ACTUAL recovery time for Aquablation

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I am considering having the Aquablation procedure and I am concerned that the standard medical field responses may not portray an accurate picture of the true recovery times. I am 60 years old and am still quite active both sexually and physically. I am a runner and run marathons and ultra marathons. I have a marathon scheduled for September in Switzerland which will require quite a bit of training. I read that in "most cases" you can return to your normal activity after 3-4 weeks. I am curious if anyone else who has had this procedure is a runner an how long it took to start back running and also how long before you can return to active sex life.

Trying to determine if I try to rush and get this done as soon as possible or if I wait until after September marathon and vacation. Any insight would be greatly appreciated.

2 likes, 42 replies

42 Replies

  • Edited

    Hi Randy - See my other posts on this issue. I started my own discussion on aquablation recovery a few weeks ago, and I have posted several times on Ihsan's thread. I had aquablation almost three months ago. I am very pleased with the results. My urinary function is now perfect, and my sexual function is the same as it was prior to the procedure, which was also perfect. So I am a big fan of the aquablation procedure.

    But I must say that the medical field drastically underestimates the severity of the recovery from this procedure. The standard line is the information you quoted, about returning to normal activity after 3-4 weeks. That is all the information that the medical establishment seems to make available. In my experience, that information is not inaccurate, just incomplete.

    What they don't tell you is that the recovery for the first three weeks or so is absolutely miserable, at least it was for me. For much of that time I was experiencing sharp pain when urinating, urinary incontinence, bloody urine, pain with erections (the only erections were involuntary night time and morning erections), swollen and sore testicles, constipation, etc. If you are concerned about training, you need to block off at least the first 3-4 weeks after the procedure, when you will not be able to work out at all. There is no way you could train for any kind of athletic competition during those first 3-4 weeks. It was a challenge for me to walk from the couch to the bathroom. Then you will need to deal with getting back into shape after about a month of virtually no exercise at all.

    The one thing I need to mention, though, is that when you start to feel better, it happens very suddenly. At some point during the fourth week, I suddenly realized that I felt like myself again. I had regained full urinary control, my energy level returned, and I was sleeping much better, only waking up about once per night to urinate. So, while the first period after the procedure was terrible, when I started to get better, I got better very quickly. By the end of week 4, I felt totally normal.

    I am not the athlete you are, but I do work out regularly, as a competitive swimmer. I asked my urologist if it was OK to start swimming again, when I saw him for a checkup about 4 weeks after the procedure. He said to go ahead if I felt up to it, but to be careful not to overdo it. By the 4th week I dipped my toe back in the pool, doing about half my usual workout for the first week back, then full workouts after that. In the context of training for marathons, I'm not sure what that would mean. My guess is that your training schedule will be seriously interrupted, if not completely cancelled, for about 5-6 weeks.

    As for sex, I was told to abstain for six weeks. That was as miserable as it sounds. Others on this board have been told to resume sex after two weeks. I found that I wasn't quite ready for sex at six weeks, but after seven weeks or so I was fine. It's the same now as it was before. See my detailed response to Blair on this issue, which I just posted yesterday and today.

    Good luck with whatever you decide to do. My guess is that if you were able to get the procedure scheduled by the beginning of April, you could be back to running by the end of May. But you would have missed the training you are probably doing for all of April and most of May. If that timing works, you'll be glad you got it done.

    • Ed
    • Edited

      Thanks Ed, this is extremely useful information. Glad all worked out for you. Seems like I will go ahead with it as soon as it can get scheduled.

  • Edited

    Randy, I'm a runner but mostly the 5k variety. I might have had a little easier recovery road than most but for the first two weeks I was still very tired, forget about other symptoms. My body was telling me to slow down. Its just been a month and I haven't run at all, but just started training with very light weights and walking briskly up to 5 miles a day. I see my Dr. in a few weeks and I'll ask her about running. I started really feeling like running about 10 days ago but don't want to potentially prolong my recovery by doing too much too soon. I did see one post whereby a guy ran a 5k just short of 4 weeks post surgery. Seems a little kamikaze. Everyone heals differently, but from what I've seen from most people you can expect 6 weeks minimum before doing any meaningful training.

    • Edited

      Thanks Bob I appreciate your insight. Good luck on your continued recovery.

  • Edited

    Randy, I wanted to give you my perspective. My procedure was on Feb 23 in Woodbridge, VA with Potomac Urology, so it's fairly recent.

    My recovery was very quick. I'm one of those guys that researches everything endlessly, and I always prepare for the worst case scenario, but hope for the best. I was prepared for a difficult first week and a moderately difficult second week, and hopefully better by the 3rd and 4th weeks. I'm pleased to say, my recovery was so much faster and easier than I had thought it would be!

