One Year Aniversary - Artficial Sphincter and Penile Implant

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Salty_clark
Regular Member


Date Joined Apr 2008
Total Posts : 95
   Posted 3/12/2010 9:34 AM (GMT -6)   
Today marks one year since the activation of my AUS800 Sphincter and AUS700 penile implant.  A year ago I was suffering from a near total incontinence (leaking in all positions approximately a liter per day.)  Also, my nerves were not spared in my da Vinci operation in 2008 and ED was complete and total.  Dr Morey of Dallas performed the AUS operation and results were totally and completely successful.  A year later I am still dry and potent.  I have experimented with using a panti-liner to catch the small drips of a cough or sneeze and it was satisfactory but recently I decided that even this was a bother and I dispensed with this innocuous pad as I didn't feel I needed it so I am about as normal as one can get after such a horendous experience. I am writing this report to let you guys know that there are procedures available to ameliorate the sad side effects of a prostectomy and you can get your life back to normal.  It is not an easy road to travel but you can attain amazing results.  So for you who are experiencing these type problems...take heart and know that there are solutions and for you who are beginning this long trek be of good cheer for there are positive actions that you can take if you face these kind of problems.
 
Good luck to all...
 
Salty

Age 75 at DX 76 on 9 May 08
DRE positive with nodule 15 Jan 08
PSA 3.8 18 Jan 08
Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.
Bone scan and CT scan Negative 12 Mar 08
Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.
- - - - - - - -
da Vinci successfully completed by Dr Fagin as scheduled.
Path Report:
Gleason downgraded to 3+4=7
Tumors confined to the prostate.
Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.
Margins Negative.
Extraprostatic Extension Negative
Seminal Vesicle Invasion Negative
Stage pT2c
As far as it goes between you, me and the fence post I am cured. 
06-24-08 <0.1 Undetectable.
09-23-08 <0.1 Undetectable.
01-10-09 <0.01 Undetectable. 
04-17-09 <0.1 Undetectable.
AUS/IPP installed by Dr Morey 1/21/09 Activation 03/09/09 successfully completed by Dr Morey...All Systems GO!  99.9% continent.
12-09 0.01 Undetectable.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/12/2010 10:19 AM (GMT -6)   
Salty,

Good to hear from you with such a good report. Hard to believe that it has been nearly a year, my time flies. I remember when you were having it done.

Yes, your report should give hope to those men fighting long term incontinence, that there are workable solutions out there if needed.

I hope you continue to do so well. Also, pleased to see you are still steady in the Zero Club.

My best to you,


David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


tallguy
Regular Member


Date Joined Oct 2009
Total Posts : 417
   Posted 3/12/2010 11:44 AM (GMT -6)   
Salty,
Thanks for your report. It looks like I am headed the same direction for the AUS800/700 two for one. I had a Virtue sling implanted in February but still am a 3 pad a day guy an still have ED.
What was your degree of incontinence following the RP? I was a very heavy/constant leaker and knew the sling was a bit of a long shot. This is an improvement for me but if I can get the results you are getting I think I will seriously consider making that same move next year or so. Did you even consider a sling?
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.
24 hr pad wt. 219gm. AUA sympton index 13/35=moderate
Incontinence symp. index severeity score=22
Rec. for sling surgery. Dr. does mostly InVance.
Researched and decided on either AdVance or Virtue.
Virtue sling surgery 2/3/10 NYU med center by Dr. Victor Nitti
 


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 3/12/2010 11:46 AM (GMT -6)   
Hi Salty,
 
Congratulations on the great conclusion to your very trying journey. Thanks for giving hope to those that find themselves in a similar situation as you were in and give prove that a positive outcome is very possible.yeah
Wishing you many years of good health.
 
Magaboo

Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
Open RP 28 Nov 06 (nerve sparing), Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; 3 days before Rad Start=0.1
Salvage RT completed (33 sessions - 66 Grays) on the 19th Dec., 08.
PSA in Jan., 09=0.05; July 09=<0.04; JAN 10=<0.04


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 3/12/2010 11:55 AM (GMT -6)   
congratulations on reaching major milestone, and on a couple of different fronts, too.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
Gonna Make Myself A Better Man: www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
32 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


gold horse
Regular Member


Date Joined Nov 2009
Total Posts : 360
   Posted 3/12/2010 9:25 PM (GMT -6)   

Hi Salty happy you are doing fine,thanks for the information. I have a good friend whom has been having incotinance for four years.

