AUS ( Artificial Urinary Sphincter) for men

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I had my cancerous prostate removed 20 years ago and had beam radiation radiation 13 years ago when PSA started to rise. I am still cancer free and undetectable PSA. Yea ! Small leaks and I use shields and when I do something strenuous, I use a depend. All controllable . Then, I had a large number of stresses ( mostly good things all happening together and a few bad things) and I wetted my bed . Got up the next morning and still had a full bladder. Although my spouse was very understanding, I was very embarrassed. This happened for several days straight and some random times. I saw a urologist and he immediately said it was delayed reactions to my prostate removal plus the radiation. Evidently, the prostate ( I was told) plays a big part in men’s continence. He did a cystoscope on me showing my sphincter muscle was strong and there were a number of blood vessels in my bladder that were more exposed probably due to radiation. He immediately suggested I have AUS surgery . Evidently, I would have to press a “button” in my scrotum every time I wanted to open the cuff and urinate. Anyone have this surgery ? Problems with the button? Other alternatives? I limit caffeine after a certain hour and limit liquids in the evening. Than you!

 

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I don’t know about everyone else, however I gave up with my urologist because I became a pill ginipig - done with that after 6 months of different pills - diapers in the long run are cheaper with no side effects- I’m only nighttime wetter and not every night - I just accepted the fact to wear protection at night which now is no big deal - when I do wake up with a wet diaper my decision to wear a diaper is that more acceptable than wet bedding to have to wash

 

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I was offered AUS several years ago. I declined, I still have everything there. Still cathing with tape protection

 

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My urologist suggested that to me last week. Said medication won't work. I said didn't want surgery that I would rather deal with the pads and night time diapers. How evasive is this surgery? Wonder about side effects from it. Same thing. Prostate surgery 8 years ago. Radiation 7.5 year's ago. 56

 

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Talking to the urologist , we agreed to revisit this in 4 months. Very hesitant about the whole thing

 

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I'm sticking with the pads and diapers.

 

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My urologist told me that there was nothing else she could do for me because all she seemed to want to do was give me pills and change my sleeping schedule. We talked about the interstim implant but again, that would not work for me because my nerves may be damaged.

Here is the big thing for me. My urologist never did a single test. Last visit her nurse asked me for a urine sample but it was never processed. It sucks but truly I feel like if you are not getting answers then it is better to move on. Also, like @dalexwitte

I don't want a bunch of surgeries that are only going to give a 5-10% improvement on the quality of life but have a 3-15% chance of complications and only a 30% chance of a good outcome.

I told my urologist, I have been in some form of a diaper at night for 20+ years. The reason that I was sent to see her was that all of a sudden I started wetting during the day after a really bad bout of constipation. Now we know that both my bladder and bowel are affected by muscle and nerve damage.

My goal is to get to see a neurologist soon.

 

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Hi
My urologist suggested it to me. I’m almost two years post surgery. 35 radium visits and 18 months of hormone shots.
I take lasix everyday due to CHF. I void
many times during the day. I decided against the surgery for the following reasons:

1. The AUS procedure is really 3 in one. Scrotum,Penis and abdomen. I am a type two diabetic and I am afraid of infection.

2. I am very active and the frequency would have me excusing myself every few minutes where now I get up when my leg bag is full. My Dr told me that is bladder extended too much it could back up to my kidney. I know even now if I’m sitting or driving I have to stand and let gravity work. This wouldn’t work with AUS .
3. It has to be replaced usually around every ten years. I am 73 years old and don’t want be thinking of surgery if I live that long.

I discussed all this with my Urologist and he agreed. The frequency due to CHF was the main determining factor.
Having said all this I’ll tell you what I use. I use the Men’s Liberty external catheter. I use 3M Nexcare absolute water proof tape along with what comes with catheter . I rarely have a problem. I also use the Uro Bag pants I ordered from Amazon. They are cotton , have pocket inside to hold bag without straps . No chaffing very comfortable.
Please feel free to contact me if you have any questions.

https://e3effa51eee72fd900e3-


2fb779bd12ec72d4612275342f2c9187.ssl.cf1.rackcdn.com/eb2da0f293b218a6b051451a029dedd7.jpg

 

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What is CHF you mentioned?

