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Tallman's journey to Coloplast Male Sling

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Posted 2/4/2010 5:30 PM (GMT 0)

Yesterday, Feb. 3rd I had Colaplast Male Sling surgery at New York University Medical Center by Dr. Victor Nitti. I have posted about my journey on other threads but on the advice of the forum moderator am starting this new thread. Hopefully this information will be helpul to others.

My RP journey is noted in my profile so I will concentrate on the decision to do the Virtue sling.

Thanks to the help on this forum I have been studying sling surgery for about six months. After having all of the tests I concluded with the help of my urologist/incontinence specialist at U of MI Medical Center that i was a good candidate for a sling to fix my contined incontinence. She has done primarily InVance (one with the bone anchored screws) slings...about 70 of them. She has done only one AdVance and about 5 Virtues. I learned about Dr. Nitti from this forum and from my urologist. He is one of the 3 inventors of the Virtue. I considered Advance, InVance, Virtue and AUS. My incontinence is moderate to severe, dry at nights and when sitting but constant leaker when standing/walking about etc.

I felt I was not ready to go with AUS (the gold standard for incontinence fixes). More invasive, and did not like the idea of having to machanically use the pump. I ruled out InVance because of the more invasive bone anchoring and some reports of scrotal pain/numbness. Also, it is one of the older slings. AdVance is newer with a lot of data to confirm success rates. However, it appears to be better for mild to moderate incontinence. Virtue is new, out of clinical trials but very little data available and some reports of problems but also some successes on this forum. I called and talked to several users of AdVance, Virtue and InVance.

I decided to take the time and extra expense to travel to NYC to have Dr. Nitti do either AdVance or Virtue. During my pre op visit with Nitti Tuesday I made the decision to do Virtue. Dr. Nitti felt that my degree of incontinence was probably greater than indicated by my pad weights. Otherwise the FUDs test and cystoscopy indicated a sling could work. Virtue had more support and details on it can be found on some of the older posts on this forum. Dr. Nitti and his two co inventors have made some adjustments to the original procedure that they feel will improve results. Dr. Nitti is very careful to point out and very candid that there is not a lot of data and experience with Virtue. That said he does have high hopes that it is a "stronger" fix for someone with my degree of incontinence if proper procedures are used. It might be worth noting that he said if it was him he would probably do the AUS because of the almost guaranteed degree of success curing incontinence. However, he understands why so many of us choose to do the sling....we can always still go to the AUS later if the sling does not work and we are willing to incurr another surgery.

My operation was at 8:30 am yesterday, Wednesday. I did it as an outpatient although I originally planned an overnight stay in the hospital. Things went so well....as Dr. Nitti explained, exceeded his expetations he gave me the option to go back to the hotel. I got back about 3:30 pm yesterday. I have had some pain, aching of buttocks and inner thigh, about 6/7 on a scale of 10. After pain medication wore off from hospital I took a couple of Advil but not much help. Had a brief spell with nausea but recovered in about 10 minutes. Took the prescribed Percoset (only one pill) and have stayed on it since. Takes care of the pain/aching fine.

My wife is a nurse (retired) so we removed the catheter at 7:30 am this morning, Thursday.  Since then I have urinated three times for a total of 535 ml. Everything seems to be working fine. Good color to urine, fine control, good stream and no pain. I am a little stiff in the lower extremities and after about six hours the pain/aching comes back but fairly mild. Have taken the pain meds three times six hours apart.

My experience seems to have followed another guy I met on this list. If you see him on some of the other threads his forum name is RonJon. He also decided on Virtue and Dr. Nitti. he lives in NY. My experience so far seems to be almost identical to his and my condition prior to surgery was also very similar.

I will keep posting my progress and will be glad to respond to any questions/observations. Also, you can email me from my profile information. I intend to fly back to Michigan Saturday but could probably fly back today or tomorrow. But, my spouse is out spending money in NYC that may rival the cost of the operation. It might be worthing to note that my BC/BS incurance is a PPO. Dr. Nitti is "out of network" so I will bear 50% of his cost myself. NYU is in the network so my normal deductibles apply. Regardless, I am happy to incur the extra expense because of the high degree on confidence I have in this procedure and Dr. Nitti in particular. A key piece of advice is that whatever procedure you elect to have done make sure your doctor has done large numbers and has had good results.

