AUS has stopped working. Activated 2 months ago and I'm in philippines

Had AUS activated Feb 8, was perfect for 10 days, not a drop. Noticed urine stream went everywhere but straight and had tenderness where reservoir was noticeable to see and feel. Doctor said we could place it deeper if didn't improve.

End of week 2 I leaked when sitting in soft chair or edge of bed, only happen twice during a week. Week 3 started leaking every time I sat down. Week 4 I had extremely long flight and lay over that involved 60 hours of travel with maybe 30 hours sitting.

Each day I leak more doing anything and now I'm leaking all the time. Walking, bending, sitting even just standing. I'm in the Philippines and was able to speak with my doctor in Iowa. He wasn't happy that in my despiration I deactivated and reactivated the device several times attempting to get the cuff to inflate more.

I can palpate the cuff and really can't feel if it is different turned on or off. The unit appears to be working in that I need to squeeze the ball to urinate and it does refill after a couple of minutes.

Following 2 weeks of constant leaking, there was one time that it WORKED PERFECT for almost 4 hours until I had to squeeze the bulb to urinate, once I did it returned to.leaking all the time. Since the reservoir is visible and near the skin surface I Have tried manipulating it thinking there is not enough pressure to fill the pump. I also have tried massaging the cuff to see if that would allow more fluid to go it. Even standing on my head doesn't help.

I'm trying to fulfil my medical mission time here in the Philippines and not due to return to the states until June 1st and will see my doctor on the 7th. I'm concerned putting off seeing my doctor 2 month might effect the outcome of fixing it.

I'm deactivating it at night thinking it may prevent it from healing into a wrong position in the event it has moved.

Any suggestions? Does anyone know if I should feel pain near the cuff in the event it has erroded or has torn? Thanks ahead of time

Post Edited (Trooper) : 4/9/2017 1:57:26 AM (GMT-6)

Trooper - I don't have an AUS yet but have done about as much research as possible before my upcoming implant next month. I had questioned my surgeon about the reported 25% revision rate - that's 1-in-4, which seemed quite shocking to me. He said they are mostly issues relating to sizing and placement. He told me of several scenarios - I won't go into the details here, but most are an inconvenience rather than a medical emergency. I'd say you are doing everything right, e.g., trying to prevent it from healing in the wrong location in case it is a placement issue. There are cases of actual mechanical failure (balloon losing pressure) but these are not common.

Of course it would be best of you could have this remedied by your original surgeon, but June 7th seems like a long way off, and one would think there's a lot more that could go wrong in that time. But again, just the fact that you have one of these devices indicates that you have already been thru quite a a lot and probably realize that there isn't much that could happen that couldn't be fixed. One might have visions of the plumbing tearing up internal tissues, but there are no reports of that. If your mission is sufficiently critical to prevent your return sooner rather than later, then that's your call. Other than fear and indecision, what you will likely experience over the next eight weeks probably pale compared to what you've been thru already. Good luck!

Trooper,

First, you should call your doctor's office again and ask to talk to the doctor's nurse. That is almost always easier then trying to get the doctor on the phone. The nurse will write down your questions, making sure the medical terminology is clear, and leave them for the doctor. Most of the questions you are asking are ones your surgeon is best qualified to answer.

My take on your problem is that you have a fairly ordinary "AUS that doesn't work very well" problem. Sadly, I happen to know exactly what that's like. Since nothing bleeds and nothing hurts it doesn't appear to be an emergency -- just a disappointment. I wouldn't deactivate your device. It sounds like it is helping somewhat.

My understanding is that the usual treatment for a disappointing AUS isn't to put in a tighter cuff but to add a second cuff or to move the cuff closer to the bladder (more proximal).

Here is a fairly-readable paper that lays out your options: Artificial urinary sphincters for male stress urinary incontinence: current perspectives -- Medical Devices 2016

I've had that problem with long flights. Best I've found is to try to hit the head late in the flight and to remain seated until most other passengers have exited to minimize time spent standing while waiting to exit.

I have never heard of the reservoir being close to the skin and visible. Mine as well as those I have talked to have the reservoir rather deeply implanted in the abdomen. I hate to add to your anxiousness. If you are still able to lock it and unlock it then I think that does not make a case for mechanical failure or pressure leakage. If it were me, june could get here quick enough, I would be worried as you are about erosion. If it were me I would try to text or email my doctor back home. As far as it healing in the wrong place, mostly people seem to be concerned about pump placement as the cuff probably is where it stay.
I think you should be worried.