Just had sling surgery

[Archives1]

I'm 68yo, had robotic RP August 2021. Saw a physiotherapist who specialises in pelvic floor not long after surgery and was what she described as just about her most diligent client ever with my exercises for 12 months and got back to 90 - 95% continent, but then I plateaued despite continuing with the exercises daily. My leakage was triggered by activity and wasn't severe but was really annoying as I like to stay active walking my dog and working in my sizeable vegetable garden in my retirement and I could feel the little involuntary squirts while doing my garden jobs. I discussed it with my Urologist at my 18 month followup and he advised he doubted I could achieve any further improvement naturally and recommended sling surgery. Before committing to the surgery I went back to the physio and we reviewed my exercise pattern and tried some different exercises for a few months but I wasn't able to achieve any significant improvement.

So at my 2 year followup with the Urologist I consented to the sling surgery and am now recovering at home after having an Advance XP Sling surgically fitted 11 days ago. I have experienced quite a lot of swelling and soreness post surgery, particularly in the testicular area, and while I haven't needed to take painkillers since around day 5 it is still quite uncomfortable. Initial results seem good, I am not experiencing any involuntary squirts so far, but then I am not being very active as per Urologist instructions ~ he wants me to avoid heavy garden work, particularly any activity that spreads my legs, for a good 3 months ~ so it may be a while before I can assess that aspect. What I am noticing in the short term is that when I do pee, while I am able to generate a good stream and pretty much empty my bladder, there is quite a bit of slow dribble that takes a while to emerge when I finish ~ I am hoping this will improve as I recover and the sling settles in. Interested in feedback on this from others who have recovered from the surgery previously.

 

[Archives1]

Good info. Thanks for posting. Please keep us updated.

 

[Archives1]

Yes that's really helpful information. Thank you. I still have a fair bit of leakage, especially over the past few weeks when I have a bad cold and constantly coughing. That has made me revert quite a bit. I am still considering some kind of surgical solution once I reach the two year mark. So these posts are always helpful

 

[Archives1]

I had sling surgery this past May after a similar timeframe and issues after RP surgery. After healing, the leakage stopped but I still had difficulty in controlling the urge to pee or getting to the restroom in time. However, I recently had another surgery that required me to be catheter and surprisingly I now have a lot better control so go figure. Overall, I'm satisfied having the sling surgery.

 

[Archives1]

Day 18 postop update ~ So far so good with the sling, no stress leakage to date but I am being far less active than usual as per Urologist's instructions ~ the real test will come after 3 months when he gives me the all clear to resume my vege gardening activities involving lots of bending, kneeling, digging, carrying etc. There is some slow dribble when I pee, like the sling is not allowing me to force out the last few drops so they dribble out ~ I have read that it can take a few weeks for the whole sling system to work properly, so am hoping this will settle down. But it is preferable to my previous stress incontinence.

There was a lot of swelling and soreness after surgery, particularly inside upper thighs and testicles, which lasted 7 - 12 days. I stopped taking painkillers after 4 - 5 days but really needed them first few days. I went and saw a local doctor on day 14 (the day after Boxing day) as the wound, while looking ok, was still weeping and he put me on another 5 day antibiotic course and advised me to go back to Tweed Hospital if it is still weeping when I finish the antibiotics so a Urologist can have a look at it. There is no swelling or pain there but it is still weeping so I plan to go back to the hospital on Tuesday when hopefully the Urologists will be back on duty after the holidays.

 

[Archives1]

Thanks for the further update. These kind of posts are so helpful. I hope you continue to improve rapidly and the sling is a real success.

 

[Archives1]

Thanks for the update, Doug. Please keep us posted. Best wishes in the new year.

 

[Archives1]

Now 6 weeks since sling surgery. I have had some issues with wound healing after an internal stitch popped and part of the wound opened, which is now almost finally healed. And I have had a nasty flu for the last 3 weeks. So between those issues I haven't been able to be very mobile and the constant coughing and sneezing hasn't helped with stress incontinence. I see the Urologist next Tuesday and will hopefully get the all clear to start being more active again and I can start getting back into my normal routines and assessing how effective the sling surgery has actually been. I will keep updating this post with progress.

