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AdVance sling 31 May 2011

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Posted 1/4/2012 12:45 AM (GMT 0)
Bill,

I went through the test you describe too, and that, along with my reported pad weights, may have been what my doc based his assessment on.

To answer your question, I was generally using 2-3 pads daily, usually three. That, however, is kind of an imprecise measurement. Worried Guy (a great human being and certified data freak) encouraged me to weigh my pads, which I have to admit sounded a little nutty to me at first. However, doing so did give me a pretty objective measure to take to my doc. That might be moot for you at this point, although you might try it for a few days to see what you come up with.

You won't be surprised to learn that my daily output varied a lot based on activity levels. On really active days I leaked as much as 175 grams. On less active days I leaked as little as 25 grams. My average over eight weekends was 87 grams. Please don't tell Worried Guy I rounded these to whole numbers; it would break his heart. ;)

Good luck with your surgery, and feel free to email me if you have questions or concerns. I understand looking forward to getting this over with. That's where I was three weeks ago. Surgery is always a drag, and this one is uncomfortable, although not very painful, to recover from. Hang in there and keep your eye on the prize. I think you'll find this worthwhile.

Jonathan
Posted 1/4/2012 1:53 AM (GMT 0)
Hello questionaboutit,

I was first implanted with a Virtue sling by Coloplast 2 1/2 years ago and the outcome was terrible.

Five months later, a portion of the Virtue sling was removed and I was implanted with an AdVance sling by American Medical Systems.

The AdVance sling has been fantastic. I am now 100% dry after using pads for approximately nine years.

Just do your research (due diligence) and choose the model of your sling and surgeon very carefully. By doing this, you should have a good outcome.

Best wishes,

John
Posted 1/4/2012 6:59 PM (GMT 0)
Hello questionaboutit,

I'm scheduled for the Advance sling implant in a couple of weeks. I was almost totally continant until I went through IMRT radiation9 months ago. Then the leakage started getting progressivly worse in the last 7 months, thus the reason for pursuing the sling implant.

I would keep trying the kegels exercise to achieve continence. You are only 3 + months out from the DaVinci Sept. 9, 2010 surgery. It took me almost 6months to achieve continence 99% and getting ready to turn away from the pads until my radiation turn my leaking around.

If I were you I would continue the kegels for a few more months and I'm sure you will beat the leaking. If you can stay away from another surgery that would be great.

I don't know about the womens sling, I have researched it and it has it similarities but the Advance male sling seems to have made considerable headway in the last few years. I'll let you know in a few weeks.

Implanting around 300 slings sound good to me. If the doctor excelled by now he should get into another profession. He would be my doctorof choice based on that experience.

don't go by the TV ads for lawyers as they are money sharks.

Good luck with your decision.

Bill
Posted 1/4/2012 7:04 PM (GMT 0)
Hello questionaboutit,

after reading my post I lost track of the years and it appears you are 15 month out..sorry about that. but one pad a day is not bad. But if your not happy you have to do what you have to do. Thats why I'm going for it myself. I'll keep you informed of my progress.

Bill
Posted 1/4/2012 11:54 PM (GMT 0)
A few thoughts:

I think the issue of whether you want to subject yourself to sling surgery is a quality of life question. If your incontinence is minimal and doesn't bother you, why go through it?

I'm not sure what you mean by an "implant." If you mean an artificial urinary sphincter (AUS), I think the sling is generally preferred for men with mild to moderate incontinence. It works quite well, is less invasive and requires no manipulation to use. I asked my doc about an AUS and he suggested it would be overkill.

As far as experience level goes, I suspect 300 surgeries is a pretty good number. Sling surgeries aren't prostatectomies. There aren't nearly as many patients for these procedures and the surgeries aren't nearly as complex. Personally, I'd have a pretty high level of confidence with a doc who has done 300 sling procedures.

Good luck, whatever you decide.
Posted 1/5/2012 11:47 PM (GMT 0)
I'm in agreement with jazzman1's thread on the quality of life issue. If the small dribbles are boyhering you theh you should think sling. But with that amount you say happens you should just stay with a pad if needed.

If a penile implant is not good enough for intercourse what's it good for then a short clothes pole hanger. If your serious about this implant you should research some other doctors. There any many new drugs that you should try first to correct this. good luck in your pursuit of happiness.

Bill
Posted 1/14/2012 2:35 AM (GMT 0)

It has been three months since my Advance sling procedure. I am still happy with the procedure but I do leak a little when my bladder gets too full and I'm too lazy to get up and go to the bathroom. Being over 50 (63), men can never get that last drop out anyway and I am no different. I'll have a spot on my briefs every once in a while. Additionally, if I slouch on the couch too much, I might leak a drop or two. I call it "positional incontinence." However, I have not worn a pad since the day I left the hospital and don't feel the need too.

