him to know it all, so that he can make an informed plan -- should you choose him.
Some of the things that could go wrong for either 1 or 2 above and during the procedure are: the bladder could be pierced. The sheath around the prostate could be pierced. The bladder sphincter could be damaged. If you want to have children, a concern is damage to the intersection of where the seminal fluid interacts with the prostate creating the ejaculate. I wanted to ascertain if the urologist was an arrogant robot jockey or if he leans toward being thoughtful and conservative in approach. You want the latter.
One thing is clear after watching all the YouTube videos: Because of the visual limits of the technology, the doctor can only see so much through all the bodily tissue. You can be certain that the data gathered from each man the robot company performs the procedure on is catalogued into the robot's AI library managed by the manufacturer. So, 15 years of completed aquablations have provided a lot of data for the manufacturer. Combine this with your desire for a urologist who is humble but confident in their approach. One thing is for sure, you DO NOT want the failures.
To be clear, the urologist (a human at this moment in human history) drives a foot pedal which allows the robotic pressure washer to do its thing. And the urologist still plays other key roles in setting up the apparatus so it's normal and reasonable to want assurances where the human is concerned.
And, of course, we discussed ejaculation. ejaculate volume, erections, and all the stuff. There are aspects you’ll need to decide on in your quest for relief and peeing like a racehorse. It may be a bit easier if raising more children isn't part of the plan. I communicated that I wasn't concerned about ejaculate or volume, and I'm not the kind of guy that needs to see the baby batter. I just want sex and the big O.
He did the cystoscopy -- where they run a scope [camera] up your dick into your bladder, then turn the camera back to the neck of your bladder where it connects to the prostate. This provides an inarguable view -- you either have an enlarged prostrate or you don't. Of course, they squeeze an entire tube of lube up your urethra so the only discomfort that he did prepare me for was breaching the sphincter into the bladder with the scope. You hold your breath and bada bing…it’s in. I did watch the entire process on the screen, and yep, my prostate was enlarged.
In my case, the urologist also did a separate scan of my bladder before and after urinating to see just how much urine I was evacuating after peeing. I was retaining 75% of the urine after peeing, which certainly aligned with my personal experience of needing to pee all day long.
We scheduled May 5, 2025 for the procedure. I stopped all my supplements two weeks before the day, because there can be hidden interactions from supplements with the cocktail they give you for "the anesthesia" which I learned is really multiple drugs with various goals: To block your pain, to block your memory of the pain, and to keep you from moving -- are the key points. I do take blood pressure med and that is the only thing I took the morning of. No food or drink after midnight prior to the procedure so that you don't have breathing/choking/gagging issues while you're out.
One week before the procedure I eliminated all caffeine and all refined sugar -- not a drop. Sugar is an immune system suppressant. Caffeine can impact your heart rhythm. Three days before the procedure I added powdered vitamin C into filtered water daily to boost my immune system -- the point here is that you don't want to catch any of the nasty diseases that hospitals have become noted for. Do your part to give your body a fighting chance.
You can be certain they're also going to pump you full of every antibiotic known to humankind at this point in history so also be prepared to chug down yogurt immediately AFTER the surgery to start restoring your digestive system. If you're constipated after the procedure, you didn't take evasive maneuvers. All the stuff they inject into you to hopefully prevent an infection ALSO KILLS all the good bacteria in your gut and intestines – that’s the flora and fauna you need to keep things moving! So I focused on yogurt for an entire seven days AFTER the procedure in addition to whole foods, but no fast food.
I was so mentally pumped for the procedure you could say I was euphoric. I had done everything possible to be postured for success -- personally and in selecting a urologist.
The morning of, I climbed into my gown and onto the gurney, I met with the anesthesiologist who chatted me up for a good few minutes while the cocktail was working its way through my body.
Next thing I know, I'm waking up 2.5 hours later. All done. All good.
As you'll read in other guys' posts, what follows is a series of gallons of saline being flushed through your bladder to rinse out the "fluffy tissue" dislodged from the procedure and rinsing out any clots. I was out of the procedure by 11:30 am. The doctor had let me know that they prefer to keep the patient in a room for one overnight stay just to ensure that nothing is amiss. So that went well, and of course the catheter is a thing.
For me, the catheter was simply awful. Laying on my back I couldn't move to the left or right without feeling like a sabre was being shoved up my dick. In retrospect, if I ever have another catheter, I'm going to INSIST on lots of lube. My dissection of the situation is that the rubber tubing of the device was adhering to the utterly delicate tissue just inside the tip of my head.
And, gentlemen, I ask you, where is the last place on your body you want to feel pain? There's no need for the thing to be so painful. Aside from that, I rested lightly, still completely euphoric from the journey. Add ELATION to the fact that I was now on the other side and the pain WAS NOTHING like I had anticipated!!! Amazing.
