Aquiblation Experience at Day 6 and Day 40
Hello Everyone – I’ve really appreciated all the information from this thread. Thank you. Here is my story, written six days post surgery. Today is 40 days after and I’ve written an update as a post script.
I’m 62, 141 cc (huge) prostate. Weak stream. Frequent need to pee (once every 45min to an hour). 6 or 7 retention episodes over the last 2.5 years. 3 ER visits for a Foley catheter, then self-catheterization for the last several episodes. Never an issue with full emptying. Two MRIs both PIRADS-2 no cancer. Low double digit PSA.
I had my Aquablation 6 days ago in Boulder, CO. 11:30 am start. One hour 9 minutes. Pre-op was easy. I emphasized to my surgeon that I prefer less aggression and would like the highest opportunity to preserve ejaculation. He agreed and said, of course, and that it was still a risk, no matter how conservative he was.
I have about 90 seconds of memory from the OR, then waking up in recovery. Kinda a surreal experience. No pain, lots of intellectual clarity, also a bit loopy and silly. Then to the room. Lots of irrigation. The Foley catheter they use is a three-tube device. One tube outflow, one tube incoming irrigation, and one tube for inflating the balloon in the bladder holding the catheter in place. Irrigation bags on an IV stand. High flow, changing about every 25 minutes. Also, my catheter bag needed to be emptied about every 30 minutes.
I was immediately hungry and had what tasted like the best meatloaf I’ve ever eaten. Even the bland steamed vegetables tasted delicious. This was maybe 3:00 pm.
The night was tough. Almost no sleep. I had four short episodes of either the catheter getting clogged with blood clots or bladder spasms. The nursing staff treated it as a clogged catheter and irrigated each time. I was grateful for their care. The third spasm/clog was at 11:00 pm, lasted about 4 minutes, and was a 10/10 pain. I was involuntarily yelling with pain. Never felt anything like that as an adult. The fourth and last significant spasm was at 1:30am. Then I started feeling a bit better. I had been scheduled to have the catheter removed at 5:00 am, and after collaborating with the night nurse, who BTW was a literal angel in the flesh, we decided to leave the catheter in and let the doctor decide.
Saw my surgeon around 7:30, and he did some major irrigation. Then he deflated the balloon and moved the catheter in and out about 3 inches 5 or 6 times to clear clots. That wasn’t as painful as the 11:00 pm spasm, but it sure got my attention. They continued bag irrigation until around 9:30, then discharged me with the catheter. I had a couple minor spasms over that day. Basically stayed in bed at home all day. Used a cane to get around, but not much need to move with the catheter still in.
I was pleasantly surprised to wake up, on day two, catheter still in, to an erection. Box checked, that’s still working. I’m really glad I asked my doctor to move the statlock (the pad that holds the catheter and tubing) to have more space from my groin. Where they had originally placed the statlock would have caused a lot of pain to have an erection as there wasn’t enough room for my penis to extend. I had previously learned this painfully from a prior foley.
Later that day (OR+2) I went into the doctor’s office to get the catheter removed. The tech did a bunch of major irrigation before removing the catheter. Before removal, she put around 50 ml of saline in my bladder to see if I would be able to pee it out after removal. Then she removed it. No big deal. She said breathe in, breathe out, and she removed it during my exhale. Stinging, but over quickly. And I was able to retain while I was still on the table. The tech left the room, and when I stood to get dressed, it all came out. No control. Lots of blood and clots. Quite a scene. Fortunately, I brought Depends (adult diapers). That was the only time I haven’t had control. I’ve had full control since. Some leaking after or in-between, but nothing significant. I’ve not had any spasms since catheter removal.
The big change is the flow is huge. Like I haven’t had urine flow like this for more than a decade. Huge, nice immediate sign of success.
My energy, while still really low, has returned quickly from what it was: essentially bedridden the first two days. Yesterday and today (day 5 and 6), I took two fifteen-minute walks with my spouse close by for assistance if needed.
I’ve had some soreness in my perineum that flared a few days ago, and flow slowed a bit. It’s improving, with flow back to nearly where it was. No fever. Still need to urinate often, and urgency is still mildly painful. I’m going to wait a couple of days to start training my bladder to wait longer. It still burns when I pee and for a couple minutes after. Tolerable, but annoying. I’m back to my surgeon’s office on Friday (day 9) for a void test.
So that’s my story. Still pretty low energy, but enough to do intellectual chores and be mobile. I’m sleeping better, which is a gift. Trying to do a little bit of non-core-involved exercise and stretches. Drinking a lot of water. Appetite is normal.
I hope this pays it forward a bit. Best of luck to you, my BPH brothers.
P.S. day 40.
The first thing that was heavy on my mind was what, if any, sexual side effects might emerge. Around day 18, sexual desire turned back on like one of those giant utility grade rocker arm switches. One moment it is OFF. The next, well, it was ON. And it was really interesting to so starkly notice how powerful and pervasive sexual desire is when contrasted with its absence. AND…everything I read said to delay sexual activity, especially orgasm, until four weeks. Mostly because it risks stinging and being a lousy experience. So I held off. I have never experienced such a high level of blue balls. It was all I thought about. It was both really humorous and, well, quite frustrating. And that was also wrapped up in my worry about retrograde (dry) ejaculation as a possibility. A few days into my return of desire, I started noticing some semen in my urine. It didn’t really bother me. But it was a testament to parts of my body are ready to go, even others are not. I begain to wonder if there was some possibility I might have a wet dream, with so much buildup. But, before that could happen, around day 24 I took matters into my own hands and was so very pleasantly relieved to discover that every thing worked VERY well. High volume and no stinging. Quite normal actually. Afterwards there was some perineum soreness for the first several time. My second ejaculation a few days later had some urine in my ejaculate. Which was a little weird. But my view is way better wet than dry. Since then everything has been normal. Amount of semen has been similar to before.
The stinging while peeing mostly stopped around that same time and after day 28 was rare. Soreness in my perineum is also gone. I started back to the gym for weights around 4 weeks after with super light weights to start. I did my first yoga class two days ago and found strength was pretty normal, but stamina was still lower than before.
Finally, frequency is greatly improved. Before I was peeing every 45 minutes to an hour. Now it is at least every 2 hours and continuing to improve. I still have some occasionally odd sensation when I pee. But they keep getting more faint. I haven’t ridden a bike yet. I probably could by now, but I’m still going to wait another week.
Overall, it was a lot to go through for sure. But today on day 40, I’m very glad I did it. I now have a new relationship with the catheters I still bring with me when I travel, out of habit. That will probably stop soon.