Sex had been my greatest concern, but I do not leak during an orgasm. I do take a good leak beforehand as a preventative measure.

As far as law suits from female sling procedures: I believe the sling and the procedures are much different than the procedure for males. I have not heard of any probems with the Advance sling, however I have heard of a few suits for the older Invance sling that is anchored with screws into the pelvic bones.

My urologist asked me if I had any radiation treatment prior to getting my sling. Radiation really screws things up internally and it might affect the performance or the placement of a sling. Please check this issue out with the urologist. I had the feeling my urologist would not have done the sling if I had had radiation.

The AUS implant concept has two components. There is the urinary artificial sphicter and then the penile implant for erections. Men can have either or both of the items installed depending on their problems. For light leakers, the artificial sphicter is overkill and much more invasive than a sling. If a fellow is more than 2-3 pads per day, then I'd look at the the artificial sphicter. If you can't get an erection at all, the penis implant is probably the only thing left to help.

Urologist have their favorite procedures and will try to sell you what they are comfortable with. Please do your own research and make your own decisions. If you are not bothered with what leaking you might have, don't have surgery. Surgery and hospital visits are not my idea of fun. I did my sling procedure as a quality of life issue as I was sick to death of wearing pads and feeling like a freak. Fortunately, all went well.

Posted 1/14/2012 3:38 AM (GMT 0)
Hello Bizman42,

It was great to read that everything is going so well for you. One more victory for the AdVance sling.

Best wishes,

John
Posted 1/14/2012 3:58 AM (GMT 0)
Since we're posting sling updates, I'll post mine here.

Next Tuesday will be four weeks post-surgery. I was elated with my results at first, and reported here that I was bone dry.

However, I found when I was able to be more active that I still leaked when walking any distance. I'm pad free when relaxing at home or working at the office, but if I walk a couple blocks, I need a pad. I don't know if it will get any better with more healing, but I'm inclined to think this will be it.

I was really upset about not being totally pad free, but I have to admit that things are substantially better. Going from three pads a day to one is progress, and I guess being happy with what you've got is the secret to happiness.

I post this mainly as a gentle reminder that you can't always count on having the best possible outcome. My doc told me two-thirds of his patients are pad-free, and it's always tempting to think that you'll be one of the lucky ones. But somebody has to be in that one-third group, so anyone who's contemplating this surgery should look for improvement, not necessarily perfection.
Posted 1/14/2012 12:31 PM (GMT 0)
Hello Jazzman1

Happy to read you remain greatly improved but also disappointed you are not enjoying total dryness.

You might try urinating every 30-45 minutes during the day, and before going for walks, to keep your bladder pressure low, and see if that helps.

You might also benefit from continuing with the Kegel exercises, especially when you urinate. Try 5-6 good squeezes after your stream stops to squeeze out the last few drops and strengthen your sphincter muscles.

Best wishes,

John
Posted 1/14/2012 2:43 PM (GMT 0)
Good thoughts, John. Thanks.

I'm trying the tricks you describe (and then some) and hoping they'll make a difference as I heal more. I am disappointed at not having achieved the absolute dryness I had hoped for, but I'm also trying to appreciate the fact that my condition is significantly improved.

It is a drag to find out my problem isn't completely solved, and it's sobering to observe in oneself how people hear what they want to hear. When the doc said that two-thirds of his patients are pad-free, my mind went straight to the expectation that I'd be pad-free. I know better, of course, and I understand statistics as well or better than most. I knew I had a good chance of being something less than pad-free, but that wasn't where my mind took me.

I do think it's important for guys on this journey to try to be realistic, and to keep some perspective. You have the choice of being grateful for what you have -- or being depressed at having had your hopes dashed. This applies to post surgical pathologies, ED, incontinence, sling surgery outcomes and more. Hope for the best, but try to keep expectations realistic. Try to keep some perspective about the whole thing, and be grateful for what you have. I guess that's the key.

Jonathan

Post Edited (Jazzman1) : 1/14/2012 7:58:04 AM (GMT-7)

Posted 1/14/2012 4:51 PM (GMT 0)
Jonathan,

I am sorry you did not get the best possible outcome. I was excited and happy for you after the initial reports. I am still happy that things are improved. Your post summarizes it well for all of us on this journey. Here is to more progress for you!

Posted 1/14/2012 5:38 PM (GMT 0)
OK, I'll give you my one year update.
At my behest, my sling was put in tight! So tight I could not urinate and had to be emergency catheterized. I figured once this healed I was "golden".
At one year, in the dead of winter with a relative humidity of <35% I am at sub observable leak. That means my underwear is perfectly dry but has a yellow stain indicating some leakage.
You know me. I must quantify this. Using a procedure too disgusting to go into on a public forum, I have determined my actual leak is about 5 ml per day. I will be totally dry if my bladder is kept to below 250 ml. I will spill over if I let it get to 400ml. I also will also produce some leak after urinating if I do not empty myself. That involves alternating between pushing my perineum, kegeling, and pushing just above the shaft. If I could wring it out I would.

