Considering an Artificial Urinary Sphincter (AUS): Need advice

@soli
I was off work for 2 weeks afterwards. It was a bit different for me, cause I had the AUS implanted 9 months after my prostatectomy.
They normally wait 12 months, to see if incontinence gets better.
But in my case, it was obvious after 9 months that it wasn't going to.

Recovery-wise... lots of rest, manageable pain, thanks to lots of pills.
After a shower, dry your bits with a hair dryer on warm, cause it's still too painful to touch with a towel.
You're still incontinent for 6 weeks after surgery, cause you have to wait for everything to heal.
So still on the pads for 6 weeks.
Then you're back to the urologist, he activates the device & you're pretty much good to go.

Like everything else, everyone's experience is different.
I still had problems with leaking for quite a while, but pills for an overactive bladder sorted that out.

I found using the device very easy from the start.
Recovering from any surgery is no fun, but this one was worth it in the end.
I've gone from 7 pads a day to zero.

@jeffmarc
If I may ask- was there any effect on having sex with it in place. I still have hopes of that but leak like crazy when with a woman.

@peterj116

Thank you. It was very helpful to learn from your experience about the recovery process after the AUS implant.

One thing that caught my attention was your mention of having problems with leakage for quite a while (I assume after the AUS was activated) due to an overactive bladder, which was eventually “sorted out with pills.” That really caught my attention because I also suffer from incontinence following my prostate surgery a year ago, as well as overactive bladder.

My OAB is not new—I have had it for decades, and unfortunately, it has not responded to all sorts of medications, PTNS, or Botox. The only treatment I have not tried is InterStim.

So, I am wondering how much an AUS would help in my case if I don't address the OAB issue at some point. It sounds like the AUS can address the sphincter-related leakage, but I wonder whether my longstanding OAB could still cause significant urgency and leakage even with the AUS.

@soli Yes, I guess I have that same question. If I get an AUS I will have three months before I go on a 3-week trip abroad, so better understanding the ups and downs of recovery would be useful. Thx...

@soli
The only difficult part is that there are stitches in your perineum and sitting down is quite painful For a week or two. I resolved that problem by rolling up a thick towel, shaping it into a U and sitting down without my perineum being touched.

For a couple of days after the surgery, it could be painful at times, I did take a 5 mg oxycodone on two days, Just one pill in the morning. After that all I needed was acetaminophen. It was more than it was stinging than it was painful when I took the Oxycodone, I guess that’s a type of pain.

They also open up the stomach, maybe 2 inches wide stitched opening. That never really bothered me, No pain from it. Maybe Because I was taking acetaminophen.

They will usually like to wait about six weeks before they activate the device. My case was activated in five weeks since I recovered so quickly.

@larryguyna
That’s one of the big benefits. No more leaking when you’re being amorous. Oral is again possible.

@jeffmarc

Thank you: it is good to know the pain is manageable with meds.

On this or another chat session several weeks ago, I remember someone mentioning pain for hours while standing. If I can locate the post, I plan to follow up with him and try to find out how his unbearable and almost constant pain was resolved.

@soli I'm on 10mg of Solifenacin Succinate per day. That seemed to do the trick.
It's worth a trip to your urologist to ask if the AUS will help in your case.
If these pills didn't help, my next step was Botox.

So you're ahead of me on that issue.
It's quite an invasive surgery, so it's worth asking if you need to resolve the OAB first.

@lagnafinc The device is activated 6 weeks after surgery, to give everything time to heal.
So nothing pad-wise changes for the first 6 weeks after surgery.

Once activated, it's just getting used to using the thing.
I did initially wear a thin pad for a few weeks after activation, but that was "just in case"... until I realised that I'm throwing away dry pads every day because they weren't needed.

So I think 3 months is plenty of time to get used to what your new normal is.
You may find yourself taking a packet of thin pads with you just in case, but the AUS should make a massive difference.

Just to add to that, you may get introduced to the wonderful world of climacturia (leaking urine at the point of orgasm).
The key to that is to pee as much as you can beforehand - go maybe 2 times within half an hour, just to empty.