Posted 8/5/2012 8:56 PM (GMT 0)
My history is RRP 1994 at Johns Hopkins, Gleason 3+4, established capsule penetration, recurrence in 2007, light to moderate incontinence since requiring 1-3 pads per day. Age 65, and need to lose about 50 pounds, which doesn't help any, I know. I see Dr. Charles Myers in Charlottesville, VA, and he recommended an artificial urinary sphincter. I decided against that. Anyway...
Since age 62, my incontinence had gotten less predictable, leading to accidents and other problems. You guys understand. I have been using Imipramine for years, did all the Kegels and so on, and even bought several clamps and tried them. Nothing successful, although I think the Imipramine helps.
Decided to investigate the AdVance Sling, based on mostly positive reports here and elsewhere. My local uro had done about 15 procedures. I decided to go to Johns Hopkins, where Dr. Jamie Wright had done about 90 of them. He did an exam, including cystoscopy, and declared me a candidate, although he could not determine how well the procedure would help me. Unfortunately, they have no way of telling ahead of time. I was very lucky to be slotted into an opening just two weeks after the exam, and great relief to me.
The procedure was on Friday June 15. It went fine. My wife and I went back to our hotel, and I crashed, skipping dinner entirely. The aneshesia did me in. I was instructed to remove the catheter on my own the next morning (since it was a Saturday, and staff is light). I did that at about 6:30 AM with no problems. Pain was minimal, and I required no meds. I drank a bunch of water, and went back to sleep.
I still couldn't urinate at breakfast time, and I stayed in the room, and drank more water. Late in the morning I could force out just a bit of urine, but nothing I would call a useful urination. Drinking more water to get things moving, it started to get a bit better around noon. We arranged for a late checkout, and by 2 PM I was satisfied that I was able to urinate sufficiently to go home. The ride home resulted in some nausea, again due to the anesthesia.
Once home, things got better each day as far as urination went. I still needed no pain meds. I did have some odd aches and pains in my legs and groin, I suspect due to the man-handling during the procedure. It took weeks for them to go away, but they did. I was instructed to take it very easy for about 2 weeks, and to not lift anything over 4-5 pounds for a total of 6 weeks (ended about 10 days ago). Also, I was told not to do anything to stretch the surgical site, like squatting. I followed these instructions very carefully.
It was pretty clear to me from the beginning that I would not be totally dry. The doctor said that his stats resulted in 50% of men dry after the surgery, and 80% were significantly improved.
I've been weighing my pads, starting about 6 weeks before the surgery. Before surgery I averaged about 100 grams of leakage per day, using 1 pad. After surgery, I have averaged about 20-25 grams per day. The worst day so far was about 85 grams, due to a lot of walking and being very tired while on vacation. Still, it was one pad, and not something that was a problem.
Interestingly, the amount of leakage started very low, and then started to increase over about 3 weeks. I attribute this to swelling due to surgery causing less leakage during those first few weeks. As I healed, the leakage increased. The average went from about 15 grams per day to the current 20-25 grams per day.
Note that my improvement is significant, with leakage only about 20% to 25% of what it had been, and perhaps more predictable. I used to feel physical leakage during the day, while walking and working. I no longer feel that leakage. Now, when my bladder gets full, I feel the urge to urinate much more strongly than before. I think that before surgery, my bladder was not filling up, but rather leakage was happening before that feeling of fullness occurred.
Urination is now about normal, but somewhat slower than before surgery, as you would imagine. The surgical sites have healed fine, and there is no residual pain or sensation from the sling. None. I don't know the sling is there, except for the improvement in leakage.
My objective going into the surgery was to have significant improvement to the point where I would need no more than 1 pad per day, and no surprise leakage causing accidents. So far, my objective has been met. Although it would have been great to be dry, I am satisfied with the results of the sling surgery, and would recommend it to anyone in a similar situation.
I hope this helps someone out there. I'd be happy to answer any questions that you might have.
Best wishes to all,
TechnoBob in South Central PA.