 


DIAGN=46 YEARS
GLEASON=3+3
FATHER HAD PC,THEN I THEN MY BROTHER STILL HAS TWO BROTHER PC FREE.
MARRIED,TWO CHILDREN.AGE 13 AND 8.
LAPROSCOPY SURGERY 6/2005
PATOLOGY REPORT.
GLEASON=3+3
TUMOR VOLUME=5%
LYMPHOVASCULAR INVASION=NEG
PERINEURAL INVASION=POSI
TUMOR MULTICENTRICITY=NEG
EXTRAPROSTATIC INVASION=NEG
SEMINAL VESICLES BOTH=CLEAN
MARGIN ALL=NEG
PT2ANXMX
DEVELOP SCART TISSUE AND NEEDED A SECOND SURGERY BECAUSE COULD NOT URINATE,
PSA 6/05=0.04,0.04,0.04,6/06,0.04,0.04,0.04,6/07,0.04,0.04,0.04,6/08,0.04,0.04,1/09
0.04,10/09,0.04
 


Salty_clark
Regular Member


Date Joined Apr 2008
Total Posts : 95
   Posted 3/13/2010 6:46 PM (GMT -6)   
TallGuy...To answer your question I will respond by saying that my sphincter did not retain any liquid passing from my bladder regardless of position...that is, standing, sitting, lying down it just didn't make any difference the liquid just continued to flow.  After showering before bed and putting on a fresh pad I would have a restful night but each morning I would have a soaked pad.  My uretera stayed open and I was unable to grippingly hold it closed more than a few seconds.  I would estimate that I was leaking well over a liter per day in the pads not including the times I would void when I was lucky enough to make it to the bathroom in time.  I did kegals til they came out my ears to no avail.  I went to a therapist who claimed she could get the sphincter to work...after two months of therapy I realized that nothing was going to help so I contacted Dr Morey in Dallas and the results have been fantastic.
Of course I considered a sling but really had no illusions about my condition and took Dr Morey's recommendation to get the AUS done.  I don't think the sling would have helped me.  Mine was a hopeless case.  I can understand you guys who leak less will have a problem deciding between a sling and a AUS.  My best recommendation is to work with your doctor and have the tests done to determine what procedure would be best in your individual cases.    I present the AUS as an ultimate solution for hard-cases like mine.  And, you know, the maintenance of the AUS is neglibile.  I simply forget its there as it doesn't bother me at all and that includes the pump mechanism of the penile implant...I just simply don't know they are there.  The only time the AUS comes into play is when voiding I have to press a little plastic tip embedded in my scrotum that controls the water pressure tube that grips my uretera and by pressing the tip it releases the water pressure and the urine flow is enabled.  Afterwards the tube is repressurized automatically within one to two minutes and the AUS is gripping my urethera again and I am ready for another cycle.  It is really of no consequence to manage it.  It has become a normality with me.  Thank the Lord.
 
Good luck to all
 
Salty

Age 75 at DX 76 on 9 May 08
DRE positive with nodule 15 Jan 08
PSA 3.8 18 Jan 08
Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.
Bone scan and CT scan Negative 12 Mar 08
Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.
- - - - - - - -
da Vinci successfully completed by Dr Fagin as scheduled.
Path Report:
Gleason downgraded to 3+4=7
Tumors confined to the prostate.
Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.
Margins Negative.
Extraprostatic Extension Negative
Seminal Vesicle Invasion Negative
Stage pT2c
As far as it goes between you, me and the fence post I am cured. 
06-24-08 <0.1 Undetectable.
09-23-08 <0.1 Undetectable.
01-10-09 <0.01 Undetectable. 
04-17-09 <0.1 Undetectable.
AUS/IPP installed by Dr Morey 1/21/09 Activation 03/09/09 successfully completed by Dr Morey...All Systems GO!  99.9% continent.
12-09 0.01 Undetectable.


