Aquablation is my 4th prostate procedure

Men's health
1

SUMMARY:

9 days ago I had the Aquablation procedure done. This is my 4th prostate treatment, and I’m sure it will be my last.

I progressed over 4 years from least invasive to most invasive treatments: PAE (Arterial Embolization), iTind, Urolift and finally Aquablation.
None of the first three treatments provided significant relief, but I am confident that Aquablation will. 9 days in I am progressing well.

MY CONDITION:

My prostate is about 40cc. My IPSS varied from 15 to 20 depending on when I evaluated. My main symptoms were weak stream, start and stop stream, nocturia (2-3 times), and urgency. I could always start a stream and usually could empty my bladder, but it could take a while.

AQUABLATION EXPERIENCE:

Preparation:

Preparation was similar to colonoscopy. Since the ultrasound wand is inserted in the rectum, I had to be cleaned out. Otherwise, it was like any other surgery preparation.

In The Hospital:

I woke up with no pain. A “CBI” catheter was inserted. This kind of catheter has 3 passages: One for draining, one for flushing and one to inflate the balloon that holds it in place. That means that it is pretty large, but I didn’t find it uncomfortable (though I’m glad I was asleep when it went in).

In the next 24 hours in the hospital they flushed about 40 liters of saline through my bladder. At first it was deep red from blood, but by the second morning it was just a little deeper than pink.

At Home:

I went home on day 2 with the same catheter and two bags – one to strap to my leg for day use, and a larger one to hang by my bed at night.

The catheter was in for 8 days. It seems like an extremely long time, but in retrospect I think it was a blessing. After it was removed the prostate had healed enough that urination was easy and painless. I had been expecting the burning and stinging that I experience after a cystoscopy or Urolift, but I couldn’t even feel the urine passing.

That was yesterday. Initially I was on the toilet every hour or so. I wore (and am still wearing) an incontinence pad inside my briefs, and at first it was essential, as I had little warning or control, but by this morning that has improved a lot. I still need the pad, but it’s just spotted instead of wet.

Already this morning my stream is stronger than it has been for years. I have to hold it down to prevent overshooting the bowl.

As the doctor warned me, there are sometimes a few drops of blood at the start of urination, but otherwise my urine is totally clear.

Outlook:

Doc says no strenuous or sexual activity for 4 weeks. At the rate I am improving, I expect I might cut that short by a few days. A couple times while wearing the catheter i started to get a mild erection. It wasn’t comfortable and didn’t last long, but gave me confidence that I haven’t lost the ability.

I am optimistic that this will be my last prostate procedure and that it will turn out well. I’ll report back here as I progress.

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2

I am the OP.

I left out one item: At home with the catheter around day 3 or 4 I started having painful bladder spasms. Every 2-3 hours during the day, lasting 30 seconds to a minute. They never happened at night.

These completely went away after the catheter was removed.

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3

I am the OP.

Now 2 weeks out from Aquablation.

Condition is about the same, but steadily improving.

  • Frequency still about 2-3 hours, but I am deliberately drinking more water to continue to flush, so it would be less otherwise.
  • Urgency has decreased and is now maybe once a day, and I can usually delay a minute or so.
  • Flow rate is excellent. I can empty my bladder in about 10 seconds, vs a minute or more before surgery.
  • Still blood at the start of my flow, but clears up after the first few inches of stream.
  • I’m still wearing an incontinence pad, but it is less necessary. Mostly just a little spotting.

Still no sex or physical activity. Urologist told me before the procedure that I should wait “3-4 weeks”. After the procedure he said “4 weeks” I will probably start around 3 weeks if the blood is minimal by then.

4

I am the OP.

Now 3 weeks out from Aquablation.

I saw the urologist today. He suggested waiting another week before physical effort, but implied that I could start working out and monitor the effects. If blood increases, then back off for a while.

Slow gradual improvement. Frequency, urgency and blood are still factors, but improving.

Flow rate still excellent, I would almost say “astonishing”, though I’m starting to get used to it.

Tests today showed that my bladder is emptying completely. This has never been a problem for me anyway.

A little experimentation revealed that retrograde ejaculation will be an issue. This is not something I care much about. It’s an acceptable side effect. He suggested that it’s more common than the ads indicate.

I’d be much more concerned about ED issues, but that’s working as well as it did before.

5

I am curious. What do you mean by ‘I am the OP’ ?

6

I am the original poster, so people realize that I am following up on my own procedure.

7

I got it! Thanks.