semen Volume after Aquablation

Posted , 14 users are following.

I am 2 months post- operation, all seems to be working fine and I have my first follow-up next month, one thing I have noticed is the decrease of semen after ejaculation. The volume is very low. Did anyone notice any change in the volume at any point? If the volume is so small, could this be a retro? Thanks

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19 Replies

  • Edited

    Hi James

    After my aquablation , i had the same condition you have. I asked my Urologist and he said that volume will increase, but it didn't. It actually got less and less. So...yes..i have RE. I only ejaculate 1-2 drops if any.

    It's not a big deal for me because i don't want any kids and my sex life is not being affected by this.

    Your situation might be different than mine, but i just wanted to let you know about my situation.

    When it comes to my urologists comment: after he performed my aquablation, i had some complications and had to visit his office a couple times and after complications were resolved he saw me only once..and that's when i had asked him about the semen volume. After that he didn't care to follow up on anything, which is fine with me because each appointment means almost 100 bucks. But given the fact that aquablation is a relatively new procedure, i would have expected him to be more curious about the whole recovery period after the operation, just to gain more experience, so he can guide other patients.

    i used to be an appliance technician and sometimes i would make a repair where i wasn't sure that my repair was successful and i would ask my customers to give me feedback after a while so i knew the outcome and that information was useful for future repairs and customers.

    Not seeing the same approach with my uro, shows me that he didn't care and thats why he also didn't give me enough information prior to the operation because he doesn't know.

    Many patients complain(what i read in this forum) about lack of information provided (or not provided) by their uro prior to the operation , so they don't know what to expect.

    Disclaimer: these are the impressions i got from my own experience and others here on this forum. Of course there are good urologists who are the opposite of what i described here.

    In the end i am still glad i chose aqablation and besides RE, i don't have any other problems.

    Sorry for the long rant.

    I hope your situation is temporary.

    Good luck

    i will follow your thread. Give us updates.

    • Posted

      Hi Ihsan

      Thanks so much for your candid opinion and for shedding more lights into this situation. I had to ask this question because I thought I was the only person experiencing it. In fact it is as what you just described. The volume was low initially and gradually decreasing . Although my follow-up appointment is in two weeks but I doubt if there is anything my Urologist can do about this as it is too late now.

      To be honest I would have chosen HOLEP if I knew that I would experience retro after aquablation. My urologist did tell me the volume may be less than before but did not say it would be decreasing to the point of not coming out.

      With HOLEP, at least I know it cause retro but the recovery would be much more quicker without having to deal with bloody urine for 3 weeks.

      I will let you know what he says when I see him couple of weeks. Thanks so much for this confirmation.

      Please don't consider your explanation as a rant, it is a lesson for everyone especially myself.


    • Posted

      Thank you so much for sharing your experience. It is very similar to mine. I'm about two and a half months out and I have maybe a few drops of clear liquid after ejaculate - barely anything. I don't think it's retrograde because I know how that felt and I don't feel any volume being pushed out. My uro and the main PA I see were so gun ho on this and kept touting "no sexual side effects". Getting my ejaculations back after stopping the Tamsulosin was one thing I was hoping for and one thing I know could happen because I had stopped it in the past. I guess I will take being able to pee when I want as a plus and just accept the other. I wish our doctors would listen to us and know that the incidence of sexual side effects is not 0% as this was touted to me.

    • Edited

      i agree %100. It doesn't bother me that i have RE. What DOES bother me is that they make you believe that there is minimal chance of having any sexual side effects.

    • Posted

      Absolutely! Although someone here has reported an improvement in the volume about 7 months after surgery and am hoping this is the case but the Doctors need to explain why the volume was almost as good initially and the starts to decrease to the point of just a drop if anything. Surely something is causing this and Aquabeam shouldn't be silent on this as well. And if this is not RE, this must be another medical condition.

    • Posted

      Hi James

      It has been a long time since i last posted.

      You are right, given a long enough of time, the ejaculation comes back.

      it is now 10 months after AB, and around the 7 month mark, i started ejaculating again, nowhere near the amount before AB, but that is normal.

      Your post was about 5 months ago, which means by now yours should have come back also..i hope it did.

      Just wanted to give an update on my situation at the 10 month mark.

      Take care

  • Edited

    James16058 give it more time to get closer to normal. Same as you on volume and force but now I am 7 months post procedure and def notice improvement.

    Remember that the catherter stretched everything from tip to prostate and that slows down the force of exit and the initial volume, it might seep out hours later.

    Doctors are the worst at explaining things.

    • Posted

      Hi Alexander, thanks so much for your reply, this is encouraging for me and I look forward to it.

      Will keep you posted.

  • Posted

    an intimate question for you and any others: I'm considering Aquablation (but insurance will not cover) and currently biding my time on Rapaflo (silodocin). This medication causes complete RE for me and is a thrill-killer during orgasm. I'm assuming the blunted pleasure is due to the RE but maybe it's unique to the med. (?) Would you or others be willing to share your experience postop with Aquablation or with this particular med if used preop? I appreciate your help!

    • Posted

      Hi Davidavid, I am not familiar with Rapaflo but I was on Tamsulocin (Flomax) which can cause mild RE. want to belive they belong to the same family of BPH drugs. I was also on finasteride briefly before getting rid of it overnight because I thought not only that it causes RE but kills any sexual drive. Even watching blue movies doesn't cut it! I didn't even have to consult my Doctor before throwing it away! After Aquablation, everything works as normal except for the decreasing volume of semen. In fact as many people have rightly stated in this forum, morning "wake-up" is back which I haven't experienced for many years. I feel the thrill as well so nothing to worry for me about that. I only noticed the volume because the urologist told me that it may not be as much as before but nonetheless thought as least expecting some. So from my experience, I still enjoy the thrill with the pleasure and definitely no problem getting up.

    • Posted

      Hi davidavid. Why will your insurance company not provide coverage?

      Thats the first thing to get going before the Aquablation procedure consultations with your urologist.

      It is not possible to pay for the Aquablation on your own. No hospital will consider you without insurance coverage.

  • Edited

    I had AB about a year ago. I have what I call "partial RE". The ejaculate is a very tiny volume and kind of seeps out. When I was on Flomax prior to the AB, I had 100% RE and the orgasm was muted. Now, even though I don't ejaculate like the good old days, the orgasm feels strong.

  • Posted

    I haven't had aquablation but decreased semen volume has been one of my concerns about having it done.

    A large percentage of semen is produced in the prostate gland and a large portion of that glandular tissue is removed during aquablation so it stands to reason that there will be less fluid produced after that tissue is removed.

    I produce what seems like an unreasonably large amount of semen and I suspect it is because my prostate is large 43 grams. I expect that if I have aquablation that volume will decrease

  • Posted


    These posts have been extremely helpful to me in providing information I was not getting from my Uro. I had Aquablation about 3 weeks ago and have had very few complications once the catheter came out. I don't have any pain urinating and there is very little blood in the urine. Like most of you, I am anxious to get back to sex. I think my Uro is recommending I wait till week 5 or 6 but I have heard others who started sooner. I have not ejaculated yet and wonder about timing and what to expect when that happens. Can anyone comment on the timing and experience of the first time they ejaculated after the surgery?

    • Posted

      I don't remember how long I waited, but it felt pretty normal the first time. Just very little ejaculate now.

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