Ready to get the gun out, My story and questions, AUS

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I just turned 62 and Prostate issues are our family curse.
My dad has had issues for a long while and while he has not had his removed and does not have cancer he has had the roto rooter a couple of times so years ago I knew my time was most likely limited and I was a candidate.

The first urologist I went to had the bedside manner of a rock. We did a biopsy and I was told I was good but there “could” be something there so he suggested we do it again. I had to pay cash for these due to insurance deductibles (not fun). The second result we got he said “well there is something there but I would not worry about it, it grows slow and you have many years and will most likely die before you are affected” so I went on my way.

About a year later as I was contemplating moving the TV into the bathroom, I was starting to study my condition more as it really was affecting my quality of life. Every where I went the first thing I looked for was the bathroom and I was up at least 4 times a night. Out with friends I was always in the bathroom.

My PSA was now around 8-10 and climbing so something was for sure up!

My wife works at a hospital and told me of a doc on campus that was supposed to be one of, if not the best surgeons in the US. From what I was told, all of the Doctors with Prostate issues came to to see him and as I learned, he has done over 500 robotic removals.

After a visit, I really liked him and he suggested a trip to their new MRI that works really well seeing the prostate in detail. When those results came back, something was there so he did a in-depth biopsy (fun but I was asleep). After the results come back I was told I was at stage 3+ and from what he could see it looked like it “could” be contained but you never know.

I went home with the O shit I have cancer feeling and came back to see him a few weeks later. When given my options of waiting and monitoring or having it taken out I ask what would happen if I did nothing. The answer was "most likely 5-7 years" so I elected radical prostatectomy via the robot and we did the surgery on August 21 2019.

There were so many questions I should of ask but did not know to ask. I read all I could and after talking more, was confident in my Doc. He said I most likely I would have to wear a small pad sometimes for “just in case” leaks but that was all.

If I knew then what I know now I am pretty sure I would have taken the 5-7 years.

The morning of the surgery the Doc ask how I was feeling I told him apprehensive but confident. He thanked me for the confidence in him and I was rolled in. I remember laying on the table as the surgery began and them going through the protocols and starting the Propofol. I chuckled and ask who invented Propofol and as the lights were starting to dim the last thing I heard was one of the nurses say Michael Jackson ;-)

5 Hours later I woke up, and said out loud, well I don’t see velvet fabric or dirt so everything must of gone OK! After the nurses broke out laughing (my care was really good) I was told the surgery went great. I was beat up, as was expected after having seven holes cut in me and my belly being blown up 7-10 times normal size so a robot could poke, prod and cut on me. Doc said the nerves were mostly saved and I should be good.

Weeks later, my PSA was 0 (and still is), so, we got the cancer in time. What I remember the most was having the catheter removed a couple of weeks after surgery. It felt like someone reaching in my penis all the way up and pulling my head out the hole! Thank God it was quick and no one had told me what was going to happen.

Two + years have now past and my troubles are still here. I am still up 2-3 times a night, I can barely get a small erection even using all of the drugs (anybody got any suggestions) and apparently, even after working hard with what felt like millions of Kegels each day, my Sphincter did not heal properly. I am leaking, a lot, and having to change the heavy duty pads 6-10 times a day. My quality of life is gone. I find I am staging these dam pads everywhere, in all of the cars, coat pockets, in and around my desk, in a cabinet at my shops bathroom plus, its just plain embarrassing as these pads leak even when used properly (I have lots of experience). I’ve tried tight underwear and pants, and still my pants get wet. I even quit drinking for three days once to see what would happen (don’t do that). I find I am running to use a hair dryer or heat gun to dry out my pants and undies so I can keep a semblance of a normal schedule and God forbid if I try to go on a small hike or ride my motorcycle on a trip!

My doc was shocked and says this is a very very rare occurrence, 1 in thousands! He suggested I see a colleague of his that specializes in options for me. I saw her and after discussion she grabbed my balls and said cough, I said you really don’t want me to do that and she said go for it, naturally I peed all over her hand. I told you so! ;-)

During this visit and after doing my homework, I ask about having a urethral sling put in. She said it will not help me at my stage. I ask about that fancy Emsella machine and she said it is not covered by insurance, is expensive, doesn’t/won’t work and to save my money. She said my best hope is for the Artificial Urinary Sphincter so I went home to study more.

