Artificial Sphincter Fitted

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Berb
Regular Member


Date Joined Mar 2007
Total Posts : 93
   Posted 6/26/2008 12:41 AM (GMT -7)   

I had an artificial urinary sphincter (AUS) fitted 3 days ago.  The procedure lasted a couple of hours and I was under full aesthetic.  The surgeon made two small incisions, one under the scrotum to insert the pump into the scrotum and to place the cuff over the urethra; the other in the lower abdomen to insert the reservoir balloon.  I have some bruising and swelling of the testicles and mild discomfort when getting out of bed, but otherwise I’m feeling pretty good.  There is a 6 week recovery period during which the tissues heal around the device, and then they’ll turn it on.

It has been nearly 18 months since my prostatectomy, and apart from a moderate improvement in overnight continence that came after 3 months, I have been largely incontinent, requiring around 8 pads a day. I took the decision to have the AUS fitted several months ago when it became clear on the best medical advice that no amount of exercising or other actions on my part would bring about a natural recovery.  There is no medical explanation for this at this time, other than for whatever reason, my external sphincter is not strong enough to hold the urine in the bladder – despite 12 months of exercises done with great deliberation and done correctly.

When I took the decision to have the AUS, I also ceased using pads which I found very inconvenient and which caused me burning most days.  I switched to a condom drain system, which I found to be very effective and to a large extent gave me my life back.  I’ve used these now for 4 months, and will continue their use until my AUS is activated in August.

Before going ahead with the AUS, I explored all avenues.  I learned from KW’s experience with the collagen and the sling (thanks KW) and I also checked out the stem cell treatment that was mentioned on Healingwell a while back (http://www.medpagetoday.com/MeetingCoverage/AUAMeeting/tb/3350).  I spoke with a doctor from the University of Innsbruck in Austria which is developing this treatment.  Unfortunately it is not suitable for those with severe incontinence, and he recommended I go ahead with the AUS.

Thanks to those on this site who posted their experiences with the AUS as it gave me confidence to progress down this path.  I’ll post an update in 6 weeks and let you know if I am dry.

Berb


59 when diagnosed, now 60 years old
Da Vinci surgery Jan 10, 2007, nerves spared, no cancer detected outside prostate
Pre surgery PSA 8, Gleeson 3+4=7, T1C, 3 out of 12 biopsies had cancer
Complication 1: urine favoured drain tube over catheter, extra time in hospital, catheter in for 2 weeks
Complication 2 - urinary tract infection - Citrobacter (hospital bug), 6 weeks antibiotics cleared up
Complication 3 - fungal growth on genitals (candida albicans) probably from antibiotics
Aug'07 Urodynamic study for continuing incontinence 8 pads per day; diagnosed bladder neck stenosis
Oct'07 CT scan indicated nothing abnormal; cystoscopy showed narrowing at anastimosis - dialated
Dec 07 averaging 9 pads a day, started acupuncture (no benefit after 10 treatments)
Feb'08 incontinence deemed uncurable - AUS scheduled for June
Post surgery PSA tests: all undetectable


M. Kat
Veteran Member


Date Joined Jul 2006
Total Posts : 715
   Posted 6/26/2008 4:08 AM (GMT -7)   
Berb, best wishes to you and I hope this is the answer to your problem.
Husband Jeff 56 years old diagnosed July 27, 2006
PSA 6.5, 2 positive areas in biopsy, Gleason 3+3=6
Radical Retropubic Prostatectomy August 30, 2006
pathology report - all clear - cancer gone
1st post-surgery PSA test <0.1, 2nd post-surgery PSA test <0.1, 3rd PSA <0.1
no more pads Oct 12, 2006
first "real" erection with use of pump 12/16/06
3/07 - occasional dribbles and erections with Cialis and pump
8/07 - 1 yr PSA <0.1
9/1/07 - achieved erection with Viagra - no pump!
3/08 - 18 mo PSA <0.1
tried Levitra - works much better than Viagra - fewer side affects


Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 6/26/2008 12:11 PM (GMT -7)   

Berb,

I'm glad to hear you made the plunge.  I follow your recovery carefully since I am to have mine put in in 3 weeks!  I have searched and searched, like you, KW, and others, and now feel I know all the clinical things there is to know about the system.  I went to hear Dennis Holt last nigh, a man who travels all over the country sharing his experiences with the AUS and the IPP.  His incontinence was as bad as ours at least and I think it was even worse, since he had both the robotic and the open prostate surgies.  The robotic left some prostate tissue remaining and therefore three days later they had to go back in with the open surgery.  I though I had it bad until I listened and questioned him.

