r/Aquablation

This is making me apprehensive about my surgery on May 28th. The Mayo Clinic says that the catheter is removed in 2 to 3 days. Yale and Johns Hopkins say the goal is to remove it the following day. Is the reality on the ground really 5 to 7? I have a small prostate with mild to moderate symptoms. I'm not on blood thinners, I'm a tall, skinny 56 year-old. The only explanation that I can think of is that I have an enlarged medial lobe. Removing that is said to leave a large raw area that benefits from the catheter being in longer.

First of all, I want to thank all of you who have written to share your Aquablation experiences. For the past 7 months, I’ve been reading lots of urology related subs (BPH, Prostatitis, Prostate Cancer, etc…) on Reddit, and after I sorted through all the procedures available, this sub has been the best source of information for me.

I thought I’d share my experience with this sub. I’m 67, had a 107.7 ml prostate and a history of increasing BPH symptoms, frequency and urgency being the worst two. I ignored the symptoms and didn’t seek out any help, thinking that this was just the way things go. I was wrong. I’ve had multiple health care professionals along the way say to me: “you’re young for this.” Just lucky I guess.

On September 24, 2025, after a week of intermittently not being able to empty my bladder fully, I found that I could not empty my bladder at all. Ended up in the emergency room of the local hospital, and I was catheterized from then until April 28, just a few days over 7 months.

Last week, my Aquablation procedure could not have gone any better. If you are anywhere near southern California, and need urological treatment, I would suggest you seek out Dr. Mihir Desai at Keck USC. I had a great experience with him and his team, and with the hospital staff at Keck USC Verdugo Hills Hospital.

My wife and I arrived at the hospital on April 24 at 8:30 am. My procedure was scheduled for 10:00. I was called into the surgery pre-operative room and was prepped. The anesthesiologist gave me an injection and then I was wheeled into the operating room. Along the way, I was introduced to everyone who would be in the room, which included a representative of the company that makes the Aquablation machine. I asked if this was usual, and was assured it was so. They asked me to move over to the operating table and put my butt in a specific location, above an indention. I moved to the table, and that’s the last thing I remember before waking up in the recovery room. According to the report I read, the procedure took just a little over an hour.

Once in my hospital room (about 11:00 am), the nurses began the flushing process, hanging large bags of sterile saline next to the bed. The saline ran continuously through my bladder and prostate through my new 22 French catheter. The catheter had three ports: one for input, one for the saline balloon in the bladder, and one for output. The color of the urine was a bit alarming, as it was deep red, but they told me that it was normal. The color slowly became lighter as the process continued. I was also encouraged to eat, and to drink lots of water. The flushing process continued until the next day, and I was discharged with the catheter and a large urine collection bag at 1:00 pm on Saturday.

I rented a VRBO apartment near the hospital, just in case of a complication, as we live about two hours away from Los Angeles. We went back to the apartment, and I relaxed all weekend, binge watching British crime dramas and having food delivered. The color of the output continued to get lighter. On Monday morning, I called Dr. Desai’s office and got an appointment with his nurse practitioner on Tuesday afternoon. Arrived at USC Health Science campus and met with the NP. Catheter removed, did the voiding test and I passed.

Because I had been in emergency rooms multiple times in the seven months of this journey, we stayed one more night just to be on the safe side. I’m please to report that I can easily empty my bladder quickly and completely - compared to last fall, I have a firehose! Got to drive home on Wednesday, April 29.

The blood in my urine continues to get lighter and lighter. When I was released from the hospital, the doctor said that as long as I could “read through it” the color was ok. I was instructed to call if the color became deep red and opaque. Today, 9 days after my surgery, the blood is very light pink, and one some occasions nonexistent. Yesterday, it no longer burned after urination, just a little odd discomfort. Today is even better.

I was really astounded how little pain I felt while in the hospital. They gave me some great pain relief meds out of the operating room, and then just Tylenol. I also received medication to stop bladder spasms. I never felt one.

I’ve had a few odd phantom catheter sensations since I got home, but they’ve stopped. I still have a little sensitivity at the end of my urethra, no doubt because of the long term catheter and the Aquablation procedure. It is getting better daily.

