My Aquablation Experience
Posted , 29 users are following.
Hi everyone
Since Aquablation is a relatively new treatment for BPH, there is limited actual patient experience information out there, i wanted to document my journey. Hope it helps others who consider aquablation.
Before my aquablation operation:
Age: 59 , Latest PSA: 6.9 , PVR : ranges between 400-700 ml, prostate size: 66 ,
severe trabeculation, mild median lobe.
Background:
i was monitoring my PSA value since my early 50's ...it was 5 next year was 6 following year was 7, then it went up as high as 13(all these are approximate values)..finally it went down by itself(see above).
i didn't have insurance at the time, so i didn't go to a doctor but was informing myself about PSA values.
In the meantime my BPH symptoms started
First thing to consider is why a PSA value would increase...besides other factors(BPH) ,cancer could cause it to rise. To rule it out, went to doctor..had digital rectal exam..no cancer indication...
Now that i had insurance...had biopsy done(12 point needle)...no cancer..
So..my problem was BPH. I chose Aquablation because it is a minimally invasive robotic treatment, which preserves all other functionality in that area.
Fast forward..2 days ago (12/19/2022) i had the operation.
I know that the experience can change from person to person...this is my experience.
the operation was really nothing to worry about...you are under anesthesia , i woke up..procedure done.
had a catheter in and a bag. Minimal to no pain(as far as i know they just gave me tylenol)..
they hung 2 bags (each 3 Liter) of saline solution which was circulated through my bladder and out, to flush the urinary system...all night long replacing both bags every hour or so.
From other patients experiences ,i was expecting them to remove the catheter the next day and doing 3 pee tests to see if i can pee and empty my bladder, but my urologist told me that the plan is to release me from the hospital WITH the catheter and that he would remove it within 3-4 days.
So now i am home with a catheter and a bag..couldn't get an appointment yet to have it removed.
Many people mentioned that they had constipation....i don't have that experience yet as of today.
many people were kinda ok with the catheter..i am not..it is very uncomfortable because as you move the catheter moves in and out into your utethra..because of this, sometimes there is shooting pain at the tip of the penis..can't wait until this thing is removed.
The urine is really bloody right now..which is expected...the important thing is to NOT have blot clots and so far there is none. many people also mentioned bladder spasms...which i didn't experience so far.
i was prescribed an antibiotic to prevent infection...pain..minimal (with tylenol).
Also..each morning i had an erection(which was painful because of the catheter)..good sign nevertheless.
Will update my post as days pass.
7 likes, 80 replies
michael25266 ihsan2022
Posted
yes, thanks for posting this, I am considering aquablation right now so good to hear about it.
Where are you located, what city/hospital?
ihsan2022 michael25266
Posted
i am located in Hudson, Florida. My urologist is Dr.Arnie Tannenbaum. He has 2 locations, one in Hudson and the other one in Spring Hill, FL. The hospital he uses to perform the operations is called Bravera Health, which is also in Spring Hill.
Jdanner46 michael25266
Posted
cincinnati
the urology group
dr.bey
ihsan2022
Edited
01/19/2023 Update. 1 month after aquablation.
Good news.
All the issues i had mentioned in my previous posts started to get better gradually, beginning 3 days ago.
Today i had my final appointment with my uro.
Night sleep..since 3 days i don't wake up even once. i go to bed at 11 pm and wake up at 7 am.
Bleeding..visually no blood anymore.
Sex...no problem...no retrograde ejaculation..amount of semen is minimal...no blood but very watery.
asked my uro..his answer..had nothing to say about the watery semen but told me that the amount
and the force will increase.
Flow..i had mentioned before that for 1 time my flow was really forcefull then it went back
to being only ok.
But since 3 days the flow increased dramatically and is almost as forcefull as it was that 1 time.
Post Void Residual todays measurement was 84 ml, which is great compared to before.
Frequency maybe every 2 hours or so...compared to before there is improvement(it was every 30 min)
Urgency if i need to, i can hold it for 5 min without a problem. Once while i was holding it, the urgency
dissapeared and i went to pee 1 hour later.
per my uro..both urgency and frequency will improve, i am still in recovery phase. My bladder will adjust
to the new situation. He told me NOT to hold.
I am still using Alfuzosin once a day. My uro told me to take it once every other day and see if everything is still ok..if it is then take 1 every 3 days and see..if still ok, then stop taking it.