I will have both the AUS and the IPP fitted in Mid July.  Although I've been very nervous about the whole process, I am now looking forward to getting them done and getting back to a more normal life.  I am lifting up prayers in your behalf now.  Please, please keep us posted as to your progress.  Not too many have experienced the kind of incontinence we have... thank the Lord most don't.  But the Lord has so blessed medical science in that we do now have an option.

Gene214


Radical open removal 2-14-07, Gleason 3+3=6
Removal of stricture 6-07, incontinence continues
Bio-feedback (4) 08-07 (no improvement)
Scheduled for AUS & implant 05-08
Surgeon cancelled one day pre-surgery, due to cardiac concerns
Nuclear stress 5/13/08
3 stents 5/27
AUS, IPP scheduled 7-08
63 years old at time of nerve-sparing surgery

Post Edited (Gene214) : 6/26/2008 1:15:28 PM (GMT-6)


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 6/26/2008 8:23 PM (GMT -7)   
Berb, Who was your Doctor and what hospital did they use?

Thanks for sharing the information.

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. 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 14, 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.
 
     


Berb
Regular Member


Date Joined Mar 2007
Total Posts : 93
   Posted 6/27/2008 3:53 AM (GMT -7)   

Hi KW. I live in Australia and the doctor was Don Moss who performed the surgery at St John of God Hospital in Ballarat.

Regards, Berb


59 when diagnosed, now 60 years old
Da Vinci surgery Jan 10, 2007, nerves spared, no cancer detected outside prostate
Pre surgery PSA 8, Gleeson 3+4=7, T1C, 3 out of 12 biopsies had cancer
Complication 1: urine favoured drain tube over catheter, extra time in hospital, catheter in for 2 weeks
Complication 2 - urinary tract infection - Citrobacter (hospital bug), 6 weeks antibiotics cleared up
Complication 3 - fungal growth on genitals (candida albicans) probably from antibiotics
Aug'07 Urodynamic study for continuing incontinence 8 pads per day; diagnosed bladder neck stenosis
Oct'07 CT scan indicated nothing abnormal; cystoscopy showed narrowing at anastimosis - dialated
Dec'07 averaging 9 pads a day, started acupuncture (no benefit after 10 treatments)
Jun'08 AUS fitted
Post surgery PSA tests: all undetectable


anxiouswife
New Member


Date Joined Apr 2008
Total Posts : 18
   Posted 6/27/2008 9:51 AM (GMT -7)   

Berb,

Thanks for sharing all your information. I have followed your posts for awhile and hope the AUS will be successful and give you a better quality of life. My husband had  RP surgery 4 months ago and is still incontinent. He showed some improvement at the three month mark but I don't know how much better he will get. The past month does not seem to show any improvement at all. We are also interested in the stem cell treatment and emailed a doctor in Austria and sent a letter to the urology department at the University of Innsbruck, but no response so far. Can you please share how you were able to call and speak with a doctor? Who did you speak with? I assume the doctor spoke English? I am not too forum savy, so if it is not appropriate to discuss this on the forum, I would be glad to include my email address in my info so we can communicate thru email.  I sincerely hope and pray your AUS will be successful. As a spouse, I see how this has enormously effected my husband. It clearly effects both the body and spirit.  Good luck with your recovery, I pray for your success.  AnxiousWife


Husband Age 61
PSA 2.32 1/06
PSA 4.98 9/07
Biopsy 12/07 results in hospitalization for severe sepsis infection
Infection causes congestive heart failure
Biopsy results: Gleason 3+3=6 10% of 1 of 6 cores on left 0 of 6 cores on left
Echo stress test 1/16/08 cleared for surgery- reevaluate congestive HF 7/08
RRP 2/26/08 blood transfusion needed
Adenocarcinoma Gleason 3+3=6 pT2c, NX. MX Clear margins Seminal vesicles no evidence of malignancy
Incontinence-bad -cysto 8 weeks post surgery for burning and incontinence-looks fine
ED-tried Cialsis(no luck) but worried about effect on heart-Now using VED for therapy
12 weeks post op incontinence still bad


Berb
Regular Member


Date Joined Mar 2007
Total Posts : 93
   Posted 6/28/2008 4:35 AM (GMT -7)   

Hi AnxiousWife,

 

Sorry to hear about your husband’s ordeal.  He clearly has had some unhappy complications.