tallguy
Regular Member


Date Joined Oct 2009
Total Posts : 417
   Posted 3/14/2010 10:57 AM (GMT -6)   
Salty,
Very good to hear and also very encouraging for any of us considering this solution. Could you give a little more detail of the surgery and recovery period. 
-How do you compare the surgery to da Vinci? Some say it is more invasive.
-How long was your recovery period?
-what could you do or not do during recovery? I know it takes 6 weeks to activate but what were you allowed to do or what did you feel like doing during thid time period?
I am still working full time and don't like the idea of being laid up too long.
From what I see now after my experience I am thinking a lot more guys should be going straigt to the AUS instead of a sling....we all tend to be eternal optomists but expecially anyone over 60 should probably talk to a lot more AUS users before considering a sling. I am still glad I tried the sling first.....knowing what I knew then. But knowing what I know now the AUS would have a better decision and a lot cheaper one than two surgeries.
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.
24 hr pad wt. 219gm. AUA sympton index 13/35=moderate
Incontinence symp. index severeity score=22
Rec. for sling surgery. Dr. does mostly InVance.
Researched and decided on either AdVance or Virtue.
Virtue sling surgery 2/3/10 NYU med center by Dr. Victor Nitti
 


RHC Jr.
Regular Member


Date Joined Feb 2009
Total Posts : 39
   Posted 3/14/2010 3:05 PM (GMT -6)   
Salty:
 
You were kind enough to have answered my prior questions about your experience with the longer term viability of the AUS.  I am happy to hear that after 1 yr. of successful operation, you are as pleased today as the days after which your AUS was first activated.
 
While my degree of incontinence is similar to yours, I still have not elected the AUS implant route.  Instead, I have been looking into autologous adult stem cell therapy.  Work on this topic for post-prostatectomy patients has been performed by Dr. Hannes Strasser of the Medical Univ. of Innsbruck, Austria.  In the USA, the first clinical trial for female stress urinary incontinence was performed (and is currently underway) at Beaumont Hospital in Royal Oak, MI.  It is my current understanding that a clinical trial for male SUI may be conducted beginning in 2011.  With the help of my AFEX incontinence system, I believe that I can hold out until then.
 
With the number of people on this board suffering with post-prostatectomy incontinence, I have been surprised that I haven't seen any discussion of adult (not embryonic) stem cell therapy.
 
RHC
Last PSA prior to biopsy  -  11.9
Biopsy  -  8/7/2008
Cancer findings at left lateral and left medial apex of prostate
Gleason score  -  3+3 = 6
Staging  -  T1c
Prostate size/weight  -  128 cc./ 99 grams
Bone and CT scans  -  9/12/2008  -  both clear
Age at biopsy  -  65         Health  -  Excellent (other PCa)  (Lift weights, play golf & tennis (incl. singles))
da Vinci RP surgery  -  12/15/2008 at Naples Hosp.
Surgeon  -  Dr. Wm. Figlesthaler
Hosp. Stay  -  1 night
Catheter removed  -  12/23/2008
Post-Op blood tests  -  2/2/2009, 5/7/2009,  8/12/2009 & 12/7/2009          PSA  -  undetectable
Completed 12 weeks biofeedback, coupled with electrical stimulation  
 


Salty_clark
Regular Member


Date Joined Apr 2008
Total Posts : 95
   Posted 3/14/2010 4:27 PM (GMT -6)   
TallGuy...There is no question that the AUS700 and AUS800 (commonly referred to as the AUS1500) is more invasive than the da Vinci.  In fact, if you look at the case videos of the same operation on the net it gives you a rather nauseating scary look in how not to treat your private parts.  But,  believe me, the bark on that dog is worse than the bite.  My operation began around 5PM and I was released from the hospital the  following day around noon.  My wife and I stayed with my grand daughter in Dallas for three days prior to returning to El Paso by plane.  Somewhat painful during the three days in Dallas but only required Advil for relief so I found it to be no more than expected.  I just kinda laid around and moved only when necessary.  Swelling decreased each day.  A week to ten days was sufficient for swelling and bruising to subside almost completely.  Dr Morey's instructions included not lifting any weight more that a gallon of milk...to just generally not strain the affected parts any more than was necessary in the normal course of each day of recovery.  Each day showed improvement.  After the first week or ten days I was back to doing my normal routines of the day.  I am retired so not much activity in the course of a normal day anyway.  The wounds began to show signs of healing after about the first week and within a month were unnoticeable.  All incisions were made in the scrotum.  One vertical and one slightly horizontal.  At activation the wounds could not be seen.  Seven weeks later at activation in Dr Morey's office in Dallas he  manipulated the pump and buttons and then I went through the same simple procedure and all was well.  My wife and I returned to El Paso by plane the next morning dry and potent.
 