So after this long story and after reading on this forum for a few days and after having bad thoughts and putting the gun away several times, I am here to see if any of you actually have this AUS device and could answer some questions?

To me, it looks really invasive, I am reading it last only 5 or so years, rubs you raw and there is a large chance of infection.
So…..
Did it work for you?
How long have you had it?
Who was your doctor (if you want to say)
Do you still leak?
If so are you wearing the big pads or the lite pads? Now many a day?
Can you feel it as you walk around?
Is it hard to operate, squeezing your balls?
How much time do you have once you push the button?
Did you have to have a catheter ?
Did it hurt?, Does it still hurt.
How long before you could ride a bike, run or hike?

What am I not asking that I should be asking?

Before this surgery I was really active, I am a small business owner, a pilot flying small planes, experimental planes, sailplanes, hang gliders and ultralights. I am a motorcycle addict with three different bikes, I love to hike and travel. Yes, I am happy to be alive but all of my quality of life is now gone. I am gaining weight, cant get it off and if I knew then what I know now I am pretty sure I would have taken the 5-7 years. I just don’t know if I can go on living like this.

Thanks for reading
 
2Wheels,
I could’ve written this letter myself. I’m in the same boat. I have been since May 2020 dealing with incontinence as a result of radical prostatectomy. I am in the process of meeting with the surgeon next week to discuss the artificial urethral sphincter surgery. I have the same problems with incontinence. It is constant with multiple changes during the course of a day. I, too have lost a lot of my day-to-day activity enthusiasm and I’m hoping for some answers. I will be watching here to see how other people respond. I hope you are able to make some good decisions and get some of your life back. That’s what I’m hoping for for me.
 
@2wheels Wow, what a story! I feel for you, 2Wheels. I wish I could offer more than words of encouragement. I'm fairly new, being just 5 months out from surgery, never had an elevated PSA before an aggressive form of prostate cancer was detected, and then removed along with my prostate. I'm healing pretty well, I think. The incontinence is now at a tolerable level. I only need to change a pad once a day, and it is mostly dry. I lead an active life, but I don't do strenuous exercises, and I feel comfortable being out in the world without risk of embarrassing myself. The biggest concern for me at this juncture is the ED. I just met with a member of my urology team, and she says she usually doesn't expect recovery to pre-surgery levels until about 18 months. My partner has been wonderful and patient about my ED, and I still have my libido, so I'm doing okay, all considered, and I am trying to be as patient as I can muster. I hope something works out for you, 2Wheels. You shouldn't have to live the rest of your life this way.
 
@2wheels

I'm sure you are going to receive lots of advice here.

Curious though, have you not tried diapers?
 
Had my radical prostatectomy august 2020. Had to go back in October for urethral stricture fix. I started walking as soon as I could which seemed to help most with the leaking. I’m 63 now and psa has been undetectable. I also ride motorcycles (off road and street). Using 1 light pad per day. Some days I tend to leak more than others, but light pads seem to handle it. ED is also a fact of life for me. Don’t give up, there’s got to be a solution. Keep up the fight!
 
Answers to 2wheels

To me, it looks really invasive, I am reading it last only 5 or so years, rubs you raw and there is a large chance of infection. Surgery is always invasive. Some have lasted 10 years and there is always chance for infection and erosion of the cuff area.

Did it work for you? Yes

How long have you had it? My first implant lasted 7 years and I just had the second one done in Nov., 2021.

Who was your doctor (if you want to say) Dr. Neil Grafstein, New York City

Do you still leak? No

If so are you wearing the big pads or the lite pads? Now many a day? Depend Shields (light pad), 1 a day.

Can you feel it as you walk around? No

Is it hard to operate, squeezing your balls? Simple, you actually squeeze the bottom part of the pump which is in your scrotum.

How much time do you have once you push the button? Once you squeeze of the pump and release, you pee.

