artificial sphincter/ sling

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jerseycity
Regular Member


Date Joined Nov 2008
Total Posts : 123
   Posted 1/17/2010 11:43 AM (GMT -6)   
looking for feedback from you guys who have had either of these procedures done. What level of incontinence were you at? The surgery itself and results. Being 16 months post surgery and still in need of pads I am curious. My leakage level is low, 1 pad a day with another to accomodate workouts after work. Both pads are usually half full. AS and sling seem to be for severe level of incontinence. Define severe when it is your problem 24/7.
The valve in the sack seems very out there. Mostly curious at this time.

 3-17- 8 went to Bruce Springsteen concert , great time
3-18-8 routine exam
3-19 doctor called said psa was elevated
what's a psa?
referred to Uro, had several more blood tests.
PSA steady at 4.75
biopsy  June 08 , 12 cores, 4 on left confirmed , right clear
gleason 3 + 3 T1c
research time.
decieded on open RP, Head of Uro  is my Doctor
Surgery done 10-1-8 by Dr See at Frodoret Hospital in Milwaukee
Cathater out 10-13 no problems
Post op,  organ confined, gleason up to 4 + 3, all clear margins
T2c 20% volume, very good outcome I feel
Incontinent and ED.  Time will tell, was told all nerves  saved.
back to work 11-5-8.
 3,6,9 month psa <0.04 one year <0.04
still use 1 pad per day
 
Walked thru the darkness on the edge of town.


TSFFZ
Regular Member


Date Joined Oct 2008
Total Posts : 25
   Posted 1/17/2010 7:20 PM (GMT -6)   
jersycity,

My condition was similar to yours. The leakage after 18 moths had decreased to minimal, but varied. Some days, i wouldn't need a pad but other days required a light one, especially during workouts. It was a situation that I was living with but I had started ED therapy with injections and I leaked urine when I was able to achieve an erection with injections. I did some research and found that the sling had the potential to reduce or eliminate that problem, so I elected to try it. I had the Advance Urinary Sling installed by Dr. Stone at UC Davis in Sacramento and the results were successful in that I no longer leak urine during erections. The drawbacks are a bit more difficulty in urinating...the stream is not as strong as the urethra is somewhat squeezed by the sling, but this is not a big deal. However, for some reason, I find that I need to pay extra attention to draining Willy after urination or I will dribble a few drops when he goes back in the pants. Not much different than before my RP, but I didn't have that issue after the RP and before the sling.

All in all, I would easily do it again. Your leakage is low enough where you should be a good candidate for the sling procedure.

What does your urologist say?

jerseycity
Regular Member


Date Joined Nov 2008
Total Posts : 123
   Posted 1/18/2010 6:02 PM (GMT -6)   
I have not discussed this with Uro as of yet. Trying to sort out data and process first. Have my 18 month exam in April . I will go into it then I suppose. I do not want to go thru surgery for a minor trade off. Can you fill me in more on actual procedure. Thanks for your comeback. I am dead in the water regarding ED so that issue may not enter equation like yours did.
 3-17- 8 went to Bruce Springsteen concert , great time
3-18-8 routine exam
3-19 doctor called said psa was elevated
what's a psa?
referred to Uro, had several more blood tests.
PSA steady at 4.75
biopsy  June 08 , 12 cores, 4 on left confirmed , right clear
gleason 3 + 3 T1c
research time.
decieded on open RP, Head of Uro  is my Doctor
Surgery done 10-1-8 by Dr See at Frodoret Hospital in Milwaukee
Cathater out 10-13 no problems
Post op,  organ confined, gleason up to 4 + 3, all clear margins
T2c 20% volume, very good outcome I feel
Incontinent and ED.  Time will tell, was told all nerves  saved.
back to work 11-5-8.
 3,6,9 month psa <0.04 one year <0.04
still use 1 pad per day
 
Walked thru the darkness on the edge of town.


TSFFZ
Regular Member


Date Joined Oct 2008
Total Posts : 25
   Posted 1/18/2010 10:57 PM (GMT -6)   
jerseycity,

Watch this video if you want to know more about the procedure:

http://www.orlive.com/sentara-profile/videos/incontinence-surgery-the-male-sling

rogerbanana
New Member


Date Joined Jan 2010
Total Posts : 1
   Posted 1/19/2010 11:31 AM (GMT -6)   
i had surgery eight years ago to remove my prostate which was at 4 out of ten on the scale. it all went wrong and i then had radiotherapy and since has been benign . i go for test every six months. over here in the UK if you are over seventy they inject you every month and it stalls things until you die of natural causes.

i have had urinary problems ever since, and use a bag which is fine once you get used to it.(i tried pads but they are smelly and unreliable). they come in all shapes and capacities. they couple up to your penis via a thing called a conveen which is like a condom ,open ended which couples to the bag.
all this is non-invasive but am considering an artificial sphincter which is a plastic device opened by the insertion of a catheter . the downside i am told is it has a life of eight years before it needs replacement . can any one confirm this/give views on the whole idea ?

thanks for reading. roger.

male_sling_problems
Regular Member


Date Joined Nov 2009
Total Posts : 134
   Posted 1/19/2010 5:08 PM (GMT -6)   
Hello jerseycity,

My situation was much like yours. I had an open prostatectomy 10 years ago with no radiation. I required 1-2 pads per day until last July at which time I consented to sling surgery.

I received detailed information and consented to an AdVance or AdVance type male sling. To my horror, the urologist doing the surgery implanted a Coloplast Virtue male sling instead of the device that I had consented to. The Virtue sling caused intolerable pain 24/7 and worsened my incontinence from 1-2 pads to 4-5 pads per day.

