Sling's?? male and female?

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kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 2/9/2008 12:37 PM (GMT -7)   
    I would like to hear from any men and/or women that have had slings done.  I will be having it done on the 22nd and just looking for some additional information.
 
    See Ya,  Kw
    43
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second opinion Doctor at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 4th, 2008 - Appointment with Original Dr. to discuss options and recomendation for surgical fix for incontinance.
    Feb. 22nd, 2008 - Surgery to install the AdVance Sling.
 
     


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 2/10/2008 12:54 AM (GMT -7)   
You probably already know this, but you are going to be charting interesting territory. You also may have seen this but I found one study on the subject, but it's almost two years old.  If anything it's probably going to have improved results.:

Early Results Of Adjustable Male Sling Encouraging
Main Category: Urology / Nephrology
Also Included In: Prostate / Prostate Cancer
Article Date: 23 Mar 2006 - 0:00 PST

UroToday.com - Stress urinary incontinence (SUI) can be an unfortunate complication of prostatic surgery and can have devastating effects on men's quality of life. The condition has also been difficult to treat reliably with more severe cases of incontinence requiring surgical correction with periurethral bulking agents, artificial sphincter insertion (AUS), and more recently pubourethral or bulbourethral sling placement. Currently available slings rely on the correction tension to be chosen in the operating room to provide sufficient urethral compression to eliminate incontinence. This determination can be difficult to estimate reliably.

A recent report by S. V. Romano, F. Nakamura and colleagues from Argentina and Brazil describes the efficacy and safety of a new adjustable bulbourethral sling for male stress incontinence after prostate surgery. The report of this multicenter trial is published in the February 2006 issue of BJU International.

The new sling has three components: the pad, a 4.2 X 2.6 X 0.9 cm thick silicone foam cushion designed to provide soft compression of the bulbar urethra, the silicone tubing connected to the pad is comprised of multiple cone-like sections that allow it to be pulled through silicone washers to adjust the tension of the sling. The operation is similar to that described by Schaeffer for the original bulbourethral sling. The perineal membrane lateral to the bulbar urethra and medial to the ischiopubic ramus is exposed and punctured with a special tool that is then passed suprapubically behind the pubic ramus and through the rectus fascia and out of the skin- much like a TVT would be placed in a woman. The pad and its silicone connection tubing is connected to the tool and pulled up. The silicone washers are placed on the tubing and the sling tension is adjusted to provide an absence of flow at a retrograde perfusion pressure of 45 cm of H2O. The silicone washers are buried on the fascia under the skin and the two suprapubic and one perineal incisions are closed.

The procedure was performed on 48 men with SUI over a one and a half year period. All men reported moderate to severe SUI for > 1 year after radical prostatectomy (39) or after surgery for benign disease (9). Of the 48 men, 19 wore an average of 5 pads/day, and 29 used a penile clamp or a condom catheter preoperatively. The mean follow-up was 7.5 months and in 30 men (63%) it was >6 months. Results showed that before and after surgery, the mean retrograde perfusion pressure was 23.5 and 47.5 cm of H2O. Overall, SUI was cured (dry, no pads) in 35 (73%) patients, and improved in five (10%; mild sporadic incontinence, one or fewer pads/day). The treatment failed in eight patients (17%, more than 2 pads a day), despite readjustment in 3 (6%) and loosening in one. The sling was removed in thee patients (6%) due to urethral erosion and in two (4%) due to infection.

The early results of this new sling are encouraging and with acceptable complication rates this procedure may provide another valid alternative to the artificial urinary sphincter for men with stress urinary incontinence after prostate surgery.

By Michael J. Metro, MD

Reference:
BJU Int. 2006 Mar; 97(3):533-39
Link Here.
Romano SV, Metrebian SE, Vaz F, Muller V, D'Ancona CA, Costa DE Souza EA, Nakamura F

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice.


Good Luck, KW, You have my thoughts and prayers.

Tony


Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (1/08): <0.1
I will continue HT until May '09. 
 
Visit my Journey at:
 
STAY POSITIVE!


myman
Veteran Member


Date Joined Feb 2007
Total Posts : 1219
   Posted 2/10/2008 6:24 PM (GMT -7)   
kw,

I just wanted to say something to you.
You are extremely brave and giving and I greatly admire the way you've handled your struggle. I know this is not the way you wanted things to go but with the attitude and determination you possess, I believe this surgery will be successful. You will do what's needed to have the best outcome.

The fact that you've been open to share and encourage others is a wonderful example of what Healing Well is all about. I have a great deal of respect for you.