 

Back in January I sent an email to the Innsbruck University but I never got a response.  I decided that given that I was going to be in Europe anyway on a motorhome vacation before my surgery, I would visit the University and see if I could get assessed.  Unfortunately, a late snowfall closed the road into Innsbruck, so I decided to call Dr Strasser.  He was not there and I spoke to another doctor involved in the project.  He spoke good English.  I’m sorry that I can’t locate the doctor’s name or the phone number that I called, but your phone company should be able to assist you to locate it if you want to call.

 

He explained that the stem cell treatment had about the same results with mild incontinence as the sling and collagen treatments, but was unsuitable for me with my 8 pads a day incontinence.  He said the AUS was the gold standard for this sort of thing.  He added that the stem cell treatment was very expensive.

 

4 months post surgery is a difficult time if you are awaiting return of continence and seeing stories of others who are regaining theirs.  Everyone has to deal with the mental side of this process in the way that best suits them. In my case, I am a long distance runner and decided shortly after my surgery to train for a very difficult run across a wartime trail in the jungle and mountains in Papua New Guinea.  I did complete this run, taking 43 hours and using 18 pads along the way.  My focus on this project allowed me to keep the incontinence from totally dominating my life over this difficult period.  I realise not everyone has a background to do such a run, nor would it attract them, but the principle is something that might assist your husband.

 

Regards

Berb


59 when diagnosed, now 60 years old
Da Vinci surgery Jan 10, 2007, nerves spared, no cancer detected outside prostate
Pre surgery PSA 8, Gleeson 3+4=7, T1C, 3 out of 12 biopsies had cancer
Complication 1: urine favoured drain tube over catheter, extra time in hospital, catheter in for 2 weeks
Complication 2 - urinary tract infection - Citrobacter (hospital bug), 6 weeks antibiotics cleared up
Complication 3 - fungal growth on genitals (candida albicans) probably from antibiotics
Aug'07 Urodynamic study for continuing incontinence 8 pads per day; diagnosed bladder neck stenosis
Oct'07 CT scan indicated nothing abnormal; cystoscopy showed narrowing at anastimosis - dialated
Dec'07 averaging 9 pads a day, started acupuncture (no benefit after 10 treatments)
Jun'08 AUS fitted
Post surgery PSA tests: all undetectable


jack38
New Member


Date Joined Jun 2008
Total Posts : 1
   Posted 6/28/2008 9:38 AM (GMT -7)   
Hi Berb,

I have been fascinated by your posts, especially this last one about your trail run!! Want to wish you the very best of success during your 6 week recovery. I had RP in Boston, USA in 1996 and have now - after 12 yrs (!!)with pads, up to 5-6 a day, decided to revisit the idea of an AUS . At the time I rejected the idea, because I couldn't get comfortble with the concept. Now I believe that it is all about the right choice of Doctor and am thinking seriously about Mayo Clinic, having read Jerry's posts. (Is Jerry still posting...?)

Best regards,

Jack

Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 6/28/2008 10:01 AM (GMT -7)   

Well, Jack38, I have been on this bumpy ride for 17 months and am now scheduled for surgery. Scarry thoughts at first, but now have made peace with these implants and am anxiously awaiting my mid-July installation of AUS and IPP. 

Both clinical research and testimonies from those who have had both the surgeries are very encouraging. It has been extremely hard to find guys who have had these implants to tell how it really is with them,  but after locating several men who have experienced them, I am now on "go."  And you are right... The trick seems to be to find a surgeon who has lots and lots of experce in installation.  I think I have found such a surgeon.

