To SLING or NOT to SLING? 3 year post DaVinci

Some of you may remember my username. I've posted before on my trials and tribulations on first being Diagnosed with IBS back in 2005, then that DX changed to NET Carcinoid metastatic Tumor Cancer after a routine CT scan. A General Hemi-Colectomy in 2006, and my first Davinci by Dr. Orinstein,to excise twin carcinoids between my seminal vesicles,and outside of rectum...."Rectum!, I nearly killed em'"

The last "BIG" surgery was my second DaVinci Robot, for a RADICAL Prostatectomy with DaVinci, (not him, the robot) back in January 12, 2009. I am still incontinent. Little jimmy, still lifeless and remains limp. My wee wee doc told me after three years without an erection, the odds are against me to ever having a natural erection in my future. I saw another Urologist today, who talked about the SLING, and the AUS...Artificial Urinary Sphincter.

The AUS is a three stage approach, all I remember is a balloon, a cuff, and a Pump is involved,maybe much more. I don't feel I want, nor need that AUS, given that I am a "light' dribbler, so the SLING, if anything, might be contemplated.


The SLING method, if I choose this approach, sounds far less invasive. "Wrapping a mesh-like surgical tape around the urethral bulb, the sling gently and slightly moves the urethra into a new position that has been shown to be a method of overcoming incontinence. Something bothersome to me about this stuff...like, "Permanent sutures in the perineum may create some pain in the post-operative period.." "Bleeding and infection of the mesh or the bone or pubic bone, erosion,inability to urinate, or recurrent leakage." SUM FUN NOW!

This method says it's meant for guys with mild to moderate urinary incontinence..two to three pads daily. I only wear one per day, if I go out of the house. I did my kegals for the first six months after surgery to help strengthen my pelvic floor muscles, which i thought helped, but now when i have to go pee, at home, I sit on the john for about five minutes after the initial pee, otherwise I still dribble. I do have 'stop & go' control,but it seems to keep dribbling.

Either i go through with this, which may or may not help me, or get used to these diapers for the rest of my life. I am 57 years old.

FIRST I have to undergo a URODYNAMIC STUDY, which involved inserting a small Foley 7 Ga, not the 20-22 GA. they use for other surgeries.

Cystometry, also known as flow cystometry, is a clinical diagnostic procedure used to evaluate bladder function. Specifically, it measures contractile force of the bladder when voiding.

Anyway, up the peepee, then another tube into the 'other' orifice (down south) to check pressure. A little numbing and a little K-Y. (I've had many bad foley removals gone terribly wrong, so
forgive me if I get squeamish here, and hence, I'm a big baby..OK, you win, I am just that, when it comes to shoving tubes in to places where they have no bizness being. I will have to be awake to talk to the doctor and follow commands, but Antivan might come in handy for the anxiety..I'm only hoping. (fingers crossed)

Million dollar questions?
Has anyone personally gone through this SLING procedure, and are you better off now?
Any leakage?
Do those permanent sutures bother you?
Any regrets doing this procedure?
Any suggestions?

Thank you all! I always have the brotherhood here in my prayers, everyday!

Post Edited (unhappycramper) : 9/30/2011 9:09:03 PM (GMT-6)

Hey Unhappy
I too have been there, done that and got the GFMPH t-shirt. Tallguy was my mentor.

Check out Worried Guy's Incontinence Journey .

Get yourself a cup of coffee, sit back and peruse. It has everything you need.

I like my sling. It changed my life. If you leak less than 200 ml/day and have residual control, do it!
You can call me if you have questions.
Jeff

Sphincter-Sling Dude, Worried guy and Purg,
I can always count on your responses..thanks a bunch!

I read a few of your previous post tall guy and Worried. very Interesting stuff, indeed! Since my kegal exercising days from RP, to about six months post, I realized I was getting better and graduated from 2-3 depends daily, plus a bed pad for sleeping, to one pad a day, and no more bed pad sheets..

I went to see my uro last week, he had me drop my drawers and cough,and nothing came out, he was somewhat surprised becuz he thought ti was a heavy dribbler. Not that bad. His nurse told me I could have UTI's because of the somewhat dampness of my diapers.

For two and a half years I've been using one pad a day, I always clean down there whenever I think of it, so because of the fact I have not had any UTI's, should I still think about the Sling knowing I can not get 100% dry anyway???

I could live with this, without having either the FUDS, or URODYNAMIC STUDY, then progressing to the SLING. In your post Tall Guy, or worried, you mentioned AMS Advance Sling for slight leakers.....I'm assuming that would be me, with one diaper,IF I go out, and none if i stay in. I just make sure when I do pee, I get all of it out.

Would it be beneficial for me anyway to follow through with the FUDS, IF I'm not completely on board with going through with the SLING? WHAT A BABY I AM!!! Thanks again!

Post Edited (unhappycramper) : 9/30/2011 8:18:51 PM (GMT-6)

Hello unhappycramper,

I was implanted with a Virtue sling, without my consent, mid 2009 and it was a total disaster. I immediately went from 1-2 pads a day to 4-6 pads a day. The ongoing pain was intolerable.