 

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Congested Heart Failure. Fluid buildup around heart. Lasix helps get rid of it by o pop adding lots of fluid

 

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FLGuy: Never did a single test?!? Never processed the urine sample?!? WTF? And no doubt she charged you and the Insurance company and maybe medicare/medicade. Did she charge God?
Asking for the odds was smart! I declined tooth implants. The after-regime is crazy and drawn out, and has a 50% infection rate - except they try not to tell you that.
Aww man. Fluid build up around heart is bad news. Make them pay attention or swat them upside the head!

Me? I'm too poor to pay attention, these days. Even trouble is not free, any more.

Take it easy -- but take it.

 

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There are other options besides AUS such as going to a good physical therapist who specializes in incontinence. One was able to help me quite a bit.
The male sling is a much less complicated operation for men who fit the criteria, one of which is light leakage. Look for the Advance XP sling procedure by Boston Scientific. I would definitely take your time and get a second opinion before having the AUS. The sling procedure does not prohibit having AUS at a later date if it doesn’t help. From what I know, AUS is considered the procedure when other attempts have not worked. It’s a valid procedure and fairly successful, but not the first option to jump to immediately. There is a good discussion of AUS from a person who had it done on this forum. I am a layman, but personally, I am considering the male sling procedure. I had prostate removal in 2018 and hormone treatment and radiation in 2019-20. I have had light leakage which got better, then slightly worse about 6 months after radiation was completed. Good luck. Take your time and research the options.

 

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I had my prostate removed 2 years ago. Age 52 I leaked very bad after that.. I did the physical therapy for months with no results... I went to 2 other urologists who sad doing the kegels exercises will not work for me... So I had the AUS installed a year later... What a game changer.. I finally got some of my life back... I have a few small leaks when exercising and when I have too much abdominal pressure, cough or sneeze.. I am having a smaller cuff installed in a week to help with that... The AUS was the way to go for me.. Love it.

 

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Glad to hear . Is the button to open the cuff difficult or awkward?

 

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I had my prostate removed 2 years ago. Age 52 I leaked very bad after that.. I did the physical therapy for months with no results... I went to 2 other urologists who sad doing the kegels exercises will not work for me... So I had the AUS installed a year later... What a game changer.. I finally got some of my life back... I have a few small leaks when exercising and when I have too much abdominal pressure, cough or sneeze.. I am having a smaller cuff installed in a week to help with that... The AUS was the way to go for me.. Love it.

@jsvames

Glad the AUS worked for you. I have had nothing but pain since mine was done.

 

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@jsvames
Can you give us an update about having the smaller cuff implanted?

How are you doing?

How is the recovery?

How long did you have to wait to have the cuff activated?

Thank you - Terry

 

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@jsvames
Can you give us an update about having the smaller cuff implanted?

How are you doing?

How is the recovery?

How long did you have to wait to have the cuff activated?

Thank you - Terry

Hello Thudson1965,
The smaller cuff was an improvement. When I sneeze or cough some urine does come out. Before the smaller cuff a lot came out.... It was like the device was not really working.
Since I already had the device implanted the never deactivated it. The recovery went well... I was 100 percent healed up in 4 to 6 weeks.
I still wear a pad for just in case. But the pad is usually dry at the end of the day... The only time it has anything in it, is when I go to the gym and work out with heavy weights.
The end result is that I am very happy with the smaller cuff and the AUS800.
When this one goes out, I will have them put the higher pressure reservoir in.

 

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@jsvames

Thank You!

I did not know about cuff sizes and higher pressure reservoirs.

Thank you,
Terry