 

[Archives1]

Thanks for the update. Sounds like you're making progress, intermittent as it might be. Best of luck in getting back to normal. Let us know how it goes.

 

[Archives1]

Thanks for the update. It was very unfortunate you got the flu in the midst of healing. I hope next few weeks see continued improvement. Please keep us updated. Those of us still considering the next steps value these kind of updates

 

[Archives1]

DouginOz
Thanks for letting me know about this thread from my post i made earlier today, i will keep following your progress, hope all continues to get better.

Thanks
watt100

 

[Archives1]

Details below but sling worked great for me ( Boston Scientific Advanced Sling). Have to be very careful for a minimum of six weeks maybe a little longer. My only issue is slight dribble after urinating. They call it post void drip and I believe it is common. Just have to get used to using TP to absorb the drip.

 

[Archives1]

Details - may be too much but:
My urologist said all of the clinical trials about the sling were done on patients that had not had radiation. Thus they did not recommend the sling for patients who had radiation. But it depends on the individual and the individual case. I was close to being dry but just couldn’t get there, especially when lifting or straining. I was wearing 1 light pad per day. I completed radiation in March 2020. I decided on the sling in fall of 2021 and had the operation in Nov 2021. Was immediately dry and have been ever since. I had considered Botox injections prior to the sling but my Dr said they very well may not work whereas the sling had a much higher success rate and that’s what he recommended. I had also been to a good physical therapist who was experienced in patients who had prostate cancer. I had been to her both after my RP in Aug 2018 and after my radiation in 2020. She taught me pelvic floor exercises, bladder training, general nutrition, etc.
On a separate note:
After my RP in 2018, my psa never went to 0 and began to slowly rise. Several tests, MRI, and biopsy of prostate bed did not show cancer, but psa was rising very slowly. I eventually went to the Mayo Clinic in MN to have a special test that could only be done there. Mayo said there was cancer and recommended salvage radiation. I had radiation of the prostate bed and of the pelvic lymph nodes as well as hormone therapy before and after the radiation. Mayo recommended 2 years of hormone therapy along with the radiation. The standard hormone therapy is 6 months, so the 2 years didn’t make sense to me. Again my urologist said the reason they recommended 2 years was because the clinical trials had been done using 2 years of hormone therapy. I did 1 year of hormone therapy rather than 2 with the agreement of both my radiation oncologist and my urologist.
I believe your individual case and situation is more important than having radiation. I also knew that if the sling didn’t work, I could always do AUS. But AUS was the last resort for me.
Hope this info helps you. I had to do much research and soul searching and praying to decide what to do. I also had good Drs that I trusted and so allowed me to decide. They recommended but did not try to push me in any one direction.

 

[Archives1]

Four months now since my sling surgery, so time for an update. My surgery wound is all healed now and no ongoing problems apart from still a little tenderness around the base of the scrotum that does seem to be slowly going away. I have finally also recovered from the nasty fluey thing I had that evolved into a nasty sinus and ear infection ~ the constant sniffling, snorting etc along with the overall shitty feeling wasn't helping with my recovery at all, but that has also been good now for 2 to 3 weeks.

So in the last 2 to 3 weeks I have started back walking every day with my dog and doing my pelvic floor exercises while walking. I have also started working again daily in my vegetable garden and around the yard. I was really unfit initially but am slowly getting back into my groove.

Now that I am able to finally focus on my continence I am finding some improvement in that area also in the last 2 to 3 weeks. My biggest problem has been post void dripping which despite my best efforts to get rid of it all before putting willy away have been resulting in quite wet pads at the end of the day.

At this point I am not noticing any stress incontinence when working around the yard and garden and that does seem to have improved. Not ready to call it resolved just yet, but looking promising. Just in the last week or so, the post void dripping also appears to be improving, so that is also looking promising. My pads in the last week or so are definitely much drier at the end of the day. I had been advised that improvement might start becoming evident from 3 - 4 months post surgery and that appears to be the case, hopefully it continues.

Next step now is to start using my vacuum pump daily again for rehab and hopefully start getting some natural results with the ED.