Artificial Sphincter Failure

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

cowboy bob
Regular Member


Date Joined Sep 2007
Total Posts : 116
   Posted 5/1/2008 10:00 PM (GMT -7)   
I had my prostate removed in June 2007.  After being incontinent since then, my doctor and I decided it would be best for me to get a two-cuff artificial sphincter installed, and I did so on April 16 (two weeks ago yesterday).  The operation wasn't bad; you know, you wake up and it's done.  A catheter was put in me until the next day, when I was to leave the hospital. That morning the catheter was removed, and a couple of hours later I was unable to urinate and was in a huge amount of pain. My doctor put the catheter back in which made me feel a lot better. The next several days (including one very bad night) I had a great deal of swelling and pain in my scrotum, but I have been told this is not unusual.  The main problem came just two days ago when I realized all of my urine flow was emitting from an area just behind my scrotum, an area that had been opened, and then closed up, during the sphincter installation. No urine was coming out of my you know what.
 
Yesterday, after conferring with my doctor, I had surgery to have the entire sphincter apparatus removed. My doctor feels that one of the cuffs may have done something to cause a problem in the section of my urethra it was surrounding. He also now feels it best to wait until Fall to consider what to do next.
 
I am trying not to  get depressed, but I am also wondering, where do I go from here?
 
Jerryv, KW, and Gene, I hope you are doing well, and would appreciate your thoughts.
 
 
Sincerely,
Cowboybob

Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 5/2/2008 5:52 AM (GMT -7)   
Bob,
 
For sure at this time my thoughts are not "peaceful" since I have AUS/penine implant surgery scheduled next week.  Had you previously mentioned on this forum you had this surgery coming up?  I don't remember reading about it.  But I have not been back around for some time so I may have missed it.
 
The only thing I can add is that when I asked my surgeon about double cuffs, he said he did not do them because it is his feeling that double cuff's cause more problems than solutions.  For one thing, he said that a double cuff does not allow proper blood flow.  But it sounds to me like you have had a problem similar to Jerryv.
 
After reading Biff's comments and now yours... I am in somewhat of a state of emotional turmoil. 
 
My prayers are with you Bob.  And for all the members who have a personal relationship with the Lord, please lift me in prayer, too.  I sure do need wisdom from Above.
 
Gene214
 
 
Radical open removal 2-14-07
Removal of stricture 6-07
Bio-feedback (4) 08-07
Scheduled for AUS & implant 05-08
63 years old at time of nerve-sparing surgery


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 5/2/2008 6:45 AM (GMT -7)   

Gene, will keep all you guys in my prayers.

Also, I replied to your question about the age of my friend.  Hope you saw that.

One other thing from my friend about his penile implant....he said he was very sore for about 5 weeks afterward, but is pleased as punch with the results.

Godspeed to all of you.

DanMan Bob


Danman Bob, Born 1951
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14; Biopsy result - 9 of 12 sticks showed cancer
Post-op pathology stated that cancer was confined to the prostate
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of late April 2008)
100 MG Viagra 3 times a week beginning December 2007
Osbon Erec-Aid Esteem manual pump for therapy beginning mid-February 2008
30 MG papaverine/1 MG phentolamine bimix injections beginning late April 2008
Five week post-op PSA 0.2, five month post-op PSA 0.1, next test August 2008


Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 5/2/2008 6:55 AM (GMT -7)   

Bob, one other question for you: When you left the hospital with your AUS, and since you did not have a catheter, what method were you given to keep the leaking urine off your incision?  My doctor said in response to that question to him, "You'll use a conveen".  I have not received a clear answer as to what a conveen is... a condoom catheter-like device?  Does it have a leg bag, etc. to catch the urine?  Thanks and likewise my prayers are with you.

Gene214


Radical open removal 2-14-07
Removal of stricture 6-07
Bio-feedback (4) 08-07
Scheduled for AUS & implant 05-08
63 years old at time of nerve-sparing surgery


cowboy bob
Regular Member


Date Joined Sep 2007
Total Posts : 116
   Posted 5/2/2008 8:39 AM (GMT -7)   
Gene,

Actually I did mention I was going to have this done, but it was mentioned well in advance of the surgery, and then I just didn't get onto the forum at all for a good while. Sorry about any misunderstanding, but I did leave the hospital with a catheter. I feel the catheter, called a "superpubic catheter," had to be put in on an emergency basis because I was unable to emit urine due to all of the swelling in my scrotum and penis. The urine had to be let out some way. This superpubic catheter, a tiny tube without much more width than that of a toothpick, was put through my groin, not up through my penis. And yes, a leg bag was attached.

I am thinking about calling the manufacturer of the sphincter today to try to reach their rep who was on hand during the surgery. Maybe he can provide some thoughts here.

