AUS (Artificial Urinary Sphincter) and Sling Male Urethral Sling Surgery

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If you have had an Artificial Urinary Sphincter and / or Male Urethral Sling surgery - Please share your experiences.

There are new members that are around the one year mark and asking questions in the introduction for new members.

The Search magnifying glass feature seems to only go back 7 months with the All Months or 12 Months options selected in the Advanced Search.

Please state
1) Which procedure did you choose and why
2) How long you waited after prostatectomy
3) Did you have radiation therapy
4) How was your recovery


For me - I had the sling surgery in Sept 2021 - it has been 15 months. Prostatectomy in Sept 2020.

1) I choose the male urethral sling surgery. Both are about the same amount of invasive. Recovery time is about 6 weeks for both. With the sling surgery, one has to adhere to the physical limits so not to move the sling out of place. Also I took a stool softener for 6 weeks, Miralax generic full dose for 2 weeks and half dose for another 4 weeks. I really needed the sling to work.

2) I had testing (urodynamics and cystoscopy) at 10 months after prostatectomy. I was leaking about 20 ounces a day.

3) I have not needed additional prostate cancer treatment. Some surgeries may have patients wait longer or choose the AUS if you have radiation

4) My sling worked too well. The 4 people who I spoke with did not have to self catheterize - this is highly unusual. Even with the following, I am glad that I choose the sling.

I had the sling surgery in Sept 2021 - it has been 15 months. I was not able to pee own my own until 2 weeks.
I self-catheterize for about 8 weeks.
Weeks after procedure
3-4 - 4 times a day
5-6 - 2 times per day - morning and bedtime
7-8 - 1 time per day at bedtime (mainly to make sure bladder was empty)

 

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Glad you had a good outcome although it took time and patience

 

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1) Which procedure did you choose and why
I had the AUS surgery because my urologist said I would be a good candidate
2) How long you waited after prostatectomy
3 years after prostatectomy, 1 year after radiation
3) Did you have radiation therapy
Yes, finished treatment in August of 2021
4) How was your recovery
Had some pain during the 6 weeks of surgery recovery, had my AUS activated 19 days ago. Still some scrotum pain but surgeon said it should subside in a few months max. After using 3-4 Depends pull ups a day I am now only using one shield pad every 24 hours. Some days the shield is almost completely dry but if I'm very active that day it may be a little damp.

Best decision I have made regarding my leakage ever! Would do it again in a heartbeat!!

 

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I just had a sling put in 5 days ago. I'm 25 months post surgery and had minor stress incontinence. Had the catheterization removed the next day and was able to pee with a little effort after filling my bladder. I took pain meds for three days after for very saw leg pain from the position they put you in for the surgery. Peeing normally now but still 3 to 4 times a night. Did have two slight leaks after a series of hard sneezes, But no other leaks. I will be going in for radiation after 8 weeks because my psa doubled. I was put on hormones to knock out all my testosterone that feeds prostate cancer. I am willing to give any additional information about my experience if asked. I'll be 74 in March.

 

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I had RP in Aug 2018. Fairly normal incontinence but was starting to get almost dry. Had hormone treatment beginning in Sept 2019, and radiation in Feb-Mar 2020, because of rising psa. Incontinence got slightly worse after radiation then slowly got better but never went away. Urologist said I was a good candidate for the male sling by Boston Scientific. I had this done in Nov 2021 at age 73. I was dry immediately after the surgery. Recovery was fairly easy with no problems, but I was careful for 6-8 weeks after the surgery to allow complete healing. It was the best decision I ever made, but I also had a very good surgeon/urologist that I trusted and I did my reading and research before the surgery. I did not need anything as drastic as the AUS. The literature does not recommend the sling if you have had radiation, but my surgeon said that was because the clinical studies that were done with the sling excluded people with radiation. If you don’t have any major problems with the radiation and your doctor agrees, then radiation should not preclude the sling. Also, if the sling does not stop the leaking, you can have the AUS later as far as I know.

 

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Thank you everyone for sharing your experiences. I am scheduled for the Boston Scientific sling on January 6, 2023. I had RP on December 2, 2019 and continue to leak (2-3 pads/day) despite extensive and intensive physical therapy. Hope my new sling will improve my quality of life.

 

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@harrisjmh

Thank you for sharing your story.

It will be good to have more knowledge from people who had radiation.

 

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Danznmann. Ask your doctor what exercise you can do to help eliminate leg pain post surgery. My legs hurt so bad, I could hardly move or walk for 2 days. They strap your legs apart wide open for the 1.5 hours the surgery takes. I think some type of stretching would help.

 

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I was told by several doctors not to have radiation until after surgery. Best to heal 8 weeks. No damage tissue from radiation for the sling to mend to.