So far I am a really happy camper smile smile smile

Posted 2/4/2010 5:46 PM (GMT 0)
tallman, excellent detailed account of this operation. i hope you get great results with it, it is a more involved op than i realized, so i hope the pain issue comes under control soon with you, and let the healing begin.

david in sc
Posted 2/4/2010 7:27 PM (GMT 0)
Thanks, I continue to feel more "normal" as the day goes on. Even going to fly back tomorrow. Dr. Nitti says I am progressing as expected.

The operation took about 1 1/2 hours. I had a spinal so could hear everything that was going on. Wish I could remember it all but I was not totally with it. No surgery is simple but in the grand sceme of things this was not all that bad.

I could hear such things as "he is a big guy" so we need to adjust this position etc. (6'4", 235 lbs). This is a teaching hospital so he had a couple of interns assisting.

 

Posted 2/4/2010 11:59 PM (GMT 0)
Tallguy: this is just GREAT news. I am so pleased for you.

Jeff T
Posted 2/5/2010 12:11 AM (GMT 0)
good stuff tall guy. I will be contacting you.

 

how do we get to profile to get your e mail?

Posted 2/5/2010 12:14 AM (GMT 0)
Just click his name and that will take you to his profile.
Posted 2/5/2010 4:07 AM (GMT 0)
Congrats, and I hope everything continues well.
Posted 2/5/2010 8:29 PM (GMT 0)
Day two following surgery.

Just got home to Michigan one day earlier than planned from NYC. Got out of Dodge early since expecting a big storm in North East. Traveling was no problem since my wife was with me to help with bags. A little uncomfortable sitting on plane but got lucky and was upgraded to first class. Not supposed to lift more than 5 lbs for six weeks. Very important until sling heals into place. Also worth noting that this expecially critical with AdVance. Perhaps somewhat less with Virtue because of stronger anchoring with the new procedure used by Dr. Nitti. But, can't count on that so very important to behave myself.

Progress still about as expected. Taking a Percocet about every 6 hours for minor pain/ache in inner thigh and buttocks. Also on antibiotics until tomorrow.
Staying dry so far with only a little residual dripping. A bit difficult to empty completely since stream is a bit slow. Need to push a little to get empty. Seems to be a result of pain med, some swelling/numbness of penis and scrotum. Dr. says my progress seems normal.

The meds can tend to constipate so I have worked to avoid that problem since there are stitches down there. Take metamucil every morning (have done this for years) and also a stool softener yesterday and drank a fair amount of liquids. Walked a good bit yesterday as well. Also used a supository this am and resulted in a good BM about 15 minutes later. Perhaps more information than some may want to hear but this stuff is all important to recovery.
Posted 2/6/2010 12:17 AM (GMT 0)
Tallman
Thanks for the updates. (And thanks for pointing it out to me!)
I am bookmarking this post so I can refer to it again. At the rate I am "improving" I have a fear that this might be my future. Thank you for clearing the path for me.
Jeff
Posted 2/6/2010 2:06 PM (GMT 0)
Day 3 following sling surgery.
Seem to be progressing as expected. Still taking pain med Percocet every six hours. Actuall went 8 hours over night and did not bother sleep. Pain not all that bad but at about 5 hours start to feel some minor pain around surgical area and inner thigh and butt if not laying down. Took last antibiotic this am.
Urination is somewhat slow but push empty. Seems to be a by product of pain med and still some swelling of penis and scrotum.
Feel great otherwise and am totall dry. A little in pad but think it is from not emptying completely. Did a good bit of walking yesterday getting from hotel at Times Square in NYC to airport gate and same when arrived in Detroit. Took about six hours travel time from hotel to our home and felt fine the entire trip. Got tired about 5 pm and took a little nap...surgery does take a bit out of you so still slept 8 hours and got up 3 times to urinate. Hope this gets down to perhaps one time after I get off pain meds and swelling/healing is complete.
Posted 2/6/2010 4:27 PM (GMT 0)
Thanks for the update. The pain and pain pill part is understandable, keep listening to your body' signals there. If you can walk that much, that would have to be a good sign. And that was a long trip to get back home, and you said you felt fine through it, that is good to hear.

