Aquablation for BPH

TYPOS:

Second paragraph should read in part "...which showed no incidence

of retrograde ejaculation..."

Another interesting note, though. The Green Light and other types of TURP that use any sort of heat, the risks are greater [but still small] of ED post surgery, whereas with the Aqua this increased risk has been eliminated because there is no use of heat. Also, presumably, less risk of strictures as well for the same reason. There are still risks with any procedure, but hopefully smaller risks with non-use of heat as part of the procedure.

I had the Aquablation  procedure last Sept 20th, here in Southern California.  Unfortunately, I had a retrograde orgasm, today.  It is something that all men have to take into account.   Don't believe that the "Aquablation" procedure is "retrograde" safe, it is not.

Hi Felix,

When you say, "last Sept 20th", are you talking about 4 weeks ago? If so, let's hope you will regain normal ejaculation with more time. 

Jim

There are some men on here that the doctors are telling them only 4% chance of retro. they tell you the same thing with TURP.  Doctor will lie to get you into surgery.  Ken 

Hi Grant

​Best of luck.  I was a possible candidate for a trial in UK too, but I have held on with what I have got for now.

Really interested to know how it goes

Mike

They're running a new trial here in the States. Last trial there  was a chance you would have TURP done since it was a double blind study. This one looks like its just Aquabation. In the end its another form of TURP but it does seem a little more accurate since its computer guided

Hi well i have put it off for the last twenty years. The uros have offered me turp many times i could have urolft but i dont think its a permanent fix so fingers crossed.

I am crossing mine too. I have had a couple(!) of Urolifts but am stuck with prostatitis and hoping for better future. Do you mind saying where you are having it done and by whom (if this site allows)?

Mike

Was the prostatitis a result of the Urolifts or did you have this condition prior to the Urolifts?

Lucky i have never had that, Frimley park surrey the head of urology there. Grant

Same place, same guy!

Not so easy to answer.  I certainly didn't have as many problems as I do now before Urolift, but Urolift has done its (perhaps temporary) job of keeping me going without drastic surgery

Grant.  Read up on it first. The 3 trails they did do not say alot about    retro but it is close 10% can you live with that 10%. Doctor will tell you lesss because they are trying to sell the procedure But i guess its better then a turp  Also there is a 5 years study that was just out on urolift  0% retro and all patient are still going strong.  I'm going on 2 1/2 year all is great  Good luck  Ken

Yes im reading all i can but not much on it at the moment of course, seems better than turp as you say urolift was my other option ive got a lot of thinking to do. Grant.

Yes think about it first.  It will be to late after it done and you have retro. Try the Urolift first you can always have the other.  And you know they do the same make a tunnel.   I'm very happy with mine and no side effects....Take it easy and good luck  Ken

It was the same guy that enthused about Urolift to me some years ago.  He is a bit of a salesman, is he not?  But actually he seems to be very much up with the trends, and I would consider acquablation by him relatively safe.

Yes very persuasive i could still have urolift not sure now!

Hi Grant,

Ask you doctor to show you where he gets the 4% retro figure? The Phase II and Phase III trials show a retro rate of 25% of TURP. Realistically, that would put the retro rate of Aquablation between 15 and 20 per cent. Also, make sure you ask if there is a control arm to the study. In the U.S. the control arm was TURP, so that meant going into the surgery you didn't know if you were going to get a TURP or Aqualation.

Jim

That is a good pointe Jimthepa.  The patient does not get to pick  Ken 

Hi i have been told aquablation only so no turp option, i think the 4% comes from the Use of no heat at all option 60% of the study.

Grant Please read everything before you sign anything.  Most of the time it one procedure against another 20 to 25% retro was in the trails  Read all 3 again.  It 's not worth taking a chance with something your not going to be happen with.   Please  Ken

Grant,

"No heat" may account for 75% less chance of retro than TURP per the Phase II and III trials, but that still translates into a 15-20% chance of retro. Just because your doctor tells you it's 4% doesn't make it 4%. 

