AMS 800 and Virtue Sling Journey

I am now the proud owner of an AMS 800 artificial urinary sphincter implanted at U of MI by Dr. Jerilyn Latini on 7/8/10


Got to the U of MI hospital Thursday at 6:15 am to begin antibotic loading via IV. After consult with Dr. went to la la land at 8:30 and woke up about two hours later in recovery.

BIGGEST SURPRISE WAS THE VIRTUE SLING INPLANTED IN FEBRUARY ALMOST MISSING IN ACTION. It was almost out of sight. As a result they did not have to remove is since it was not in the way. If you read my previous thread started back in February on Tallmans Coloplast Sling Journey you will see how I started out pretty continent and gradually slid back to where I was pre sling. I may post more on this later after I consult more with the docs about the sling and it's remaining there along with the aus. Should be something to learn here for the pros as well as us amatures/victums.

Back to the surgery. Looks like everything went like expected. Two incisions, one in the perineal area between scrotum and anus and one above the package in same incision where I had a hernia fixed 40 years ago. She incised in the same place both where the cut was for the sling and where the hernia was done. Incisions are over two inches long. Pain is not bad at all. Some stinging around the upper incision but not bad unless I squirm too much. Willie and the "poor boys" look fine. The boys are a little swollen buy not as much as I expected.

After the surgery I was in the recovery area for a couple of hours where the antibiotic IV was started again and continued until I was released at noon today. I was starving after fasting since midnight so they were generous and gave me a couple ice chips to chew on. I was then moved to their overnight/short stay unit. Same place where I recovered when I had RP two years ago and similar to what I was in at NYU in NYC for the sling surgery. Had great nurses and great attention the entire time. Finally got some beef broth and jello mid afternoon and then a nice turkey dinner about 5:30 pm.

The assisting Drs. stopped by about 2:30 to check on me, Willie and the boys. This is a teaching hospital so they usually have one or two neophytes in tow. My surgeon Dr. Latini (A really nice, very attractive young lady with wonderful mannerism and a highly skilled surgeon)stopped by about 6:30am after doing two more AUS that afternoon. She told me about the "hidden sling" and plans to talk to Dr. Nitti who did the installation to ponder what happened. She actually could see/feel part of it but it wasmostly out of sight and she did not want to "cut and explor" for no good reason. On a side note, I now wonder if I should have stayed at U of MI and had her do the sling. She had only done 4 Virtues and was doing mostly AMS Advance for slight leakers and for more heavy leakers like me was recommending the "bone anchored" Invance. She supported my decision to have the Virtue done by Nitti since he had done many more of these and is one of the co inventors. Regardless, no reason to look back. Both of them told me the AUS was a better bet given my leakage....but stubborn me, I had to try the other first....no regrets....just second guessing.

So, I had a relaxing night at the hospital. We live about a 45 minute drive away so my wonderful wife of 37 years went home for the evening. She is a long since retired RN so she watchs me very closely. Had a little trouble going to sleep so took another pain pill and a sleeping pill. Finally go to sleep about midnight since my sleep pattern was interrupted by the nap during surgery. Woke up wide awake about 4 am, brushed my teeth and shaved just to feel normal. All three Drs. arrived at 6:15 on morning rounds to again check on me, Willie and the poor boys. Dr. Latini gave me a lesson on how to "tug" on the bulb in my scrotum twice daily to ensure that in heals in the proper place in the scrotum. Evidently it can work its way up a bit and make it more difficult to activate. I was surprised that I have no soreness at all in the scrotum.

Had a nice breakfast at 7:30 am and it took the rest of the am for the antibotic IV to empty have the catherter pulled and make sure I could urinate OK. No problem, I even made it to the toilet without leaking two times before checking out. I will be on antibiotic pills for a week...they are really big on that to prevent any infection. Also have prescript for pain pills as needed but if like surgery before I will only need them for a couple of days. I also will be rubbing bacitracin ointment on the perineal incision three timse per day. I have to wait until getting home to shower so may get a bit "ripe" by morning. Typical instructions not to lift more than 5lbs for six weeks and avoid anything that strains those areas like bending etc. I have a follow up appointment with Dr. Latini in two weeks. I intend to recover at home and return to work a week from Monday. Office job so may do half days depending on how I feel.

