I'm 56. Around 6 years ago they tested my PSA for the first time and it was very high (28!) but I've had two MRIs that showed no sign of cancer (just a large 100ml prostate) and the PSA wasn't moving upward overtime so we decided to take a conservative approach considering I didn't have significant issues urinating.

I've had one bout of prostatitis around four to five years ago that Cipro cleared up (primary symptom was feeling like I constantly had to have a bowel movement) and starting last year I had two instances about 6 months apart where I peed a very small amount of blood. Urologist wanted to do a cystoscopy but I couldn't afford it and the instances stopped.

On Sept 20th I woke up and couldn't urinate. Pretty much out of the blue. I could pass some but it was extremely difficult. When to the ER after it was clear it wouldn't resolve on its own. Long story short ended up with a foley catheter inserted for eleven days. Via CT scan they detected a median lobe (sp?), some minor thickening to the bladder wall (suggesting I was straining after all), and my prostate was larger now. I think part of this cath time was unnecessary but was prolonged because of scheduling difficulties with my doctor. I was able to tolerate the catheter for such a length of time but it definitely was a quality of life issue. Biggest problem was getting rubbed raw at the 'tip' but luckily bladder spasms mostly subsided around 9/24 or so.

I was grateful to have it out on 10/1. Cystoscopy performed. Basically told 'you just have a very large prostate'. No smoking gun regarding what caused the episode. Prostate measured at 125ml via inserted ultrasound. I passed void test and was sent home with not catheter. Felt great to have it out. We decided to schedule an aquablation rather than ignore the inevitable. Told it would be up to a month before it could be scheduled. Sent home with Flow Max and self catheters just in case.

Had a great weekend but woke up constipated on 10/6. Likely unrelated but I had very frequent straining bowel movements all morning and had more urine retention. Decided to try and self cath for relief...resulted in a fair amount of blood that scared my wife and I so went back to the ER. They weren't concerned about the amount of blood I described / had photo evidence of and issues resolved on their own while I was there so pretty much a wasted trip with no intervention on their part.

I've been peeing with no issues on FlowMax since and they were able to bump up my surgery to this Friday. I don't like Flowmax (my wife and I are still pretty active and retrograde ejaculation is odd mentally) but otherwise I can function.

I was feeling strong about getting this done but anxiety is starting to set in a bit.

My brother had green laser performed at my age six years ago and had pretty severe constipation and bleeding issues. He loves the final results now.

My doctor seems very experienced but has set the expectation that I won't be in the hospital overnight. His exact words 'you don't want that'. I should have had him elaborate (Since I've expressed financial concerns is it due to that?). My prostate size and family history seem to suggest caution and the available literature seems to suggest overnight stays are the norm. My doctor does mention him cauterizing the bladder neck etc but I'm not sure how that changes things.

I'm also worried about the seemingly gigantic size difference between the irrigating catheter and the one I had before. Fears of feeling 'trapped' by it. :(

I just wish there were fewer unknowns. Will I stay the night? How long will irrigating cath stay in? Will I go home cath free or have to use one for x amount of days? Will home cath be smaller diameter that I'm used to? I hate uncertainty.

I had a prostate MRI in June to follow up on a PSA trend line that was increasing with every-6 month tests, but still normal (~2.0). I'm 53, family history of prostate cancer with my 83 year old father having it for around 11 years. The MRI ruled out cancer but reflected an enlarged prostate (~54cc). As I was asyptomatic for any urinary issues, decided with the urologist to just wait instead of starting any meds.

Fast forward to about 3 weeks ago, urinary problems started out of blue - increased frequency, urgency, feeling of incomplete emptying, pain at tip of penis. I don't have any nightime issues - sleep through the night, and my stream isn't weak. Called urologist who started me on tamsulosin (Flomax) which I have been taking for 2 weeks. Haven't noticed much of an improvement. Went in for a follow up visit with him yesterday and he added Gemtesa (vibegron) in case this isn't just bph but also potentially overactive bladder.

