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Male Sling for Incontinence

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Posted 9/30/2011 10:02 PM (GMT 0)
I am now almost 11 months past my robotic radical prostetechnomy.  My leakage is now down to an average of 2.3 ounces per 14 hour day, which usually means 2 or 3 pads per day.  I'm womdering about a male sling as a way to get to zero leakage.  Does anybody have experince with a male sling, and if so, what kind?

Thanks,

Reminderman

Posted 10/1/2011 12:38 AM (GMT 0)
I've got no advice for you, but I'm just about exactly where you're at in my journey, so I'll watch this thread with interest.
Posted 10/1/2011 3:40 AM (GMT 0)
Dear reminderman,

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
Posted 10/1/2011 12:37 PM (GMT 0)
Dear reminderman,

You should contact Worried Guy in this forum. He was our host last weekend for GFMPH gathering and has a successful Advanced Sling that keeps him dry. He would be an excellent mentor for what you are going through.

Good luck

Terry TWG

Posted 10/1/2011 5:21 PM (GMT 0)
Thanks to John, Terry and Jazzman for your replies. They are very helpful.

Reminderman
Posted 10/1/2011 6:04 PM (GMT 0)
Zero leakage may be a tall order. Worried Guy and Male_Sling_Problems are both happy as clams with their Advance slings, and I'm sure there are lots more success stories. On the other hand, success isn't universal. I stumbled on this Advance Sling study from last year, which defined objective success as "pad-free or a reduction to 2 or less pads daily":


J Urol. 2010 Jan;183(1):247-52.
Patient perceived effectiveness of a new male sling as treatment for post-prostatectomy incontinence.
Gill BC, Swartz MA, Klein JB, Rackley RR, Montague DK, Vasavada SP, Angermeier KW.

Source
Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio 44195, USA.

Abstract

PURPOSE:

Objective measures show the AdVance() sling provides some benefit in post-prostatectomy incontinence. To our knowledge no validated, patient determined outcomes have been used to assess this procedure. We described the patient perceived effectiveness and postoperative complications.

MATERIALS AND METHODS:

A retrospective chart review was followed by a telephone survey consisting of the Patient Global Impression of Improvement, Patient Global Impression of Severity, and questions about recommending the surgery, daily pad use and complications. Successful outcomes were Patient Global Impression of Improvement responses of very much better or much better without further incontinence treatment. Objective success is defined as pad-free or a reduction to 2 or less pads daily.
RESULTS:

A total of 35 patients received the sling a median of 25 months after prostatectomy. Telephone surveys were administered a mean of 35 weeks after the sling procedure and 33 patients were contacted. Of the cases 18 (51.4%) and 21 (60%) were patient determined and objective successes, respectively. Of the patients with subjective treatment failure 3 would recommend the surgery to a friend and 12 were undecided or would not. Furthermore, no patients with subjective treatment failure were pad-free and 10 (58.8%) had pads that were mostly wet on changing. For the entire population a reduction in median daily pad use from 2.5 to 1 was observed as well as a strong association (p <0.01) between Patient Global Impression of Improvement and Patient Global Impression of Severity responses. Three individuals pursued further treatment with bulking agents and 3 had retention that resolved.
CONCLUSIONS:

The AdVance sling is safe, and demonstrates similar subjective and objective outcomes. The procedure can benefit some individuals with post-prostatectomy incontinence and, therefore, may be another treatment option for this condition.
Comment in

J Urol. 2010 Jun;183(6):2468-9; author reply 2469-70.
Posted 11/29/2011 11:12 PM (GMT 0)
I'm checking in since posting my question in early October about the success of male slings.  I appreciate the abstract on the study by Cleveland Clinic on subjective success rates.  Read some other threads and there seems to be various experinces on the amount of problems during recovery from the sling implant. Are there any new comments about recovery problems?  Before my prostatechnomy I had pudendal neuralgia but none since prostate was removed.  But I'm a little concern about the sling surgery irritating the pudendal nerve which is in the area of the perenium.

Thanks,

Reminderman

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