Gene214


Radical open removal 2-14-07, Gleason 3+3=6
Removal of stricture 6-07, incontinence continues
Bio-feedback (4) 08-07 (no improvement)
Scheduled for AUS & implant 05-08
Surgeon cancelled one day pre-surgery, due to cardiac concerns
Nuclear stress 5/13/08
3 stents 5/27
AUS, IPP scheduled 7-08
63 years old at time of nerve-sparing surgery


Berb
Regular Member


Date Joined Mar 2007
Total Posts : 93
   Posted 6/29/2008 2:26 AM (GMT -7)   
Hi Jack,
 
I think it's sensible to reconsider the AUS, especially after 12 years of leaking (that's a long, long time!!).  In the meantime, you might want to consider the condon catheter drain bag system.  It has made all the difference to me.  I found the Conveen brand to be most suitable for me, but it's important to get the correct fit irrespective of brand.  The Incontinence nurse did a good job in selecting a number of possibles for me to trial.
 
Pretty much most days now I don't even feel the device on me.  I ran the London Marathon in April with it and it stayed put for all 26 miles.  Rarely do I get any leakage, and in pretty much every case it's because I did not dry myself properly before putting the condom on.  I change it once a day and I usually use a 350 ml bag, although 500 mls and 750 mls are also available.
 
I could not agree more about the choice of surgeon.  The surgeon I selected has done around 130 men, which is quite a lot for this type of operation.  It gave me a confidence to proceed that would not have been present if the surgeon had been new at the game.
 
If you (or anyone else) are interested in reading a report I wrote on my run in Papua New Guinea, email me at jlindsa1@yahoo.com.au and I'll send you a copy.
 
Regards
Berb

59 when diagnosed, now 60 years old
Da Vinci surgery Jan 10, 2007, nerves spared, no cancer detected outside prostate
Pre surgery PSA 8, Gleeson 3+4=7, T1C, 3 out of 12 biopsies had cancer
Complication 1: urine favoured drain tube over catheter, extra time in hospital, catheter in for 2 weeks
Complication 2 - urinary tract infection - Citrobacter (hospital bug), 6 weeks antibiotics cleared up
Complication 3 - fungal growth on genitals (candida albicans) probably from antibiotics
Aug'07 Urodynamic study for continuing incontinence 8 pads per day; diagnosed bladder neck stenosis
Oct'07 CT scan indicated nothing abnormal; cystoscopy showed narrowing at anastimosis - dialated
Dec'07 averaging 9 pads a day, started acupuncture (no benefit after 10 treatments)
Jun'08 AUS fitted
Post surgery PSA tests: all undetectable


jerryv
Regular Member


Date Joined Jan 2008
Total Posts : 52
   Posted 6/30/2008 6:39 AM (GMT -7)   

Hi Berb

Read with interest about your being fitted with an AUS.  Hope all goes well with you and it looks kike the doctor you had do this had done many before.  I had two of them installed and they both failed because of a doctor that apparentely didn't know what he was doing.  I am now scheduled to have this done again but will be done by a specialist at Mayo Clinic in Rochester ,Mn.

You state you are using a condom drain system and seems to work well for you.  I wonder if any other men have used this and what their success rate is.  I'm sick of cumbersome pads.

The best to you on your recovery and would like to hear from you after activation.

Jerryv


Berb
Regular Member


Date Joined Mar 2007
Total Posts : 93
   Posted 8/5/2008 1:57 AM (GMT -7)   

I know some of you are contemplating the fitment of an AUS, so I’ll give you an update on my progress.

 

I had my AUS turned on today.  It’s early days and I’m not one to sound the horn of victory prematurely in case things don’t work out, but I’m presently optimistic about the outcome.  It was 4 hours from when the AUS was activated until I went to the toilet and passed 250 mls, around 50% of my bladder capacity.  During this time, I lost a small amount of urine into a pad – probably less than a teaspoonful.  As someone who had previously gone through 8-10 pads a day, this is a big step forward.  There’s the possibility that this will improve as the cuff beds in to the urethra, according to the urologist.

 

Over the 6 weeks since the operation, things have gone smoothly.  After the initial swelling and bruising, things settled down.  I’ve had some soreness when I sit on a chair for too long, and also some irritation where my clothing rubs on the area that was stitched.  But these are improving.  I’ve had no pain following the activation, although there has been a sensation of wanting to pee in the penis itself. 

 

I’ll give you another update in a couple of days.  Tomorrow I will go for a run and see what happens.

