Any experiences with Artificial Urinary Sphincter (AUS) or Sling?

Posted by 160972 @160972, Jan 17, 2023

Hello. Just wondering if anyone has a long-ish term experience with either the sling or AUS. I had a partial nerve sparing prostatectomy in 2018. I have mostly recovered ED issues, but urinary incontinence persists (1-2 pads per 24 hours-fairly light). I now am looking at salvage radiation for BCR, and have read and been briefed that both issues will get worse down the road. I'm 62, very active-run, lift weights, etc. Could easily live with the current state, but concerned about getting worse. Thank you for any input

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firespooks | @firespooks | Jan 17, 2023

I had the Sling installed 2 years after my prostatectomy. I was using 2 large pads per day. Then after the sling surgery, I’m down to 1 medium pad per day. I’ve had the sling since 2009. No complications so far . What I drink has a big impact on how much I leak. Coffee is the biggest offender. I still get frequent urges to use the restroom. I did not mentioned, that I also had 39 salvage radiation treatments 7 years after my prostatectomy. Hope this helps. Stephen.

budisnothome | @budisnothome | Jan 17, 2023

In reply to @firespooks "I had the Sling installed 2 years after my prostatectomy. I was using 2 large pads..." + (show)

I had rp in 2017. It came back in lower tummy. 35 radiation. Could not stop bleeding and clots. 40 hyperbaric chamber sessions to stop bleeding. Had aus installed Aug 21. Could not get it activated. Changed sides for the pump Dec 21. Nope. Emergency surgery Feb 22 to take it all out. Now going thru more. Had supra public catheter Dec 23.2022. Next week cysts to see if bladder ok. If ok reconstruct urethra which has almost closed due to aus cuff eroding urethra. Many more problems. If choosing aus 800 be sure your bladder and everything else is 100% working order. Too much can go bad if not is great working order. Check with Boston scientific who makes the aus to see if doc recommended and is able to handle problems.

John, Volunteer Mentor | @johnbishop | Jan 17, 2023

Hello @160972, I would like to add my welcome to Connect along with @budisnothome and @firespooks. I don't have any experience to share but thought you might find the following 2022 research article interesting if not helpful.

-- Artificial Urinary Sphincter Is Better Than Slings for Moderate Male Stress Urinary Incontinence With Acceptable Complication Rate: A Systematic Review and Meta-Analysis:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8863861/

jbuuck | @jonbuuck | Jan 18, 2023

I'm 61 and had similar complications as you following my RP in May of 2019. Based on the recommendation of my doctor at Mayo, Rochester, I had the AMS800 implanted in March of 2020. The surgeon who did my implant surgery reported that he does the most of these in the world. It truly has been a lifesaver, and it allowed me to go through my adjuvant radiation. I was using three large pads a day, and now I use one pad for "drips and dribbles" a day with no pad at night. I can tell that my AMS800 took some punishment with my radiation, but it still holds up quite well. As reported in another post, coffee does seem to compromise the functioning of the AUS, but once I'm through the first part of the morning (can't give up coffee!), I'm good for the rest of the day.

natem | @natem | Jan 24, 2023

In reply to @firespooks "I had the Sling installed 2 years after my prostatectomy. I was using 2 large pads..." + (show)

If I may ask, how many years after radiation before another recurrence, if any? Thanks!

firespooks | @firespooks | Jan 24, 2023

It went from 0.01 after my radiation treatments to 0.20 3 years later. I am now at 0.73 8 years later. Both my doctors want to wait for hormone therapy .