The pain was so horrible that I had the Virtue sling surgically removed at The Cleveland Clinic approximately one month ago. The specialist at The Cleveland Clinic, Dr. Kenneth Angermeier, implanted a American Medical System AdVance male sling before completing this 3 1/2 hour procedure.

Although I still experience considerable pain from the "removal" surgery, I am 100% dry with the AdVance sling. It is great to be completely dry after 10 years of wearing pads.

If you are considering sling surgery, I would encourage you to carefully research your choice of slings and doctors. A good place to start is to Google: FDA / MAUDE Adverse Event Report

Under Brand Name, type: AdVance Virtue and InVance one per report.

Choose 25 reports per page.

It is also meaningful to consider the yearly number of specific model implants compared the the number of reported MAUDE injurious adverse events. For example, I have reason to believe approximately 9000+ AdVance male slings were implanted in 2009. The AdVance sling had nine (9) adverse event reports for 2009 ending 31 DEC 2009. Using these numbers, their implant to injury ratio would be approximately 1000:1.

It is more difficult to estimate the total number of Coloplast implants for 2009 since they refuse to disclose this information. They do disclose that they were hoping for 120 volunteers for their ongoing Clinical Trials. So if they succeeded in obtaining 120 Clinical Trial volunteers and another 90 implants were done outside Clinical Trials in 2009, their estimated total would be 210 implants for 2009. Considering their 21 MAUDE adverse event reports for 2009 (not including November and December due to reporting lag) their estimated current ratio would be approximately 10:1.

When I look at this comparison, I am not surprised that I was one of the unlucky ones that suffered so much with the Coloplast Virtue sling.

I would be interested in hearing from others that have suffered unreasonable or intolerable pain following sling implant surgery. My email address is: bigxbadxjohn2@yahoo.com

Best wishes,

John




I

tallguy
Regular Member


Date Joined Oct 2009
Total Posts : 417
   Posted 1/21/2010 6:58 PM (GMT -6)   
I will be having a sling implanted February 3rd. I am still undecided and will choose either the AdVance or the Virtue sling. I am 16 months post RP and have been a constant leaker during the day but dry at night. After doing all of the urodynamics testing my Michigan doctor recommends that I am a good candidate for a sling. My local doctor does primarily InVance (bone anchored) slings and I hav decided against that one. I will travel to New York and have Dr. Victor Nitti do my surgery. He has large numbers of the Advance sling and about 20 Virtue. He is also one of the co inventors of the Virtue. There is not much data available on Virtue so as noted in the other post that one is more risky but seems to have great promise for those of us that are moderate to sever in terms of incontinence.
I have learned a great deal from this forum and have talked to some of the members about their experience. I will post results of my sling surgery once I return from NYC the second week of February.
64  year old male in excellent physical condition.
No serious illness of any kind.
PSA jumped from 3 to 8 in one year between annual physicals.
Biopsy/pathology confirmed postate cancer.
pt2b NO Mx with a Gleason score 3+3=6.
DaVinci prostatectomy, Robotic surgery July 23, 2008.
Tumor type: Acinar
size 5.5 cm x 5.7 cm weight: 77 gm.
Largest tumor nodule: 1.3 cm
All surgical margins were negative.
Seminal vesicles uninvolved by tumor.
Urinary incontinence incurred immediately followin surgery. Dry at nights but no control during day. Tried drugs imipremine and detrol but no help and caused side effects so stopped them.
Unable to obtail erection from beginning. Viagra and Cialis were used in low dose but caused headache so discontinued. Using pump for erection effectively with rubber clamp.Very loving relationship with wife and we are both fine with this situation as it is.
Underwent physical therapy and kegal exercises with no results for incontinence.
Uideo fluoroscopic urodynamics and cystourethroscopy testing in Oct. 2009. Resulted in recommendation for surgery to insert InVance Male Sling System for incontinence cure. Alternative is new sling called Virtue by Coloplast. Planning this surgery for January 2010.


dword56
New Member


Date Joined Feb 2010
Total Posts : 1
   Posted 2/1/2010 4:14 PM (GMT -6)   
I had a Radical Prosectamy in Feb 05.  Never had a leak but the ED hung around. In Nov 07 I was in a motorcycle wreck and broke my back. Now I lost alot of feeling in my groin and lost control of my bladder.  My doctor felt the Advance Sling would fix my problem so I went along with it and went ahead and did a penile implant at the same time.  That was Oct 13th 09 and I just left the doctors office today where I scheduled another surgery to do the artificial sphincter.  In my case the advanced sling did not help.  And for reference I am very dissatisfied with the penile implant.  I will be looking for another doctor to look into either taking it out or trying another one.  I will not use the same doctor in that situation.  When I explained my complaint to him he just shrugged me off and said it was enough for intercourse and that was better than before.

tallguy
Regular Member


Date Joined Oct 2009
Total Posts : 417
   Posted 2/4/2010 5:37 PM (GMT -6)   
Sounds to me like you are a good candidate for an AdVance Sling. See the new thread I started today. Tallmans colaplast male sling journey.
64  year old male in excellent physical condition.
PSA jumped  3 to 8 in one year
pt2b NO Mx with a Gleason score 3+3=6.
DaVinci RP,  7/23/08. Tumor type: Acinar
size 5.5 cm x 5.7 cm weight: 77 gm.
Largest tumor nodule: 1.3 cm. All margins negative.
Incontinence & ED. Dry nights , no control during day.
Imipremine and detrol, Phy ther. and kegals no help.
FUDS and cystourethroscopy testing 10/09.
Rec. for sling surgery. Dr. does mostly InVance.
Researched and decided on either AdVance or Virtue.
Surgery scheduled for 2/3/09.

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