Aquablation: Done!
Posted , 40 users are following.
This is a follow to my earlier oft-postponed scheduled aquablation. It finally happened on Tuesday, Dec 7, 2021. A summary of the days thus far:
Tuesday, 12/7: a 6 a.m. visit to the local nearby casino to "unwind." (I'm serious 😃
Tuesday 8:00 a.m arrival at the hospital. Check in procedures for 30 minutes or so and then an unfortunate delay of a couple of hours as my doctor had a busy surgery schedule that day. Anesthesiologist checked in to explain his side of the procedure (my favorite guy for the feel-good stuff he administers.) Moments later I was in a deep sleep -- and moments after that, it seemed, awake and finished!
I was told the entire procedure lasted a bit more than an hour. No complications. But for my age (75) and the "condition" of my years-long BPH-battered prostate, my doctor recommended two nights in hospital with catheter. I was OK with that. I can't say I felt discomfort of any kind in the immediate aftermath, though morphine and another pain killer were allowed and welcomed on days 1 and 2.
So today is 2.5 days out from the surgery. I got home an hour ago. I had the obligatory pee session before being discharged. Yes, it burned. But a small price to pay, I figure, in the very early going. Flow is not (yet) a gusher, which surprised me for the stories I have heard. But I am patient. Biggest issue for me thus far: constipation. Been plugged up since Sunday but am told that will resolve itself once life's daily routine takes over.
Perhaps the best relief of all: no more dull, 24/7 malaise discomfort in my lower belly area. GONE! That is VERY encouraging as I have lived with that for many years now. Like a block of wood behind my navel. I am also hoping for a true night's sleep tonight and more energy resulting tomorrow. (Prior to surgery, 3 naps per day were standard in my state of permanent fatigue. ) I can accept 1 or 2 pee breaks in the night going forward....if that's what evolves. Prior to surgery, up every 90 mins or 2 hrs.
So. So far so good. I am early to the recuperative phase so we will have to see. I see my uro again in about a month. If I missed anything, please let me know. Good luck to all.
3 likes, 65 replies
owen35669
Posted
I refer all followers here to the "8 days to aquablation" thread where I just posted an important milestone update. Sorry...I didn't know I was on a different thread line. Will try to re-post it here once the moderator clears the info. Thanks.
owen35669
Edited
12/19/21I am now 2 days away from a two-week anniversary since surgery. The bloodish tinge in my urine is largely gone. There remains some urethral and rectal burning., which I assume is from the urinary function contacting still raw tissue. (I read that the prostate is up against the rectum and has to be peeled away during the surgery. Hence, I guess, the rawness.)
The big news for today for the first time: I finally have a stream plentiful enough to make that familiar and glorious long-ago blub-blub sound of urine hitting water! I was thrilled 😃 It's a marker, I hope, that the healing is on schedule. Wife and I also jumped the gun today (by two days) on a two-weeks-no-sex rule of my doc. We can report all systems working with lift-off! Only noticeable side aspect: very watery semen. But all else is like it was before I had the problem -- and that's been years. I am very glad I sidestepped the retrograde ejaculation issue of the laser approach to this ailment.
I don't mean to generalize and my experience may or may not be typical. But I am now glad I chose aquablation and hope I can say the same a month from now and beyond. I next see my doc on January 4. 75 years old and feeling 50 again. I will continue to update here as needed.
russ_777 owen35669
Edited
Your experience is similar to mine.
I also had immediate relief from a chronic (~18 months) dull aching pain in my lower abdomen that could not be diagnosed as separate from BPH. I could tell in my hospital room as soon as I was sober enough from the anesthesia that it was completely gone. Still don't know what caused it though it obviously may have been related to my prostate growing into my bladder or putting pressure on adjacent nerve bundles.