Jim

I see, ok well i have to think about this the only reasonably safe option as Ken mentions! is urolift thanks for the info. Grant.

Hi can i ask has the urolift worked for you reguarding flow etc and can i ask what size your prostate was? thanks Grant.

Hi Grant

​Slightly complicated answer - sorry!  Prostate size about 80cc - possibly too big for Urolift (the man said).

​Had NHS Urolift at Frimley August 2015.  Had issues with some pains and eventually paid for him to look see privately.  He found one tag problem, took it out and put 3 more in, ending up with 9 tags - almost a record.  That was Jan 2016.

​Since then the flow is tolerable most of the time, but I would like it to be better - especially at night.

​I have been suffering with prostatitis too for some time, which clouds the issue.

​I have posted my day by day Urolift experiences on this site somewhere - not pleasant reading - but I think I was unlucky

Yes mine is aporox 70cc so a bit big also for this i think, also i was told that my flow is so bad that urolift would not improve me enough hence going towards the aquablation option, lets hope the urolift has not caused your other problems thanks for the info Grant.

A doctor does not know if a procedure will work untill its done.  They can only suggest.   The urolift will do what it is suppose to do open the prostate and free the bladder neck.  No side effects.  Going on 2 1/2 years for me.  Mine was the size of a large lemon and closed where he could not get the camera in.  Had 4 implants.  All great  Try it first that make me all you need  Ken 

Kenneth.  I know you are well intentioned but you are putting a lot of pressure on Grant to do as you did.  We are all different.  That fact that you only have 4 implants (I have 9) shows your prostate is much smaller, so Urolift is more applicable to you.

?Grant should consider his own situation. 

Reading this forum, I get the feeling that in US there is a great deal of distrust of Urologists.  In the UK we don't feel they are so bad, and that they have our best interests at heart.

I didn't sense Kenneth was putting "the screws" on Grant but you bring up a very good point. There is a tendency here (and elsewhere) where men try and convince others to do the procedure that worked for them and conversely to avoid a procedure that didn't work. This is more human nature than scientific. 

Like you said, "consider (your own) situation" because it may not be a good match for someone else's. And that's why while anecdotal data is helpful, it should also be pared with trial data. And the trial data again, should be compared to your own individual situation as trial participants themselves are often cherry picked.

Jim

Im sorry if it like I'm doing that.  I am just trying to get him to think about what he is doing.  Why have your prostate cut out when having it pulled apart may work just has good and has no side effects.  Doctor don't worry about side effect there not the ones that have to go through them. You have to look at the pros and cons of any procedure you have.  You also have to remember that doctor don't know if a procedure will work until it's done.  You have it cut out they it's to late.  Life is to short to give up on your prostate  Ken   

Its true we in the uk seem to have more trust in urologists maybe because money does not come into it on the nhs, but we dont get the choice and speed of appointmants i understand exactly where Kenneth is coming from its really worked for him but as you say 9 clips to his 4 i guess the size difference of the prostate thanks to all of you for the imput i will let you know how i get on! Grant

Grant I know its a hard discision to make. BUT don't let them diside for you because it takes longer to a appointmants.  To me it seams like you have to take what they are welling to give you. And you and your concerns don't matter.  Just be carefull  Ken 

Hi Grant

​I wonder whether you went through with the Aquablation trial in August.  How did it go?  How are you?

Mike

grant: uro assures me only a 4% chance of retro?

------------

Really? Based on what. Read my previous comments on the phase III data for a more realistic expectation.

Jim

Hi im due to have it in oct! but im still not 100% about it, the retro figures are a bit higher then what i was expecting, at this very moment im looking at the rezum procedure so will update you, im still uncertain why i was not recommended the urolift procedure i have no median lobes etc in the way and he said i was a good candidate for it but due to my very weak stream did not think it would help me enough, surely most guys that have urolift have a weak stream?.

Grant

Perhaps the doc knows how to do Resum, and has bought equipment to do it,but doesn't know anything about Urolift . Get another opinion.