Hope you continue to recover well.

David in SC
Posted 2/6/2010 5:30 PM (GMT 0)
Hey Carl,

 

thanks for the info via e mail. I will look at that video today. The words " am totally dry " in your post must have felt great to write. What differs with the colorpost procedure  from the AdVance? I'm off to google land. Put on some Springsteen and watch  the proceedure.

Posted 2/7/2010 2:47 PM (GMT 0)
Day 4 following surgery.
Progress continues. Took last pain med (Percocet 1 pill every 6 hours) at 1:00 pm yesterday. Took one Advil PM at bedtime. Slept 8 hours and only got up once. Pain has subsided a lot. Still have some tenderness around surgical area and some numbness of penis and scrotum. Urination is better now that I am off Percocet.
Wore only a light pad and briefs to bed and no leakage at all. Same so far this am.....seem to be totally dry. Yesterday did 1/2 mile on treadmill...slow walking and walked a while in local Walmart with no leakage.
Posted 2/7/2010 4:46 PM (GMT 0)
I did view the surgery video at Sentara General hospital by Dr Kurt Cammon in 2008. Really shows exactly what's done and how. Very educational. I think at some point I will have this done. The  6 to8 weeks down time is the real problem for me. The lost wages and inabillity to do my work is a real negative. I may have to wait untill I retire to be able to do it. That may be this fall if some things fall into place. It also may be a couple years from now. Thanks for the tip on the video. Hope you continue to heal and remain dry. It is really a quality of life issue that can be achieved with this operation.
Posted 2/7/2010 5:14 PM (GMT 0)
Wow, your daily reports just seem to be getting better and better. So glad to hear the news. Got to be giving you some confidence in the procedure you just went through. The proof is in the pudding, of course.

David in SC
Posted 2/7/2010 5:33 PM (GMT 0)
Carl,
I am reading every word in your posts ... two or three times.
You wrote "totally dry" ! Fantastic!
I have a question for you. You offered to let me call you but I'm guessing other guys like me might have the same question.
Can you blow your nose without flooding? The only time I can enjoy that simple pleasure is when I am standing in the shower or on front of the toilet with my pants around my ankles.
The next test would be when can you lift a 20 pound weight. But please don't rush things.
Thanks for helping a fellow leaker. 320ml/day
Jeff
Posted 2/7/2010 7:01 PM (GMT 0)
Worried Guy,
Actually, I have blowed my nose a couple of times....a bit gently since any pressure down there at this point is not good.
I will need to wait out the 4-6 weeks before trying to lift anything more than 5 lbs (gallon of milk) or do anythings else that might put pressure on that area. One of the big problems they caution you about is doing too much too fast. This is especially true with AdVance sling.
I am going to be a good boy because it would be stupid to mess this up by not waiting until totally healed.
Jersey City
There is also a video showing the Coloplast Vitrue Sling procedure if you want to see that one you can get an idea of the difference.
Purgatory
Yes, feels really good to be getting back to normal and really hope the progress continues and gives the proof in the pudding. Now that I am off the antibiotic and pain med I can go back to having my nightly single barrel bourbon or martini before dinner.....yah hoo!
Posted 2/9/2010 11:53 PM (GMT 0)
Day 6 after Virtue Sling sugery.

Progress continues with one week post surgery coming up tomorrow. Off pain meds for two days and no problem. Still some sensitivity when sitting but bearable. Worked in my home office chair slightly reclinging for for several hours successfully. All body functions normal otherwise. Should be back to work full time next week with no problem. Need to be careful that I don't try to do too much too soon while the inside healing continues.turn turn turn yeah

Posted 2/10/2010 3:34 PM (GMT 0)
Carl....