Regarding not being able to pee like a race horse immediately, I had significant inflammation in the apex of my prostate as my surgeon was careful to preserve as much tissue there as possible. This lead to my flunking my first two pee tests resulting in my catheter being in for ~ 10 days. Part of that catheter time was due to timing of follow up appointments with my regular urologist after I returned home (~ 300 miles from where I had the Aquablation done).That urologist recommended my taking 800 mg of naproxen/day after the 2nd failed test thinking that inflammation was the problem and knowing that my urine had been clear for several days. After about 3 days of taking the naproxen I had no problem passing the 3rd pee test. That was aided somewhat by the nurse injecting 225 ml of sterile water in my bladder before pulling the Foley since the Foley has a dilating effect in the urethra. In spite of that I had great improvement compared to pre-Aqua every time I went after that. Per a urodynamics test my peak flow rate had been 5 ml/sec prior to surgery and I estimated about 20 ml/sec (average, not peak) following final removal of the catheter.
As my urologist (who had recently had prostate surgery himself) said, don't get frustrated, this is what recovery can be like and it varies from patient-to-patient.
I had no sexual side effects and if anything had better erections and orgasms after the surgery. My take away on that was that having an organ grow to 4+ times its normal size in my case can affect more than just urination.
owen35669 russ_777
Edited
Thanks Russ. Happy to know that we are having similar progress. Speaking of:
UPDATE/3 weeks from my 12/7/21 aquablation surgery:
Had my first "normal" voiding experience in years this past week. Haven't experienced this pace of flow in 20+ years. Not the much-referenced gusher like an 18 year old, but a "normal" flow that meets my expectations -- at last 3 weeks after surgery. Still off an don difficult to begin a stream at 2 in the morning but I figure that will resolve itself in time. Will report it to the doc anyway.
Bigger picture: No more blood tinge in urine; diminished urethral and bowel pain; urine flow significantly improved as noted; sexual function intact -- or seems to be ,save for watery ejaculate.
I see the doc on January 4. At the recovery pace I am keeping, I will likely applaud him when he enters the exam room! Aquablation has been a life changer thus far. Visiting relatives at Christmas commented to my wife that they hadn't seen me so chipper in a long, long time. The pelvic pain of which Russ speaks was real and a blight on my overall demeanor and expression. For years. Pain now gone and I am back.
Not much more to say, though I will update further at end of week #4 and after I see the doc. Choice of a solution is a big decision for any of us suffering BPH, but I can say that, for my own experience, I am glad I did this. Onward and good luck to all.
bob955 owen35669
Posted
Hi Owen-
I am really stressed out because all the doctor's are recommending surgeries that have retrograde ejaculation risk of between 50% and 100%!
I was told by a couple of doctors that Rezum has not provided good results for median lobe patients, so I would now like to consider Aquablation.
Your last update was 4 months ago. Could you provide an update on any symptoms and on a scale of 1 to 10, as to how happy are you now?
Did you need to do self catherization at home and if so, for how many days? Did you need to self catherize even before surgery?
Were you able to avoid retro ejaculation?
Do you know your prostate size? Mine is small, 30 grams.
Anyone else reading this who could share their Aquablation experience here, would be very helpful to me.
Thank you so much.
Bob
ksflyer bob955
Edited
Hi,
Me......58 year old may with large (90cc) prostate.....in full retention, on catheter for 3 months prior to getting the surgery.
I had prostate aquablation on January 3, 2023. It's now ~5 weeks later, 95% healed up.
Definitely glad I did it. First two weeks of recover were difficult, things started getting better around third week, still having minor pain when urinating but it has been steadily decreasing. Can't pee like an 18 year old but can be "good enough", much much much better than before.
Getting up once per night to pee and being able to start a decent stream right away. Able to spread out going pee 2-3 hours during the day.
Surgery and recovery.....
Most interesting and different thing for my prostate aquablation was my surgeons preference to leave the catheter in for 7 days, not the normal 2-3. The pros of this is that he has seen a near zero percent "failed to pee" rate after catheter removal. The cons are you have catheter for 7 days that does some pain through out then entire lower region.
Additional note, have a pain management plan defined before leaving the hospital that includes prescription pain killers (5-7 day supply....probably will only need for 3 days) and rotation of Ibuprofen and Tylenol.
