Posted 7/23/2019 5:13 PM (GMT -6)
A short recap:
RALP in March 2018. Incontinence didn't improve past 5-6 months of Kegels. Worked with a pelvic floor physical therapist through winter of 2018-2019. Very little improvement. 4-5 heavy duty pads a day. "Accidents" frequent. In March 2019 elect to have an AUS installed and schedule it for middle of May 2019 after a half-marathon I was already signed up for. Had minor, non-running related, back issue so surgery rescheduled for 3rd week of June 2019.
I showed up for surgery at Billings Clinic at 5:30am. They wheeled me into the OR at 7:30am. Surgery went well and I was home at 11:45am with catheter installed. They recommended that I take the pain medication before I actually needed it and I did but only that first day and the following morning. If I was doing it over I wouldn't take it at all due to the constipation it caused even though I drank lots of water, etc. The level of discomfort was about 25% of what experienced with the RALP.
On day 2 I removed the catheter following the instruction from the nurse. She gave me a syringe that fitted the catheter and said to withdraw the fluid and to do so twice to make sure it was all removed and the balloon was completely deflated. I did so and slowly withdrew the catheter. The feeling was weird but not painful.
As an aside, when I had my catheter removed a week after RALP, the physician did a quick withdrawal of the fluid and then pulled on the catheter like he was starting a lawn mower. It was extremely painful.
Once I had removed the catheter it was a matter of taking it easy. I didn't have to be convinced to do so. By day 3 things started swelling up and the bruising became apparent. The scrotum swelled to about twice its size and was very sensitive to touch. They had shaved me from about 2 inches above the pubic bone, a path about 5 inches wide that extend down, between the legs, and partially to the buttocks. That whole area turned purple, then black and then faded while going through the colors of the rainbow. I was tempted to do a time lapse but decided against it.
There is one incision at the belt line of the right side where the balloon/reservoir was installed. The other incision starts of the back side of the scrotum and extends just short of the anus. Both were glued shut. Both areas were very sensitive.
I did get up and walk. My man cave is in the basement and I have no trouble navigating up and down the stairs. Sitting is an issue but I'd bought a donut shape cushion and had it at the ready and it made all the difference.
Once the swelling subsided I found that the lack of hair is problematic. Since I am still wearing a pad the skin of the scrotum sticks to it and gets pinched by it. I alternated between baby powder and lotions for some relief.
I also noticed that my incontinence was worse than ever and trying to clamp things up with a Kegel were very ineffective. When I mentioned this to my doctor she said that is normal as the structures that the Kegels strengthened were what she had cut through. I was up to 6-7 pads per day.
The hospital had called to check on me after I'd been home for a while and on about day 4 the urology nurse called to check and to remind me that I needed to pull down on the pump 3 times a day to keep it in a low position while things healed up. There was no joy in that activity because, at least at first, I had to probe through swelled and sensitive tissue and pull the thing down. I suppose it was worth it as it is now as low as it can be in the scrotum and easy to access.
At the 2 week post-op visit everything is fine. Activation in two more weeks. I am still taking it easy, not lifting, but doing some good walks.
Yesterday, July 22, was the 4th week visit and activation day. My doctor looked things over, said everything is healing well, found the pump, squeezed the sides of its upper part for a moment or two, then gave the lower part a squeeze and said that was that. She offered me the opportunity to wait there a while to test it out but I felt pretty confident that I would be OK on my own.
Two hours later I felt the urge to go, a feeling I rarely felt except when laying down. I went into the bathroom, sat down, used one hand to hold the top of the pump, and to keep things pointed downward, and gave the pump a squeeze with the other hand. I could feel a slight "swish" of liquid moving through the pump and then I had a natural flow of urine. I was elated.
I wore a pad the rest of the day and by bedtime, having gone several times, the pad remained dry.
I am now on day two and have gone pad free all day. Since I got clearance to resume all activities I did a 2.5 mile run this morning without incident. My goal is to get back up to my usual 8 mile run by the end of August.
I am extremely satisfied with the results so far. Yes, there was some discomfort but a small price to pay for finally being dry again.