Did you have to have a catheter ? Depending, for the first week or two.

Did it hurt?, Does it still hurt. The incision on the bottom between the scrotum and the rectum is a bit uncomfortable when you sit. It get better as it heals.

How long before you could ride a bike, run or hike? I don’t think they recommend riding a bike
 
It sounds like I had the same Doctor as you did. I wish I would of known what I know today before I had my prostate removed, and I should of got second, and third opinions. You would think the Doctor would have your best interest in mind and tell you everything. I think mine just wanted to take it out as if he gets a commission on every one he takes out per year. I have read a lot of stories on this site of people that have had their prostate removed and are in the same boat as I am in.

I am 55 years old and very active.. I know I have talked to you before on this site. The AUS is definitely the way to go. I had the exact same problems that you describe... I have come to the realization that I will never be like I was.

There is a shot called Edex that will help with the ED. They have other injectables also, that are cheaper.. My insurance covers Edex. But you will need to get the AUS first so you do not pee when having sex.

The AUS, I squeeze the plunger in my scrotum a few times and that releases the cuff around the urethra, allowing urine to come out. I can actually pee without releasing the cuff, but it come out very slowly. Its not going to hold it back like your body used to, but it does work good enough to live normally. I still wear a pad, just for coughs and sneezing. Some urine does come out when that happens. They do make a higher pressure balloon that I will ask for next time I have this done. You have about 2 minutes before the cuff will close after opening it.

They will cut you above your abs to put the balloon. The cuff goes around your urethra which is right under your scrotum. Then the plunger goes in your scrotum. 6 weeks recovery time then they will activate it. That will be a great day. Just make sure if you get this done to find a doctor that does a lot of these per year. (At least 80 per year) There is a lot to getting it right. The cuff sizing is the main part that needs a good experienced doctor. I checked around for prices also.. I had UVA put the system in. They billed my insurance company for $67,000. I had to have the cuff resized a year later. I had that done at Duke. They also messed with the pressure balloon. They charged my insurance company $47,000. I did call Houston Metro Urology to have it done there. They wanted $150,000.. Unbelievable.
Hope this helps.. If you have any questions, my email is jsvames@hotmail.com
 
my very first concern is your mental health. I highly suggest seeing a counselor ASAP to address your PTSD and other issues. I have been in constant counseling since my diagnosis 9 years ago.

As for the AUS, it works incredibly well, but I think you should prioritize your mental health first.

Steve
 
@snow, I just renamed mine “alternative Undies”. Sounds more fashionable. Guys, I really hope you can find a good and less expensive procedure. I didn’t have the prostate but did have a procedure for pain that migrated and damaged my nerves overnight. I am so sorry and can somewhat empathize.
 
@Alwayssinging @Alwayssinging
Alwayssinging said:
2Wheels,
I am in the process of meeting with the surgeon next week to discuss the artificial urethral sphincter surgery.

How did your meeting go? Make any decisions?
 
@snow, @Dmorris My wife and I adopted the term “Uniforms”. Having both gone to private schools when we were younger, it’s kind of the same concept. You might get a couple of choices of tie, or shirt color, long sleeve/ short sleeve but no matter what you had to wear a Uniform to get into school every day… If someone were to overhear us they wouldn’t have a clue what we’re talking about!
 
Follow up. Had the AUS surgery done yesterday 03/17. Have a bag of frozen peas between my legs as I type this. My Doc (Sophia Goodridge) was great and said it went as per plan with no issues. I told her she didn’t have balls the size of grape fruit 😀. Thank god for the bottle of oxy! Now to get rid of this catheter in a few days and heal for 6 weeks before throwing the switch.
Thanks for Everyone’s info here, @jsvames @johnAM it really helped me move forward.
 
2wheels, glad to hear that you did the surgery. Once the pains are gone and the device is activated, you'll never regret that you did it. Continue your sense of humor and be well.
 
So far, So good, Activation was not fun but did not kill me. Working on getting back in shape now that I am no longer leaking. Just finished a short story/ small book about my three years in hell.
 
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