I decided to use the cheapest pad Walgreens has to offer and cut them in half. I then stick a handkerchief inside my underwear to further save on pads. I have also optimized what and when I need to drink. It is a small price to pay for dry pants. Life is good!

J
Posted 1/14/2012 7:06 PM (GMT 0)
Good tricks, Worried Guy. My leakage has occurred while walking 1-6 blocks, and I always urinate just before leaving the building. Maybe I need to wring the serpent a little harder, although I always take my time and wait for those last few inevitable spurts that I never used to have to wait for.

Pushing on the perineum is out of the question just now, but when I heal up some more I'll give that a shot too. Maybe this will be more manageable in the long run than it now appears.

If you had told me a couple years ago I'd be writing this kind of stuff, I would have written you off as a nut case. The changes that time can bring...
Posted 1/17/2012 7:45 PM (GMT 0)
Jazzman,

I think you have read my stuff so you know that my sling did no good at all and that i ended up with the AMS/AUS. I was in the bad 1/3 also or for me it was more like 1/10. At first i thought I was going to be dry also but as the swelling went down and i did more activity I returned to about where i was pre sling. Hope yours will not go that way but know that the AUS is still there if you end up needing it.

Worried Guy,

I LOL when I read your comment about squeezing it to get those last drops out. If you do that right it might even be fun! tongue

Posted 1/18/2012 7:38 PM (GMT 0)
Jazzman,

Sorry to hear you're still leaking a bit post sling, however it does seem that your leakage has been reduced by 2/3's. I'm going for cyctoscopy in early March and am hoping doc recommends the sling before artificial spincter. I guess we can always do the a. spincter if the sling proves innefective.

r

Posted 1/19/2012 12:37 AM (GMT 0)
Thanks, Arch. You're right; the problem is two-thirds solved. Perspective is everything.

Actually the problem is nearly 100 percent solved when I'm inactive. I can drive to work, sit around the house or the office, mosey over to get a cup of coffee or visit a co-worker, and even slowly walk up or down the stairs -- and stay dry. But if I walk more than a block at any kind of normal street walking pace, I leak. So I guess it's a pad for that daily walk.

Things could be worse. In fact, they recently were. Unless things deteriorate from here, I doubt I'll ever be an AUS candidate. I'm hoping I don't go the way of TallGuy. You've got to really be motivated to go through these surgeries more than once.
Posted 1/19/2012 7:23 PM (GMT 0)

Gentlemen,

I crossed the bridge on Monday 16 Jan and had the Advance Sling implanted. I was really amazed that this was an outpatient procedure. The surgery went extremely well and when I awoke I was suprised to find that I had no foley inserted like they said I might have after the procedure. I was told that they did some test during surgery and determined I would be fine without it.

Upon waking I urinated twice @ around 200cc's each time and another 150cc after being wheeled to my room to await my release to be on my way home after 8 hours start to finish...I love modern medicine.

I was a bit tired and rested the comfortably the rest of the day without much pain, but did take the precribed pain meds as needed but kept them to an extreme minimum. My urinating has been normal with no flow issues and going as needed like it used to be when normal before my prostatectomy.

Day 2 - I felt pretty good without much pain while keeping my diet mainly on soft foods for the fear out getting blocked up even though I took stool softeners 2 days prior and after surgery.  This was a good move as on day 2 relief came without any problem and I did take the advice of the raised toilet seat that makes it much more relaxing. I graduated to solid food at dinner on day 3 still with no blockage problems. 

Days 3 and 4- I'm doing basically the same thing just taking it easy, moving slowly, lying down on occasion and relaxing in a soft comfortable chair which I stress is a must as my under carriage is still pretty sore along with the groin area. It feels like I caught both games of a double header with that type of muscle soreness in the surgical area. I'm also nursing along a swollen scrotum with ice packs, that is slowly getting back to looking like it should (Let me stress slowly)

The good news which I have been saving for last is that I have been dry so far for 4 days now. I hope this isn't false hope like Jazzman experienced and I can see why it would be a downer for him.  But so far so good.

 I'm trying to take things easy like I was told too even though it is very hard to do as your brain responds before you realize you are  starting to do something physically which is restricted.  I keep catching myself though.  Have to follow the doctors orders to make this successful.

I'll post again in a few days to let you know how this Sling implant is working out for me like most gentleman have in this forum.

Bill

Posted 1/20/2012 12:04 AM (GMT 0)
Congratulations on taking the big step, Bill.

I'm glad you're getting such good results with the sling. Feels great to be dry, doesn't it? Definitely go easy and seek out soft furniture. You'll feel a lot better in a couple weeks, but you'll obviously still need to act as if you didn't. Your new mantra is: go easy.