    I spent the night in the hospital - which I highly recommend, if your doctor will allow you. They run about a 50 gallon drum of saline through your bladder (lol I don't know how much it was, but those bags are huge and they changed them all evening and night, up to the next morning). They stop the irrigation about 8:00 the next morning. And then the urology nurse from the previous day comes and pulls out the catheter. That was the only unpleasant part of the entire experience. (yeah it kind of hurts, thank God it's only for about 5-10 seconds). Then, you just drink drink drink for a few hours, while you still have an IV going. Walk the halls, and cross your fingers that you can pee! I felt the urge but couldn't pee initially. Scared me that I'd have to get the catheter back in and spend another night. But after about 4-5 hours, eventually I got small little spurts of what was mostly blood out. I had drank so much water, that for the next hour or two it seemed like I had to pee every 5 minutes. Not real big amounts, and not real good flow, but at least I could pee. Once they see you can pee about 150ml and that you aren't retaining too much in your bladder, they let you go home.

    So for me, the only difficult day was that day after the procedure, before I left the hospital. I got home about 6:00 that evening. Slept pretty good since I was so tired from only getting 20 minute naps in the hospital. The next day, took real pain medicine and Pyridium, as a precaution against pain and burning. I did have some red colored urine that day, but not bad. And some of that was because of the Pyridium that already colors it orange. By the next day - Sunday - I was about 99% pain and burning free. Took a couple arthritis strength Tylenol that day but no pain medicine. Still took some Pyridium. Little to no blood in urine. By Monday - no pain meds at all, not even Tylenol. No Pyridium. No pain, no burning. No blood in urine. So for me, my recovery was basically two days - the day after the procedure and the next day.

    My flow is about 100% improved. Very nice now. The only thing that hasn't improved is frequency. It might be about 10% improved. It's not significantly better than before the surgery -- but it's certainly no worse either. At my followup yesterday, he said it's not unusual at all for frequency to take a few months to improve. He said since I was feeling so good at 2 1/2 weeks, go back to normal routine. No more restrictions.

    So, just wanted you to understand, there are guys that get better very quickly, and others that take longer. I'm 55 years old, go to the gym every day, used to run a good bit before I messed up my knee training for the Disney half marathon. Don't run anymore but still work out most days and ride my bike in the good weather. I don't know that being in good physical condition helped my recovery but I'm sure it didn't hurt it either. My prostate size was also fairly small - I had a median lobe obstruction that was causing most of my issues. So that probably contributed to my fast recovery as well.

    Hope that is helpful in considering to move forward with your procedure.

    • Edited

      bcb1.... You definitely the exception according to my Urologist. Yes it was mostly likely the size that spared you the pain and extending bleeding.

      After 4 months now , the only issue is the RE.

      Also I was in the hospital 4 days to get completely flushed and make sure my higher than norm temperature was not an UTI, which it wasnt but guess my doctor convinced the insurance company I was a canidate for longer term care.

    • Edited

      Well Alex, it looks like I'm another exception; I just think we're all different. Today I am 14 days post op and feel like a million bucks. I'm 68 years old and my exercise consists of a 30 minute daily bicycle ride and a 10 minute daily dog walk. I ride motorcycles daily, but not to much exercise effort required there.

      My experience was similar to bcb1 with the following exceptions: I went home with my cath and had it removed on day 6. On day two or three my urine was clear and yellow until one day I did not drink enough water, turned pink to red. Called the clinic and they advised drink, drink, drink and soon the clear yellow returned.

      After being on Tamulosin for the last 10 years I've had RE and once I go off of it (doc says to stay on it for 6 weeks), I'm hopeful the RE goes away.

      I'll continue to take it easy until the doc clears me. I am only left wondering why I didn't do this 10 years ago. As I said, I feel great and can now pee like a teenager again.

  • Posted

    Thanks. That is great news. I am meeting with the doctor tomorrow to hopefully get on his schedule as soon as possible.

  • Edited

    I am a 59 year old male who had Aquablation on 03/14/2023, at Virginia Hospital Center. After the initial pre-op procedures, my surgery began at 7:30AM and concluded before 9:00AM. The only real issue for me was the catheter. The nursing staff changed the catheter just about on an hourly basis. I was fortunate to have minimal pain and required no additional pain meds after the surgery. I also had several rounds on antibiotics inserted into my IV during the day and night of my one day hospital stay. My urologists was confident that I would leave without a catheter and I had no issues with the removal before my discharge. The nursing staff did prepare me for the possibility that I would go home with a catheter. I was required to void several times the morning of my discharge and after each void, the nurse would do an ultrasound to verify that my bladder was emptying satisfactorily. I was released around 11AM on 03/15/2023 and still have minimal burning when urinating with some blood at the beginning of urination. I have taken no pain meds with the exception of tylenol pm to help facilitate sleep. Urine flow has drastically improved and urgency has decreased but we are still early in the game. For those contemplating this procedure, understand that this is surgical procedure. I was not expecting a breathing tube to be inserted. Will update after my next visit with the urologists on 03/27/2023.