Gene, I don't know why, but I seem to be in the small percentege group lately. Last year I was in the group that got prostate cancer. Then I was in the small group that did not become continent. Now, most surprisingly of all, I am in the small group for which the artificial sphincter has not worked, at least not on the first go around. But as a born again Christian I am putting my trust in my Lord and Savior, Jesus Christ, and know that everything will be fine. Maybe it will be a few more months and the surgery will be done a little differently, or maybe a miracle will occur and I will become continent yet. But I will be fine.

Gene, remember that the artiphicial sphincter works successfully in a super high percentage of guys. I know you will be one of them. Do not worry.

Bob

cowboy bob
Regular Member


Date Joined Sep 2007
Total Posts : 116
   Posted 5/2/2008 9:34 AM (GMT -7)   
Gene,

I just got off the phone with a lady they call the "patient liaison" at the manufacturer of the sphincter. She was very nice, and eased my concerns. She said she'd been in her position for 22 years, and it is a very rare occurance when an installation is not successful. She said that sometimes the urethra is nicked during surgery, and sometimes the urethra becomes infected following the surgery, which weakens it. She did not have anything negative to say about double cuffs. She also said that it usually 3 to 6 months before a reinstallation of the apparatus is done, thus my upcoming wait.

I told her that I'd had knee jerk reactions to all of this, wondering if I should run up to the Mayo Clinic, or try to find a doctor who had done hundreds of these. I told her I didn't want to do this tho,' as I have a lot of confidence in my doctor, and I like him a lot as a person. She said I should just relax, and the next time I see my doctor, to just have questions ready for him, and have a good heart to heart. Ironically, this is the same thing my wife told me just this morning.

I then asked her about a "worse case scenario." I asked if there is ever a time when a guy simply cannot be made continent, no matter what is done. She said this is super rare, and normally occurs when the man is very old (that's not you or me), and may have a great number of health issues, bladder problems, etc.

Bob

jerryv
Regular Member


Date Joined Jan 2008
Total Posts : 52
   Posted 5/2/2008 12:29 PM (GMT -7)   

Hi Cowboy

It seems to me that you have a doctor such as i hasd;  one who is not qualified to do this operation.  My doctor had more excuses than you could imagine.  Cowby i had this done twice and nothing but failure and i know the pain both phisically and emotionally you are going thru.  I've beem there, but we must not get discouraged.  You sound like a nice guy thar deserves the best.  Don't go back to this guy because you will regret it and all you will have is excuses.  When the first one failed i had a new one put after six weeks.   When i went to Mayo the whole thing was taken out in a emergency operaton and they told me after this heals i will have to wait six months for a new one.  Am going to Mayo on May 6 to be checked out and have xrays taken to see if all is well.. See if you can't get some one who has done a lot of this and ask the questions i posted the other day.  DON'T TAKE ANY MORE CRAP FROM THE DOCTOR YOU ARE NOW GOING TO.  When i went to Mayo it was an altogether different scene.  I am going up next Tuesday and ask all the questions because i do want a unit that works..We got to do this ,Cowboy, because being wet all the time is no fun either.

If you want me to keep you posted please let me know. 

Blessings


cowboy bob
Regular Member


Date Joined Sep 2007
Total Posts : 116
   Posted 5/2/2008 12:54 PM (GMT -7)   
Thank you Jerry. I sure am praying for all the best to you, too. We've got to get the quality of life back that we once experienced.

I know what you are saying, and my fall down is that I am too nice of a guy to easily tell my doctor adios. When I see him again in two weeks I am just going to level with him and see if he feels this was just an isolated incident that could have happened no matter who was doing the surgery, or if he feels someone else would be better. I know one thing. I don't want to have another failure after waiting another 3 to 6 months. Not sure I could take it.

cowboy bob
Regular Member


Date Joined Sep 2007
Total Posts : 116
   Posted 5/2/2008 12:55 PM (GMT -7)   
p.s. to Jerry- Yes, most definitely keep me posted on your progress.

Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 5/2/2008 3:04 PM (GMT -7)   

Bob, Jerryv, KW, Biff, and others very interested in AUS/penile implant:

Last night before I went to bed I read Biff's take on the AUS/Penile implant.  Since I am scheduled for AUS/implant next week, Biff's straight-forward words grabbed my attention. Bob, you grabbed it too!  I immediately began praying for insight as to whether I should cancel or go ahead.  I emailed Biff & gave my cell number, since he provided his email address in his post. Although it took a while to go to sleep, I did and slept good.

Today I went to the hospital to pre-register.  In the next consultation room was a guy who had also had prostate surgery and I overheard him say, "I sure wish they had put my prostate back in after they took the cancer out."  I should have laughed with him, but I was not quite in the laughing mood.  It was all too close to "home."

