ACTUAL recovery time for Aquablation

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

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.

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.

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

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.

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.