Aquablation therapy is a minimally invasive treatment for Benign Prostatic Hyperplasia (BPH). The procedure uses a robotic-assisted, heat-free water jet to precisely remove obstructive prostate tissue, offering relief from lower urinary tract symptoms. Since sexual function is a significant concern for men considering BPH surgery, understanding the specific post-procedure outcomes related to intimacy is important. This article details what to expect regarding the timeline for resuming sexual activity, the impact on ejaculation, and the effect on erectile function and libido after undergoing Aquablation.
Resuming Intimacy: The Post-Procedure Timeline
Resuming sexual activity following Aquablation requires patience to allow the body to heal completely. Most urologists advise patients to wait until the temporary urinary catheter has been removed and initial urinary discomfort has stabilized. This period typically spans between two to four weeks post-procedure before sexual activity can be safely attempted.
Waiting ensures the surgical site is adequately healed, minimizing the risk of bleeding or discomfort. Attempting intimacy too soon can irritate the newly resected area, potentially leading to increased blood in the urine or delaying recovery. During this time, temporary side effects like hematospermia (blood in the semen) may occur, but this usually resolves as the internal surgical site continues to heal.
Ejaculation: The Primary Sexual Outcome
The preservation of antegrade ejaculation is a primary advantage of Aquablation compared to many traditional BPH surgeries. Antegrade ejaculation is the normal process where semen travels forward and exits the body through the urethra during orgasm. Traditional procedures often result in retrograde ejaculation, where semen enters the bladder instead of exiting the penis.
Aquablation’s robotic precision allows surgeons to create a customized surgical map that targets obstructive tissue while sparing ejaculatory structures. This involves carefully avoiding the bladder neck and the verumontanum, which direct semen flow. Since the procedure uses a heat-free water jet, it avoids the thermal damage common with laser or electrocautery treatments.
Clinical studies consistently show high rates of preserved antegrade ejaculation. Data indicates that between 72% and 99.6% of men maintain their ejaculatory function, with studies reporting preservation in roughly 81% of sexually active men. This rate of ejaculatory dysfunction is significantly lower after Aquablation compared to older techniques, such as Transurethral Resection of the Prostate (TURP).
While the ability to ejaculate antegrade is largely preserved, some men may notice a change in the characteristics of their semen. A small percentage of patients may experience a decrease in the overall volume or force of the ejaculate. This change is typically not considered a failure of the procedure, as the preservation of antegrade flow remains the primary functional goal.
Impact on Erectile Function and Libido
Aquablation is considered “erection-neutral” due to its precise and non-thermal mechanism. The robotic system uses real-time imaging to guide the water jet, allowing the surgeon to avoid the delicate nerves that control erectile function. This targeted approach protects the neurovascular bundles necessary for achieving and maintaining a firm erection.
Clinical studies have shown a 0% impact on key sexual health metrics, including erectile function, orgasmic function, sexual desire, and overall sexual satisfaction. For men who experience improvement in their urinary symptoms, some reports even indicate a positive correlation with improved erectile function post-procedure.
Any surgery can temporarily affect a patient’s sexual response, potentially manifesting as a short period of temporary erectile dysfunction. This is often attributed to temporary swelling or psychological factors related to recovery. These temporary issues typically resolve as the body heals and the patient regains confidence. Overall, the risk of long-term, irreversible complications to erectile function and libido remains very low.