I found I couldn't bend in the middle too cool after surgery so I picked up some doodads at the drug store that really helped:

* A long-handled shoe horn. (tying your shoes is really uncomfortable, and probably ill-advised)
* A device for putting on socks without bending over. (deceptively simple and works like magic: tinyurl.com/7764zvb)
* A sponge on a stick for washing your feet.

The whole kit cost me about $30. Money well spent. Besides, you'll save that much on pads the first month.

Enjoy your newfound dryness in good health.

Jonathan

Post Edited (Jazzman1) : 1/19/2012 5:10:32 PM (GMT-7)

Posted 1/20/2012 3:27 PM (GMT 0)
thanks for posting Bill...good to hear of your success and hope it continues, I'm following your updates with interest as I'm hoping for the same surgery.

r

Posted 1/24/2012 5:46 PM (GMT 0)

It's been 8 days since the Advance Sling Implantation and the soreness is slowly leaving my Perineum area.

I still cannot sit on anything hard. I did have a some spotting on my underwear in the last 2 days which seems to worry me.  The swelling is going down and I'm not sure if this is attributting to this spotting due to pressure relief. I was wondering if anyone out there has also had this happen to them during their healing progress.  Please let me know. 

Sometimes I think I feel some dripping but I'm still dry when I check.  I'm starting to get feeling back in my pelvic area and will start Kegels again to try to strengthen the muscles again hoping this will help any setback. 

I have been taking it slow and easy with hopes this implant will heal as advertised. But so far so good.  I miss doing my general activities but I'm following doctors orders. I see my doctor in 8 days and will see what he thinks of my progress so far with this spotting issue. I'll keep the forum informed of my progress. turn

Posted 1/25/2012 1:12 AM (GMT 0)
Bill,

Sounds like you are progressing normally. I don't remenber for sure but I think I had some spotting in Perineum area after my sling surgery.

Be sure to follow your Docs orders carefully and don't try to do too much too soon. You need to let things heal in place before doing any lifting and/or straining. They say to not lift more than an gallon of milk but I think straining by getting in/out or cars and activities like that can be equally if not more potentially damaging. You will feel like doing more than you should do......give it the full six weeks.

Posted 1/25/2012 2:14 AM (GMT 0)
Hey Bill,

Congrats on making it eight days post-surgery. It sounds to me like you're coming along pretty normally.

I wouldn't freak out over a little spotting. I think it happens occasionally to lots of guys who have generally good outcomes. I'd take it in stride as long as it doesn't become a regular thing. All bets are off during the healing process.

The feeling wet but actually dry syndrome happens to me sometimes too. Weird, huh? I think that probably passes with time too.

It's good to hear that you're healing up and things are working pretty normally. Hang in there; I'm sure you'll be fine. Just be sure to lay off the James Brown splits for another five weeks. I keep catching myself.

Jonathan
Posted 1/26/2012 5:33 PM (GMT 0)
Jonathan,

I know you developed leaking problems after your implant.

When and in what time frame did you go back to the incontinenced issue you previously had mentioned in your previous postings.  Thats what I'm afraid of that I might be heading down that road as I'm only 11 days out from my implant.

I havehad  some urine spotting once in awhile on my under shorts but nothing like I had before my sugery.  So far I'm content with that and hope it doesn't get any worse like you are experiencing.

Update 11 days out and still feeling sore in the surgical area but not too bad. Still taking it slow and haven't lifted anything heavier than a gallon of milk.

I haven't driven yet or token any long walks but getting more mobile every day.  I see the Doctor next week any have a lot of mobilility questions for him.  I hope he give me a bit more confidence to move about as I'm afraid of undoing what he has done. Tired of being house bound so I'll keep my fingers crossed and the post coming. turn

Bill

Posted 1/27/2012 1:33 AM (GMT 0)
Hi Bill,

I think I started noticing some leakage at about 10 days to two weeks. As I got back to work and started walking longer distances, I noticed the leakage. Let me clarify, though. I didn't really leak when I was sitting around the house or working at the office, and other than occasional minor spotting, I still don't.

I'm still not all that active and I'm still under the "gallon of milk" restriction, so we'll see how things work when the restrictions are off and I'm fully healed. While I was initially pretty disappointed at not being 100 percent dry at all times, there's no denying that my condition is substantially improved. And while I have noticed some leakage that wasn't present in the first couple (very inactive) weeks, it doesn't seem to be getting any worse with time.

If things stay the way they are, the surgery will have been well worth it. It's always disappointing to not have your highest hopes met, but when I compare my current continence with my former three pad a day habit, I feel pretty good about things.

I hope it all works out at least as well for you. It sounds like you're on a good track.

Best,

Jonathan
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