bladder sling installed by my DaVinci team

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Ripandburn
Regular Member


Date Joined Aug 2007
Total Posts : 125
   Posted 2/4/2009 12:40 PM (GMT -7)   
I had originally sent an e-mail offline to Bluenose to ask this question since he and I had the same surgical team, but didn't get a response from him. It may have ended up in either his junk mail box or mine. Anyway, I will pose it to the group with hopes that Blue chimes in.

Here's the question...when my prostate removal was done a bladder sling was installed. Our surgeons do it with all their patients now. They say it helps to keep the leakage to a minimum. I agree, it has done that and all is good. But what I am finding is that it seems like my bladder can't get as full as I use to be able to get it before the surgery. My thought is that the sling is so tight around the bladder that it doesn't allow the bladder to fill up as much as it use to.

I asked my surgeon the last time I was there, and he said, "you're just getting old". I am 53 and never had this problem before my surgery, so I don't agree. I think it's a lot of bull.

For those of you who have had some experience with this could give me some input...especially Bluenose, I would appreciate it.

Thanks
53 years - 5' 11" 205 lbs.
T1c 3+3=6
DaVinci July 16, 2007
Bladder Sling installed during prostate removal
nerve sparing with both nerve bundles intact
all cancer contained within prostate nothing near margins
11 weeks post-op - no more pads
all PSA's since removal < .1 - Undetectable


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4813
   Posted 2/4/2009 2:22 PM (GMT -7)   

I don't have a sling, but I don't think I can hold as much as I used to...

I had a talk with my surgeon two weeks ago...I told him about heading home after having a few beers at happy hour a couple weeks earlier. Told him if I had a gun, I would have just ended it in the car..Never had to go so bad in MY LIFE...I was a bit concerned that I might have injured myself..He said no the injured part and suggested I stop sooner if I have to go pee pee confused

I think we're all different after surgery...

 

 


Age 53   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
 
06/25/08 - Da Vinci robotic laparoscopy
Catheter in for five weeks.
Dry after 3 months.
 
10/03/08 - 1st Quarter PSA -> less then .01
01/16/09 - 2nd Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.
 


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 2/4/2009 2:32 PM (GMT -7)   
Rip...I think I actually can hold more now after surgery and I don't have the sling either. Probably because I had the urge so badly before the surgery I was going every 1/2 hour. But as Steve said...it is different for everyone. But a side question, was the sling installation during surgery standard practice or was there other reasons to do it during the prostate removal. Reason for the question, my surgeon basically indicated that the sling was only performed if required after surgery. Did your surgeon make that decision before hand or during the actual surgery because he suspected a continence problem based on what he saw. Never heard of anyone else having it installed during the surgery.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base) - Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (4+3) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA 5 week Oct 2008 <.05
       3 month Jan 2009 .06


SebringR
Regular Member


Date Joined Oct 2008
Total Posts : 29
   Posted 2/4/2009 4:02 PM (GMT -7)   

I had the sling installed with the surgury also.  I think what happens is the bladder shrink with the lack of bladder control.  It is like with my grandson, if you constently take him to pee his bladder will never stretch.  I am 9 months out from the surgery now and I can hold as much as I used to.  But there seems to be one caviot to that, with my bladder is now more sensitive to certain fluids.  I can hold as much water as I ever did and can drink a lot and go for hours.  But is seems that certain fluids with cirtic acids seem to make me want to go sooner and acutally can cause that embarassing leakage( I am usually dry and have been for months).

Hope this helps.  But I think your bladder will return to normal as you stretch and gain more conifidence.


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
 


Bluenose
Regular Member


Date Joined May 2008
Total Posts : 260
   Posted 2/5/2009 7:46 AM (GMT -7)   

 

 Hey Rip, how ya' doin' pal....Nope, sorry I never did see your email, but then that doesn't mean it wasn't there somewhere!

  As far as your question goes....I think maybe you're right....sometimes. Somedays I think I may visit the head more than other days,  but then I did that pre-surg. I very seldom have to get up in the night to relieve myself....most mornings on my first visit....I still impress myself! So I'm holding that well.  Other times during the day if I'm in a position of not being able to get to a head, during a meeting or whatever, I can hold it. Now, I think that may be what I feel more with the sling is the urge, you all know...wow, I do think that is more intense post-surg. But then like Ive said, I think all those sensations are more intense post-surg, don't know if I'm just more aware or what. I guess I'm not really running to the head enough to really be concerned with my freqency of visits.  All in all though, I wouldn't have changed a thing with my surgery. I'm real pleased with my outcome and I'm not worring about tomorrow till today.....Hope that helps Rip

 As far as different fluids go. I can still have a few beers with no problem at all...nothing that I feel is out of the ordinary without having to run off and relieve myself anymore than pre-surg.

 Les-These guys talk about the sling in the pre-surg planning. They're very good about explaining the procedure and yes they do it as the norm.

