Aquablation - 7 Weeks Later - Does it Get Better?
Posted , 15 users are following.
I am 56 and had Aquablation on Aug 18. I did some earlier posts stating that I was happy about how the procedure went but I feel like over the last 3 weeks or so things have really plateaued and gone back a bit.
The clearest benefit of the surgery is that my bladder holds much more and I don't have to strategize my daily activities around bathroom locations. The problem is, once I have to go, I REALLY have to go, even worse than pre-surgery. There is maybe a 5 minute gap between feeling the need to go and wetting my pants and I've had some unfortunate incidents on the way to work.
Stream: The good news is that I don't have any super slow and thin streams like before surgery. On day 4 after the surgery I did pee like a racehorse but it seems to have slowly but steadily gone backwards since then. It now seems to be on the high end of what it was pre-surgery.
I met with the nurse practitioner 2 weeks ago today who advised patience and said my prostate still looked like it had a really bad sunburn and was still recovering. In fact, at least until last week I was peeing out noticeable chunks.
So, I would say a mixed result from surgery. Not horrible but not as good as I hoped. Question to people who have been through this: I am almost seven weeks post-surgery, is it likely to get better?
3 likes, 54 replies
cali-mike1970 michael55618
Edited
Man, this is so helpful. I've narrowed it down to PAE and Aquablation. I have similar symptoms as you and I hope I can get the results you did. My urologist said optimal outcome, everything goes back to normal, common outcome: frequency and urge decrease, steam gets much better (I'm assuming PVR will get better too). I'll take that. Doesn't think I'll be any worse off. Said I would only have to take off 1 week of work (I work in a busy, semi-stressful tech job - zoom calls and deliverables). Do you think I should take a leave of more time to de-stress during recovery? How long would you take optimally? Also, did you have any burning in recovery (like on what scale?) How long did you have the catheter in? My uro said 1 or 2 days is typical depending on color.
michael55618 cali-mike1970
Edited
One week off after Aquablation should be plenty if things go reasonably well. I had my surgery on a Thursday, got the catheter out on Monday and was back to work that day (I work from home in a low stress job though). By that evening, I felt like I was 90% recovered and almost euphoric. But then I woke up early on Tuesday with what turned out to be a UTI and I was sick as a dog for 24 hours (if you start to get symptoms such as chills, call the doc right away so you can get on antibiotics ASAP).
One to two days for the catheter removal sounds doable but a bit optimistic. (My general impression at the moment is that both the doctors and the Aquablation company give an overly optimistic view of the recovery period). My urine was red wine-colored for quite a while and it was only I think on the 16th day that all traces of blood were gone. I can still occasionally get a little blood even now, for example when peeing after sex. If you have never had a catheter before, it is mostly psychological because it is a humbling experience. It is a mild nuisance and you will want to stick around the house while you have it in. But ultimately it was not nearly as bad as I imagined it would be.
In terms of pain/burning, right after they took the catheter out, when I urinated, there was not much pain when I started the stream. But as I progressed, a knife-like pain would build up so that there were a couple of times it got so bad I had to stop. But I managed the pain with ibuprofen. My memory is that after a day or two it was not really a big deal.
Also, I should mention that my experience in the recovery room after the surgery was more unpleasant than other people on here have described. When I woke up, I had a feeling like my bladder was so full it was ready to explode but there was nothing I could do to relieve the sensation. I was also getting terrible spasms. Luckily, I had a nurse who was attentive and she got me some high quality pain pills and something for the spasms. It passed quickly though and by 7:00 p.m. that evening I was ready to decline the pain pills. Overnight in the hospital is not fun, because the nurses have to keep emptying the bag and I did not sleep much. But I was home with my family by 5:00 p.m. the day after surgery.
compiler michael55618
Posted
Does the aquablation therapy have any impact on sexual function, little or no difference at all?
michael55618 compiler
Edited
No impact for me.
michael55618
Edited
Here is a short 3-month update. I plan to see the doctor in January and will do one more update then.
STREAM - No change this month. It continues to be adequate but disappointing. I find this a little confusing because many people on this site say that their stream improved a lot, even when their other problems did not improve. I am just the opposite: improvement in many areas but not this one. (My doctor told me I would chip the back of the toilet, as I have noted previously.)
SLEEP - I continue to need to pee once per night. I don't think my prostate is 100% to blame for this. Most nights I wake up after 4-6 hours. My bladder is so much better that sometimes I don't feel any need to pee at all, yet if I don't go, I can't go back to sleep. It's like my brain is just programmed to do this.
