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Can Artificial Unrinary Sphincter and Penile Implant be done simultaneously?

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Prostate Cancer
Has anyone had both a Artificial Urinary Sphincter and penile implant done at the same time?
What was experience? - 100.0% - 1 votes
Any physical restrictions and if so for how long? - 0.0% - 0 votes
Recommendation of urologist in San Francisco Bay Area that specializes in AUS and penile implants. - 0.0% - 0 votes
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Posted 4/16/2013 5:47 PM (GMT 0)

I am considering having an artificial urinary sphincter (AUS) due to incontinence from robotic prostatectomy four years ago.  I am also considering a sling procedure, but the mixed results and complications that I have heard about makes me dubious.  I use about one pad per day with most of the leakage occurring when standing, walking or exercising.  I exercise 5 or 6 times per week up to two hours per day.  The exercising is mostly gym workouts that include the following:  stationary bike (armchair not regular bike seat); elliptical; free weights; floor exercises, which include stretching of the groin area.

 

I am also considering a penile implant because of Pyrenois Disease, due to either the surgery or Dupuytren’s Contracture which I have a mild case in both hands.

 

I would appreciate any input that anyone regarding the experience of having both an AUS and implant done at the same time and what were their results?  Do you think either of the procedures would impede the exercises I am doing?  Does anyone know of an urologist that specializes in these procedures in the San Francisco Bay Area?

 

______________________________________________________________________________

 

Currently 73 years old  - Da Vinci Surgery at age 69

PSA 5.6  Pre surgery gleason 3+3 - Post surgery gleason 3+4

10 core biopsy 3 cores containing cancer of 5%. 30%, and 40%

Negative margins - Perineural Invasion - T2

All post surgery PSA's <0.01

Post Edited (Giants Fan) : 4/20/2013 11:23:15 PM (GMT-6)

Posted 4/16/2013 8:32 PM (GMT 0)
Welcome to the site.... I don't think we've had anyone do both surgeries. My guess would be that it's probably not a good idea..

But hang tight, I'm sure others will chime in.
Posted 4/20/2013 3:44 AM (GMT 0)
There are several guys the used to be active in HW that had both done at the same time with good results. I think it was in Dallas but don't remember for sure. If you do a search for AUS and IP you should find the threads.
The Uro that did my AUS would not do both. She said that it was too much surgery at one time. But again, others had good results doing both at the same time.
Posted 4/20/2013 3:53 AM (GMT 0)
This might help.
https://www.healingwell.com/community/default.aspx?f=35&m=1532941
Posted 4/21/2013 5:22 AM (GMT 0)
Thanks tallguy. 

I will do a search on AUS and implnat and see what is available.  I did not realize you could search by topic and bring up threads for those items.  Bare with me as I learn the procedures as I am somewhat technologicaly challenged.

Giants Fan

Posted 4/21/2013 11:57 PM (GMT 0)
I had both done at one time. two surgeons. One could do both, but I felt comfortable that each one was a specialist in his own area. I don't think either operation is a pleasant experience and together is probably worst than but getting it all over at once was a plus, I think. My implants were done 1/11/11 and now the AUS has lost some of it's effectiveness, it was 100%, or very near, at first and now I wear a pad, just one per day and it's not soaked by day end. My implants were done at Methodist in the Houston medical center. Dr. Timothy Boone did the AUS and Dr. Larry Lipschultz did the IPP. The IPP works very well. Your biking will be effected by the AUS, sitting on the "cuff' part of the device will cause it to leak, although it won't leak worst than it does now. A special bike seat will help, maybe. The IPP should not affect bike riding or any other exercise.
Posted 4/22/2013 6:28 AM (GMT 0)
knotreel - Thanks for the response and information.  It was encouranging to know it could be done at the same time, but like you I think that a specialist in each procedure would provide the best results.  It is disappointing to hear of the AUS not performing better.  According to the research I have done so far the AUS is considered the "gold standard".  As I am currently using only one pad per day, although usually soaked after exercising for almost two hours, it would be discouraging to go through the procedure and in a couple of years be back to where I am currently. 
Posted 4/22/2013 1:39 PM (GMT 0)
Perhaps your starting point , being not totally incontinent, would give you a good result. Before my AUS I was totally incontinent ,meaning all my urine leaked out unless I was sitting or laying down. Even though I my AUS performance has degraded somewhat, I still consider it a great result. If need be, I could get a cuff replacement which is a much easier surgery than the original. At worse case for you, if you had the AUS you would leak a lot less.
about the degradation in my unit, I think my urethra has atrophied a little from the constant constriction of the cuff so a smaller cuff should fix me up.
Posted 4/22/2013 5:46 PM (GMT 0)
knotreel

