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

Catching up... I decided to have sling surgery in Jan 2023, a month after starting hormone therapy for recurrent PCa. I went from having severe stress incontinence to now having urgency incontinence. I can hold it longer but when I have to go, I have to go quickly. Still wearing pad because I can't always get to a restroom quickly enough. Better than the severe incontinence I had, but not what I hoped for. Plus I have to start radiation, so I'm trying to make as much progress as possible before starting radiation (progress with incontinence will slow down or stop bc radiation stiffens the whole area). Anyhow, PSA is basically zero, so I'm ok to prolong radiation and continue PT to try to improve this urgency incontinence. It is unpredictable...
 
RJ I have read that a possible side effect of the sling is urge incontinence and also nocturia can increase with it as well in a few cases
 
Thanks to everyone for sharing. I’m 64 and in pretty good shape. Had RP last August and am still in diapers. Too much leakage for pads. Dry at night and if seated but at work it’s a constant dribble. Met with surgeon yesterday and am going to try an AUS. He doesn’t feel the sling will work for me. I will keep everyone posted on my journey
 
Wanted to update on my post above regarding urgency incontinence after sling surgery. My surgeon started me on Gemtesa/vibegron a week ago, and it has immediately made a big difference. He suggested that I not look at the side effects, so I decided to be a sport and not look... until now. I just glanced before writing this, and I have been nauseous, but I was already nauseous from Lupron and Xtandi, so it's hard to say how much of the nausea may be coming from Gemtesa. Anyway, I have been enjoying the added freedom of much-improved continence these last few days.
 
I decided to have the Sling surgery this past Mid April. It solved my leakage although the urgency still exists so need to be mindful of distance to bathroom. Still some lingering light pain from where the sling is attached but very tolerable. From where I was to where I am now, I'm happy in having the surgery. Next up is ED problems. Urologist is suggesting injections. Not too keen on sticking a needle in my unit. Anyone using this method?
 
I’m three days since surgery to implant the AUS. I’m getting around pretty well. The incisions in the perineum and the abdomen don’t hurt much. The worst has been getting up from sitting or getting off the bed, since this takes essentially a sit-up. My scrotal sack is black and blue, and sore. The doc has me pushing down the pump into my scrotal sack at least once per day. However, the sack is still so swollen that I can’t feel the entire contour of the pump, let alone the button. I am hoping that as the swelling goes down, I will be able to feel the whole pump. Any experiences from others at this stage would be welcome.
 
Ricard,
Thanks for the update. I’m scheduled for the 27th. Will post my experience as well. Hoping for the best for you.
Scott
 
Coming up on 2yrs post RP.
will be having a penis pump with urethral sling surgery in August. It's call a MINI JUPETTE . Dr says it should end my leaking wich is about 1 shield per day. And allow for erection that can perform. Will keep yall posted.
 
Thanks for the update. Like you I am down to one Tena one pad per day or a couple of light shields. On a sedantory day like a Sunday I could almost get away with no protection but when I'm doing yard work definitely need it and as I've mentioned a few times playing the bagpipes on a full day at a competition has me using the external catheter. So I'm keeping my options open and seeing the urologist at the end of September for a review, at which stage I will be 18 months post op. On a recent phone call she said she had seen improvement in some up to two years. As for all of us, time will tell. On the ED front I feel some stirring but not sufficient. At the moment it's the Vacuum Pump which I find Ok.

I hope all goes well for your operations and as always updates on how things have gone are always appreciated
 
Well am now fully healed. Penis pump is fantastic. Wife and I now have a great sex life again. The leaking is pretty much non existent, as long as I'm not drinking alcohol. The only long term downside is that I always have a 50% erection to keep the Leaking under control.

I would strongly recommend especially to the younger guys here to look into this.
 
Thanks for the update. It is so helpful to hear other people's experience. I'm glad it has worked out well for you. I hope everything continues on well for you. I have heard about that permanent erection issue with the pump. How do you find that?
 
Yesterday I was in a primary school where I help out two days per week. Just a little amount of leakage because it is a fairly sedantory job. Today I was sweeping the yard, shovelling and using a heavy back pack leaf blower. Had to use three Tena twos. Such a contrast. Maybe it is time for the AUS. If I could manage without the operation it would be great but when you have only slight leakage when inactive and much more when you are doing a heavier job the temptation is to become inactive, which is not good for your joints, muscles and heart. Living in Northern Ireland there is a problem that none of the local hospitals do the AUS operation and it requires a trip to England. So that is a bit of a disensentive. On the other if it gave me better quality of life I would make the effort for the sake of a trip to the mainland and a six week wait. I'm just so conflicted. I'm just not sure what to do.
 
I had the AUS surgery this past July. I’m back wearing regular underwear with pads ( I could not get out of diapers post RP). Like you I have very light leakage when not doing anything requiring exertion. When at work I need to use up to five pads per day. I’m on my feet a lot. I saw the surgeon who performed the AUS surgery in December and he feels we can improve the situation so I’m getting a revision this Monday. Admittedly I’m a bit nervous because I’m in medicine and we.have a saying “the enemy of good is better “. The possibility of being down to a pad a day is hard to pass up so I’m going to try. Compared to where I was a year ago I’m happy but he feels a little tighter cuff will solve the problem. I’ll post next week and let you know how it went.
I know many on this forum are bigger fans of the AUS procedure than I am based on their results. I would still do it again even if I stayed as I currently am. Just hoping to get results that will really get me on the bandwagon.
Boomer59
 
Just got home from surgery to revise the AUS. They downsized the cuff around the urethra. Not much pain and I’m allowed to resume using the device. Going to bed now will report on results tomorrow
Boomer
 
Hello all. I’m post op day two and mildly sore. I’m very optimistic that I am no longer leaking much. I’ve been pretty sedentary while recovering and will return to work next week where I will really find out how much improvement I’ve gotten. Based on the last day I seem much improved.
Boomer
 
Update. I one week out from my revision of the AUS and I can say I’m thrilled with the results. I’m completely dry unless I lift heavy weight or such. During normal activity I have no leakage issues at all. The revision was easy as I was just a bit sore but I can finally say that I see why the procedure has fans. Starting to feel normal again. Today I returned to work for the first time and that’s where I experienced the most leaking. Completely dry today. I still am wearing a thin pad rather than the thicker ones that I used before but I am very happy with the results of the revision.
Boomer
 
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