I had the surgery early the morning of January 3rd and was released around 11AM the next day. Nursing staff did this massive flushing process the entire time, constantly pushing saline solution into my blatter and then draining it out. Went through 12-15 liters while I was there. Did get blocked at one point with tissue that would not drain, went through a "traction" procedure that was totally tolerable, no big deal. "Traction" is basically they stick a big syringe on the catheter line, force fluid and then rapidly pull it back out to un-clog it. It worked for unblocking on the second attempt.
I stayed in a hotel local to the surgery location for two additional nights (I live 3 hours from where I had the surgery). This was a good decision, I was not ready to sit for a long car ride. Even on the 4th day after surgery for the card ride home I laid the seat back the entire way while my wife drove us home.
The catheter caused a lot of pain in my testicles, penis, and elsewhere down there. All of this pain went away after the catheter was removed.
I was able to pee after I removed the catheter at home myself (no big deal ---- check YouTube for instructions). It gushered out about an hour after I removed the catheter. The gusher was due to my entire urinary path having a massive catheter in it. The urine stream settled down to something mush more normal pretty clickly.
Lots of blood and some debris in my urine for the next 7-10 days.
Now five weeks since surgery, 95% good, just some minor pain occassionally when peeing.
Sex.........hurt and was unpleasant when I tried it with my wife at about 4 weeks, at 5 weeks no pain, but not yet what it used to be. Hopefully will continue to see improvement on this front in the coming weeks.
Final thoughts......the surgery itself is no big deal, your knocked out, you wake up and it's done. The surgery is absolutely worth it, run for the surgeon and get it done. Recover sucks, if you are "blue collar" work plan for at least 4 weeks off, maybe 5. "White collar" worker should plan on 2 weeks off if you work from home and 3-4 weeks off if you must drive into an office. It is expensive, so make sure your health care coverage is in place to cover it. The hosptial surgeon billed for $100K, the negotiated payment was $30K ($7K of which I owe due to my deductible).
Getting your surgery scheduled.......if you are in retention like I was you need to be the "squeeky wheel"......make phone calls explain that you are on a catheter and need be scheduled for the earliest available surgery date and get on the cancellation list. Cal back weekly to see if there are any cancellations. I got a very nasty infection after being on a catheter for 2 months that put me in the hospital for 4 days....quick action kept this from killing me. Catheters are evil infection pathways into the body. If you are on a catheter you need work with your medical team to get you in for TURP as quickly as possible (2 weeks, not 2 months).
There's probably more, I'll stop there.
Ksflyer
james16058 ksflyer
Posted
Hi Ksflyer, thanks for sharing your experience. I am on second week post surgery as well and share almost the same experience other than the catheter came off before discharged the third day. At what point did you find it comfortable walking round the block or about other than in-house? Did you continue with your BPH medication after the surgery? What is your average water intake per day in the first 2 weeks?
cavo owen35669
Posted
hi, what were your symptoms pre surgery. not sure it was mentioned but i can not find it. i also have this weird pain like sensation in lower abdomen you guys mention. how big was your prostate? was it pushing against the bladder.
thanks
owen35669 cavo
Posted
If I may suggest, you need to have BPH formally diagnosed if you suspect you have it. That would of course be by the input of your doctor or urologist. Pain in the lower pelvic area, I assume, can have many causes -- in my case, BPH. I had BPH and experienced that pain for many months. The pain was gone after my surgery. But again, I was diagnosed with an obvious cause. Good luck.
cavo owen35669
Posted
owen, would you mind sharing doctors name who did your procedure. i am having no luck finding anyone in colorado, would most likely had to do a trip.
thanks
owen35669 cavo
Posted
Sent you a PM. Also, I was able to Google several docs in Arizona -- much closer than Wisconsin, no? (Interesting that no docs for aqua are listed in Denver.)