Made a new friend in the stall next to me that is my same age and had the AUS just after me by same Dr. I suggested he join healing well. He had his RP in 1999. Was only using one light pad until he had a blockage. When the blockage was fixed he became free flowing and "lost his life" and hopes to get it back with AUS. Perhaps we will see him here......

Perhaps more than you wanted to know but if anyone has questions let me have them. So far not a bad experience at all. I will post updates when anything of interest happens.

Post Edited By Moderator (James C.) : 1/17/2011 8:00:41 AM (GMT-7)

Hello Tallguy,

Wishing you a full and speedy recovery. Please keep us informed as you learn more about the "disappearing" Coloplast Virtue sling.

Best regards,

John

This is the one week anniversary of my ownership of the AMS 800 artificial urinary sphincter. And, I am probably the only dude on the planet with both a Coloplast Virtue Sling and AMS 800 in place at the same time. Guess I should change my alias to Sphincter-Sling Dude. As noted in my first post, we assumed sling would need to come out at least partially to make room for the AUS. Since it was not in the way and barely visible the surgeon decided to leave it in place rather that slicing and diceing to remove it. So far so good. My recovery is going pretty much text book. Was on narcotic pain meds the first two days and then stopped and am now doing Advil only. Will be on 4 antibiotic pills per day for two weeks. Pain is gradually receeding and is mostly from upper incision, NorthWest of the penis. Same spot where one would have a hernia fixed. Pain (more like an internal sting) is not bad and comes only when twisting or standing/sitting. This one still has the steri strips in place. Both incisions are doing fine with no leakage/seeping. the lower one is a long one starting near the anus and running a third of the way up the back side of the scrotum. It did not have strips applied. I add bacitracin ointment to this one twice daily. Looks like the Doc did a nice job. Interesting to note that the Doc that did the sling incised the same spot (only smaller) and he put a varnish type of covering over the stitches that took a couple of weeks to wear off to protect the area. This time they did not do that. Different strokes for different Docs. Willie and the "poor boys" are doing fine. The boys are still a bit swollen and the scrotum is still tender to the touch but no pain. The swelling makes for some "adjusting" when trying to sleep on the side and I use a leg pillow (Wal Mart special) to keep separation in that area.

Another interesting thing to note is that my leakage/incontinence is about the same as the first week after I had the sling implanted. Pretty good control and I don't seem to leak much. This was the same after the sling but each week the leaking got progressively worse. I suspect it may have been because of the swelling helping close the sphincter. Is that the case now or with the addition of the AUS is this adding some bulk in there that is helping close the sphincter? Will I even to activate the AUS? I am guessing yes and as I begin more activity and swelling goes down i will start leaking more.

Well, that's the latest. For you dudes considering the AUS this is not half bad. about the same as getting the RP done or having a sling installed. I intend to be back to work next week at least half days. I have been working from home most of each day. Take a little time for 2-3 15 minute walks and a short afternoon nap each day.

Stay tuned for more if interested! I will update again in a week or so unless someone has questions before.

My Cystoscopy is scheduled for early Sept.
By the way; what is a FUDS test?

Spacer,

FUDS stands for flrourodynamics tests. I had both it and the cysto at the same time. If I remember right the FUDS is when they fill the bladder, see how much it holds and how well you can hold it. The cysto, if I remember right, is the camera that lets them see what is up/in there. These tests give them a better idea of how well your parts are looking and functioning to determine if you are a candidate for either a sling or AUS.

Wiggs,

Thanks for the encouragement. Really helps to hear from you guys that have been down this road.

I see you also have the penil implant. Are you satisfied with it? Also, how was the surgery and recovery compared to having the AUS done? I may be in line for the penil implant but not excited about going through another surgery and beind out of commission for another time.