During December 2009, part of the Virtue mesh was removed and I was implanted with an AdVance sling. It has been fantastic. I am 100% dry after using pads for 10 years.

I still suffer considerable pain from the remaining Virtue mesh that remains in my body and nerve damage from the Virtue sling fiasco.

If you go forward with a sling implant, make certain your doctor discloses the sling model you agree to on your consent form to minimize the possibility of a "bait and switch" disaster like I suffered.

Also make certain your doctor is very experienced with the sling of your choice and has a good success rate with this same sling.

Feel free to email or call me.

Best wishes,

John

Ok guys...Thanks for weighing in. have either of you checked out the videos prior to your procedures? To tell you the truth, I am a little, (ok, a lot) more paranoid after looking at the above video of the Advance Sling. How do I ask this Dr. If he's experienced in this, without giving him a complex, or any pressure to do a GREAT job?

So the permanet sutures don't bother you at all? I would think they would be there for eternally, and would get in the way, of whatever.

The first hurdle to overcome as a wimp,(due to extreme previously three catheter removals that did not go so well) is for the upcoming CYSTOSCOPY, or URODYNAMIC STUDY, which is freaking me out, I do have ANTIVAN, and the nurse told me to take some beforehand,to help with the anxiety. I would rather to put out, but they have to ask me questions during the procedure.

I think most guys tell the masses here in this forum that Cystoscopies and the like, don't hurt at all, that you only feel the pressure. YEAH, RIGHT! C'mon be truthful, if it's gonna hurt, it's gonna hurt. Why give someone a false sense of security, then ......"HELLO...WHAT THE %%$# was THAT?.....OUCH" then in alots of pain...I think I already have scar tissue from the Catheter being left in so long after RP.

They are going to squirt/inject Lidoocain to help numb, but i don't think there would ever be enough lidocain to numb what I am about to feel. Squeamish as I am, things are supposed to come out of that orifice, not in.

As little as I drip after going to the bathroom, Nothing during the night, just a few dribbles after I pee, I may undergo the upcoming study, but thinking twice about going through with this Sling-Thing, because a few dribbles are not that bad at all, compared to maybe a slip of the knife and possible unforeseen problems in the ER. Maybe something I can live with. I have been through four operations because of my cancer and my RP,and I don't like hospitals as much anymore.

Guys,
Did anyone ever hear of collegan injections to bulk up around the urethra ne k to stop moderate leaking.
len

Collagen in the urethra...My reg. Uro told me about another Uro that does that, but that other Uro never discussed that method, just the Sling, and the AUS. Besides, I think I have scar tissue from the surgery, so it might make it worse in that area.

Thank you for your candor guys. I guess that's what I'm more or less wanting to hear. Things like, "I do not want to tempt fate", and "I can live with the drip."

Guess I can 'think' that I can live with the minor drip, as long as it does not progress into more drippage from weak pelvic floor muscles, and I really hate saying this but things have been known to go bad during some surgeries, yet, if he is a competent Doctor, he should know his stuff.

I'm still on the fence, and still wondering, if I feel I do not want the sling for minor drippage, should I still go ahead with the URODYNAMIC STUDY, and exactly what that would that accomplish, I'm not sure. Maybe that would be further proof of percentage how bad I am down there with the pressure of this test.

I know it's all in my head, but lately, I've been dreaming primarily about the Uro Study with tubes up BOTH my orifices,then compliment that with the Sling surgery.....I am a wreck.

Anyone out there that has had the sling, but regrets it?

I was just putting it out there to see if the majority think that if I'm NOT going to go through with the SLING Procedure, would there be any benefit of going through with the URODYNAMIC STUDY anyway? All this is supposed to do is to measure the pressure in the bladder, I think.

I dribble far less than I used to,and wear a pad a day when I go outside, weather I think I need it or not. DEPENDS cost cheaper at Costco,than anywhere else, I feel, so if I can with that that, then I don't want to temp fate.

This is something I can live with, but just wanted to know if I should go through with this study in two weeks, or cancel. Some say the Cystoscopy doesn't hurt, yet others say it's most excruciating, so I don't know if it's worth the possible pain, or who to believe, whether it hurt or not. I'm a big baby, I guess, not a glutton for punishment.


Almost three years out of RP, do they still think KEGALS are beneficial for strengthening the pelvic floor muscles?

I can highly recommend the Advance Male Sling. After 3 years of incontinence the AMS made me totally dry and have been that way for almost 3 years.

I am probably at the same point as you are, to sling or not to sling. My Uro doesn't want to discuss the sling yet. He is suggesting collegin injections in the area of the bladder neck to bulk up the area. The injections are done on an out patient basis. A needle is inserted into the pelvic region. He says that this proceedure can stop moderate leaking.
I think I will give it a try in February rather than the Advance Sling.
Any thoughts?