I’m very pleased that I chose this procedure, and that it all went so well. I’d encourage anyone with BPH to study all the procedures and make an informed decision that works for you. I’m glad I chose Aquablation.

Over on the BPH sub, one of the members created a website for educational purposes. It lists 18 procedures available and ranks effectiveness and invasiveness. I think it’s a good tool. You can find it at: bphguide.com

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Here’s a timeline of my BPH journey if you’re interested:

9/24/25

Local emergency room - unable to empty bladder, 18 French catheter inserted to empty 1 liter of urine, advised to visit primary care doctor and get referral to urologist.

9/25/25

Met with PA in primary care office, referral to local urologist. PA told me that the catheter would need to stay in until I met with urologist. Ordered this as STAT. Flowmax prescription, began taking it.

10/6/25

STAT status not known by local urologist’s office. Met with local urologist. Nurse replaced catheter with another 18 French. Doctor said it needs to stay in until they do bladder testing. Orders renal ultrasound.

10/26/25

In evening, severe chills, fever starts, temperature 101.5°

10/27/25

Temperature 101.5°, called urologist’s office at 8:30 am, spoke to nurse who advised me that she would talk to doctor and call me back. 2:50 pm, received call back from urologist’s office. Advised me to call my primary care office. Called primary care office. Advised that I go to either urgent care or emergency. 5:15 pm, went to local emergency room. Foley catheter is taken out and replaced with new 18 French in emergency room, IVs started, heart monitoring. I hear “Strep Alert” when I am escorted to my room in the emergency department, it’s referring to me.

10/28/25

Admitted to hospital in guarded condition with urinary tract infection at 1:00 am, got to room at 2:00 am, IV antibiotics and Tylenol, and testing

10/29/25

IV antibiotics and Tylenol, and testing

10/30/25

IV antibiotics and Tylenol, and testing, released 3:00 pm

10/31/25

Visiting nurse - first visit, took history, reviewed meds, brought supplies, ordered more

11/1/25

Received medical supplies that nurse ordered.

11/3/25

Renal ultrasound, ordered by local urologist.

11/4/25

Visiting nurse - second visit, Nurse advised me that my area has a lack of urologists. They are in high demand, and many are here from LA a few days a week. Other patients have similar experiences to mine, with doctors being disengaged and unfriendly with poor bedside manner. She advised me to take a list of questions and insist on answers, if not at the time of the appointments - via email. She encouraged me to ask about treatments that he performs. She encouraged me to consider LA based doctors.

11/5/25

Primary care visit, discussion of second opinion, kidney stone, consider UCLA, USC, Cedars Sinai. Starts second opinion referral to different local urologist. This urologist refuses to take me as a patient.

11/12/25

Met with primary care doctor. He advised keeping appointment with local urologist.

11/18/25

Met with local urologist. Removed catheter, did voiding test, passed test. Made appointment for January 20 for cytoscopy. Referral to ultrasound and order for blood work. Unable to urinate past 4:30 pm. Back to local emergency room at 9:00 pm. Put in 18 French foley catheter and drained liter of urine.

12/4/25 (was able to get in early)

Cytoscopy with local urologist. Prostate is “huge” (in his words), and bladder has wrinkles. “I can’t guarantee that you’ll have normal urinary function.” Foley catheter replaced with new 18 French. Stopped taking Flowmax.

12/6/25

CT scan of pelvis.

12/19/25

Appointment with local urologist for prostate biopsy. Staff neglected to give me instructions for procedure at previous appointment, so I was not prepared with enema. Procedure canceled until 1/20/26.

1/19/26 (able to get in early)

Transrectal biopsy of prostate in local urologist’s office. He estimates prostate is 90.6 cc. New 18 French foley put in. Results on February 3, 2025.

2/3/26

Local urologist visit. No cancer. He offers me a TURP. I asked for referral for Aquablation or HOLEP, he gives me a referral to a doctor who is a friend at Keck USC.

2/12/26

Contacted by Keck USC office. Online appointment made.

3/5/26

Online appointment with USC at 1:00 pm. Doctor (friend of local urologist) tried to talk me into a Single-Port Robot-Assisted Prostatectomy. Said that it was more permanent and said negative things about Aquablation. Renal scan required if I want to proceed. I waited for 1 1/2 hours online, and then he called me on the phone to discuss.

