My Aquablation Experience Day #9 After Surgery

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Hello all, just joined the forum. Thanks for any feedback.

Background Summary: At 50 years of age in 2020, literally at my birthday meal, I started having a “gnawing/achey” feeling in my perineum. This turned into a trip to the urologist and about six bouts of prostatitis over 3 years. My PSA was never horrible, moving from 2.12 at age 46 to a high of 3.6 at age 50, but then dropped to 2.6 at 52, and rose to 3.1 at age 53. Doxycycline tended to get rid of the prostatitis, which always resulted in cloudy urine for a few days, and then doxy would get rid of it. However, despite the inflammation going away, I had straining, frequency issues, urgency issues, and lastly, discomfort when sitting. I was diagnosed with BPH, and prostate grew from 57 grams in 12/2021 to 66 grams in 11/2023, about .4 gram growth per month over 23 months. Tamsulosin helped me a lot, and I was quite comfortable on the drug for several years. Main problems with Tamsulosin were retrograde ejaculation, decreased semen output, sinus inflammation/clogged nose all the time, and a general feeling of weak muscles.

I decided on Aquablation surgery because of virtually no risk of incontinence or erectile dysfunction, and no risk of permanent retrograde ejaculation which always happens with TURP or other heat based procedures. My doctor said you get a better channel with aquablation than green light laser, and he had done over 40 aquablations in addition to all the other kinds of surgeries. He has over 30 years experience, but aquablation is relatively new. Plus my bladder was retaining 24% of its water, and I figure the procedure would help me empty out more, and that might reduce prostatitis (my theory being a sewage in the bladder causing periodic infection). I had Aquablation surgery on 1/16/24, so here’s my experience:

-Days 1-2: Aquablation Surgery on about a 70 gram prostate - and catheter stayed in for 48 hours, discomforting, but very little other pain from the procedure itself, maybe a 4 on a scale of 1 to 10; just took Tylenol; bladder flushed with lots of saline. STOPPED Tamsulosin before surgery cold turkey. IV antibiotic was Ansef (Cefazolin) in hospital followed by 3 days of CIPRO Floxacin (no problems). Removing of catheter hurt like hell for five seconds.

-Days 3-6: A lot of blood in the urine (but my Doctor did minimal cauterization to prevent hemorrhaging). Had total control of urine, just a lot of urgency. Constipation ended on Day 4 with coffee and prune juice to the rescue.

-Day 5 I passed some half inch to one inch nasty wormy red clots. Large output of urine. Drank a lot.

-Day 6 Had a significant scare around midnight as I could not urinate at all! Doctor said I may need to go to the ER and get catheter put back in and flush out bladder. I decided to drink more water to put more pressure on my bladder (a crap shoot bet because if it didn’t work I’d be in a lot of pain on the way to the ER) Then I said a prayer, relaxed, 2 sitz baths later, and by the grace of God blew out a BIG fat one and a half inch slug clot. Two cups of fluid passed out hard. What a relief.

-Day 7 Urine ALL Yellow No Blood

-Day 8 Urine vascillates between pink and yellow

-Day 9: Submitting this to the forum. Blood clots are all gone. Back to work, as I work from home sitting at a desk in front of a computer. No real pain to worry about. Just what I state below:

My questions to the forum are I noticed that my flow pressure was much BETTER pre-surgery on Tamsulosin, which I stopped taking. Also, I never woke up during the night on Tamsulosin, but now I tend to get up twice a night during recovery. There is a hesitancy to start urinating, and it’s painful to get started. The flow isn’t bad, but at least it’s steady. The post operation flow is certainly much better than my pre-Tamsulosin days. I only pee out now about 225 ML of fluid, whereas on Days 3-7 I was peeing out almost 450 ML at a time. Are these symptoms normal? Will my flow pressure and urine output increase? I am worried about POUR (post operation urine retention) Am I being impatient? I have to follow up with my urologist in two weeks. He did say I might have frequency and hesitancy issues for awhile. Should I go back on Tamsulosin just for a few weeks to speed recovery? Would that help or give me a false sense of progress? I really don’t want Tamsulosin as I figure that’s a basic benefit of having the surgery- getting of the meds!

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2 Replies

  • Posted

    Hi Ken,

    I hope you have been feeling better over the last few days. I had Aquablation in August 2022. Some of what you are saying sounds familiar to me.

    1. At about the 3-week mark after surgery, the doctor put me back on Tamsulosin.
    2. It is disappointing to hear that your flow was better pre-surgery while on Tamsulosin. My flow was better after the surgery than it was when I was on Tamsulosin, but only a little.
    3. My flow never really improved much. I also had problems with post void retention, which kept going up with each visit to the Uro.
    4. My doctor's office was convinced that my bladder had been damaged due to the problems associated with BPH and that I would need to start cathing. Needless to say, that was not what I wanted to hear. Finally, they did a cystoscopy. It turned out that I had scar tissue, some of which they were able to address during the cystoscopy procedure. They seemed pretty surprised about the scar tissue. My doctor claimed that it is less common with Aquablation that with TURP.
    5. Bottom line is that after the cystoscopy procedure, my flow improved some more. At my last visit, I was able to completely empty my bladder, which was great news. But I cannot make it through a full 7-8 hours of sleep without needing to pee.

      So, If things don't improve for you, I would push for a cystoscopy to see if you have scar tissue.

  • Edited

    Give it some time. I would say the 6 week point is where you can really determine whether things are improved or not. You could have some blood clots that are clogging things up, or a lot of inflammation. If you are concerned about your flow, I would go back on the medication till the inflammation calms down. You'll probably pass a big clot or scab around week 2-3.

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