How soon after aquablation can sexual activities be resumed?

Resuming Sexual Activity After Aquablation

Sexual activity can typically be resumed within 1-2 weeks after aquablation, with most patients safely returning to sexual intercourse once initial urinary symptoms have stabilized and any catheter has been removed.

Evidence-Based Timeline

The available evidence does not provide specific guidelines for resuming sexual activity after aquablation. However, based on the procedure's minimally invasive nature and clinical trial data, a reasonable approach can be constructed:

Early Recovery Period (First 1-2 Weeks)

• Initial healing occurs rapidly after aquablation, with most patients discharged within 1.6 days and experiencing significant symptom improvement within the first month 1
• Catheter removal typically occurs within days of the procedure, marking an important milestone for resuming activities 1
• Light intimate activities (hugging, kissing, fondling) can be considered once the patient feels comfortable and any immediate post-operative discomfort has resolved

Full Sexual Activity Resumption (2-4 Weeks)

• Sexual intercourse can reasonably be resumed once urinary symptoms have stabilized, typically within 2-4 weeks post-procedure
• This timeline is considerably shorter than traditional surgical approaches like TURP, which often require 6-8 weeks of recovery 2
• The key advantage of aquablation is the preservation of ejaculatory function in 81% of sexually active men at 12 months, significantly better than TURP's 77% rate of retrograde ejaculation 1, 2

Critical Anatomic Considerations

Ejaculatory Function Preservation

• Avoiding damage to the verumontanum and ejaculatory ducts during the procedure is essential for maintaining ejaculatory function 3
• Penetration of ejaculatory ducts increases the risk of postoperative anejaculation by 8.6-fold (OR 8.6,95% CI 1.09-67.5) 3
• Only 6% of aquablation patients experience retrograde ejaculation compared to 23% with TURP at 3 months 2

Patient Counseling Points

What to Expect

• Sexual function typically improves rather than worsens after aquablation, with only 33% of sexually active men reporting worsening sexual function through 6 months compared to 56% after TURP 2
• Erectile function as measured by IIEF-5 is generally preserved, with sexual function remaining stable at 2-year follow-up 4
• Energy and desire for sexual activity often improve as obstructive urinary symptoms resolve 1, 5

Safety Considerations

• Wait until urinary symptoms stabilize before attempting intercourse to avoid discomfort or complications
• Ensure adequate healing of any urethral irritation, typically 1-2 weeks post-procedure
• Monitor for any bleeding or discomfort during initial sexual activity and report persistent issues to the urologist

Common Pitfalls to Avoid

• Do not delay counseling about sexual activity resumption—patients benefit from proactive discussion before discharge 2
• Do not assume all BPH procedures have the same recovery timeline—aquablation's minimally invasive nature allows earlier return to activity than traditional TURP 5
• Do not overlook partner concerns—include discussion of what to expect and reassurance about safety 2

Long-Term Outcomes

• Durable sexual function preservation is maintained through 5 years of follow-up 6
• Retreatment rates are low (4.3% at 2 years), suggesting sustained efficacy without need for repeat procedures that could further impact sexual function 4
• PSA reduction of approximately 50% occurs by 5 years, which should be discussed to avoid confusion about prostate cancer screening 6