 

Berb


59 when diagnosed, now 60 years old
Da Vinci surgery Jan 10, 2007, nerves spared, no cancer detected outside prostate
Pre surgery PSA 8, Gleeson 3+4=7, T1C, 3 out of 12 biopsies had cancer
Complication 1: urine favoured drain tube over catheter, extra time in hospital, catheter in for 2 weeks
Complication 2 - urinary tract infection - Citrobacter (hospital bug), 6 weeks antibiotics cleared up
Complication 3 - fungal growth on genitals (candida albicans) probably from antibiotics
Aug'07 Urodynamic study for continuing incontinence 8 pads per day; diagnosed bladder neck stenosis
Oct'07 CT scan indicated nothing abnormal; cystoscopy showed narrowing at anastimosis - dialated
Dec'07 averaging 9 pads a day, started acupuncture (no benefit after 10 treatments)
Jun'08 AUS fitted
Post surgery PSA tests: all undetectable


Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 8/5/2008 5:20 AM (GMT -7)   
Great news Berb!
 
Since my implans went in 3 weeks ago, I too am waiting excidedly to test the outcome.  I could handle a "teaspoon" as opposed to what I now experience.  Thanks for the update.
 
Gene214
PC diagnosed 12-06 @ age 63
Radical open removal 2-14-07, Gleason 3+3=6
Removal of stricture 6-07, incontinence continues
Scheduled for AUS & IPP 05-08
Surgeon cancelled one day pre-surgery, due to cardiac concerns
Nuclear stress 5/13/08
3 stents 5/27
AUS, IPP implanted 07-16-08
AUS, IPP activation appointment: 08-18-08


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 8/5/2008 8:07 PM (GMT -7)   
I loose a teaspoon everytime I turn around!!!!!! Glad things are looking up for you. I will be right behind you.
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. 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 14, 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.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
     


Berb
Regular Member


Date Joined Mar 2007
Total Posts : 93
   Posted 8/6/2008 2:43 PM (GMT -7)   
A further update…

I got no leaking during my running yesterday, which went for 75 mins in 2 sessions. I included some sprints and some stairs to see if that would induce leakage and it didn’t. It was also a pain free run, telling me that they did a good job in locating the equipment in the right parts of the body to allow normal activity.

One of my goals over the coming weeks is to stretch my bladder which has shrunk through lack of use over the last 18 months. This is done by holding on longer when the urge to urinate comes. As my bladder fills, I get surges of pressure and I contract my muscles to assist the AUS until the sensation passes in a few seconds. However, I’ve noticed a few drops sometimes escape, and after a while, I get a wet patch on my underwear about one to two inches across. I’m going to wear a light panty liner to catch these from today. I also get squirts during a bowel movement, and interesting also once when I turned on the shower.

I’m finding the squeezing of the pump a little harder to master than I thought it would be. It requires more than light pressure to activate it, and you have to hold the other end firmly with one hand while squeezing, otherwise, the pump just slips away under the highly mobile scrotum skin. But with practice this is getting much better. I’ve learned to wait 45 seconds after passing fluid for the pump to close off, before giving things a final shake; otherwise you end up with fluid in the urethra which has nowhere to go but out.

But all these are minor things. I am very happy with the unit which I would rate in my instance at 99% effective. Hope this encourages others in the same position as me to give it a go.

Berb
59 when diagnosed, now 60 years old
Da Vinci surgery Jan 10, 2007, nerves spared, no cancer detected outside prostate
Pre surgery PSA 8, Gleeson 3+4=7, T1C, 3 out of 12 biopsies had cancer
Complication 1: urine favoured drain tube over catheter, extra time in hospital, catheter in for 2 weeks
Complication 2 - urinary tract infection - Citrobacter (hospital bug), 6 weeks antibiotics cleared up
Complication 3 - fungal growth on genitals (candida albicans) probably from antibiotics
Aug'07 Urodynamic study for continuing incontinence 8 pads per day; diagnosed bladder neck stenosis
Oct'07 CT scan indicated nothing abnormal; cystoscopy showed narrowing at anastimosis - dialated
Dec'07 averaging 9 pads a day, started acupuncture (no benefit after 10 treatments)
Jun'08 AUS fitted
Post surgery PSA tests: all undetectable


Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 8/6/2008 5:59 PM (GMT -7)   

Way to go Berb!  What a great encouraging word!  I'm looking forward to my activation.