owen35669
Edited
FINAL 'Report" following my doc's follow-up to my aquablation surgery (detailed above) on 12/7/21
One month to the day, saw my Milwaukee, WI uro for a follow up. I consider myself 90% "recovered" from the aquablation and I am overall delighted with the results and would do it again. Stream is significantly restored (as I tell friends "I can pee like a 55-year old again!") I know the reports of race horse comparisons for post-surgery flow, but I am thankful, at 75, for my progress and not at all troubled by what I consider "normal" these days. BTW, for the first time my uro commented on the prostate itself. he used the words "swollen and inflamed -- indicating an obviously long term LUTS situation." I didn't ask for my size as I don't really understand any of that. I do know bathroom breaks are no longer a constant in my life, and that significant and long-term pelvic pain is gone and resolved.. The only disappointment: I continue to show a tendency to UTIs and -- most recently -- yeast infection. I thought only women were supposed to get those routinely but I guess not! I am about to go on meds for it -- again, as I have a UTI right now. . We'll see how that works out, but I am overall delighted with the impact of aquablation on my of life. Oh --- and sexual function is A-OK!
This will likely be my last post on this thread. Good luck to all and feel free to PM me if questions.
brad69663 owen35669
Posted
i had my Aquablation 4 days ago and, i have to say, although it is early days, I am extremely happy with how it went, and how I feel now, and also I am amazed at how little pain I have felt since the operation.
To add a little more detail - the operation went smoothly, after a request from me to the doctor to calibrate the procedure so that i would not have retrograde ejaculation. The only glitch was that i apparently had an erection during the operation, which required an injection into the shaft of my penis to make it subside before the procedure could start - I now have a temporary and completely painless purple bruise on my shaft, which thankfully is starting to disappear now!
Post-op, I was surprised to find i could not feel that i had a catheter inside me at all - probably a result of the anaesthetic still in my system.
The catheter was removed the next morning, and i must admit, this was painful (5 out of 10 pain) but thankfully swift - around 30 seconds.
Then began the long wait to pass urine - i drank a glass of water every hour as instructed, but nothing came out for several hours and i was worried they would recatheterise me.
Then i passed 50ml, including a clot of blood, followed an hour later with 200ml, followed by 400ml an hour after that and then another 300ml. it was mildly painful to pass urine -2/10 maybe. The bladder scan after each pee showed i was still retaining a lot of urine in my bladder - up to 800ml - but since i was able to pass urine ok I was discharged and will be reviewed at a check up in 3 weeks time.
Since then the stinging pain on urination has almost disappeared and the urine has almost returned to a normal colour, without blood in it. I also experienced constipation.
The urine flow on days 2 and 3 were amazing and full on - also i didnt have to strain to urinate - it just came out as soon as i dropped my trousers! Today I have noticed a slightly weaker flow and more control and also less leaking in my pants after finishing.
I am a little but sore, but apart from 500mg of paracetomol at bedtime i am not taking any painkiller medication. So far so good - I will keep you updated (57 year old male, UK).
brad69663
Posted
A quick update. it is now day 6 and my urine flow has become much narrower and slower - similar to Owen's experience on day 6 - so i am hopeful that like Owen the flow will increase again in a few days time.
i still have mild pain on passing urine and a dull ache in the rectum but am not using any painkillers except one tylenol at bedtime.
its hard to sleep at the moment as i am getting erections during my sleep and these cause a momentary pain in my urethra which wakes me up.
Otherwise i am working full time during the day (luckily i work from home and my job is desk-based) and i feel generally fine.
brad69663
Posted
Day 8 update - still some pain from erections during the night, a little bit of blood on urination (the doc warned me there would be a second wave of blood in week 2 as scabs heal). Urine flow has increased a little but not by much - a little bit of mild pain and delay when i start urinating but once its started, no pain at all. otherwise i am not taking any painkillers and feel absolutely fine
brad69663
Posted
Day 9 - much improved urine flow, tiny amount of blood / tissue coming out with urine, no pain from erections last night, bruising on shaft slowly diminishing, a little bit sore down below but all moving in a positive direction!