Visit from nurse, replaced catheter, pain, blood. Urine was flowing when she left about noon. Urine stopped flowing. Visit to local emergency room to replace improperly placed catheter, 5 to 7:30 pm. Hospital replaced 16 French with 14 Coude catheter.

3/6/26

Call from Keck USC, they wanted me to schedule another appointment with prostatectomy doctor. I declined and requested to change to Dr. Desai, who does Aquablation. Transfer is in the works, they’ll call me soon.

3/7/26

Transfer to Dr. Desai complete, appointment set for March 11 at Keck USC campus in Los Angeles.

3/11/26

Visit with Dr. Desai and a fellow (student). They thoroughly explained the procedure, benefits, and risks. Said Aquablation was a good solution for my condition. Kidney issue is mild, and not of great concern. Wants an MRI of prostate before surgery.

3/12/26

Aquablation scheduled for April 24 at USC Verdugo Hills Hospital. Will need preoperative checkup with primary care doctor 30 days before procedure.

3/25/26

Received order for MRI of prostate from USC

3/31/26

Scheduled MRI, 4:10 pm, Results indicated a 107.7 ml prostate.

4/13/26

Pre-operative physical and lab work

4/23/26

Arrived at VRBO apartment near hospital in evening.

4/24/26

Aquablation performed by Dr. Desai and team at Keck USC Verdugo Hills at 10:00 am. Bladder and prostate flushed out with sterile saline for 24 hours.

4/25/26

Released from hospital with 22 French catheter with three ports, 1:00 pm, went back to VRBO apartment near hospital in case of complications.

4/27/26

Scheduled followup appointment with Dr. Desai’s office

4/28/26

Followup visit with NP at Dr. Desai’s office (USC Urology). 220 ml of sterile saline injected into bladder, it all emptied, passed urinary voiding test, Catheter removed. Spent night at VRBO apartment near hospital, and had no issues emptying bladder. Scheduled follow up with Dr. Desai.

4/29/26
Arrived home

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Here are some things that I have realized during this journey, in no particular order:

• The first few days with a catheter are the worst. I think it’s because the lubricant and betadine leak out the urethra. It always burned for a few days, then settled down.

• Don’t worry about stuff leaking out around the catheter, just keep it clean. After surgery, you may have some blood leaking out, just keep it clean. My visiting nurses supplied me with no rinse cleanser to keep things fresh between showers.

• Showering every morning was my ritual. Change the night bag to the smaller leg bag, then shower. I carefully washed myself, using lots of soap, and lots of rinsing. Used a fresh washcloth every day.

• Be careful of not allowing anything to go into your urethra. I think I inadvertently helped cause my urinary tract infection because I put some Vaseline on the catheter to keep things smooth. Don’t do it.

• My local urologist is not a great communicator. I understand that many are this way, and since there is a shortage of them, they get away with poor bedside manner.

• My local urologist’s office staff did not give me any instructions about catheter care, and didn’t instruct me on hygiene, and didn’t provide me with supplies (hygiene products, leg bags, alcohol wipes, nitrile gloves, etc…). Ask for help if you need to be catheterized for a long time, insurance covers supplies.

• Visiting nurses are a great resource. After my infection in October, my primary care doctor ordered them for me. They will keep tabs on you, take vital signs, watch for infection symptoms, and order supplies for you. I had a visit about every other week.

• Be informed and assertive regarding your choice of procedures for your urology issues. There are many procedures available, and you can choose, along with a good doctor, the best one for you. Be aware that doctors have specific procedures they perform, and will try to steer you toward their speciality.

• I purchased a license for Eureka Health, an app that organizes health information for you. It grabs information from the web, and provides links. The sources are Mayo Clinic, Cleveland Clinic, UCLA, USC, etc… good quality information. You can ask it questions, and it will answer them for you in an easy to understand way. (I was freaking out over my prostate biopsy. I asked Eureka what my chances were for cancer, and it said about 35%.)