I asked my Uro how long before i might end up needing another operation. Given the fact that there is no long term data with aquablation, i asked him to make an educated guess, nothing official.
He told me that his estimate is at least 10 years, maybe much longer.
i mentioned that aquablation is always compared to TURP. He said that when it comes to this estimate, we should compare it more to open prostatectomy, because there are variations of TURP resection amounts, meaning the amount of prostate tissue removed can vary dramatically. So..with aquablation a maximum amount can be removed safely. Given the fact that prostatectomy operation means removing the whole prostate, how is that a comparison? Maybe Aquablation is the closest they come to the total removal.
So...disclaimer..this is anecdotal ...i am just documenting my conversation with him and as i said before his statement is only an estimate...nothing more...pls take all this with a grain of salt.
One thing i forgot to ask him, was about my new PSA value..what should it be..what is normal?
Someone here in the prostate issue forum had mentioned that the full recovery takes 3 months.
So..i am going to wait until 3 month anniverary..then take a PSA test and see.
I am going to post about my situation after i take the test and have results.
I hope my experience is helpful to people who consider Aquablation...i learned a lot from other peoples experiences and wanted to contribute also.
As of today i am glad i chose Aquablation even though it was a tough month.
compiler ihsan2022
Posted
Please update your symptoms after stop the Alfuzosin.
ed68391 ihsan2022
Edited
Hi guys - It has been a while since I posted on here. I am on about the same schedule as Ihsan, having had aquablation on Dec. 15th. For all my bitching for the two or three weeks after the procedure was first done, I have to say that at this point (almost six weeks out), I am very pleased with the results.
During the day I have complete control of urinary function. I use the bathroom about every 2 1/2 hours, at which point I have a strong, satisfying urinary stream, such as I have not experienced in years. No more urgency, no more difficulty passing urine, no more blood in urine stream. I no longer worry about rushing to the men's room and hoping I get there in time. In short, everything seems to be back to a normal urinary function. I still wake up once per night, usually at about 3 am, but at that time I produce a power washer of urine, empty my bladder completely, and go back to sleep. For an old guy (almost 66), that seems acceptable. Before the procedure I was getting up 4 or 5 times per night, usually just to pass a few drops.
I have not been given the green light to have any sexual activity yet - two more days - so I can't comment on ejaculation/semen issues, but I can report no problem with getting erections. I wake up with them every morning. I'm not sure why my uro tells me I must abstain for 6 weeks after the surgery, but he insists upon it. I know others have gotten back in the saddle sooner than that. I'm reluctantly following his advice, so I'm waiting a few more days.
I had an incident a couple weeks ago with painful testicles. My GP put me on an antibiotic, thinking it may have been a UTI or another infection resulting from the procedure. (There is absolutely no chance it could have been an STD.) I think it may have been just blue balls, but in any case that has cleared up.
I saw my uro about 3 1/2 weeks post procedure. He actually apologized for the lack of pre-op communication about the recovery experience, and he acknowledges that I should have been better prepared about what to expect. Other than that, he says everything looks good and I am recovering as expected. He has scheduled another appointment with me about 3 months out, at which point I will have another PSA test. (One thing I neglected to ask was the amount of prostate tissue excised.) At that time we will also evaluate whether I should come off the daily Cialis (5 mg) that I have been taking for about four years. My sense is that the Cialis had not been helping the BPH symptoms for a long time, and there is really no point in taking it any longer. I never needed it for ED symptoms, and that was too low a dose of Cialis to treat ED anyway. So we'll have that discussion later.
All in all, I am glad I had the aquablation, but I will say that the recovery is absolutely miserable for about three to four weeks. Anyone contemplating this procedure should insist upon a detailed discussion with his doctor about the recovery process. Most of the information about this procedure on the internet skips over the details of the recovery process, whether from urologists or from the manufacturer of the device. The recovery symptoms appear to be temporary, but they are debilitating and demoralizing in the short run, and they should not be overlooked.
You will need to plan to take a considerable amount of time off work after this procedure, unless you are comfortable going to work in depends and having no bladder control. (That would not have been an option for me.) I would suggest that you need to block off at least three full weeks away from your place of employment for recovery. After that, you should feel great. At least I do.
ihsan2022 compiler
Posted
Uro had said...take one every 2nd day ...if alright then lower it to every 3rd day..if all good then stop.
what i did is stop right away...has been a week now.
first 2 days after stopping i realized that initiating urination was harder and the flow was somewhat less....but 3rd day it got better and now the initial flow is back again.
so..all in all...did not have a huge effect..and i can still sleep through the night without having to visit the bathroom
everything is good.
bcb1 ihsan2022
Posted
Really good to hear the results you are getting, sounds definitely like it was the right choice.