I chatted with the pre-registering nurse to see if very many get the AUS and pennile implant in this hospital.  She named my doctor and another one as doing lots of them.  Since my doctor's office is less than a block away from the hospital, I high-tailed it over there and asked to see the doctor's head nurse. He was gone to lunch but receptionist said she'd have him call me, which he did before I even got out of the building.  I just leveled with him and told him I was terribly frightened and told him about HW posts.  Said he: "There is a certain amount of risk."  I know.  I know.  But... "You should know that your doctor does about seven AUS's a week and about one penile implant a week.  Out of all he has done, he now has had problems with two.  He is a great surgeon."  Now my hope is not in a man, good doctor or not, but... 

...Somehow, that's all I needed to hear today to give me the green light to go on with my surgery.  Then there was this call from Biff. In spite of Biff's expressions of disappointment last night, he was wonderfully encouraging, sharing how bit by bit things were getting better for him.  He does not come on to HW often, he said, but for some reason felt he should last night.  I really believe the Lord sent him to us...at least to me... So you guys have become a source of good information for those at this site who are struggling with incontinence and impotence.  We need more info from patients who have been there and done that.  Most surgeons have not been the patient.  They know how to do the job but don't know how it feels to be the patient.  But I really do appreciate their skill.

Cowboy Bob, I too know the Lord and am looking to Him.  I know my postings sometime do not reflect that fact and instead give off the sense of panic, but "I know Whom I have believed, and am persuaded that He is able to keep that which I committed to Him against that day." (2 Tim 1:12)

So to you all, thank you all at HW for your patience and prayers, especially next week when I go under.

Gene214


Radical open removal 2-14-07
Removal of stricture 6-07
Bio-feedback (4) 08-07
Scheduled for AUS & implant 05-08
63 years old at time of nerve-sparing surgery


cowboy bob
Regular Member


Date Joined Sep 2007
Total Posts : 116
   Posted 5/2/2008 3:36 PM (GMT -7)   

Gene,

You have encouraged me just now, more than you know.  I can tell you have a terrific doctor who could probably do a couple of these before breakfast and just be warming up. You have nothing to worry about.  Also, as I mentioned, the operation is no big deal. You get shaved, you go into a nice sleep, a great staff takes care of you, and then you wake up!  Just one thing- I once woke up pretty nauseated coming out of a knee operation, but they can put medicine in your anesthesia that will prevent that. They did that for my AUS surgery, and I felt just fine when I woke up!

All the best to you Gene!

Bob

 


jerryv
Regular Member


Date Joined Jan 2008
Total Posts : 52
   Posted 5/2/2008 3:48 PM (GMT -7)   

Hi Cowboy

I will tell what led up to my going to Mayo

Before i had the first surgery i asked the doctor several times to show me a unit and tell me how it worked  This was never done and so when it was activated i had no idea of what to feel for.  I want you to know my doctor is a very nice guy, a guy you would like to have as a close friend.  When this unit was activated i had a scar tissue about 2" long 1" wide and 1/2" thick, very hard.  I thought this was the pump and the doctor said to squeeze on a soft spot.  I could get it to work a little and i said to dr ,it never empties my bladder and he said that's as good as it get.  When this thing started to abcess they took everything out and he said the pump broke.  When i went to Mayo and told this to the doctor he said that was strange since Mayo had been installing these since 1972 and never had a pump break.   6 weeks after this failure another one was installed and after the 6 week waiting period waiting for the activation i was still draining from the scrotom and the doctor said it was urine.  I asked him how that could be and he said he didn't know.  I later found out this was an urethral erosion which could have happened during the operaton.  The doctor gave me some antibiotics and told me to come back in two weeks.  That when i had enough and went to Mayo.  If you want to call Dr Elliott i know he will be happy to talk to any of you.

I am so glad to be with so many believers in Jesus Christ because without Him we are nothing.  We are given good direction from Him and he gives us the ability to make decisions.

So nice to meet all of you and we all pray for each other. I have put Cowboy and Gene on my daily prayer list.

Blessings

Jerryv

 


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 5/2/2008 9:31 PM (GMT -7)   
I like my Local Doctor too. But even he said he would go to a specalist for that.
I'm watching all of you and wishing for great results.
KW
    43 at Dx and Surgery
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - 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 Consultation for Incontinance 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 AMS AdVance Male Sling.
    March 27th, 2008 - Sling not working, Little or no improvement.
    April 18, 2008 - Collagen injection.  Back to using 4-6 full pads a day within a week.
    May 15, 2008 - Another collagen injection to try to Band-Aid the leaking for our June cruise.  Will start making conusultation appiontments for AUS after we return.
 
     

New Topic Post Reply Printable Version
Forum Information
Currently it is Thursday, February 22, 2018 8:05 AM (GMT -7)
There are a total of 2,931,957 posts in 321,691 threads.
View Active Threads


Who's Online
This forum has 160402 registered members. Please welcome our newest member, JeanJean.
346 Guest(s), 8 Registered Member(s) are currently online.  Details
Taytay459, JeanJean, Dizzyagain, island time, 1000Daisies, Dogdays, PamSmith, Szabo246