• I wish that someone along the way would have said “this could take a while.” No one indicated that I would be catheterized for seven months. The reasons it took so long include: scheduling doctor appointments, holidays, scheduling lab work, scheduling testing, my urologist being a jerk, etc…

• Seek out a large university teaching hospital if possible. This is my second experience with one, having previously had surgery at UCLA. They have cutting edge technology and my experience is that they are actively interested in helping you.

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Aquablation
I have found it super useful reading other peoples accounts of their Aquablation journey. I have therefore decided to document my own experience in case useful.

The journey
I’ve suffered for a number of years with urinary symptoms, including slow flow, hesitancy and broken nights sleep. I previously had a Urolift which made no difference whatsoever. Prior to that, drugs also had zero impact.
I therefore sought further investigation and after a cystoscopy it was found I had a median lobe which was obstructing the bladder outlet. My prostate is regular size 21g so my issue is I guess more of an anatomical one.
I researched the various treatments available and felt Aquablation would be more suited to me given the lower incidence of sexual disfunction. I am 53.
I then went and found an experienced practitioner who confirmed I would be suitable for surgery. There was then a wait of around eight weeks to get a slot with the surgeon.

The procedure
The day arrived and I was asked to come at 12:30 pm. I was shown my room, met various staff members and then spoke with both the consultant and anaesthetist who explained the process and answered my questions.
They were a number of other people on the doctors list that day so I was finally taken down at 4:30 pm.

I woke in recovery at 6:30 pm and was told the procedure had gone well. I was then taken back to my room where I was asked to drink as much fluid as I could. I also had a meal.
The night itself, I could best describe as one of broken sleep with nurses coming in to check blood pressure and make sure th catheter is working.
The catheter itself is cumbersome and uncomfortable but on a brighter note it has been less bothersome than I had built up in my mind. Also on a positive note, I’ve had remarkably few bladder spasms though I recognise it’s early days.
I will keep up my account over the next days and weeks.

Good luck to all and I hope your journeys are successful.

Day 2
Catheter removed which was slightly uncomfortable but very quick. It’s a big relief to have it out and you can move much more freely.
Pee test to be released from hospital. My surgeon requires you go three times, each time it is measured and the residual amount in your bladder is also measured.
The power took me by surprise, as strong a flow as I’ve ever known.
As you may have read elsewhere, it stings a bit but manageable and discomfort falls away quickly

I read many threads on Reddit prior to getting this procedure done. Quite helpful. So I wanted to convey my own story. 

56 years old. Prostate about 75 g. Significant urinary issues for the past couple of years with poor stream, frequency, urgency… high IPSS score. Urologist felt that this would be a great option. The practice in Northern Virginia, for the past several years, has been doing the prostate artery embolism a few days before aquablation for two reasons: 1) help with decreased bleeding during the surgery 2) continued reduction of prostate size overtime.  Decided to move forward, hoping to get good results like many have on this website.  

Had the PAE on April 28. This procedure was fairly straightforward. Lasting approximately one hour. Initially when I arrived, IV was placed and I was taken back into the operating room. They obtained access via the vessels in the groin with local anesthetic and mild sedation was provided. Embolization was done to both the right and the left-sided vessels, but access was only obtained from the right groin. Went home approximately one hour after the procedure. 5 to 6 hours after the procedure, I began noticing that it was painful to initiate urination. I was told that this was going to happen because of the blood flow to the prostate being reduced. Definitely uncomfortable overnight but manageable with Tylenol. I was advised not to take any NSAIDs as I would be having the aqua ablation the following morning.