My Aquablation is scheduled for Feb 23 in Woodbridge VA. I feel a mixture of hopefulness, anxiety, and at times terror, lol. But the doctor is experienced, and I keep telling myself the first week or two of pain, burning, etc is worth the long term results.
I will start a thread and post updates when I have mine done, as yours as definitely helped many on here.
ihsan2022 bcb1
Edited
i definitely think it was the right choice.
ed68391 seems to have a similar recovery as mine.
So it seems like our long recovery period is not uncommon.
Others may be more lucky and are up and running in a shorter time period.
i wish you good luck and speedy recovery.
Everything will be fine as long as you set your expectations right.
ed68391 ihsan2022
Posted
Just to add a little more info to my last update. I've had sex for the first time since the aquablation procedure. Everything is working fine, and I did ejaculate and produce semen. There was not as much volume as before (which is a little surprising considering I had not ejaculated in over six weeks), and like Ihsahn I observed that the semen appeared to be more watery than usual. The orgasm itself was not as pleasant an experience as usual, almost a bit painful. I'm hoping I'm still recovering and that aspect of life continues to improve. I may continue to abstain for a few days and try not to have sex as often until the experience improves. Otherwise, everything is great.
ihsan2022 ed68391
Posted
earlier you had mentioned that you forgot to ask your urologist about the amount of tissue excised. I did ask my uro, but he said that there is no way to measure that because the tissue is obliterated and being flushed out. Only way would be to measure the remaining volume/size of the prostate and that would involve an extra procedure or ultrasound, at which point i said nevermind..i don't really need to know.
But what i forgot to ask was what my PSA value should be after this procedure.
Did you already have a PSA test done. i know that you mentioned that 3 months out you will get a PSA test...did your urologist give you any information about that?
ed68391 ihsan2022
Edited
Hi Ihsan - I'm not surprised to hear that there is no way to measure the amount of tissue excised. I also meant to ask whether there was a biopsy done, but I assume they really can't collect a sample due to the nature of the procedure. I only know that I had a fairly large prostate going into this according to an MRI report that was done in Sept 2021 - about 116 g.
At my last urologist visit in early Jan. 2023 (about 3.5 weeks post-procedure), my uro said I should have a new PSA taken in about three months. He said the PSA should not be done until that time because the reading wouldn't be indicative of anything after such a major upheaval to the prostate. Things need to get healed and back to normal before the PSA test will provide useful information. That made sense to me.
So I'm scheduled to have the PSA test done in the first week in April, then go see the uro in the second week of April. I'm a little nervous about this, because my PSA was 6.3 in Sept 2021, tested at a different facility, then 7.3 when I saw the uro last October, which was the last time I had the PSA test done. That's a pretty major increase in one year. I understand that a rapid increase in PSA can be indicative of prostate cancer.
My uro didn't make anything of the high PSA or rapid increase last October. He said he was assuming that the high PSA was due to enlarged prostate. He didn't find anything unusual, other than size, with the DRE. I will note that my BPH symptoms got much worse from fall 2021 to fall 2022. Also, when I had the blood drawn for the Oct 2022 test, it was right after the DRE. (No one told me not to do that. I was right there at the hospital with the order for the blood work, so I figured I might as well get it done right away, rather than come back another day.) I had exercised vigorously earlier that day, and I had had sex to orgasm that morning. I only found out later that each of those three things (DRE, exercise, and ejaculation), independently, can cause the PSA reading to skew higher. For this upcoming test, he specifically told me not to have sex or to exercise vigorously for 72 hours before the blood draw. I will be sure to follow those instructions. I'm sure he will do another DRE when I see him the week after the blood draw.
I'm not sure what to expect these next PSA results should be. I am anxious about it, but there's nothing to be done but to wait until the healing proceeds. I'm assuming that the number should go down, as there is less prostate tissue, but I really don't know.