Neal

Grant  Like I said before.  If you are not sure about any procedure you should not do it just to do it.  The doctors can only tell you what they think. If you want to try the Urolift you should. It is your body and you have to stick up for it.  Tell them this is what I what to do.  They should do what you want and if they tell you no get another doctor.  You can all ways go and do something else.  Take care  Ken

Hi Grant, Could you tell me the latest retro figures for aquablation. Also, if no retro experienced, any info on post op fertility issues, if known.

Dave.

HEY Grant......October is just around the corner.  I had a very slow stream before I had my Urolift.  Had a scope done the doctor could not get the camera in my prostate.  After he opened me up with the Urolift I have no problem.   2 1/2 years.  I hope you make the right pick for you.  Don't do anything your not sure of just because your due to have it done.  Ken

Hi sorry I don't know the latest figures my uro just says low! no actual figures until after the next trials I guess.

Thanks Ken, It's the only thing I can think of at the moment! .

Dave and Grant,

Check out the Phase III presentation on their website for the retro figures. I would not call them "low" at all. From memory, the incidence of retro was around 30% of the control (TURP) group. Even taking  very conservative figure of retro in TURP (60%) that would mean 20% retro in the aquablation group. You will find a lower number (8% again from memory) in their presentation, but I don't see how it's possible that the TURP group only had 24% retro. More likely, they came up with a low retro figure due to a faulty questionnaire and/reporting. 

Jim

It seam like a lot of the trails run around the bush.  There is nothing up front.  20% is very high to take a chance.  Remember this is a controlled study.  They answer question the way they want.  So you figure 20% of 111 comes to about 22 men with retro.  Do you really want to take the chance of being 1 of the 22....Read up on all you can    Ken   

Hi Grant

What's the latest with you?  Did you decide on Acquablation or .....?

?I am considering it still ...

Best

Mike

Sorry replied to Tom and not you, yes had it in oct all seems ok no retro thank god!

Great news Grant.

Did the main man do it at Frimley?

​Mike

Yes he did ,seemed a lot of blood for a few days with irrigation In hospital but no pain .

Well, I had the phone call today, giving me a date in a few weeks for the aquablation.  So now I have to make a decision whether I go for it or I carry on as I am.  

I have a 123cc + prostate, I have 9 pairs of urolift clips in there.  I have a small bladder (possibly only 300cc), and have urgency and frequency issues.   Sometimes I go every hour throughout the night, but sometimes only once: totally depends on how much and when I drink.  My flow is poor, and perhaps is slowly getting worse, but sometimes it seems to flow really freely.  I have been living with these issues for years and somehow manage around them.

I may make a list of pros and cons...

Maybe I will end up being 'normal' - but somehow I am pessimistic about that, as it is difficult to imagine after all this time that I will be able to put off peeing for ages like 'normal' people.  But my prostate seems to keep growing so I am scared I will have full retention.  I am also worried that my case is extreme with so many urolift clips and such a large prostate, so that the operation may have issues.  Of course, I may end up with RE after all, or worse ...  but I cannot see anything else that can help me coming along.

Mike I think you should do pros and cons.  The urolift has keep you open and it did what it is suppose to do.  What I am worried about is that I don't think it is your prostate.  You still will only have a bladder that will hold 300 cc I don't think getting rid of the prostate is going to solve your problem.  It is a lot to think about.  The water aquablation is just another way of doing a Turp.  You have a hard decision to make  I wish you all the best  God help you  Ken  PS  What did the doctor tell you.  Did he give you any odds    

Hi Mike, I can understand this is a difficult decision for you. Perhaps best to speak to your urologist again first. Run your concerns past him and try to get more info as to the results he has achieved to date as to RE etc with other patients on the study. Perhaps you would keep us informed as to what you decide please. I have a vested interest in as much that I too have a gland in excess of 120 cc but no urolift clips fitted. I put my 300cc bladder capacity down to the size of the gland. I am in the UK & think I may possibly have seen the same urologist in Surrey as you where I first learnt of aquablation. He told me that he had operated on glands up to 140cc to date, this was some months ago before the current study began. Good luck. Dave.