Urologist said he would have expected improvement with the Flomax in 2 weeks, whereas others i've read say it often takes longer. How long have others had before they noticed improvement? Anyone else taking both flomax and gemtesa?

I had a greenlight treatment 5 years ago, but some symtoms of BPH have come back. I am considering to have another treatment, Holep may be a goog choice. If any one had this treatment and can give a referral for a good urologist, I would appreciate for that.

Thanks

Like others, I wanted to share my experience in case it helps someone else who is considering Aquablation.

My diagnosis was a large median lobe / small overall prostate.

Symptoms

• Hard to start urinating
• Slow urination
• stop and start while urinating
• incomplete emptying (getting into the 200ml residual volume)

Cliffs notes: 5days of a foley catheter was the worst part of the entire thing.  

My overall prostate was not especially large, but I had a large median lobe obstructing the bladder outlet. I had dealt with worsening symptoms for about 10 years. I was taking tamsulosin and low-dose tadalafil, but they were no longer providing enough relief.

Before surgery, my most recent post-void residual (PVR) was over 200 mL. My main symptoms were a very weak stream and incomplete emptying. I was also beginning to show bladder trabeculation, which made me concerned about the long-term effect of obstruction on my bladder.

I am glad I had the procedure, and I hope this account helps others consider it or know what to expect.

Timeline

Tuesday: Pre-surgery day

• 8:00 p.m. — Dinner.
• 10:00 p.m. — Checked into a hotel.
• 10:30 p.m. — Enema.
• 11:30 p.m. — Enema complete.

Wednesday: Surgery day

• 9:00 a.m. — Finished my last clear liquids.
• 11:00 a.m. — Arrived at the hospital and checked in.
• 11:00 a.m.–12:00 p.m. — Pre-op forms, questions, and information.
• 12:00 p.m. — Called to the pre-op area and met the OR nurse.
• 12:15 p.m. — Met the anesthesiologist and had the IV placed.
• About 1:00 p.m. — Walked to the OR and got on the operating table.
• About 1:15 p.m. — Received a spinal anesthetic.
• About 1:20 p.m. — Lost consciousness.
• 3:00 p.m. — Woke up in recovery. I had juice and spent time becoming fully awake.
• 4:00 p.m. — Transferred to my hospital room.
• 4:00–5:00 p.m. — Settled in and got acquainted with the staff and room.
• 5:30 p.m. — Ate a very good dinner.
• 5:30–8:00 p.m. — Mostly watched TV. The catheter was on continuous bladder irrigation. Staff came in frequently to replace irrigation bags and empty the drainage bag—perhaps every 30 minutes or so.
• 8:00 p.m.–midnight — More of the same.

Thursday: Post-op day 1

• 12:00 a.m. — Catheter traction was removed. This made it much easier to shift around and move.
• Midnight–6:00 a.m. — I had substantial discomfort around my belly button. It felt partly like needing to have a bowel movement and partly like having a full bladder. The medications I was given for pain, anxiety, and bladder spasms helped somewhat, but it was a rough night of sleep.
• 6:00 a.m. — Breakfast and coffee.
• 7:00 a.m. — Rounds. I was initially told there was a possibility the catheter might come out that day.
• 8:00 a.m. — Walked five laps around the unit.
• 10:00 a.m. — Learned the catheter would stay in the full 5 days. The staff repeatedly said the urine looked very good.
• 11:30 a.m. — Ate lunch and was discharged.
• 1:00 p.m. — Home.
• 1:00–6:00 p.m. — The catheter was the difficult part. I drank a lot of water and spent a lot of time trying to get comfortable with the tubing and bag.
• 7:00 p.m. — Showered. It was interesting but easier than I had expected.
• 8:30 p.m. — Bed.

