Sphincter, Sling, Penile Implants

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cowboy bob
Regular Member

Date Joined Sep 2007
Total Posts : 116
   Posted 11/14/2008 10:56 PM (GMT -6)   
July last year I had my prostate removed.  Then, this April I had an artiphicial sphincter installed (double cuffs) as I was using about 9 pads per day.  The installation did not go well, and I had to have the system removed.  Now, at 4 pads a day and with a new doctor, I am trying to decide whether to get the sphincter again, or to try the sling.  Oh, and I also want penile implants.  I would love to get the sling if I knew it would work, but I understand it only has an 80% success rate. On the other hand, if I got the sphincter AND the implants, that would be a lot of hardware in me.  Any suggestions anyone? 

Veteran Member

Date Joined Jul 2008
Total Posts : 637
   Posted 11/15/2008 8:45 AM (GMT -6)   
Hi bob, I think everyone is different, but it would seem to me if the AUS didnt work, the sling would be less likely to. We had the sling first, and it didnt work, and now the AUS...There are guys that have had great success with the AUS and penile implants....
Husband Pete
dx Jan 2001 age 67 gleason 4 + 3 PSA 16.5
seed implant and conformal radiation Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06
Fistula operation 2/07 MSK
Many cystoscopies and ER visits with strictures
catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/07
AUS Operation at MSK Sept 8. Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK
Some difficulty with AUS arising Nov 10 2008

Regular Member

Date Joined Jan 2008
Total Posts : 52
   Posted 11/15/2008 9:09 AM (GMT -6)   
Hi Cowboy
This is Jerryv and i am the guy who has the AUS fail twice.  I know your feeling and i can tell you what my decisions were and maybe you can use them.  First, i think you have to find out why it failed.  In my case it was a doctor who had very little experience with AUS.  The doctor i am now working with at Mayo Clinic has performed 800 of these and the majority of these have been taking up where some doctor screwed up..He says they call him the Garbage Man at the clinic.  I think you have to ask a lot of questions the most important of these is how many have you done ,what is the failure rate and why did they fail.  I was supposed to have an AUS installed Wednesday last but the opening in my bladder was so small they could not get a scope up there so they had to operate to fix that.
One of the main things is we have to keep very positve because once we get down on ourselves we lose a great deal for proper useage of anything we try.I had to wait 6 months before i could get a new one installed.  I don't have it yet but i will in four months.  If you have any queastons please ask.  I have had a great deal of experience living with the failures.  All the best to you,Cowboy

Regular Member

Date Joined Mar 2007
Total Posts : 422
   Posted 11/15/2008 12:09 PM (GMT -6)   


I seem to be one of very few guys on this board who have lots of the hardware.  I had both AUS 800 (sphincter) and AUS 700 (penile implant) installed in July.  Since activation, it has been very pleasant to have control of my urology department again.  I am one of the guys who, thus far, is pleased with both devices.  Although the scrotum does have extra hardware,  to me it is well worth it.

KW will no doubt be along soon to comment on his sphincter.  He first had the sling, which did not work for him, and later on had the AUS (sphincter).

If you want to talk, send an email and a phone number or I'll email you my phone number. My email address is available on the side.


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!
10-20-08 went back to surgeon for a follow-up.  Both devices are working very good and surgeon was very pleased that I am very pleased.

Regular Member

Date Joined Oct 2008
Total Posts : 29
   Posted 11/15/2008 2:19 PM (GMT -6)   

I had the sling installed as part of my original surgery, by a doctor that has preformed over 200 of these.  I have had no problems.  It is hard to tell if it help me get my continence back sooner, but from what I have read from other posters it certainly did not slow it down (surgery 4/15 - pad free 7/1).


Age 51
Father died of prostate cancer at 73
Yearly PSA testing.
Biopsy after PSA went up .75 in one year
6 of 12 in needle biopsy where cancerous
DaVinci surgery 4/15/2008
Last PSA .008

cowboy bob
Regular Member

Date Joined Sep 2007
Total Posts : 116
   Posted 11/16/2008 6:11 AM (GMT -6)   
Thank you all so much. Thankfully I believe I have found an expert in this field to do the work this time. I just hate being in the gray area, not wanting the sphincter unless it's necessary, but also being afraid that I'm too incontinent (4 pads per day) for the sling to work.

Veteran Member

Date Joined Nov 2006
Total Posts : 883
   Posted 11/16/2008 9:32 PM (GMT -6)   
Bob, WE know EXACTLY how you feel. The "leakers" that have had to deal with incontinance for several months....or years....in my case fully understand your concerns about the hardware.
At 4 pads a day you may get some relief from the sling. I would make sure you have an expert on the sling check your case out. In hindsight, the Doctor that did my sling has done hundreds of slings on women and several on men using other techniques or materials. I just happen to be his first using the AdVance Sling. I do not know why my sling did not help more than a few weeks?
As far as the AUS. My Doctor said he almost never sees a need for the double cuff if the AUS can be installed properly. I do not know where you live but if you are able to travel to Dallas Texas I would highly recomend my Doctor. I have not regretted my decision to have the AUS one bit. It gave me a normal life back after two years of constant worry about leaking out of a heavy pad and being wet all the time.
I can also be contacted at the e-mail address on my HW profile. I will also talk on the phone if you wish.
Good Luck,
    43 at Dx and Surgery (RRP)
    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
    Oct. 6th, 2008 - AUS Activation by Dr. Morey

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