We're right here,
Susan
Husband Diagnosed 11/17/05 Age: 63 PSA: 7.96 No Symptoms
2/09/06: LRP - Post Pathology - Gleason 4+3 Stage T2b NO MX
3 mo. PSA: 11.8 Stage T3a
6 mo. PSA: 18.8 Stage IV Systemic w/ distant lymph node involvement
Start HT - Lupron 3 mo. shots
12/06/06: PSA 0.8
03/07/07: PSA 0.3
06/06/07: PSA 0.1
09/05/07: PSA 0.1
11/27/07: PSA 0.1


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 2/10/2008 7:15 PM (GMT -7)   
Tony, Thanks for the research. Yes I have seen that study. The AdVance sling is a newer device and has shown as much as 80% of patients get 100% control. I hope to be in that 80% group for a change. But if not, I know it will greatly improve things.

Susan, Thanks for the encouragement and support.

I will be posting updates on "My Journey" as things go along.

KW
    43
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second opinion Doctor at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 4th, 2008 - Appointment with Original Dr. to discuss options and recomendation for surgical fix for incontinance.
    Feb. 22nd, 2008 - Surgery to install the AdVance Sling.
 
     


Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 2/10/2008 8:21 PM (GMT -7)   

KW, as per our telephone conversation, I am trusting a good outcome for you.  Of course I am extremely interested in your sling surgery.  That, of course, may be an answer to my own problem. 

One thing, however, troubles me.  I did a search on the AdVance.  From what I read, it's best results were for those who had mild stress-related incontinence.  I could not say mine is mild, so I am wondering, of course, about how it might or might not help me.  Best wishes and prayers for you.

Gene


Age: 64
07/05 - Biopsy: Suspicious looking cells. 
12/27/06 - Biopsy
1/24/07 - Dignosed cancer: Gleason Grade: 3+3=6
02-14-07 Radical Open Nerve-sparing surgery
Pathology Stage of cancer: T2c
4-18-07: First Post-Op psa = 0.011
05/31/07: Cystoscope reveals "Stricture"
06/12/07: Procedure to remove stone & dilate uretha at stricture: Successful procedure..
8/31/07: Back to new urologist for regular check up & received 2nd post-op Psa.  It was 0.05
8/31/07:  First Bio Feedback session.
9/19/07: Finished 4 Bio Feedback sessions.  No imporovement with leaking. 
9/26/07 - Started injections 
10/27-07 - Began using clamp at uro's encouragement.
02/01/08 - Still leaking & cannot contain urine in bladder except when sitting or laying down.  Can hold it for abut one minute before drip, drip, drip.
02/28/08 - See Uro. Will discuss artificial sphincter 
 


DesertGal
Regular Member


Date Joined Dec 2007
Total Posts : 65
   Posted 2/11/2008 2:34 PM (GMT -7)   

Hi kw,

Here's a female version of the sling surgery. I had the sling installed a year ago because of stress caused incontinence. Bending, coughing, laughing, sneezing, lifting etc, and also having 3 children.  It was the best thing I ever did for myself! And my self esteem!  It was done as an outpatient procedure, went home that afternoon and had the cath removed the following day.  I was feeling really good within a week and had instant positive results.  Had to take it easy for about 6 weeks and not lift anything heavy.  So I hope you have the same success story as I do. 

Good luck and keep us posted!

Marie


Husband 55 years old
No symptoms
PSA taken on routine health exam
06/18/07  PSA 9.2
07/14/07  Put on antibiotics for a month
09/18/07  PSA 8.77
09/18/07  PSA % Free  9.61
10/17/07  Biopsy =  Gleason 3 + 4  (7)
10/17/07  Biopsy 40% Right Side less than 5% Left Side
12/31/07  D Day!  Davinci Surgery Day - Jon Huntsman Cancer Institute
12/31/07  Left side nerves spared, Right side partial, right nodes taken
01/11/08  Cath removed, post-op gleason 3 + 3 = 6, nodes clear
                Margins - capsular invasion but no penetration.  T2C
02/08/08  Dry pad free
02/08/08  Started taking low dosage of Viagra


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 2/11/2008 7:44 PM (GMT -7)   
    Gene,  Yes the best results are for mild to moderate incontinance.  At 6 pads a day we are just over the moderate stage.  I feel at this point anything is worth the effort to try for some improvement.  As I said,  If I just get to one pad a day for drips and leaks I will be happy.
 
    Thanks for the support,
 
    KW
    43
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second opinion Doctor at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 4th, 2008 - Appointment with Original Dr. to discuss options and recomendation for surgical fix for incontinance.
    Feb. 22nd, 2008 - Surgery to install the AdVance Sling.
 
     

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