Thanks again for your response.  It is encouraging to know that you think there is a fairly easy solution to the AUS problem you are experiencing.

Giants Fan   

Posted 4/22/2013 8:13 PM (GMT 0)
Well, I could be oversimplifying the "re-cuffing" a bit, the only AUS implante I have received feedback on the re-cuffing actually had the scrotal as well as the abdominal incision for a new reservoir. But he left the outpatient surgery with the cuff activated rather than the 6 week healing we all have before the AUS is activated. The urethra is attached by some connective tissue to the perineum and the initial operation involves cutting the urethra free so it can be encircled by the cuff, a good deal of the trauma must be caused by this.
I think the bottom line is it will make you better. And, the IPP works well but it is most important to get the right fit, some people go to the IPP "mills" that do a huge number but I felt best served at a teaching hospital where the professors do the critical stuff.
Posted 4/23/2013 3:20 AM (GMT 0)
I was exploring having both procedures at the same time and if you have a skilled surgeon, they can do it for you. You kind of get two birds out of one surgery, but recovery will be slower. I regained continence so I only had the penile implant procedure.

So it is possible, but like the cancer surgery, be careful on who you select.
Posted 4/23/2013 5:14 AM (GMT 0)
knotreel

Thanks for the advice and encouragement.  The urologist who did my robotic surgery is no longer doing surgery on men, only treating female urological problems.  He wants me to have one of the other urologists in his clinic do any future surgery.  I am considering one of them, but will also interview other urologits before making a decision.

Giants Fan 

Posted 4/23/2013 5:16 AM (GMT 0)
Giants Fan,

I went to our PC support group meeting last night and the talk by the guest Doctors was on ED and incontinance, both Doctors said that both could be done at the same time and that they regularily did both. There is apparently a 4-6 weeks recovery time after the operation and there is a fair bit of pain for the first 3-4 weeks. But this would be expected by the nature of the implant surgery. Good luck.
Posted 4/23/2013 5:16 AM (GMT 0)
Giants Fan,

I went to our PC support group meeting last night and the talk by the guest Doctors was on ED and incontinance, both Doctors said that both could be done at the same time and that they regularily did both. There is apparently a 4-6 weeks recovery time after the operation and there is a fair bit of pain for the first 3-4 weeks. But this would be expected by the nature of the implant surgery. Good luck.
Posted 4/23/2013 5:27 AM (GMT 0)
Devestated1

Congratulations on gaining continence.  The continence has been the most frustating for me.  If it were not for the Pyrenois Disease I would not have to have the implant.  I definitely will select the best surgeron I can find.

 

Thanks for your innput.

 

Giants Fan

Posted 4/23/2013 5:31 AM (GMT 0)
RangerTug

Thanks for the advice.  I will look for the most experienced surgeon for these procedures I can find.

Giants Fan 

Posted 4/23/2013 2:28 PM (GMT 0)
Giants Fan,
I am not sure what is considered as a norm but my AUS doctor ,Dr. Timothy Boone a Methodist Houston, did a urodynamics test that involved placing a catheter I my urethra an rectum an the whole test was run on a computer. He said that this would tell him the pressure that my remaining urinary sphincter could hold. Then he could one of the four reservoir that each have different pressure outputs. I am just saying this to let you know that selecting the correct reservoir could only be in a similar fashion. Not sure if all doctors go to this much trouble or have the equipment? Good luch in your search. My advice, go for it, we are not getting any younger!
Posted 4/23/2013 4:00 PM (GMT 0)
knotreel

Good advice on the tests.  I will try and find the most accomplished surgeon that uses these pre-op procedures.

Giants Fan 

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