Sling, or artificial urinary sphincter?

I had a sling installed 2016 and now I have an AMS 800 AUS.

The sling worked well with no leakage, that I recall, but it failed after three years.

The AUS was installed in 2023. It works well but I do get slight leakage.

The sling worked right away and there was no pain involved; the recovery took about a week as the incisions healed.

The AUS recovery took six weeks. The the operative sites to heal before it could be activated. There was no material discomfort during the six weeks. I'm very happy with it. Squeezing the activation bulb has become natural.

Before the sling was installed, I had 33 shots of prostate bed radiation. My new urologist was surprised I got away with having a sling installed. Apparently having a sling installed after radiation is not the done thing around here. Could this be the cause of the sling failure? Don't Know.

I had about five months of pelvic floor training from thoracic physical therapist. She had me doing specific exercises targeting the three muscle groups in the pelvic floor. Despite doing assigned exercises diligently, there was no improvement in leakage. I had the AUS installed after that.

I’ve heard from somebody else that the Recovery from sling is not easy. I don’t think my urologist impressed me with that information when we talked. I’ve also heard that the sling doesn’t always work and you have to go through that recovery to find out. It’s especially a problem if you’ve had radiation. Donate to charity

I’m actually going to talk to the specialized incontinence urologist for A second time, tomorrow, about different options. Mine isn’t usually even 1 pad a day, unlike you.

One of the very active members of the Advanced prostate cancer user group at Ancan.org had the artificial sphincter installed and he loves it. He had terrible problems like you described, but he’s had the artificial sphincter for a couple of years at least, and it works great for him. He recommends people with serious incontinence should get it.

Thankyou, guys. Awesome information.
Sounds like the sling is a temporary - maybe in the hope that it'll resolve itself by the time it's due for replacement(?)

6 weeks for the AUS? I just had 6 weeks for the prostatectomy. No radiation. Yet.
How is mobility during that 6 weeks?
But it sounds great once it's healed. Longer recovery, but might be worth it.

Thankyou. I really appreciate the feedback. New physio tomorrow, so I'll se if they have any new tricks up their sleeve.

I had the sling 1 year after RP. The incision in scrotum to rectum was uncomfortable with the sling and it failed . 1 year later a new dr put the AUS in and the incision was in same place. The cuff was put around the urethra under scrotum and the pump by testicle in scrotum and the fluid ballon was put by bladder. Yes it was/is uncomfortable at times . 1 thick pad normally gets me through the day . No pad at night needed I probably leak a little more than 3 1/2 years ago when I had the surgery. But I’m happy I had the AUS surgery.. a friend in his 70s I know had the AUS few months and is happy with it.

Is the pad just for backup? I thought the balloon would squeeze the urethra tightly closed.
A bit scared of the pump in the scrotum. What if you squeeze the wrong bulge?.....

"6 weeks for the AUS? I just had 6 weeks for the prostatectomy. No radiation. Yet.
How is mobility during that 6 weeks?"

For me mobility wasn't a problem; however, I was restricted no not lifting over 10 Lbs.

"Is the pad just for backup? I thought the balloon would squeeze the urethra tightly closed.
A bit scared of the pump in the scrotum. What if you squeeze the wrong bulge?....."

I'm not sure how the cuffs work. Could they be different sizes that are easy to get wrong? In my case there is no problem in selecting the right bulge Hormones have taken care of that issue:)

Of possible interest. I asked my Uro about bike riding with an AUS. She said no problem.

Cool. Thankyou. I'll see if it's an option.

I had the Sling installed in 2008 . I was using 2 large pads per day. Now I’m down to one medium pad per day. Right after the surgery , I was instructed not to lift anything heavy or bike riding for 2 weeks. A little sore afterwards. But all else OK.

I did not has a sling, but I've had an AUS for 2 years. I'm in agreement with the other patient, @gmul. I went from no control, 12 or more pads per day, to 1 or 2. I'm completely confident to participate in normal activities and life. Squeezing the activation bulb is second nature. I'd do it, again. A life changer.

It's interesting this topic came up. I'm seeing a pelvic floor therapist preemptively now (pre-surgery) along with a personal trainer to try to be as ahead of the curve as I can be and the therapist was talking about another patient with the AUS who raves about it and has even offered to talk to any of her patients about it. My first reaction was "well there's a sling that doesn't require activation" but it's hard to argue against the logic of regaining the second sphincter that was removed since it's something I've lived my whole life with. Given what I've read elsewhere and even in this thread, I think if I end up needing anything I'll opt for the device over the sling.