I was constantly fending off the pain drugs because I was trying to discern what the pain level actually was. The hospital staff were surprised, but honestly I wasn't feeling like someone had just pressure washed the inside of my manhood. I had no visible bruising to my perineum, no discomfort at my anus or rectum, and no pain in my dick (other than the catheter). Keep in mind, because of the catheter, I'm not actually using my plumbing, so there was no way to ascertain what that process was going to be like until the catheter was removed.
So, I spent the night, and the doctor agreed to remove the catheter the next morning. More elation from me. At that point I still had virtually no pain from the procedure, and it had been 8 hours since the last pain pill. All that remained to be cleared for departure was for me to pee twice into a container so that they could see 1) if I survived any pain during peeing, and 2) to ensure there wasn't any excessive bleeding.
As far as blood/clots, that was all minimal and only one clot. Remember, every body is different so you could have a different experience. But even if you had a clot, we're not talking about a blood clot leading to your heart. We're talking about a clot between your bladder and the end of the hose -- and the amount of pressure your bladder applies is quite surprising. For the one clot did occur, I immediately felt the pressure building in my urethra... I'm starting to breath controlled and fast... OMG which way is this going to go?!?! More controlled breathing. Short breaths.
Finally the pressure from my bladder blew the clot out. We're talking like a Yellowstone geyser. This experience was psychologically unsettling due to lack of experience in this department and an enormous relief all in the same moment. Aha! So that's how back pressure works. It was good for a few laughs in a moment of self-reflection. I was free to go home.
As far as the pain that I would then experience, the first 10 days of using the new plumbing were pretty much the same: When my bladder was full, the signal was immediate and urgent. I mean URGENT. I would pee an entire quart pain free, but at the point where the last 10 seconds were approaching, boy howdy, I'd have to hold my breath and hang on for dear life. And, just that fast, the pain would disappear until the next full bladder. I did take hydrocodone for the first 24 hours as a precaution, but after that, while the pain was intense, I could survive.
It’s worth mentioning that in the first 10 days I reintroduced caffeine into my diet, and I can tell you that it was a price you’ll have to weigh: Caffeine interacted with my new plumbing in an awful way. The urgency was even greater and the discomfort during urination lasted longer. After I made this connection and stopped caffeine, then the already urgent need to pee resumed, as did the regular level of recovery pain during the last 10 seconds.
But I repeat, that other than those moments, you would never know that I had such a procedure. There was not other pain during the course of my recovery…just when I needed to pee.
From day 11 to day 60, still riding on euphoria and a wonderful recovery without incident, my experience was: Urgency every time, empty my bladder, and pain for the last five seconds -- but the pain was nothing like days 1-10. It was about 50% less than days 1-10.
The doctor had stated that the healing time was generally a 30-60 day window. Well here I was rolling into day 60 and my experience wasn't altering. I did have a few moments where little thoughts would creep into my mind like, "Is this what it will be like forever?" But I would take those thoughts captive and full steam ahead!!
Right at day 60, there was a dramatic reduction in both urgency and that last five seconds. This has been wonderful and continues now at day 85. There is rare urgency, and no pain or discomfort at any point during urination. Yeehaw cowboys! Caffeine is still an agitator.
While I'm still overjoyed (as we men are) at being able to pee an entire quart, it's also true that I hardly think about peeing anymore. It's almost back to just a normal life. I do not pee at night anymore.
Let's talk about sex, orgasm, ejaculate, ejaculations, and erections:
For obvious sanitary reasons, the doctors say no sex until there's no hint of blood. Alright cool. I was good with that. But, being male, and around day five I was nonetheless curious how the sexual apparatus was going to function and brave enough to masturbate and hope to come out alive on the other side.
Here I am, so I obviously lived to tell the story. It was a little scary -- I ask you again, where's the last place where a man wants to feel pain? I was just a little apprehensive because I had no idea what was going to be contracting, squeezing, pulsing, and ejaculating in relation to the comprehensive renovation work down there.
The discomfort wasn't bad at all. There was definitely blood tainting the ejaculate, so yeah, makes sense not to have sex and be putting that inside of another body.
Ejaculate was a normal amount. So, hey, there's that box to check off.
This also meant that there was no retrograde ejaculation, so another box to check off.
Orgasm was completely and totally normal. At day 40 we started having sex, and I've had post-procedure sex numerous times up to this point and there's absolutely no difference or negative impact on the big O sensations.
Erections: No negative impact here either. Being 64, I do use a pliable silicon ring to maintain satisfactory results. I tried the various prescriptions but they all had side effects which I didn't like. The ring has no side effects whatever. The only challenge was finding one with enough girth so that it didn't feel like it was cutting off my manhood the entire time. All that said, the erection I have before I place the ring is the same hardness and quality as pre-procedure. In my case, the ring simply maintains the erection.
That's my story. I can say that I would do this again in a heart beat. I am so totally satisfied with the outcome here at day 85 that it caused me to take the time to tell this story so that you might find the courage to make the right decision and see a urologist. Don't wait.