Yesterday, Feb. 3rd I had Colaplast Male Sling surgery at New York University Medical Center by Dr. Victor Nitti. I have posted about my journey on other threads but on the advice of the forum moderator am starting this new thread. Hopefully this information will be helpul to others.
My RP journey is noted in my profile so I will concentrate on the decision to do the Virtue sling.
Thanks to the help on this forum I have been studying sling surgery for about six months. After having all of the tests I concluded with the help of my urologist/incontinence specialist at U of MI Medical Center that i was a good candidate for a sling to fix my contined incontinence. She has done primarily InVance (one with the bone anchored screws) slings...about 70 of them. She has done only one AdVance and about 5 Virtues. I learned about Dr. Nitti from this forum and from my urologist. He is one of the 3 inventors of the Virtue. I considered Advance, InVance, Virtue and AUS. My incontinence is moderate to severe, dry at nights and when sitting but constant leaker when standing/walking about etc.
I felt I was not ready to go with AUS (the gold standard for incontinence fixes). More invasive, and did not like the idea of having to machanically use the pump. I ruled out InVance because of the more invasive bone anchoring and some reports of scrotal pain/numbness. Also, it is one of the older slings. AdVance is newer with a lot of data to confirm success rates. However, it appears to be better for mild to moderate incontinence. Virtue is new, out of clinical trials but very little data available and some reports of problems but also some successes on this forum. I called and talked to several users of AdVance, Virtue and InVance.
I decided to take the time and extra expense to travel to NYC to have Dr. Nitti do either AdVance or Virtue. During my pre op visit with Nitti Tuesday I made the decision to do Virtue. Dr. Nitti felt that my degree of incontinence was probably greater than indicated by my pad weights. Otherwise the FUDs test and cystoscopy indicated a sling could work. Virtue had more support and details on it can be found on some of the older posts on this forum. Dr. Nitti and his two co inventors have made some adjustments to the original procedure that they feel will improve results. Dr. Nitti is very careful to point out and very candid that there is not a lot of data and experience with Virtue. That said he does have high hopes that it is a "stronger" fix for someone with my degree of incontinence if proper procedures are used. It might be worth noting that he said if it was him he would probably do the AUS because of the almost guaranteed degree of success curing incontinence. However, he understands why so many of us choose to do the sling....we can always still go to the AUS later if the sling does not work and we are willing to incurr another surgery.
My operation was at 8:30 am yesterday, Wednesday. I did it as an outpatient although I originally planned an overnight stay in the hospital. Things went so well....as Dr. Nitti explained, exceeded his expetations he gave me the option to go back to the hotel. I got back about 3:30 pm yesterday. I have had some pain, aching of buttocks and inner thigh, about 6/7 on a scale of 10. After pain medication wore off from hospital I took a couple of Advil but not much help. Had a brief spell with nausea but recovered in about 10 minutes. Took the prescribed Percoset (only one pill) and have stayed on it since. Takes care of the pain/aching fine.
My wife is a nurse (retired) so we removed the catheter at 7:30 am this morning, Thursday. Since then I have urinated three times for a total of 535 ml. Everything seems to be working fine. Good color to urine, fine control, good stream and no pain. I am a little stiff in the lower extremities and after about six hours the pain/aching comes back but fairly mild. Have taken the pain meds three times six hours apart.
My experience seems to have followed another guy I met on this list. If you see him on some of the other threads his forum name is RonJon. He also decided on Virtue and Dr. Nitti. he lives in NY. My experience so far seems to be almost identical to his and my condition prior to surgery was also very similar.
I will keep posting my progress and will be glad to respond to any questions/observations. Also, you can email me from my profile information. I intend to fly back to Michigan Saturday but could probably fly back today or tomorrow. But, my spouse is out spending money in NYC that may rival the cost of the operation. It might be worthing to note that my BC/BS incurance is a PPO. Dr. Nitti is "out of network" so I will bear 50% of his cost myself. NYU is in the network so my normal deductibles apply. Regardless, I am happy to incur the extra expense because of the high degree on confidence I have in this procedure and Dr. Nitti in particular. A key piece of advice is that whatever procedure you elect to have done make sure your doctor has done large numbers and has had good results.
So far I am a really happy camper
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.