GREAT!!! Glad to see your daily posts show you've gotten the same excellent results with Virtue that I got.

We're both really lucky to have found this procedure and this doctor.  I will see him for my 3 month checkup in March and am curious if he's done others and is getting the same results.

I'm beginning to think Virtue will eventually replace AdVance, InVance and maybe even AUS

And to all those out there who are suffering from Incontinence, check "Virtue" out!!!!

rapids

 

Posted 2/10/2010 3:45 PM (GMT 0)
Question,

Did you guys get insurance to foot the bill, or is this considered "cosmetic "?
Posted 2/10/2010 3:52 PM (GMT 0)
I have BS/BC of Michigan. I was covered for this surgery. But, since this is a PPO and Dr. Nitti is not in that network his portion was covered only 50%. However, the NYU hospital is in the PPO network so it was covered with normal deductible/copay. I am medicare age but since still working I have coverage through my employer with BC/BS.

I think Rapids was Medicare and he told me his was covered as well but he can comment further.

Posted 2/10/2010 4:01 PM (GMT 0)
Ron,
Agree and thanks to you and this forum I was able to find Dr. Nitti and learn enough to decide on Virtue. It would appear that Dr. Nitti has only recently perfected the proceedure with Virtue and this may not be true with all doctors. Coloplast needs to get their act together and report some statistical results so others have better information to consider in their decisions.
I certainly agree that anyone considering sling or AUS surgery should check out Virtue in their decision process.

Today is Day 7, my one week anniversary of Virtue surgery continues with same excellent progress. Walked 3/4 mile on treadmill yesterday (snow outside) with no leakage. I am eating/drinking normally including coffee, nightly cocktail etc. with no adverse effect. I can even sit at my office desk in a very comfortable chair (leaning back) for extended time periods without pain. Sitting upright is still not very comfortable since surgical area (down there) is still healing.
Posted 2/10/2010 6:34 PM (GMT 0)
To Carl and Goodlife,

To Carl,

Great to hear eveything is going so well!! In my case, those slight pains I attributed to just healing, are completely gone. So I feel like I was before the prostate surgery, totally continent, except for a very infrequent drop or two. And I drink a lot of fluids (coffee, tea, water) during the day.

Goodlife...

I'm still getting statements, but in my case Medicare is covering their part, then it goes to my supplemental plan. So I'll be paying very little, if anything , probably just a deductible.

Since Medicare covers it and other plans generally  follow what medicare does and does not cover, I can't believe it's considered cosmetic. Check with your plan as well as any doctor you would use. I'm sure they can justify it.  If you are really serious, both Carl (tallguy) and I gave info in previous posts about the doctor we used in New York.

If we can help you in any way, please let us know.

rapids

Posted 2/10/2010 11:55 PM (GMT 0)
Tallman,

Thanks for this thread.  I am 3 &1/2 months post robotic surgery & use 5 to 8 pads a  day if I am active at all.  I can hold my urine if I am sitting or sleeping, otherwise it's a constant drip.  I will be following this thread eagerly to see of the sling continues to work for you.  Did your Dr. recommend a minimum time after surgery before going for the sling?  Also, was your incontinence history similar to mine & at what point did you decide that incontinence was not going to get better?  Last of all, did you do Kegels & if so, did they help you at all?

Posted 2/11/2010 1:40 PM (GMT 0)
Heavy Leaker,
Your situation sounds similar to mine. I was leaking this same way from the beginning. I did Kegals, physical thearpy, drugs imipramine/detrol, and electrical stimulation with no success. At about six months my uroligist/surgeon referred me to an incontinence specialist and we did all the pad weight testing at about 9 months and FUDs/cystoscopy etc. at one yery. At that point my Doctor said I was unlikely to improve further and recommended I consider sling surgery. This is about the same time I discovered this forum and began studying various slings and AUS.
Based on all I have heard you still have some time to expect improvement and it is worth trying everything including Kegals and anything else your doctor recommends. My history is in my profile below.
Feel free to ask more questions here as I am sure others can help you as well. Feel free to email me if you like. If you click on my name in the box on the left it wil take you to my address.
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