 

 


 
  age: 53  Pre-op PSA Feb 08' 5.0, April 08' 4.1
  Biopsy 5.1.08, 5 of 15 cores postive, T2a, Gleason 3+4=7
  DaVinci performed 7.29.08
  Bladder sling installed, umbilical hernia repaired during surgery.
  Path report, "cancer fully contained, margins clear".
  Cath removed 8.8.08, ED therapy begins 8.9.08
  100mg Viagra three times a week, pump for ten minutes daily
  and hold for ten minutes.
  8.16.08 switched to Levitra 20mg, immediate results
  9.15.08 Pad free at night, one thin (light) pad during the day
  9.18.08 1st Post-op PSA Undetectable Zero's....Yes!
  12.22.08 2nd Post-op PSA  Zero's still...
  Pads gone 1.3.09, finally found the courage...Thanks ya'll
          ".....tryin' to reason with hurricane season...."
       


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 2/5/2009 8:28 AM (GMT -7)   
Good information here for our new friends and guests (and something I didn't know about until this thread started).

I know my doctor never even made any reference to this type of procedure before the surgery except in passing and then only as a subsequent procedure if needed. I think that this is just one more subject that should be discussed in more detail up front with the doctor. If the addition of a sling during the removal of the prostate will help with the incontinence and recovery, why put a patient under a second procedure when it could have been done up front doesn't seem logical to me. I wonder if there is some sort of guideline the doctors are using as to who gets a sling and who doesn't. If it helps...shouldn't everyone get one?

Wow more and more there are so many questions to ask before making any final decisions....sure can be overwhelming for those recently diagnosed and are seeking treatment options.

Again...great thread and discussion.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base) - Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (4+3) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA 5 week Oct 2008 <.05
       3 month Jan 2009 .06


Bluenose
Regular Member


Date Joined May 2008
Total Posts : 260
   Posted 2/5/2009 8:53 AM (GMT -7)   

 

 I agree Les....Our surgeons were involved in  a study(with IU Med. Center) and outcomes concerning just that. I was told their postive outcomes with IC was somewhat higher than the national average. I've never checked it out myself, I heard it from my surgeon...I'll take his word. I mean in my case, everything he told me would happen, happened....

 I just had a co-worker Dx'd and underwent surgery the 5th of the month...this guy is a physical specimen....71yo and still working 40 a week.....71yo just the same. He used the same guys as Rip and myself.....he's up and moving real well, said he's not felt this good in awhile...his IC very minimal at four weeks today. So yeah, I'm a believer in the procedure and you're right guys need to be bringing it up in thier pre-surg consults....
 
  age: 53  Pre-op PSA Feb 08' 5.0, April 08' 4.1
  Biopsy 5.1.08, 5 of 15 cores postive, T2a, Gleason 3+4=7
  DaVinci performed 7.29.08
  Bladder sling installed, umbilical hernia repaired during surgery.
  Path report, "cancer fully contained, margins clear".
  Cath removed 8.8.08, ED therapy begins 8.9.08
  100mg Viagra three times a week, pump for ten minutes daily
  and hold for ten minutes.
  8.16.08 switched to Levitra 20mg, immediate results
  9.15.08 Pad free at night, one thin (light) pad during the day
  9.18.08 1st Post-op PSA Undetectable Zero's....Yes!
  12.22.08 2nd Post-op PSA  Zero's still...
  Pads gone 1.3.09, finally found the courage...Thanks ya'll
          ".....tryin' to reason with hurricane season...."
       


Ripandburn
Regular Member


Date Joined Aug 2007
Total Posts : 125
   Posted 2/5/2009 1:13 PM (GMT -7)   
Thanks for all the replies. All I can say in the end, is that things are definitely different in the bladder filling area.
53 years - 5' 11" 205 lbs.
T1c 3+3=6
DaVinci July 16, 2007
Bladder Sling installed during prostate removal
nerve sparing with both nerve bundles intact
all cancer contained within prostate nothing near margins
11 weeks post-op - no more pads
all PSA's since removal < .1 - Undetectable


Berb
Regular Member


Date Joined Mar 2007
Total Posts : 93
   Posted 2/6/2009 4:01 PM (GMT -7)   
I can hold nowhere near the level of urine I did pre PCA surgery.  My pre-op capacity was measured and was 450 mls.  Today, the most I can hold after sitting in the car for a couple of hours is 250 mls, at which point the urge to go is intolerable and when I stand up I get small squirts past the artificial sphincter.  While moving around the most I can hold is 150 mls.  This has not improved since having the AUS turned on 6 months ago, and I have come to live with it.  I've attempted trying to hold it longer to try and stretch the bladder, but it did not achieve anything over several months so I no longer do this. I believe it is not so much a question of bladder capacity, rather along the way I seems to have picked up some urge incontinence. 
 
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

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