Aquablation: Done!

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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.

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  • Edited

    I had Aquablation three weeks ago today. Past history of Cool Thermo 6 yrs ago, then Rezum 3 yrs ago,, both did not last, helped some but did not last,, and as with meds and supplements that don't really accomplish or do anything,, needed to get something done that will last longer... Some reduction in size but eventually increased to where it was 75cc size,, so up 4 to 5 times per night, etc.. and TURP or something else became something next...cvhose aquablation from 5 yr studies,,,

    Had some bleeding that would not resolve so ended up in a longer stay than usual, 3 days and sent home with catheter,,, flow has been restricted, blood lasted for at least 2 weeks, mostly clear now, but flow is slow to improve, continued burning on urination, urethra swollen and really not fully resolved, soreness still,,, went to work after about 10 days,, urologist says I am in the norm,, bleeding for 2 to 3 weeks, some clots to still show up and eventually a scab but not seeing the scab pass yet....

    Will report back in a week or two...

    • Posted

      Thanks all for posting. Keep us updated on your recovery. I am looking at having this procedure in the next few months.

    • Posted

      thank you for posting too, considering going aquablation and worried about recovery -seems like it's hit or miss for everyone so good to hear your updates.

  • Posted

    Yes Thanks for posting your experience.

    I am starting down the road to find a procedure for my BPH. Going to see my Uro on Thursday.

  • Edited

    Unfortunately, after deciding on Aquablation and booking an appointment with a Uro that offered it, turns out it's not covered by my insurance. I hear that Medicare, Aetna, BCBS and Humana cover it. I'm under a United Health Care Plan by name, but I believe that my company is self insured? so they may be stingy on approving newer treatments.

    I am at max out of pocket for the year so I really wanted to do it before year end.

    Deciding whether to do an alternative procedure or appeal to company to approve it for next year and pay. In the mean time I'll have the 2 bladder stones blasted.

    • Posted

      My company offers UHC as well. I have heard that you can appeal and sometimes they cover it on a case by case basis. It seems rather dumb that they do not cover it as it takes a fraction of the time as TURP in the operating room and has less chance of complications.

    • Edited

      UPDATE: AQUABLATION DONE!

      (FIRST OFF, a request to the management of this web site. The protocol for accessing the page is wayyyyy too involved. Passwords, magic id words, etc. Can it be simplified? I wanted to post this weeks ago but was closed out and didn't have the time to play. This is not the Pentagon deep web, so maybe simplify things a bit?) As for my aquablation:

      December will mark my 1-year surgery anniversary. I can no longer say it was a near perfect experience. At best, my flow has improved nicely and there are no sexual side fx. That's good. But urinary frequency is as problematic as ever. Every two hours at night if I dare to drink fluids after 7 pm. Maybe every 3 hrs if I don't. That is disappointing. My uro says a 76-year old man shouldn't expect much better. And here I thought aquablation would resolve a lot of that. Uro thinks frequency may be bladder-related and hasn't ruled out resuming kegel exercises -- though I am not confident that can help having done those in the past. Doc may also restore alfuzosin therapy. I see him in a few weeks.

      If I had to grade my aquablation experience now 9 months later: a 6 on a 10- scale is about the the best I can muster -- mostly for the improved flow and continued sexual function. Wish it was better news overall but that is life. Good luck to all.

    • Posted

      So your Night Time Urination Frequency/ Nocturia has not improved but is the same as before the Aquablation Therapy, right? How about the urinary frequency and urgency during the day? Thanks for sharing!

    • Posted

      Each slightly improved. But only slightly. Actual flow/stream has seen the real improvement, but still pre-occupied with frequency. Though it can be said I consume more fluids than the average individual. Not extreme, but likely above average

    • Posted

      i am in the same situation as you. UHC denied the preauthorization, stating that it is an unproven/experimental procedure. I know that Aquablation was FDA approved in Dec 2017

      and Medicare approved it in Dec 2020...so..how can it be unproven? Today i wrote my appeal letter and supporting documents and tomorrow i'll send it by mail. If you guys are interested how this works out, i can write an update (which they need to respond with a decision within 30 days).

