Aquablation Experience 03/23/23

Jonathan hope you are doing well in you first day post aquablation. Thanks for sharing you insight. Hope you continue to improve and keep us updated on your progress.

Day 2...

Still at the hospital this morning, I woke up tired (due to typical hospital "poking and prodding and taking of vitals" through the night), but feeling well, and having a surprising lack of discomfort. I was still being irrigated, and was passing some small clots through the Foley (quite typical). They next disconnected the irrigation, and saw that I was continuing to pass urine with small clots (with the Foley still in place). Before they removed the catheter (as was planned), I expressed concerns to the physician's assistants about the possibility of clots clogging my urethra (and causing retention and and ER visit) over the weekend, and they explained that I could keep the catheter in over the weekend if I desired, and I opted for this instead. I now have the catheter removal and voiding test scheduled for this coming Monday morning.

Overnight, I had a bit of bleeding had that had passed between the outside of the catheter and the inside of my urethra making a bit of a "sticky mess" at the tip. I was permitted to walk to my room's shower and carefully get myself cleaned up. It felt really good to be clean again. My only discomfort was at the tip, where the catheter was moving around a bit. A good tape patch was then used to hold it in place, and discomfort is now quite minimal.

My meds were reviewed, and for now, they're keeping me on my Alfuzosin, and have me on a ~ two week Ibuprofen/Tylenol regimen, as well as adding Senna stool softener. I was instructed to drink 8-10 glasses of water a day, to not lift more than 10 lbs., and to “abstain” for 6 weeks. I was released after lunch, and was even allowed to walk from my room, through the halls, and out to the sidewalk to the car. I was amazed that I was feeling this good just a little over 24 hours of the operation.

I'm now writing this post from my recliner, in the comfort of my home, still amazed that I had the procedure just yesterday morning. The liquid in my catheter bag is a light tea color (darker than the watermelon color that it was when I was still being irrigated). Presently, it is without clots.

Truth be told, I'm still a bit apprehensive about the catheter removal, and of potential level of discomfort upon urination, but in the mean time, I'm looking forward to a relaxing weekend, and will report back on Monday.

Can you hold your pee after the catheter removal (urinary incontinence)?

This morning, I had my post-surgical 3 way 22F Foley catheter removed, and had a post-void test. While looking forward to getting it out (waking up “aroused” with a catheter in place is less than pleasant), I was still a bit apprehensive about potential discomfort of the catheter being removed, and asked the Urology nurse to let me honestly know when she was going to remove it, and to slide it out gently rather than to do any tricks such as to say “ I'll remove it on 3 count” and then to actually yank it out at “2”. Thankfully, she complied, and was very gentle.

She first put 200 ml of sterile saline into my bladder (via the catheter), then carefully deflated the Foley's balloon, and with her gentle pull, it slid right out. Discomfort /pain level was honestly only about a 2 on a scale of 10, and only lasted for less than 5 seconds. Phew!

I was given a 1000ml urinal bottle and a drinking cup, and told to drink water and come back (“in about 4 hours”), when I had filled the urinal for her. I was concerned about potential incontinence, but my concerns were unfounded. I left the office, went down to the waiting area, drank a cup of water, and a few minutes later went to the men's room, and was easily able to initiate flow into the urinal bottle. I had complete control of my stream, only had a small tinge of pink, and the discomfort was negligible (maybe a 1 out of 10 at the most). I went back to the waiting area, drank more, and repeated the process until the bottle was full. For me, this was only a 2 hour mostly comfortable process, and I felt like Pinocchio (“I can pee like a REAL boy now”!).

I brought the bottle back, had to wait about 5 minutes for the nurse, and she was very pleased to see both the short time that it took me to fill it and the content's relatively light color (just a tinge of pink). My residual (via the ultrasound) was 128ml, and the nurse expressed that she had hoped for less. I expressed that it had been more than 5 minutes since I had last voided, and that I felt that I could now easily void more. She handed me an empty urinal bottle, showed me to the local restroom, and less than a minute later I was back to her with a bottle with more than 100 additional ml in it. She was quite pleased to see the then “only ~30ml” PVR.

Gentlemen, it's hard for me to even begin to fathom that just less that 100 hours before this, I was in only in PRE-OP for my Aquablation procedure, was close to being in retention, but now had no incontinence, had complete control over initiating and stopping my flow, flowed “like a 20 year old”, and had only negligible discomfort. (Note that yesterday, I had experienced some mild bladder spasms, was told that they should stop when the Foley was removed, and they did indeed almost immediately resolve themselves).

Writing this now (a few hours post my above experience from this morning), I have continued to be able to have complete (and pain free) voiding, with only a small clot/tinge of color at the start, but with a HUGE smile on my face, and admittedly tears of joy in my eyes that I can now easily do in 5 seconds what just last week (and for the last 5+ years) I had to struggle for more than 15 minutes to do.

I realize that we all heal differently, that this is only my first catheter-free post-surgical day, that during healing things may take a step backwards, and that it's FAR to early to know if I'll have RE, but oh my...I can only wish that others of you can be as “fortunate” as me to have this easy and seemingly successful time of it.

Best wishes to all for an easy procedure and to a successful recovery.

Excellent update. So glad to hear all the positive results. Hope it all continues to get better each day.

If you are comfortable sharing....was your surgeon Dr Lloyd Harris at Penn? How many had she done before yours? Did she warn of potential retrograde ejack (and did it concern you)? Thanks

Hi All,

A relatively quick update today...

Last night (Monday night) was my first night without a catheter (since my Aquablation procedure on Thursday morning). I went to sleep a little after midnight, not quite sure what to expect, and how things might go... I woke up at 2:37 AM with a moderate urge to go (all was dry in bed), I went over to the toilet, effortlessly voided (not even a hint of pink!), and crawled back into bed...The digital clock still showed it still being 2:37...It felt like a dream, as prior to my Aquablation, I would have been half asleep on the toilet straining to void for more than 15 minutes, and have then spent another more than half hour trying to fall back to sleep with a heavily disrupted sleep cycle. A parallel event occurred at 5:45 AM (but this time the clock showed 5:46 upon my return to bed). I was truly elated.

I woke up at 7:30 this morning so very well rested, and relieved of the anxiety of what to expect. I must however honestly state that when I woke up, it was with a slight discomfort (a slight stinging of my urethra), as my "member" seemed to be quite fully awake too. I guess that it needs just a little more time to heal from the catheter, and I'm planning on abstaining for the full 6 weeks as suggested by my Urologist/Surgeon.

Gent's, I realize (and am greatly appreciative) that I appear to be one of the luckier ones here, and must reiterate that I'm only 63, relatively fit, and have no diabetes/other comorbidities , and typically heal quickly. That being said, It's still hard for me to fathom that I only had the procedure ~125 hours ago. I can honestly state that other than this morning's very mild stinging when I awoke fully aroused, "If I didn't know that I had just had the procedure this prior Thursday morning, I wouldn't know that I ever had (or needed) the procedure" . I realize that I'm only 5 days into it, but it has been truly miraculous for me, and I can only wish similar (easy and effective) experiences for the others of you that are going through this.

• Jonathan