Posted 5/24/2017 6:53 PM (GMT -6)
Thanks all. More context lest you think this has been a cakewalk. I know AUS stories do not always end well.
David, I am annoyed with UW. I could not even get a consultation appointment with Dr. Volzke or Dr. Wessells. They offered me a consultation with another UW doctor in March. (I started this effort last November.) So, I asked for another referral from my urologist. Dr. Govier, at Virginia Mason, did my surgery.
Dr. Govier did a cystoscopy and urodynamics test. Neither were good outcomes. He could not get inside my bladder due to the stricture. My sphincter is completely dysfunctional. He speculated it was radiation damage. The urodynamics showed "marked bladder instability." He recommended we proceed with a worst-case outcome of deactivating the AUS if things did not work out. He told that earlier in his career he would have refused. He told me erosion rates are 3-4 times worst for radiated patients. But, recently he is having some success with patients like me. So, we moved forward.
On the day of surgery he told me if he could not get get a 12-14 french catheter through the stricture he would not do the surgery. But, dilate instead and try again at another time. He did get the catheter through.
His goal is to get 5 years from this 4.5 cm cuff. Then revise to a 4 cm cuff and get another 5 years. Revise again for another 5 years with perhaps a 3.5 cm cuff.
The backstory: I did not use pads for almost 5 years. I had colon cancer resection surgery. They brought in my urologist to place stents in my ureters during surgery to protect the ureters. He had to dilate my bladder neck to get through. He said I had a big-time structure. Perhaps the scar tissue was keeping me dry. That began a cycle of self-cathing and incontinence during my subsequent chemo. When I finished chemo I transitioned to total incontinence.
I also speculate about the oxaliplatin. I never even saw a mention of this in medical literature as it relates to incontinence. But, I had so much neuropathy. I still have some nerve damage above my knees. At the worst of it, even my penis and rectum were mostly numb. (Resolved now!) Is that contributing?
So, when I say I am thrilled, this is why. And, I give credit to Dr. Govier. He had the courage to push forward. I appreciate that!