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Steve326
New Member


Date Joined May 2011
Total Posts : 13
   Posted 5/3/2011 3:04 PM (GMT -6)   
I had my AUS (articifical urinary sphincter) activated on Feb 7; so I am 3 months into it.  I am very pleased with it; although not 100%.
 
Prior to the implant surgery on Dec 20, 2010, I was using about 10 pads per day.  Since my RRP was in July 2009, I was 18 months post-RRP and did not expect any further improvement.
 
The surgery went well, although 4 months later I still have some soreness under my scrotum.  I have not used a pad since the day my AUS was activated.  However, I still have some leakage when I sit down and when I am lying down.  It is minor, but still aggravating.  I'd say it has been 95% effective for me.
 
It is still an issue with my sex life, though.  Given I still have some leakage, I have to be careful than I would like.  The best news is that my PSA remains near 0, 20 months post-RRP.  I am thankful for that.
 
I'd appreciate any cooments or questions.
 
Good luck to all.

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 5/3/2011 3:54 PM (GMT -6)   
Hi Steve, interesting post and I'm glad to hear that the AUS has and is going well for you!

I don't think we've "met" so hello and welcome to this corner of the world.

Congratulations on the near zero PSA. Does that mean it is less than 0.0? Or???

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  

Steve326
New Member


Date Joined May 2011
Total Posts : 13
   Posted 5/3/2011 4:19 PM (GMT -6)   
My Dr. uses the ultra-sensitive PSA test.  It has come in at .005 consistently, so I consider that near zero.
 
 

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 5/3/2011 4:40 PM (GMT -6)   
A nice low number, Steve. Congratulations!

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/3/2011 4:45 PM (GMT -6)   
Good PSA number, and sounds like a big, although not perfect, improvement with your AUS. Good luck, perhaps it will continue to improve
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Steve326
New Member


Date Joined May 2011
Total Posts : 13
   Posted 5/3/2011 5:33 PM (GMT -6)   
So I see you had no ED or incontinence problems. Congrats!! That is what I had hoped for from the robot, but I had both. If I could do it again, I'd go open RP w/o the robot. Also, I had a prima donna for a doctor and I found out he's not as good as he thinks.
Male 59
RRP-July 2009
pre-op PSA - 7.4
Gleason 7 - 3/4; organ confined
Latest PSA March 2011 - .0005 (ultra-sensitive)

tvwohio
Regular Member


Date Joined Sep 2010
Total Posts : 172
   Posted 5/3/2011 6:42 PM (GMT -6)   
Steve
 
Good news on AUS.  Mine was activated on 3/22/2011 so  you were a little earlier than me.
 
So far for me, it has been a good experience.   I do leak a little but nothing like the 8-10 pads a day prior to activation.  
I understand the scrotal soreness, I told my wife it felt somewhat like a razor burn and it was opposite the inplant.   To me it is hard to describe.
 
The leakage happens to me if I don't pump at least 3 times on pump as well as shake off good.
Sometimes I notice more than others - especially in the middle of night if I go and aren't careful.
 
I just came back from the Y and was exercising - wt machines, crunches etc and wore a pad JUST IN CASE.  When I took it off for showering there wasn't much leakage at all.
 
I have had ED since the RP - 10 years ago. I tried injections, cialis and finally settled on pump.   I have found the rings do a good job from any leakage.   Not certain how much leakage you have.  When trying injections, I wore a condom because of leakage. 
 
Good Luck
 
Tom of Ohio

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 654
   Posted 5/3/2011 8:37 PM (GMT -6)   
Steve I had my AUS implanted 1/11/11 and activated about Feb 10. I like mine too and I leak almost zero, but I am curious about the pain you and tv are having. I thought I was the only one with some pain associated with my AUS. Are you guys saying you are having pain on your scrotum? or is it associated with the cuff site on your urethra? I have been concerned with some pain that is associated with the cuff when it is activated. I also get occasional buring on urination at the cuff and it is not due to a UTI. My doctor said that my response was not the norm. I will see him next month for a scheduled follow up and he will look into the pain issue then.
Ron
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.

Steve326
New Member


Date Joined May 2011
Total Posts : 13
   Posted 5/3/2011 9:46 PM (GMT -6)   
Ron - my pain is from where the incision was under my scrotum.  I still have some slight numbness too.  The Dr. told me he expected soreness for 3 months. It has now been 4 months for me, but I'm not too worried. it seems to lessen a bit each day.
 