Meanwhile, I continue to think the aquablation was a good decision. Daytime urinary function is just about perfect. I'm still waking up once or twice per night, but not because of an urgent need to urinate. While I'm lying awake and sensing a slight urge, I figure I might as well get up and go. I think if I could train myself to stay asleep I wouldn't be in the bathroom in the middle of the night. Sex function is back to normal, although I do think the semen is more watery and the ejaculation is not as forceful as it used to be. I'm hoping that improves.
Let's continue to compare notes as we both heal from this procedure. Best regards - Ed
TK1326 ihsan2022
Edited
Thank you for all the information. I am 57 years old and I am scheduled for Aquablation on Monday morning at Stanford Hospital.
Have been in complete urinary retention since July. Self catheterize 5-8 times a day. Bladder and kidneys had gotten extremely distended, and blood test showed kidney levels were in the high zone.
Your information lets me know what to expect for the next month.
ihsan2022 TK1326
Posted
i wish you good luck and hopefully it will be all good.
ihsan2022 TK1326
Posted
i hope everything went fine with your Aqablation. Can you give us an update?
TK1326 ihsan2022
Edited
The surgery went well. I am now 10 days post op.
Not really much pain after the surgery. Right out of the OR they gave me two Oxycodone. Through the night and until discharge they gave me Tylenol every 4 hours and that was it.
Through the night they flushed fluids through the Foley, lot’s of fluids!! They were in every half hour to 45 minutes changing new big bags of fluid and emptying my catheter bag. I remember reading in here that someone said you do not really get much sleep in the hospital that night, that is very true. Lots of blood coming out in the bag the entire time as you said.
At home still had quit a bit of blood draining into the catheter bag for the first 4 days. This is normal as someone else said and Dr said. I took 2 Tylenol a day, pain still was not bad.
A week after surgery I took out my Foley at home. Waited 2-1/2 hours after removing it for bladder to fill and then went to void…. Holy cow, I pee’d!!! I text my wife and told her, “I just p****d like a race horse!” You have to remember guys, this is the first time I have pee’d without any catheter in 8 months!! I was very excited to say the least…
It was a very strange and worrying moment until my brain sent the message to open up to let the urine out… Right before it came out it felt like my body was not going to let it out like it had been for eight month’s, then boom it came out with force!! It did burn and sting some but I did take the Azo which helped.
Flow is good still not much blood yesterday and none so far today.. I am having bladder pain and pelvic floor muscle pain with the urgency to go. The pain is not bad it is more of a discomfort pain. I believe this might be specific to me because I have not been able to urinate at all for the past eight months. I believe the bladder and muscles are trying to learn to work again and that is what I am feeling. Started the pelvic floor muscle exercises yesterday to help with this.
No problem with incontinence, just some small dribble the day I took the Foley out. No constipation, I did take Miralax each night to prevent it.
At the three week mark post op I will catheterize myself and measure the post void residual to report to my Dr.
Will not know about RE until three week post op.
Even this early on I would do it again and have no regrets. Remember, I could not urinate at all so this is life changing for me. The pain was also very minimal which surprised me. I have had six other surgeries and the pain in this was the least of all of them.
We will see how things go at the three week mark, again thank you all for input and your experiences, it really does prepare you for what might and might not happen to you.
Hope this helps someone else out there thinking about Transurethral resection of the prostate with Aquablation.
ihsan2022 TK1326
Edited
i was thrilled to read the good news..and it will get better as you heal trust me.
i hit the 1.5 month mark right now and everything is almost perfect.
i say almost because as in your case , my bladder still thinks that it needs to empty even if only 100 ml - 200 ml has accumulated(like before operation)...so i still visit the bathroom more than i should be(right now about every 2-3 hours). But all this was expected, my bladder needs to adjust to the new reality, but holy cow, the flow is really great when i have a full bladder(i tested it by drinking 1.5 liters of water).
Like you, i have no regrets and am glad i chose aquablation.
when it comes to RE..i don't have RE...sex..seems to be better than before.
it is unbelievable how a small organ had so much adverse affects on my quality of life.
I had back pain/kidney pain before...all gone.
Best wishes to all who consider and have this operation.
bryan_12345 TK1326
Posted
Hi, Read your comments with interest. I am considering aquablation or laser. I self cath daily and have for years. Its OK. I have had a badder neck incision and urolift with not great results. I am just so worriedthat another unsuccessful surgery may make things worse. Would u mind telling me your past Uro surgeries/experiences briefly. Hope all is still great with your aquablation. Thanks Bryan