AdVance sling 31 May 2011

It has been nine days since the installation of the Advance male sling. Tenderness is much less and the stitches are beginning to dissolve and drop off. On the whole, I remained stunned at how little pain and discomfort I experienced from the surgery. Additionally, I am stunned and amazed at how well the sling appears to be working. I wore a pad on the trip home from the hospital but haven't worn on since. I have not leaked one drop. I walked several blocks yesterday around the town square and never worried about spotting my khaki shorts. Normally, I am not that lucky when buying products and having them perform as advertised. I am taking it one day at a time but I am enjoying everyday that I do not need a pad or worry about leaking.

I spoke with a fellow who had the Invance sling (screws) installed two years ago and he wanted to know why I did not get the same sling. He is the guy who suffered for six months with post-operative bone pain and now wears a pad because he leaks getting into and out of a car.  Gosh, excessive pain and it doesn't work. Why, indeed, didn't I get the same sling?

I am giving myself a few more weeks before I attempt the ultimate stress test: the orgasm. Yes, it's that important.

The amount of leakage varied depending on what I was doing during the day. Standing for a long period of time or resting my rear on the edge of a table would make me leak more. Sitting for most of the day, not so much. I play a lot of golf and that didn't seem to make me leak excessively. Most days I would not feel as though I needed to change pads. If I went to Arizona in the summer, I seemed to leak more when I was hot. At night, I might leak a tad but normally the pad appeared dry in the morning. I never weighed the pads to get an idea of the amount I leaked per day, but I would guess 100-150ml on a heavy day and 50-100ml on a light day. That's just a guess. Overall, I rated myself as a light leaker two and a half years after the prostatectomy. I was at 5-6 pads per day after having a catheter for six weeks. I was using the male pads sold at Walmart (48 pack). They remind me of the old-style feminine napkins from the 60s and 70s: fairly thick and substantial.

I have noticed two odd sensations. One is the response of the Kegel muscles. I am able to do Kegels again but they feel much different, location wise. A previous poster suggested that the urethra is moved so the Kegel muscles can be more efficient. Something is certainly different, but in a good way. It's hard to explain but I don't feel the need to have strong Kegel muscles as a requirement to prevent leaking.

The other strange feeling is a full bladder. It feels differently now. Again, hard to explain but it is just an oddly different feeling when I have the urge to pee. Maybe not as much urgency and certainly not as much effort to hold it until I get to the bathroom. My stream is somewhat thinner than before the sling but there is still plenty of pressure behind the flow to eliminate in a normal time frame.

I stood for about an hour at a meeting last night as the chairs were too hard to sit on. I was thrilled to find that the wetness I felt in my pants was perspiration rather than pee. I considered it a valid test of the effectiveness of the sling, so far.

In your posts I think you used a raised toliet seat in early stages of recovery. I assume this reduces squat level and pressure on incision area. What type and size did you use. They come in 4,5 and 6 inch heights. Also padded or firm. Any advise regarding this.

Another fellow on these pages recommended a raised toilet. My daughter had one and I borrowed it not knowing the height (maybe 4 inches), but it is definitely hard. I only used it out of my concern for not stretching the groin area too much. The big warning from the doctor was no squatting, but I didn't ask if sitting on the toilet was considered squatting. I stopped using the raised seat today out of comfort and I'm tired of dealing with it. I felt no pressure, pain or stretching using the normal toilet seat. I think if I had used the normal toilet earlier, the sutures might have pulled more making it uncomfortable. The stitches are gone now and there is little tenderness around the incision. I don't think there is a problem now. Additionally, I used wet, flushable wipes to ensure I cleaned the area well. I take two showers everyday to make sure I'm clean. I don't want to have an infection caused by poop.

Do yourself a big favor. Start stool softners two days before surgery and limit yourself to a liquid diet at least 24 hours before surgery. You do not want to battle impacted bowels like I did. My bowels don't like anesthetia and I was foolish to eat a big meal the night before. What an idiot.

I am still amazed at how little real pain and discomfort I experienced. I could be lucky and I'll take it. Another fellow said he returned to office work two days after surgery and I was skeptical prior to surgery but I might have been able to return myself. An inflatable donut produced hot spots on my butt and I didn't like it. The best bet for me was a very soft cushion. Office chairs aren't the softest and I would take a fluffy pillow or something similar. A chair should have strong arms allowing you to lift yourself out of the chair with your arm strength while not putting pressure on your abdominal muscles. I stayed away from low chairs or a low sofa because I would have to bend too much trying to get out. I have been known to roll out of a low couch onto my knees and then get up from there. Fortunately, I am retired and have no pressing need to return to a hard chair.

My surgery was on a Tuesday and the doctor said I could drive on the weekend. I waited a full week and always take our Suburban. Having a car with a high seat is a real plus as there is no deep bending of the waist to get into and out of the car. I wouldn't even try to get into a Corvette for at least a month. Our other car is a  Nissan Altima, but I will avoid it for several weeks. As an aside, a friend who had the Invance sling (screws) says he leaks most when he gets into and out of cars. Stay clear of the Invance sling.

Jazzman, I believe the Cleveland Clinic has a doctor there that has done a ton of Advance slings.

Sounds like things are working out well for you. I've been following your updates with interest as I'm a pad or 2 leaker after 1.5 years and am looking at my options. I'm seriously considering the Advance but would have to investigate where and who does it in my area. The continence clinic asked me to try less kegels and drink at least 2 litres of water per day but this has worsened my situation to 2-3 regular size pads per day.

I'll be watching for more reports

thanks

r

It has been just over three weeks since my Advance surgery. I couldn't be happier.

Last week, I was moving in bed and lifted my legs a bit high and I had a small squirt of urine. At first, I was very concerned but I haven't leaked since. I figured I relaxed my pelvic muscles too much when I moved. In order to pee now, I have to consciously relax the muscles for the urine to flow. I must have done that on a fairly full bladder. It helps to keep your bladder empty by peeing every hour or two. Other than that one episode, I have been dry.

I had to dig to find a doctor that had done many of the Advance procedures. I just happened to find one here in the DFW area. I believe the AMS website (maker of the Advance) has a list of doctors who do the procedure. I was going to travel if needed. Cleveland, Norfolk and Boston have clinics that I contacted who have much experience with the Advance sling.

Ron, we have a muti-story home and I rode the elevator the first few days just out of fear of falling. Walking up stairs was no problem physically and there wasn't a restriction for me. I started using the stairs just to get exercise after sitting so long.

I highly recommend the Advance sling. It was nearly pain-free and works like a charm.

Great to see your update and hear things are working well for you, must feel amazing to have such a positive outcome. I'm hoping to have sling surgery in Toronto and recouperate at my son's house but he's on the 3rd floor and no elevator. I won't see my Uro for another 10 days but am hoping I can sway him towards starting referrals to get things going in that direction. In the meantime I'm running and lifting weights trying to get in as good a shape as possible should surgery be recommended.

thanks for the update.

Ron