Gene214


PC diagnosed 12-06 @ age 63
Radical open removal 2-14-07, Gleason 3+3=6
Removal of stricture 6-07, incontinence continues
Scheduled for AUS & IPP 05-08
Surgeon cancelled one day pre-surgery, due to cardiac concerns
Nuclear stress 5/13/08
3 stents 5/27
AUS, IPP implanted 07-16-08
AUS, IPP activation appointment: 08-18-08


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 8/6/2008 8:40 PM (GMT -7)   
GREAT Berb. You are making me look forward to my AUS already!
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. 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 14, 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.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
     


Alex007
New Member


Date Joined Aug 2008
Total Posts : 2
   Posted 8/17/2008 5:47 PM (GMT -7)   
Hi,
 
  I'm thinking about getting AUS, and looking to chat to about the procedure and the after results.
Were there any side effects.
 
Thanks,
Alex007
 

Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 8/17/2008 6:07 PM (GMT -7)   

Alex,

I'm not sure what might be determined to be saide effects.  It is surgery, with the risks.  Then, it also is a man-made device instead of the one God gave.  But when everything goes well and the new sphincter is allowed to operate as designed, it is a jewell of a device.  The thing I have noticed about my own attitude toward such devices are the stages I have gone through.  First it was "I'll neve have that."  Then after failure to regain continence afte months of trying, it becomes a "hummmm...  Maybe I should consider it."  Finally, there is the "Yes. I am going to do it!"  One usually will do what one can to get back to normal , if it is at all possible.  Continence and potence is possible to some who have failed to attain the natural and expected.

I am to get my AUS and my IPP activated tomorrow.  I will report back on the after-effects asap.  Perhaps then I can speak from experience.  Berb will most likely be along to share his experience.

Gene 


PC diagnosed 12-06 @ age 63
Radical open removal 2-14-07, Gleason 3+3=6
Removal of stricture 6-07, incontinence continues
Scheduled for AUS & IPP 05-08
Surgeon cancelled one day pre-surgery, due to cardiac concerns
Nuclear stress 5/13/08
3 stents 5/27
AUS, IPP implanted 07-16-08
AUS, IPP activation appointment: 08-18-08


Alex007
New Member


Date Joined Aug 2008
Total Posts : 2
   Posted 8/17/2008 6:18 PM (GMT -7)   
Gene,
     Thanks for the info, good luck.   I'm thinking getting the AUS.

kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 8/17/2008 6:59 PM (GMT -7)   

    Berb,  Glad things are going well for you.  I have my AUS comming up this friday 8-22-08.  Thanks for the updates.  I will start a AUS post as I go through my journey also.

    LW

   


    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. 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 14, 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.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    July 30, PSA 0.00.
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
     


Berb
Regular Member


Date Joined Mar 2007
Total Posts : 93
   Posted 8/18/2008 3:19 PM (GMT -7)   

Good luck for Friday KW.  Big day for you.  Hope it goes as well as mine has. 

Here's an update on my situation 2 weeks after the AUS was activated.

I have no pain and don't even know the device is there.  I have no leakage most of the time, even when I am running or doing heavy lifting.  Exceptions: (1) I wear a light pad / liner to catch the drips that happen after urinating before the device has had time to shut completely, which takes around 60 seconds and I find it hard to stand there that long.  (2) I sometimes get leakage when I get an urge to urinate and I hold off on advice from the doctor to try and lengthen the period between urinations so as to stretch the bladder back to its normal size after 18 months of no use.

Nothing happening at all on the ED front though - totally dead.

Berb


59 when diagnosed, now 60 years old
Da Vinci surgery Jan 10, 2007, nerves spared, no cancer detected outside prostate
Pre surgery PSA 8, Gleeson 3+4=7, T1C, 3 out of 12 biopsies had cancer
Complication 1: urine favoured drain tube over catheter, extra time in hospital, catheter in for 2 weeks
Complication 2 - urinary tract infection - Citrobacter (hospital bug), 6 weeks antibiotics cleared up
Complication 3 - fungal growth on genitals (candida albicans) probably from antibiotics
Aug'07 Urodynamic study for continuing incontinence 8 pads per day; diagnosed bladder neck stenosis
Oct'07 CT scan indicated nothing abnormal; cystoscopy showed narrowing at anastimosis - dialated
Dec'07 averaging 9 pads a day, started acupuncture (no benefit after 10 treatments)
Jun'08 AUS fitted
Aug'08 AUS activated - highly effective
Post surgery PSA tests: all undetectable


Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 8/20/2008 5:56 AM (GMT -7)   
Berb,
 
A question for you (or anyone else who has AUS): 
 
Did your doctor recommend deactivation of the device at night?  I had read in my research that some recommended it and some did not.  It occured to me that my doc did not mention it so I emailed him and he said it was not needed for me.  What did your doc recommend?
 