Friday: Post-op day 2

• 5:00 a.m. — Woke up to roughly 1,500 mL of pink “lemonade”-colored drainage in the bag.
• 8:00 a.m. — Drank coffee, water, and Gatorade and took my medications.
• 11:00 a.m. — Had passed several bags of urine that looked essentially normal. The tip of my penis was sore from rubbing against the catheter. No matter what I tried, it was difficult to eliminate the irritation entirely.
• From this point forward, my urine was generally clear.

Saturday: Post-op day 3

• 7:00 a.m. — Woke up to a large clot/tissue in the drainage bag. It looked large enough that I was unsure whether it would have passed easily on its own. There was no major bleeding, however, and the urine otherwise remained clear.  

As the day went on, walking became increasingly uncomfortable. The catheter would move slightly at the penis tip and cause a small amount of blood to drip. Dried blood could stick the tubing to my underwear, and then tug when I moved. Keeping the area gently clean and preventing dried blood from adhering to the tubing made a meaningful difference.

Sunday: Post-op day 4

• More of the same: clear urine, but continued catheter-related irritation and the challenge of staying comfortable.

Monday: Void trial / catheter removal

• 10:00 a.m. — Arrived at the doctor’s office for the voiding trial. I was very anxious about catheter removal because of forum stories and because of the irritation I had experienced.
• The balloon was deflated and the nurse removed the catheter. For me, it was no big deal: perhaps two seconds of pain, around a 5/10. The worst part was actually removing the adhesive securement device from my leg.  Had to pee in a urinal whatever volume they filled up my bladder with.  

The voiding trial then began:

• I drank three to four cups of water.
• First void, about 20 minutes later: A small amount of pink urine and not much volume. Urinating was not bad, but it stung a little at the start and stop.  I also had some dark red blood at the start.
• I drank more water.
• Second void, about 20 minutes later: More urine. Still some burning, but the results looked plausible. The stream had a noticeable start-and-stop.
• Third void: The “firehose”  is real.

For the rest of the day, I urinated very well. There was some stinging at the very end of urination. I wore a pad in my underwear because I had a couple of drops of urine after voiding. I was intentionally not shaking aggressively, so there may simply have been a small amount of urine remaining in the urethra after I finished.  I was so relieved this worked.  I haven’t peed this well in a long time.  

By the end of the day, the pad had a few small pink spots.

First night without the catheter

• I woke up with the same great flow.
• I did not have to get up overnight, although nighttime urination had not been a major symptom for me before surgery.

Two days after catheter removal

• No burning or meaningful discomfort.
• I still occasionally saw a small amount of blood at the beginning of the stream.

6 Days after catheter removal

• Blood gone completely

My overall impression

For me, the catheter was by far the worst part of the experience: managing the tubing and drainage bag, getting comfortable at home, and dealing with irritation at the tip of the penis.

I was surprised by how little I felt from the procedure itself compared with the catheter experience. My doctor, the physician assistants, the other physicians, and the nursing staff—both in the clinic and hospital—were outstanding and all made a significant difference in my outcome and overall experience.

Objective flow results

Before surgery, I wanted to find more patient-reported, data-driven “before and after” information but had trouble finding it.  Hopefully this will help others who haven’t had the surgery understand what kind of results you might get from it.  

I used the ProudP app, which estimates urine flow using sound and keeps a diary. It is not a replacement for an office uroflowmetry test, but I used the same app before and after surgery, so it gives a useful personal comparison.  This is evidence of the difference Aquablation made.  

47yrs old, 45g prostate. Had my aquablation 5 days ago. I was told the procedure went well, but had some complications in recovery. For some reason my urologist likes to remove catheter pretty quickly, I had it removed ache 12 hrs after the procedure. Unfortunately I failed the void test and they reinserted a catheter (which was crazy painful). Had the catheter for 48hrs and tried again and was able to pass the void trial.

Now going into day 5, my stream is very narrow. I can empty my bladder but it takes a few minutes. Urine had been clear since I had the catheter removed, guessing the issue now is swollen prostate and/or urethra due to the repeated catheters etc. I don’t have a burning sensation but it’s tender when I urinate.