On April 29, I went in for the aqua ablation. After initial preoperative questioning and IV placement, I was taken to the operating room and under general anesthesia, the procedure was performed. I woke up in recovery with a catheter and continuous bladder irrigation. The catheter was larger in size and so extremely uncomfortable. The procedure lasted approximately one hour, and I was in recovery for an hour and a half. I went home with the catheter in place. It was very, very uncomfortable and painful. I kept hydrating. At this Urologist practice they do not keep patients in the hospital if there is no significant bleeding. I went home approximately 2 p.m.. getting home was very uncomfortable with the Catheter in  place. Small tiny steps till I  was able to get into bed. Any tiny movement would produce significant discomfort with the catheter. Till the following morning, I had to empty the catheter bag three times, producing about 6 L of urine. Thankfully, I did not notice any blood or blood clots, but the urine was orange in color because of treatment with pyridium , which helps to decrease pain with urination and the presence of the catheter. Overnight sleeping was very difficult because of this catheter in place. Had to wake up several times to empty the bag. My wife flushed it once before going to sleep. The following morning, even the tiniest movement I’m getting out of bed was painful because of the surgery and the catheter. My follow-up appointment was The next day at 11 a.m. and they had told me that if I did not have any blood in my urine and I was producing an adequate amount of urine, they would remove the catheter. I went into the office, and the catheter was removed. That, I have to say, was extremely painful. The pain lasted for about 10 or 15 minutes after the catheter was removed. I was asked to follow up in the office four hours later to see if I was urinating appropriately or if I was having significant post-void residual in my bladder.  I spent the last next few hours just relaxing. And hydrating. My first opportunity to urinate, and I immediately noticed a huge increase in my stream. There was also significant urgency. I could barely make it to the bathroom. I did not notice any blood again the urine was orange-tinged. I kept hydrating and urinated several times. At the appointment in the morning, I was told that if I was not urinating well, then they would have to replace the catheter. The thought of that brought extreme fear to my mind. So I kept hydrating and thankfully appropriately urinating. The appointment at 3 p.m. they confirmed that my residual volume in the bladder was low and that I was good to go. That was such a relief. I could not imagine if I had to get that catheter reinserted. 

For the past 5 to 6 days, I have just been hydrating. Primarily Tylenol for pain. Peridium as needed but trying not to use it. I have not noticed any significant bleeding and maybe am thankful that is because of the PAE procedure. Moderate significant pain on urination occasionally when starting, but typically when ending. Hydrating with about two or 3 L a day. For the first couple of days, I had very little control and needed to rush to the bathroom and occasionally did not make it before starting to urinate. Definitely the feeling of urgency. Stream is fairly strong. Needed to wear Depends diapers a couple of times when I was not close to a bathroom. As I use less and less of Peridium, urine is more yellow, but I have noticed a lot of froth or bubbles in the urine. Has anyone else noticed that? 

Pain is only associated with urination. Also noticed that I was significantly constipated, the first four or five days. Had to take Colace and psyllium powder. Forceful bowel movement produced a lot of pain in the penile and pelvic area. Thankfully, that has subsided over the past couple of days.

For the first few days, I did not do much with respect to activity level. Four days postoperatively, I started going for small walks in the neighborhood. This morning, I went for about 30 minutes’ walk. When I initially started walking a couple of days ago, there was pelvic discomfort, but that is getting better. 

Symptoms right now primarily pain on urination with urgency improving day to day. Have not noticed any significant blood.  During the night, I have been having to get up about two or three times to urinate.  But a few occasions have had pain from urination that lasted about 10 or 15 minutes. Pain primarily in the pelvic and near the head of the penis. 

As well, as I mentioned, definite frothy foamy urine. 

I asked my surgeon, and he stated that that was normal. Seeing if anyone else is experiencing that?

Hopefully, in the next one or two weeks, I can return to the gym and do some moderate amount of exercise. Hoping that the strong stream, which frankly I have not had for the last three or four years, continues indefinitely. Urgency has improved slightly, or at least the ability to hold the urine till I can get to the bathroom. 

I will keep updating over the next several weeks as recovery progresses. 

....and feeling good. 68yo, with many years of worsening symptoms, topped off by visible blood in the urine, bladder stones, and 100g prostate. Assured by my urologist that Aquablation was the way to go, scheduled procedure for a time I wasn't traveling for work.

I woke up after the procedure, including bladder stone removal, with no pain. Stayed overnight, had the catheter removed the next day and went home.

I was basically given four instructions: No exercise except walking for four weeks, no sexual activity for four weeks, no lifting objects > 10 lbs, and plenty of hydration.

Recpvery so far has been uneventful. Blood in urine for first two weeks, gradually diminishing. Still some discomfort while peeing, gradually diminishing. No other pain. Urgency gradually diminishing. Back to work with no problem.

Looking forward to trying out the sexual function in a week or so. So far, though, I'd give the procedure an A+