I am still bubbling like about my new sphincter!
 
Gene214
PC diagnosed 12-06 @ age 63
Radical open removal 2-14-07, Gleason 3+3=6
Removal of stricture 6-07, incontinence continues
Scheduled for AUS & IPP 05-08
Surgeon cancelled one day pre-surgery, due to cardiac concerns
Nuclear stress 5/13/08
3 stents 5/27
AUS, IPP implanted 07-16-08
AUS, IPP was activated on 08-18-08.  They both work!
 


Berb
Regular Member


Date Joined Mar 2007
Total Posts : 93
   Posted 8/20/2008 4:54 PM (GMT -7)   
Hi Gene.

I asked if it needed deactivation at night and he said no. I recall someone on this website some time ago, sorry can't recall his name, saying he deactivated at night because he had a lot of pain and this managed his pain. I have no pain day or night, and I have not even tried to deactivate it, although I have the instructions to do so if needed.

How is your bladder handling the volume? Once I get more than 100 mls (after about an hour), mine starts giving me the urge to go, accompanied by bladder contractions which I manage by pulling a Kegal until the urge passes, which it does. I can get to around 200 mls, then I really have to urinate. I've been given some anti-spasm pills but advised to use them sparingly (haven't used them yet), as the goal is for my bladder to stretch back to normal size and this is aided, he says, by holding on as long as I can.

Berb
59 when diagnosed, now 60 years old
Da Vinci surgery Jan 10, 2007, nerves spared, no cancer detected outside prostate
Pre surgery PSA 8, Gleeson 3+4=7, T1C, 3 out of 12 biopsies had cancer
Complication 1: urine favoured drain tube over catheter, extra time in hospital, catheter in for 2 weeks
Complication 2 - urinary tract infection - Citrobacter (hospital bug), 6 weeks antibiotics cleared up
Complication 3 - fungal growth on genitals (candida albicans) probably from antibiotics
Aug'07 Urodynamic study for continuing incontinence 8 pads per day; diagnosed bladder neck stenosis
Oct'07 CT scan indicated nothing abnormal; cystoscopy showed narrowing at anastimosis - dialated
Dec'07 averaging 9 pads a day, started acupuncture (no benefit after 10 treatments)
Jun'08 AUS fitted
Aug'08 AUS activated - highly effective
Post surgery PSA tests: all undetectable


Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 8/20/2008 8:22 PM (GMT -7)   
Berb,
 
My doc. has not talked at all about the bladder capacity.  I don't even know how many ounces I am urinating, but I will start noticing.  I may be trying to go too often because I don't want to drip.  So far, if I go about once per hour, I am not dripping any.  I am not wearing a pad at all.  My briefs are staying dry.  That is so great to me.
 
Berb, one thing I have noticed is that my stream is not as strong as it was pre-surgery (for AUS).  Of course I am talking about my stream when I first get up in the mornings.  The rest of the day was a costant drip, drip.  I seem to be emptying out ok.  I feel that perhaps all the changes which have taken place in my penis (implant) might be constricting my urine flow. Have you noticed a change in your stream?
 
Also, when I release the cuff to urinate, it takes a few moments for the urine to start comingl out.  How would that compare to yourself?
 
 Gene214
PC diagnosed 12-06 @ age 63
Radical open removal 2-14-07, Gleason 3+3=6
Removal of stricture 6-07, incontinence continues
Scheduled for AUS & IPP 05-08
Surgeon cancelled one day pre-surgery, due to cardiac concerns
Nuclear stress 5/13/08
3 stents 5/27
AUS, IPP implanted 07-16-08
AUS, IPP was activated on 08-18-08.  They both work!
 

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