Successful Aquablation Surgery

Here's how the journey began. I started having a slower stream when I was around 69 and after a time reverted to sitting down instead of standing while urinating since it was easier. A couple of years later I decided to see a urologist about the issue assuming, because of my age, I had BPH, even though my PSAs were a constant 1.5 and my primary doc never indicated an enlarged prostate. The urologist, an older guy, conducted a brief digital exam and a sonogram and prescribed Tamsulosin and a consult with a surgeon. Shocked, I asked him why I would need a surgeon. He said I had BPH and if the Tamsulosin did not work I would require TURP surgery. Almost immediately following this visit I started my extensive research. I discovered Tamsulosin can cause retrograde ejaculation (RE) and TURP surgery will practically guarantee RE as well as a high possibility of incontinence and even erectile dysfunction in some cases. This information scared me off for another year until I finally tried the Tamsulosin which did not cause RE, but it also did not relieve any symptoms. Stupid me, I went back to the same urologist and he recommended TURP as soon as possible even though he did not even do another exam. By this time I was armed with information regarding the many other options to this radical surgical procedure and suggested a few, but the guy said TURP was best. That was the last time I saw that doc...the next day I set up an appointment with a urologist at the other hospital in town. This older guy was somewhat better in that he actually did a thorough examination, took a sonogram which indicated I was retaining a lot of urine, and conducted a cystoscopy (imagine that). The cystoscopy revealed an elarged, trabeculated bladder. My poor bladder had been holding excess urine for years until it was highly stressed. I had no idea this was happening as my symptoms were minimal at best. It was also determined that I had a relatively small prostate (32g), but with a large median bar and high bladder neck which was cutting off urine flow like a ball valve. Guess what he said I should do? You got it...TURP. By this time I had researched Aquablation and asked him about it. He told me he wasn't familiar with the procedure. I suggested other options like green light lazer, Rezum, Urolift, etc., etc., but only TURP came out of his mouth. I decided to start self-catheterizing to relieve bladder stress while I reviewed my options. I did this for the next year and a half and would have had no real concerns about continuing for the rest of my life except for the UTIs that began to pop up about every two to three months. During this time I really threw myself into BPH research. Aquablation appeared to be a no-brainer, but there were no local doctors (Missouri) performing the procedure. I had a virtual conference via phone with Aquablation docs in Houston and Arkansas. Both of them said my prostate was too small to be treated effectively by the procedure. That was a kick in the nuts...now I was back to the other surgical procedures with bad side effects. Then I hit this forum and read about a guy with physiology just like mine who was successfully treated with Aquablation in New York. Not wanting to go to New York I contacted a rep via the Aquablation website and he referred me to Dr. Lewis Kriteman in Atlanta (Georgia Urology) who has performed more Aquablation procedures than any doc in the world. We had a phone consult and he confirmed that I was indeed a candidate for the procedure and my appointment was scheduled. Two months later I flew into Atlanta on a Wednesday, had pre-op on Thursday, Aquablation surgery early Friday morning, and flew back to Missouri on Saturday with a Foley catheter and leg bag which I removed myself the following Monday. The surgery was painless since I had a spinal block (the shot was also almost painless). After the morning surgery I went through equally painless saline irrigation all day and was discharged to my hotel (which was conveniently located across the street) around 10pm. The only thing disturbing was how red the urine was inside the transparent tubing of the irrigation machine and later the catheter. I was told this was normal and bleeding would continue for 24-48 hours until the catheter was removed. There were also some clots and detritus in the catheter bag that bothered me, but was told this also is to be expected. Post surgical pain was minimal, just kind of a dull ache in the prostate area. I did not take any painkillers. Getting ready to remove the catheter on Monday was a stressful moment. I had been told by ALL the docs I had seen that there was up to a 50-50 chance that my bladder would not have enough strength and flexibility left to fully excrete urine. I prayed. Then I removed the catheter. Thank goodness I was told to deflate the balloon on the end of the tube before I pulled it out or it would have been a real eye opener. After the catheter came out I waited for about thirty minutes then went to the bathroom hoping for a eureka moment. Lo and behold it came. I peed without a catheter for the first time in a year and a half. It was real bloody and several clots popped out causing bloody urine to spray all over the place, but fortunately I got it cleaned up before my wife came home and accused me of being a slasher. There was a little stinging sensation while peeing, but nothing noteworthy. For the rest of the day I had a strong urge to pee about every hour (also expected), but hallelujah I peed like a racehorse each time. By the third time there was little to no blood in the urine at all. By midday I became concerned about sleeping that night, thinking I was going to be up constantly running to the bathroom. I was one of the fortunate ones that had never experienced nocturia in the past (probably because of the stretched bladder) and wondered how the surgery would affect this. As it turned out, I slept like a baby all night long (10:30pm to 7am) without having to get up once to pee. It is Tuesday as I write this, one day after catheter removal and the fourth day following surgery and I feel great. What a blessing to be able to pee like a normal person again. You never really seem to appreciate something until you lose it. I do not yet know for sure if I am retaining urine after voiding. It doesn't seem like it, but you can't really be certain without a sonogram or using a self-catheter to check, and I'm not about to stick a catheter back up my urethra until the prostate heals. Also, I don't know about RE since I'm not supposed to have sex yet (I definitely don't have ED, got a boner while on the cath and that was interesting). Bottom line...guys, please don't let a bunch of old urologists tell you that TURP is the only solution. These docs and their resident hospitals have been doing the procedure since the 1950's and fondly refer to it as a roto-rooter. They blow off harmful side effects by saying it's more important to pee than to have sex (they presume old guys don't do it anymore). Peeing of course is vitally important, but that doesn't mean you have to lose sexual functionality. It's a definite profit center for them and a virtual assembly line process. I can't say that Aquablation is for everyone, or certainly that the results will be like mine since we're all engineered in different ways, but I can firmly say that it was the best decision I could have made. I'm so glad I took the time to research BPH thoroughly, because there is so much misinformation out there, a lot of it from medical professionals.

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