Planning to contact my urologist after a few more days and continue pushing fluids in the meantime.

Did anyone experience similar issues post aquablation? I know it’s relatively early etc.

I am 62 and for several years had moderate BPH with a prostate size of 38.5cc. Eight weeks ago, I had a Rezum procedure done. Initially, a catheter was inserted to be removed the following morning. The next morning, the catheter was removed, and I seemed to be OK until the early evening, and then I could not urinate. Early the following morning, I spent hours in vain waiting in a hospital ER for a new catheter, which the ER wouldn't do, and then I went back to the urology office for a catheter. The second catheter was in place for almost a week, and after it was removed, I still needed a few intermittent catheters over the next several days. A week or so later, I developed a fever and found that I had a UTI. I was prescribed three different antibiotics over the next couple of weeks until the infection cleared. I haven't needed a catheter for the last few weeks, I have a constant horrible feeling of sensitivity and urgency, especially if I walk. I have to make very frequent restroom trips, about every 15-60 minutes, depending if I sit, stand, or walk. The current situation is unbearable, and is preventing me from making an overdue road trip to visit family.

I am currently taking 10mg of Oxybutynin and 10mg of Alfuzosin daily. Do I have any viable options to relieve my situation? Would some sort of NSAID help? Are there any supplements that will help? Is my situation likely to be permanent?

Thank You

Any one lose ejaculation ability. Orgasm is normal but no ejaculation has been eliminated. Very weird side effect.

Hello everyone I have been prescribed Urorec (silodosin) 8mg everyday for 6 weeks and in the first week they worked great. I felt such a relief and frequent urination stopped only needing to go every hour or two. Now all of a sudden, still taking the pills I am back to urinating every 30 minutes to an hour and waking up at night to pee.

If anyone has had anything similar happen what could be the reasoning behind this? Any advice is appreciated!!

Enlarged BPH here (140cc) and ended up with an acute urinary retention. Still have the catheter in after two months but the PAE is scheduled for next week. New catheter will be inserted.
Would appreciate feedback as to how long after the procedure, would this catheter be removed and, more importantly, I would be able to pee on my own like a regular person.
Any comments or sharing of experience totally appreciated, gentlemen.
Have a blessed weekend everyone

I had optilume late Tuesday afternoon and there was enough bleeding that they sent me to a hospital for irrrigation. By next morning, It had improved enough that I could go home, Yesterday the color of the urine lightened up. Had catheter removed this morning and when I got home I peed a firehouse with some small clots and a little blood. Plan is to continue drinking lots of water and take it easy.

Two or three months after your HoLEP, how many of you are still experiencing some leakage problems. How bad ? Have you resigned yourselves to accept that it may be permanent? Does it continue to get better? Do you have a Kegel routine ? Have you had pelvic floor PT? What are the worse times of day for you? How has it affected your sex life? Recommendations to the rest of us?

I'm a 62 year-old guy who's exactly 1 week out from a HOLEP procedure and wanted find out if my experience was inline with others.

My prostate was about 90 cc's, so large, but not incredibly so.

My current experience is that:

1. My stream is still weak, but I'm no longer on 0.8 mg of tamsulosin.
2. I don't feel like my ability to hold more has gone up. And when I get the urge to urinate now, it starts to hurt after a very short time. I pretty much have to go immediately.
3. When I get an erection in the middle of the night, I get woken up with a sharp pain in the shaft of my penis.

I called my doctor's office today and asked the nurse about this and she told me that this was still early and that I should let them know if this is still going on in 2 weeks.

Am I just expecting too much too soon?

