Incontinence Surgery Decision

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Lumpi
New Member


Date Joined Apr 2011
Total Posts : 1
   Posted 4/15/2011 1:09 PM (GMT -6)   
I am a 75 yr old male considering sling surgery after RLP.  PSA is .0 as of 5 yrs and 11 mo.  The urologist I am seeing is recommending Virtue MS.  If the reports I am reading are in the majority (not good), I am leaning away from Virtue to Advance.  Virtue sounds like it is a better support to urethra and bladder control to stem incontinence but there is very little info of success rates on either V or A.  I would like professional opinion on which of these, if not another procedure is most proven for stress using 16 t 20 pads each 7 day period.

tallguy
Regular Member


Date Joined Oct 2009
Total Posts : 419
   Posted 4/15/2011 6:56 PM (GMT -6)   
Be very careful with a decision on Virtue sling. Very little data available. It did no good at all for me and I ended up with an AMS 800 AUS. You can read about my journey if you paste the links below in my profile or search the site for tallguys virtue sling journey.

tallguy
Regular Member


Date Joined Oct 2009
Total Posts : 419
   Posted 4/15/2011 6:59 PM (GMT -6)   
Sorry, my did not post so I will try again. Also you can email me at the address shown in my profile by clicking on my screen name.
66 year old male
PSA jumped 3 to 8 Jan 2008
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.
Incontinence & ED. Dry nights , no control during day.
FUDS and cystourethroscopy testing 10/09.
24 hr pad wt. 219gm. AUA sympton index 13/35=moderate
Virtue sling surgery 2/3/10 NYU med center
Appeared to help but gradually returned to pre surgery condition.
Back to 3-4 pads/day.
Latest PSA 4/1/10 negative.
AMS 800 artificial urinary sphincter implanted 7/8/10 at U of MI.
AMS 800 activated 8/25/10 Dry for first time in 2 years.
Links to my journey posts:
http://www.healingwell.com/community/default.aspx?f=35&m=1847812
http://www.healingwell.com/community/default.aspx?f=35&m=1710681
http://www.healingwell.com/community/default.aspx?f=35&m=1948599

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 654
   Posted 4/16/2011 9:09 AM (GMT -6)   
I would recomend going to a specialist who deals with mens incontinence as his primary focus. I have to believe that these guys are more up to date on which device is the more appropiate for your situation. I have heard that a sling is more appropiate when leaking is not 100%. THe specialist I when to did a fancy version of a urodynamics test then  cyctoscopy and his recomandation for my case did not include a sling. There have been a few people here on this site whose sling implants have been ineffective or worse ( see Tallguy's journey) but the latest sling feedback has been from  Worried Guy and his sling has worker for him. However, it might be that we don't hear much when some of these slings do work out. In my case my leakage was 100% during the day, ie all my urine leaked and zero trips to the toilet during the day unless I was reading, driving or otherwise sitting still. They call the AUS the gold standard for incontince and there is a reason, it works.
06-08 1st biopsy neg psa 4
10-09 psa 5.5 2nd biopsy 1/12 pos. 10%, G(4+3) age 65
12-15-09 RRP Tulane NOLA Dr Lee
Path, 1%, clr marg, no EPE, no SVI, nodes cl, G(4+3)
100% incontinent @ 12 months
ED, pre-op severe, post op total
10/10 Dr Boone, Methodist recomended AUS
AUS/ IPP performed 1/11/11 Methodist Houston
post op psa's 0.04,<0.1,<0.1,<0.01@12 mo.
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