I've never had pain in my urethra or when going.  I'm guessing on your case it will eventually go away.
 
My leakage is slight, but still a problem.  It happens mostly while I am sitting or while lying down on  the bed.  it is still slight, so I'll not worry about it.  I've still not worn a pad since the day it was activated.  Since I'm thinking about having the penile implant done this summer, I'll ask the Dr. if he can "adjust" the cuff while I'm under.
 
Good luck on continuous inprovement with your AUS.
 
 
 

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 654
   Posted 5/4/2011 7:55 AM (GMT -6)   
I read an overview of the AUS system online and they discussed using four different pressure settings for the resevoir. Maybe you need to go the next level. I have wondered if I should have had the next lower pressure setting since I am having irritation of my urethra? Anway good luck on the IPP.
Ron
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.

Steve326
New Member


Date Joined May 2011
Total Posts : 13
   Posted 5/4/2011 8:32 AM (GMT -6)   
I didn't know about the different levels.  I'll check on it.  Thanks.
 
Also, do you know anything about the penile implants?  i may go that route this summer.
 

Neoman
Regular Member


Date Joined Nov 2010
Total Posts : 192
   Posted 5/4/2011 2:13 PM (GMT -6)   

I also had/have some soreness on my scrotum and had mine activated last November. Though it has slowly lessened overtime, still have some I call it tightness where the incesion was made on the lower part. I have not worried about it, and that is where I also squeeze the device. So, I am not sure if I aggrivate it some when doing that.

I can also leak when laying down as I approach the 4 hour mark. My doctor said though when I lay down, I should be able to not go as often as when I stand up, as there should be less pressure on the device (I have a Neobladder vs a normal one). So I set a timer to make sure I go at about 4 hours.

I use one pad a day, and that is such a relief from wearing a condum cath and leg bag 24 hours a day. When I sit wrong, it can leak as we can activate the cuff somewhat by putting pressure on the device. I always try to watch that, but still it happens.

Am glad, other than your concerns that all is going well. I love my AUS, I love my AUS..(kinda like that commercial!!) turn

 

Chris


Bladder Cancer fall 2008, age 53
MVAC Chemo fall 2008 to Jan 2009.
RC of Bladder Feb 2009
Stage 2 high grade bladder cancer
also detected after bladder surgery high grade Prostate cancer
Had AMS 800 implanted July 2009 but surgeon nicked uretha and the cuff had to come out. Then developed infection soon after and they took it all out. Reimplanted Oct. 12 2010 after fistula/infections healed

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 654
   Posted 5/4/2011 6:08 PM (GMT -6)   
Steve here is and excerpt from the article had includes a discussion of pressures. I used a google search for "artificial urinary sphincter article" and this one is faily complete and is on Medscape and the article is called, Artificial Urinary Sphincter Treatment & Management By Sajadi and Kim.

"Balloon reservoirs come in 5 preset pressures—41-50, 51-60, 61-70, 71-80, and 81-90 cm water. The lowest pressure required to close the urethra is used. Balloon reservoirs are typically placed in the lower abdomen. For uncomplicated bulbar urethral cuffs, the most commonly chosen balloon reservoirs are the ones with preset pressures of 51-60 and 61-70 cm water. For bladder neck cuffs, the balloon reservoir with pressures of 71-80 cm water is chosen because higher pressures are necessary to occlude the bladder neck. Patients with prior radiation or surgical changes that present a higher risk of erosion may benefit from a 51-60 cm water reservoir. In addition to a lower pressure reservoir, some advocate transcorporal cuff placement in patients with a history of radiation therapy. "

After re-reading the article, I am not sure that the resevoir can be adjusted in its pressure, but the good news is the doctor will know. I do have the IPP and that was implanted with the AUS on 1/11/11. That device seems very foolproof and it I think they almost always work. THere are lots of things to think about even after you decide to get the implant. Several guys on this site had the dual implants before I had mine done. I am happy with the results of the IPP. You can visit FrankTalk.org and probably find out more than you can on this site as the frank talk site is focused just on erectile disfunction issues.
Ron
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.

Steve326
New Member


Date Joined May 2011
Total Posts : 13
   Posted 5/4/2011 6:30 PM (GMT -6)   
Thanks, Ron.  Great information.
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