BLEEDING - About 3-weeks ago, I had sex twice within 48-hours for the first time. After the second time, I experienced significant bleeding. In the early morning I staggered into the bathroom half asleep and was jolted awake when I could not pee at all, just like in the bad old days. About a second later, a big gob of blood shot out. As recently as a few days ago, I got a small amount of bleeding, with no apparent cause.
paul34021 michael55618
Posted
I will keep following your progress. Im 4 weeks out and knowing what I might expect is great.
With my extended hospital stay, with constant flushing, is really is making my life much easier.
michael55618
Edited
Five month follow-up. So, I have been feeling great lately and have been sleeping through the night many nights. The last time I was at the Doctor's office in late September my PVR was 47.
I went to a scheduled visit with the Uro today. I got a very unpleasant surprise in that my PVR was over 250. Urinalysis was negative for any infection.
I have to go back in 4 weeks to see if this was some kind of one-off test result or if the result is similar. This is just very weird because I have no urgency or any other symptoms currently. If the result is the same I might need to be re-scoped or even go back on Tamsulosin.
compiler michael55618
Posted
How is the frequency? What are the Uroflow results, better than before the procedure or the same?
michael55618 compiler
Edited
No issues with frequency. I've actually never had a Uroflow test.
Although my urinalysis came back negative for an infection, my leukocyte level was abnormal. Based on my half-ass online research, if that is not caused by an infection, then another possible cause is an obstruction. I am wondering if I have some scar tissue. That would also explain why my flow is sub-optimal.
TKM michael55618
Posted
My understanding is that the leukocyte level is the main indicator of infection.
michael55618
Edited
SIX MONTH UPDATE - For me the frustrations continue. My PVR is now over 280cc. I'm back on Tamsulosin and have a cystoscopy scheduled in a month to find out what is going on. There may be a stricture that can be removed at the cystoscopy, but if not in an out-patient procedure. The other possibility is that my bladder is just too stretched out.
I can't tell you how disappointed I am after being told that despite having Aquablation, self-catheterization may still be in my future.
not_too_shabby michael55618
Posted
Sorry to hear this Michael. I hope they find the cause and it is a quick solution for you.
compiler michael55618
Posted
Are your BPH symptoms such as difficulty urinating in the morning, urinating at night, frequency, urgency, dribbling of urine worse than or the same as before the Aquablation therapy without taking tamsulosin now?
michael55618 compiler
Posted
The weird thing is everything you listed is better than before Aquablation. The only real problem at this point is PVR.
compiler michael55618
Posted
Do not worry about the PVR too much but symptoms. Do you still need to take the Tamsulosin after the procedure?
michael55618 compiler
Posted
I discontinued the Tamsulosin about a month after the procedure. Now I'm back on it.
The issue with PVR is that if it keeps going up, I may have to self-cath, which means that the procedure will have been a waste of time.
not_too_shabby michael55618
Posted
If you haven't already, try 10mg time release Alfuozin. It worked better than two doses of Tamsulosin daily and it didn't give me RE. Cost with my insurance was the same.
There is a video on youtube about a guy who had turp and then about 6 months later he was having issue urinating and the doctor found he had a narrowing of the bladder neck. Maybe that is what is going on with you. Hopefully the cystoscopy gives a clear picture of what is going on.
compiler michael55618
Posted
Sorry to hear that. If you need to continue on the medication, the outcomes of surgery may be not very good. Please update what is the reason for the poor surgical outcomes.
michael55618 not_too_shabby
Edited
Thanks! I think I found the video you are talking about. It sounds like his problem resolved but he had to endure two more general anesthesia procedures to remove scar tissue. I've suspected for a long time that my problem was scar tissue because I briefly had a period after surgery where I had a fire hose but it soon was reduced.
tony92329 michael55618
Posted
I am having a similar situation.
I had Aquablation 6/30/23 My recovery went very well and I had a nice full stream, and was
empting my bladder quickly. Around the 6 week mark my stream became very fine, starts off strong but then weakens and starts dripping and takes much longer to finish.
Also urgency and frequency have increased again as well.
I tried to get back in to see the doctor but got the nurse practioner instead.
I was tested for infection and came back negative.
I was told to go back on Flomax, and that it takes up to 3 months to see the results.
I can understand taking a long time to better, but to get better quickly then go back to where I started is very disappointing.
I am 66, very healthy, prostate size was 90
michael55618 tony92329
Posted
Sorry to hear that. I would definitely talk to your doctor about scar tissue if it does not improve. He may be able to improve things some with a cystoscopy, which is pretty simple and quick. Let us know how you are doing.