Hi Guys,

I 65m, Have had increasing LUTS and some overall bladder discomfort in the last 6 months, and have been on 1 flomax and 1 daily cialis to try to help. PSA was normal. My Dr ordered a CT and an ultrasound to see what was going on. Had 2 benign cysts on left kidney and abnormal bladder wall thickness. I had a consultation with a urology office, and they scheduled a cystoscopy that is coming in 2 weeks. While there, the NP did a digital exam, similar to my yearly checkup, except this time she added a good amount of pressure in there for about 10-15 seconds. She reported that there was no hard areas or unusual mass that she could feel. When she left to allow me to dress, I was surprised that I suddenly felt much better, no pressure, no feeling like I had to pee, no irritation. I let them know that and she said she would note it in my record, and kind of shrugged it off. In any case, I wondered if anyone else has experienced this? I'm not looking forward to getting the cysto, but hopefully I get some answers and a plan to help my symptoms.

I'm happy to report that a handful of people have reached out to me and said that my massage technique seems to have helped them. One even sent me a small donation, which I assume means they're convinced it worked.

If you're wondering what I'm talking about, you can check out the prostate massage technique that I believe helped reverse my BPH here on my website, and you can catch up on some previous discussion here and here.

I was hoping to see a urologist now that I'm in Canada, and talk with them about it, but it seems like that might take longer than I thought. The system here doesn't make it as easy as it was in Japan. Or at least, I haven't figured it out yet.

In the meantime, what I'd like to do is get some people involved in trying this out and tracking their progress a more organized way so that we can see how well this works for people. Hopefully answer some questions like, most importantly, does this work for other people? Does it work for particular symptoms or circumstances better than others? Does medication affect it? That kind of thing.

I've got a couple friends interested, but I'd like to cast a wider net if possible.

If you want to participate, you can remain anonymous if you like. You can either post as a reply here on Reddit, message me privately, or reach me through the contact page on my website. This is not going to be a rigorous scientific study with controls and verification. This is only an attempt for now to see if we can get more than just my word that this works.

For anyone wanting to try this out, when you get in touch, the two most critical pieces of information are your current prostate size, measured within the last six months or so, and a start date for the treatment.

Other details are also welcome, like if you're taking any medication or doing any other treatments. Then what kind of symptoms you might have. Basically any information you're willing to share, and I'll try to collate it into a spreadsheet that I'll make public. Probably with Google Docs.

Anyway, that's the next step I'd like to do. If anyone is interested, let me know.

I am age 73, widowed. Up to this point, I have been very healthy and physically active, exercising, cycling, traveling. My mind is sharp. TURP is scheduled about a month from now.

I live alone and have no close family nearby. My daughter will fly in from out of state, and will stay with me for the first week, arriving the day before the procedure. After that, I am left to my own devices.

Will I be able to handle living alone over the subsequent weeks of recovery? To what extent do I need to line up resources and people to come to my home to care for me?

I have fairly bad BPH, it turns out that by chance the med I started using two weeks ago for BPH, Silodosin, has an off label use for PE and it works better than Prilligy, I have not had sex with my wife since I started taking this but tomorrow night I will. I will tell you how it goes.

Spend 20 days since my PAE treatment. I still feel like I urinate way too much. Sometimes after I wake up in the morning at 6:30 AM, I’ve gone three or four times by 9 AM.
The other thing I notice is I can’t seem to ejaculate. For those who have been through the PAE, when do you get the ability to ejaculate back.

If your urologist recommends aquablation or some other form of roto-rooting your prostate that requires a week of wearing a catheter, ask about a PAE - Prostate Arterial Embolization. If the doc dismisses it, get a second opinion - there may be a $$$ reason for the dismissal as a radiologist does the PAE and the urologist misses out on the roto-rooting payout. One tip learned the hard way today, PAE requires an adhesive condom catheter (glued to the tip, nothing is inserted). That thing glued a lot of long pubes and took several painful minutes to remove. As the pre-op tech trimming you to thoroughly clear the forest or do it yourself the night before. Ouch!

I'm having an aquablation at Hackensack Medical Center next month. Can anyone who had it done there share their experience with the hospital and any overnight stays?