      When i did a research on who decides if a procedure is considered proven and not experimental anymore, to my surprise ..there is no entity that makes the decision ...so..just because FDA and Medicare approves and covers it , doesn't mean anything...that's BS. Anyway , i had to vent a little.

    • Posted

      Yes, please keep us updated on your appeal. I will be in the same situation in January when I switch to UHC from Kaiser. I have also looked into pay cash for the procedure and have been quoted prices around $14K-$16K including hospital stay, anastesia, etc. I am a little nervous going that route as I don't want to be hit with a much larger bill than they estimated.

    • Posted

      I am in the U.S. I am on Medicare via a Medicare Advantage plan. The procedure was fully covered without issue.

    • Posted

      FYI: Humana covered my procedure in 2021. Human Gold Plus is my plan.

    • Posted

      Hi everyone.

      As i mentioned before my aquablation operation was denied by United Healthcare.

      I submitted my appeal letter and documents a little over a month ago.

      Today , when i checked my user portal for UHC, i saw that they NOW have approved my operation. Wanted to share this information with you guys because some of you wanted an update on how it goes. So..appealing their decision worked out for me.

      Now i have to contact my urologist and hopefully setup a date for the operation.

    • Posted

      How did you persuade your health insurance to change the decision, by the doctor's support?

    • Edited

      I had no help whatsoever from my doctor.

      i just asked for all the documents about my prostate from him.

      i found a form called Grievance Form on United Healthcare's website.

      i filled that form(which is a very simple 2 page form).

      i explained why aquablation is NOT an experimental/unproven procedure by referencing Medicare's Aquablation approval article (i printed this out and attached it to my appeal documents package). This article has extensive information about all the trials and outcomes). Also mentioned that FDA also approved it.

      Also pointed out that other major insurance companies approve this procedure and asked them politely to reconsider their decision.

      So..The whole appeal package contained 1) The grievance Form 2) Medicare Aquablation approval article 3) all my previous doctor records.

      That was it. By the way obviously there was no new information that i submitted that they didn't already know...They had all my records..They know about medicare and fda approval...

      I am guessing that they realized that i will not let it go and fight their denial decision and decided that it wasn't worth the trouble i will cause and just approved it.

      If that was the reason for their approval, they were right..i was getting ready to take further steps if they didn't approve it.

      i planned to contact the Florida Office of Insurance Regulation to file a complaint.

      But maybe i just got lucky..IDK

    • Posted

      Hi Owen, at some point you might want to ask your doctor about a condition called "interstitial cystitis." I have that condition. It's more common in women but men are not immune. It was confirmed when doctor filled bladder with water to capacity and was able to see lesions/ulcers. I'm lucky in that I only have frequency, no pain. Drinking lots of water is good. Strict avoidance of tea, coffee, and soda helps and probably alcohol as well. As far as i know a simple cystoscope will not show the lesions - the bladder has to be blown up. Good luck finding the cause of your frequency.

    • Edited

      So..update..i will have my aquablation surgery Monday December 19.

      Hope all goes well.

    • Posted

      Relax. Your doctor should have already performed the cystoscopy, a flow rate and post-void residual test as well as measuring your prostate size. Asked your doctor about your bladder trabeculation grade. What is your prostate size?

    • Posted

      i am not too worried about the surgery. Like you said, i already had a cystoscopy and a biopsy, besides all the other tests.

      Little more info:

      Age: 59 , Latest PSA: 6.9 , PVR : ranges between 400-700 ml, prostate size: 66 ,

      severe trabeculation, mild median lobe.

    • Posted

      You may record your volume and frequency before the procedure so that you can compare them after the procedure.

    • Posted

      I'm on UHC PPO, they covered prostate aquablation. Hospital got an OK/confirmation prior to proceeding. I had it done January 3, 2023. Insurance paid $23K, I'm paying a $7K deductible on top of that (fortunately hospital has a monthly payment plan)......bet $7K I've ever spent.

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