 

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Thanks for the heads up on the leg pain/need for stretching. My doctor also warned me that I may have to use a cathater after the surgery and during recovery.

 

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Is there somebody with long term experience (7+ yrs) of having sling or AUS?
I am very interested to hear your story.

 

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I'm 78.5 and all my procedures were done at Mayo - Phoenix

1) Which procedure did you choose and why? AUS because of too much stress incontinence while playing pickleball. Urodynamics showed an atonic bladder which disqualified the sling. I had 3 opinions and landed with Dr. Wolter who does 4-6 AUS's in a month and has been doing them for 20 years (14 at Mayo)
2) How long you waited after prostatectomy? 15 months
3) Did you have radiation therapy? No
4) How was your recovery? AUS was activated on 10/19/22. Once in a while I get a squirt when I sit on a hard surface, but I am learning ways to minimize it. No problems otherwise.

 

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I had RP in August 2021. PSA tests since then are negative so no concern of needing radiation at this time. Been doing kegel exercises 2-4 times a day but still having minor leaking (1 light pad/day) with maybe additional one after golf. 68 yrs old in fairly decent health but frustrated that I'm not fully recover now being 15 months after surgery. Urologist recommends the Sling. I can relate to Danznman's frustrations! Any other suggestions prior to signing up for Sling/AUS surgery?

This is my first time looking at a blog so appreciate the above posts.

 

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Thanks for all the comments. I have recurrent prostate cancer one year after robotic RP. Incontinence is still a big deal - can get through the night generally dry. Some days I have better control (depend plus 4 or 5 pad changes) and other days, it just seems non-stop with little or no control, especially later in the day. Lots of PT. Now I'm facing hormones for 2 years and radiation for 8 weeks... Needless to say, I'm pretty discouraged.
Considering sling or AUS. My prostatectomy surgeon and 2 oncologists will be consulting with each other this week to discuss my case. Noted @Gkudisch comment about having sling surgery 8 weeks prior to radiation. I'm also concerned about leg pain from the stretching during surgery as I already have issues with stiffness in my low back/legs/hips from degenerative discs.
Anyhow, I'm reading everything you guys post here about slings and AUS devices with great interest. Already searched history here. Comments appreciated.

 

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Hang in there. I had RP in Aug 2018. PSA never went quite to 0 and slowly began to rise. Had hormone treatment beginning in Sept 2019 and 8 weeks radiation of prostate bed and pelvic lymph nodes in Feb- Mar 2020. Total of 1 year of hormone treatment. Had male sling surgery in Nov 2021 and it worked great. After all that, I am doing very well and still undetectable psa. It is important to have good doctors and a good radiation team and to have faith in them. Wishing you the very best.
Kind Regards

 

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I also have post surgery left hip pain from the position they put you in. The hip only heart twisting , but now I have to be careful twisting the hip.

 

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I had the Boston Scientific pelvic sling surgery on January 6, 2023. The procedure took 90 minutes and I went home with a foley catheter. This morning I removed the catheter, drank gallons of water and have voided five times. I have been dry between voids. I am beyong happy!

Following the surgery I was in considerable pain in my penis, especially due to the catheter. However, I expect I will heal quickly. I have to avoid strenuous activities and squatting for three weeks on order to allow the sling attachments to heal in place. The surgeon attached the sling to my uretha and the two sling attachments came out through my thighs. This new type of sling has teeth on the attachments to help hold the sling in place (much like a zip tie but attached to my thigh muscles, thus, the need for three weeks healing. I did not have any leg pain that others mentioned.

Note: I am 67 and had a RP on December 2, 2019. Despite extensive and intensive physical therapy I continued to leak (2-3 pads/day).

I strongly recommend the Boston Scientific pelvic sling based on my initial experience. I will have to wait and see how fast I heal and how well the sling holds up but for today I am seriously thrilled with my new found driness.

 

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Super news!

 

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Just to keep thread active so it will show in searches
Thank you,
Terry

 

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Yes good idea. I am now 14 months post op and using a two or three light shields daily. I could make do with one heavier pad. As we all know it depends on the level of activity. Still doing some pelvic floor exercises and have an appointment at end of Sept when we will review if I have made any more progress. Depending on the outcome could continue for another six months to the two year mark or look into the sling surgery. Or alternatively if the IC is manageable I might leave things as they are. I set my mind to enjoy the summer, try not to think too much about the issues and wait for the review in Sept. I did six sessions of counselling which helped my mood a lot, having felt a bit downhearted at the one year mark.

I spoke to a a guy in church today. Had RP around Christmas time. Doesn't wear pads, had only the rarest of stress leaks when he sneezed, has 70 per cent recovery of erectile function and that with nerve sparing on only one side. Delighted for him. But as I reflect on my experience and so many others on this forum you can only conclude it's a strange unpredictable beast this prostate cancer