    • Edited

      Thank you for posting this. Please keep us updated. I will likely be having the procedure within a couple if months and I'm very interested in outcomes. Especially regarding sexual or urinary side effects.

    • Posted

      Thanks for the information. I hope your recovery continues with minimal issues.

  • Edited

    So I have a somewhat related question since I met with the new urologist last week. He seemed to be in alignment with doing the procedure, but wants me to come in this week for a cystoscopy. I am definitely fine with that, but then over the weekend he sent in a prescription for Flomax to my pharmacy but this was never discussed with him. I have an 80 gram prostate with middle lobe and some bladder wall thickening that showed up on the original MRI from the other urologist. I do NOT want to put this off and I definitely do not want to try the medicine route with all of the potential side effects. The original urologist that wanted to do the simple prostatectomy also told me that with the size of my prostate that medicines would do no good.

    I will discuss this with him on Thursday, but I am wondering if this is some type of requirement by the insurance industry that doctors have to get the patient to try the medicine route prior to surgery. Any insight would be great.

    • Edited

      I will tell my experience with medication. I'm 58 years old. Ive been using Cialis Daily 5mg for many years. I've never been certain if it had any effect on my BPH but it has good side effects so I would gladly use it regardless of BPH. I started flowmax many years ago at the low dose. I didn't notice any improvement so it was increased to the high dose. I'm not sure if I get any benefit from it. I haven't noticed any side effects from it. Certainly not retrograde ejaculation. The only side effect I may have is low blood pressure when I stand up. I have stopped and started it a few times to see if I can see a difference and I haven't noticed anything but I've kept taking it in hopes of it helping. I saw my urologist two weeks ago and he suggested increasing my Cialis dose to 20mg per day. I did that one time and the headache it gave me was intolerable. I decided a couple weeks ago to stop the flowmax again and I haven't notice any difference from not taking it.

      I have been offered finasteride many times but I have always rejected the idea. One reason being that I am on testosterone injections and I have to give blood a few times per year to keep my hematocrit down. However, I wouldn't use finasteride regardless due to sexual side effects.

      My urologist is really busy so my appointment for cystoscopy and prostate ultrasound isn't for another three weeks but I have a UroCuff test on Thursday. I was told the urine flow test is mostly for the insurance company. They said they believe me that I have BPH urinary symptoms but they have to prove it to the insurance company.

      If the tests indicate aquablation would be appropriate i hope to be able to get it done as soon as possible after my tests.

    • Posted

      hi randy

      i had my aquablation on december 19 th 2022, so..3 month into the recovery almost all my symptoms went away. I don't even think about my prostate anymore..

      One exception..i have RE..which i don't care about anyway.

      I was taking flomax for 1 year. Flomax is kind of a muscle relaxer for your prostate, which considering the systoscopy, should be a good thing...the more the muscle is relaxed the easier it should be to do the systoscopy...that's the way i am thinking..obviously i am not a doctor but that could be the reason he prescribed it to you.

      Good luck with your aquablation.

      i didn't have a median lobe issue but other than that my situation was very similar to yours.

      my prostate was 70 gram and i had bladder wall thickening also.

    • Posted

      ihsan2022, it seems you are the first one reporting RE after the Aquablation therapy.

    • Posted

      isan2022 might be the first to mention it, but RE is real after Aquablation at least for me and my doctor certainly agrees its an issue.

    • Edited

      Other than this forum, everywhere on the web, they make it sound like it is a non issue but it happened to me. Either i am one of the non lucky ones or it is common and nobody reports it.

      The whole idea behind this forum is to let people know what happens in real life, so they are not mislead.

      As many of you know , i have my own thread where i documented everything(didn't document my RE yet though).

      i will post my final comments there, once i have my PSA test done, to see how much difference aquablation made.

      So far i didn't find anyone reporting about the PSA value after aquablation.

    • Posted

      Did you ever report the prostate size? Did your doctor explain why you should have RE after the Aquablation? Did he map the save zone well during the procedure?

    • Edited

      prostate size was 70 . i saw my doctor 1 time after aquablation after that he didn't schedule any appointment, neither did i.

      He didn't care enough to ask didn't tell him.

      i don't know how well he mapped the zone..

      What's done is done..Nothing i can do about it. As i mentioned a couple times...i don't care about the PE...i am just grateful that i have no other problems down there.

      PE doesn't affect my sex life at all and i don't want kids at this problem.

      I just reported my PE to you guys so people know and consider this when making a decision. In the end, bottom line...i am happy that i went with aquablation, compared to all the other procedures.

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