All,

I will cross the two week anniversary tomorrow. Things seem to be healing according to expectations. Pain is pretty much gone. "Willie and the poor

boys" seem to be doing fine although I do still have some light soreness around the lower stitches and some soreness/tenderness of the scrotum...and still some swelling. Am back at office work for 2-3 hours starting yesterday and doing fine. I get a little spotting on the pad I wear since I am now sitting more. Need to tay and avoid sitting on that area and putting pressure on that ares. Need to sit more on buttocks according to directions. Hard to do when getting in and out of car and driving.  Upper stitch still has steri strips on it and seems to be doing fine. Another guy who had surgery the same day had his strips fall off the first week. Says his upper stitch area is slightly raised and hard to the touch for a half inch area. Mine does not seem to feel that way but perhaps the strips are hiding that feeling. The AUS bulb seems to be in the correct place on right side of scrotum. I am supposed to pull down slightly on  it 2x each day to ensure it heals in proper place. Seems to be plenty low enough. I can feel the tube running upward and it even has a slight kink in it so it would appear to be as "low as it can go". Anybody have experience with one not staying in place?

Doc recommended putting bacitracin ointment on lower stitch 3 times per day. Did not say when to stop. Wife/nurse thinks I should stop since it tends to keep that area damp. Anyone else know about this?

Have follow appointment with Doc next Wednesday and will report again then. Stay tuned. Can't wait til I get this bogger activated.

Tallguy,

I am five months past activation of my penile implant. I am satisfied with it, but I understand that "things" get better with time.

Wigs

Tallguy,

I feel they are pretty much the same. Post surgery discomfort. Two incisions; scrotum and lower abdomen. Approximately, six weeks recovery time. Activation, training visit.

Wigs

Had my AMS800 activated June 7th. I can't compare it to canned beer, but it really beats being wet all
the time. This has been one of the most uncomfortable operation I have had since a meatomy back in
1999. At this point there is still some discomfort where I imagine the cuff to be. All things considered,
I am satisfied with the device.

Spacer,

Sounds consistent with what the Doc was telling me prior to doing the Virtue sling.....he would go for the AUS if he was in my place. I was too stuborn and wanted to try the Sling first. Cost my insurance company a bundle and me a little pain and suffering and wasted 9 months in the process. These are often tough decisions but usually it's best to trust your Doc.....and learn as much as you can from this forum before making a decision.

The last couple of days the soreness/tenderness and swelling all seem a lot better and I am now pretty much back to where I was prior to having the AUS implanted three weeks ago yesterday. Still not supposed to lift or strain anything for another six weeks.

tall guy, hang in there, you are so close now to activation, and i hope its all that you need it to be when the time comes. glad you are holding you own through this waiting time

Progress update: Tomorrow will be my six week anniversary of having the AMS 800 artificial sphincter implanted. It might be interested to anyone following this thread that it has taken almost all six weeks to get back to what I will call a comfortable feeling in the lower parts. I have not had any significant pain for 3-4 weeks but there was still considerable soreness/numbness in the scrotum area. This made it uncomfortable to walk and sit. This last week I can say that I am pretty much back to normal for sitting and walking. This is very similar to my experience with the Virtue sling I had implanted back in February. We tend to forget that it really does take the body about six weeks to heal after one of these procedures.

Six weeks is also the time line for activation of the AUS. I had to delay my appointment that was supposed to be this Monday so it will be next Wednesday. This will be the day of recogning. After two long years post RP I am ready to be dry. I will report again next week to describe what happens at the activation appointment and immediately following.

Hello Tallguy,

Please know you have my very best wished for a DRY activation. After all that you have endured for "the cause", you certainly deserve a good outcome.

Best regards,

John

Jersey,

Good to hear from you..again! At a mild two pads per day it sounds like you may still have dry hopes. I pray that you do. Assume you are OK sitting and at night. I am again at 2-3 fairly full pads (even with my sling in place) during the day and one light one in the evening. If I sit a lot and head to the potty immediately after getting up I can get by with 1 or 2 less pads. Don't use anything when sleeping but still get up 2-4 times at night depending on liquid consupmtion. Bladder shrunk so we are hopefull this should correct it once I can get some help squeezing my pipe.  Also, I still have my evening cocktail (or two) and that is good for my mental health but not for the getting up thing. Also have one cup of half decaf half regular first thing in am. Bottom line is that I am leading the life I want to lead and could honestly have a very decent quality of life this way if I had to. That said I am still glad I am doing the AUS, assuming it gets me out of pads. Most guys with AUS seem to still wear a light panty liner just to catch the occasional leak but that's a lot better than those bulky Depends and Tena jobs I wear. But I am rambling...just hope that some of these comments are helpful to guys like you that are still on the damp fence. More next week after we turn on the magic switch and I learn how to pee all over again.