So that is kind of the step by step process.  In reality and in hindsight the whole procedure was less dramatic than one would think prior to the operation.  The main thing I think is the skill level of your surgeon.  A very well experienced surgeon in this type of procedure like Dr Morey is key to the successful outcome.
 
Good luck
 
Salty

Age 75 at DX 76 on 9 May 08
DRE positive with nodule 15 Jan 08
PSA 3.8 18 Jan 08
Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.
Bone scan and CT scan Negative 12 Mar 08
Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.
- - - - - - - -
da Vinci successfully completed by Dr Fagin as scheduled.
Path Report:
Gleason downgraded to 3+4=7
Tumors confined to the prostate.
Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.
Margins Negative.
Extraprostatic Extension Negative
Seminal Vesicle Invasion Negative
Stage pT2c
As far as it goes between you, me and the fence post I am cured. 
06-24-08 <0.1 Undetectable.
09-23-08 <0.1 Undetectable.
01-10-09 <0.01 Undetectable. 
04-17-09 <0.1 Undetectable.
AUS/IPP installed by Dr Morey 1/21/09 Activation 03/09/09 successfully completed by Dr Morey...All Systems GO!  99.9% continent.
12-09 0.01 Undetectable.


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 3/14/2010 7:44 PM (GMT -6)   
    I would highly recomend the AMS 800 AUS.  My only suggestion would be to find a Dr. that does them on a almost daily basis.
    KW
    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
     Dec. 2006 – Oct. 2008 Cystoscope, Two Collagen injections,Second Opinion   
    Consultation for Incontinance at OU Medical Center, Bio-Feedback       
    training, Chiropractic, Accupuncture , AdVance Male Sling, Two More Collagen 
    injections, AUS Installed and Activated (Dr. Morey at UT Southwestern Dallas TX)
    All to try to resolve incontinence (using 6-8 Depends Guards a day)

    To Date All PSA's 0.00.

   http://www.healingwell.com/community/default.aspx?f=35&m=721171

    http://www.healingwell.com/community/default.aspx?f=35&m=978691


Wigs
Regular Member


Date Joined Mar 2009
Total Posts : 89
   Posted 3/22/2010 8:18 AM (GMT -6)   
Salty, while I have not celebrated my first year anniversary, I have had both the AUS800 and the AMS700 implanted. The sphincter in May 2009 and the implant in December 2009. Both are "up and running". Like you, I was totally incontinent, going through 4 diapers and 6 - 8 pads in a 24 hour period. I am still wearing a light liner pad to catch the cough and sneeze drips, but believe me, I am not complaining. I have just recently had the implant activated and still in the beginning stages of using it and getting the hang of it. I still experience some discomfort in my scrotum after a long period of sitting. I have a desk job, so I try to get up and take a brief stroll down the hall about once an hour. Like you and others, I would definitely recommend the procedures to any candidates considering either one of them, or both.
Diagnosed @ age 47 - September 1997
PSA 5 / Gleason 3+3
Seed Implant - January 1998 @ Trident Hospital, SC
PSA 2.4 - July 2007
PSA 2.7 - July 2008
PSA 3.0 - November 2008
Diagnosed @ age 57 - December 2007
Gleason 4+3
Salvage Prostatectomy & Colostomy - March 2008 @ MSKCC, NY
Urethral-Rectal Fistula Repair - August 2008 @   Cleveland Clinic, OH
PSA < .03 - Aug 2008
Colostomy Reversal - January 2009 @ Cleveland Clinic
PSA < .03 - Jan 2009
AUS implant - May 2009 @ Cleveland Clinic
PSA < .03 - May 2009
AUS activated - July 2009
PSA < .03 - July 2009
Penile Implant - December 2009 @ Cleveland Clinic
PSA < .03 - December 2009
Penile Implant activated - February 2010
 
 

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