AUS Installation Report

A short recap:

RALP in March 2018. Incontinence didn't improve past 5-6 months of Kegels. Worked with a pelvic floor physical therapist through winter of 2018-2019. Very little improvement. 4-5 heavy duty pads a day. "Accidents" frequent. In March 2019 elect to have an AUS installed and schedule it for middle of May 2019 after a half-marathon I was already signed up for. Had minor, non-running related, back issue so surgery rescheduled for 3rd week of June 2019.

I showed up for surgery at Billings Clinic at 5:30am. They wheeled me into the OR at 7:30am. Surgery went well and I was home at 11:45am with catheter installed. They recommended that I take the pain medication before I actually needed it and I did but only that first day and the following morning. If I was doing it over I wouldn't take it at all due to the constipation it caused even though I drank lots of water, etc. The level of discomfort was about 25% of what experienced with the RALP.

On day 2 I removed the catheter following the instruction from the nurse. She gave me a syringe that fitted the catheter and said to withdraw the fluid and to do so twice to make sure it was all removed and the balloon was completely deflated. I did so and slowly withdrew the catheter. The feeling was weird but not painful.

As an aside, when I had my catheter removed a week after RALP, the physician did a quick withdrawal of the fluid and then pulled on the catheter like he was starting a lawn mower. It was extremely painful.

Once I had removed the catheter it was a matter of taking it easy. I didn't have to be convinced to do so. By day 3 things started swelling up and the bruising became apparent. The scrotum swelled to about twice its size and was very sensitive to touch. They had shaved me from about 2 inches above the pubic bone, a path about 5 inches wide that extend down, between the legs, and partially to the buttocks. That whole area turned purple, then black and then faded while going through the colors of the rainbow. I was tempted to do a time lapse but decided against it.

There is one incision at the belt line of the right side where the balloon/reservoir was installed. The other incision starts of the back side of the scrotum and extends just short of the anus. Both were glued shut. Both areas were very sensitive.

I did get up and walk. My man cave is in the basement and I have no trouble navigating up and down the stairs. Sitting is an issue but I'd bought a donut shape cushion and had it at the ready and it made all the difference.

Once the swelling subsided I found that the lack of hair is problematic. Since I am still wearing a pad the skin of the scrotum sticks to it and gets pinched by it. I alternated between baby powder and lotions for some relief.

I also noticed that my incontinence was worse than ever and trying to clamp things up with a Kegel were very ineffective. When I mentioned this to my doctor she said that is normal as the structures that the Kegels strengthened were what she had cut through. I was up to 6-7 pads per day.

The hospital had called to check on me after I'd been home for a while and on about day 4 the urology nurse called to check and to remind me that I needed to pull down on the pump 3 times a day to keep it in a low position while things healed up. There was no joy in that activity because, at least at first, I had to probe through swelled and sensitive tissue and pull the thing down. I suppose it was worth it as it is now as low as it can be in the scrotum and easy to access.

At the 2 week post-op visit everything is fine. Activation in two more weeks. I am still taking it easy, not lifting, but doing some good walks.

Yesterday, July 22, was the 4th week visit and activation day. My doctor looked things over, said everything is healing well, found the pump, squeezed the sides of its upper part for a moment or two, then gave the lower part a squeeze and said that was that. She offered me the opportunity to wait there a while to test it out but I felt pretty confident that I would be OK on my own.

Two hours later I felt the urge to go, a feeling I rarely felt except when laying down. I went into the bathroom, sat down, used one hand to hold the top of the pump, and to keep things pointed downward, and gave the pump a squeeze with the other hand. I could feel a slight "swish" of liquid moving through the pump and then I had a natural flow of urine. I was elated.

I wore a pad the rest of the day and by bedtime, having gone several times, the pad remained dry.

I am now on day two and have gone pad free all day. Since I got clearance to resume all activities I did a 2.5 mile run this morning without incident. My goal is to get back up to my usual 8 mile run by the end of August.

I am extremely satisfied with the results so far. Yes, there was some discomfort but a small price to pay for finally being dry again.

Sounds great man happy for ya I go 8/8/19 to get activated which will be my whole 6 weeks I have been getting hard but no sex hopefully everything will go as yours did. Still couldn't get in the water went all the way to Gulf shores just to walk on the edge of the water hope to be able to run work out and swim again soon.

Had my visit and I had to much muscle tissue to active hurt top and bottom it was just too much tissue around the pump he told me to bath in warm water for 3 wks and got me on muscle relaxers anymore advice?

thanks my man you know i want to get this going and hope it do what it suppose to do

Awesome I have 3 more weeks to try it again I have allot of muscle tissue.

Give it some time. Don't expect to accomplish anything in particular in any given attempt. The idea is to get things to relax so you've got more wiggle room to tug on the pump. Being warm makes those muscles relax but being anxious can make them tense up. If you are a read-in-the-tub kind of guy take a book to the warm bath with you and give things a bit of a tug every few pages.

Ok my doc call me today and said squeeze the bottom part of the pump to activate I'm like the paper work says squeeze the sides first like you did when we try last time. Oh you don't have to do that just squeeze the bottom soft part so I tried being nervous about it I got it half way flat squeezing hard I might add but it didn't work so I told him just let me come in even if it's a4 hour ride plus I'm still sore and it hurt. What should I do? Keep trying or let him do his job?

That's the way I understood it too but mine has never been activated so he was telling me that you can activate it just by pushing the bottom part of the pump but I'm going up there next week and let him do it

Thanks

Thank you VinceinMt for your input. Just the info I was looking for. I had my prostate removed last Aug. 20th, 2018. Did well with the surgery, but really hated the 10 day using the catheter. I am now turning 69 and in, I think, great health. In 2018, the PSA values got out of hand and the biopsy indicated cancer. The operation was successful and the cancer was contained to the prostate. Over the last year, PSA values <.01. I've been wearing pads 24/7. Did the exercises to try and improve, and that helped a bit. Overnight and sitting around I do ok. The incontinence is a 3-4 pad a day thing for me. In the afternoon, I sometimes use a clamp when I want to get something done. I started running again, three months ago, and completed a 10K race last week. Running doesn't cause me make leakage. So, I had a checkup with my Uro this week and we discussed my incontinence, did a video test of the urethra. I asked about the sling, but my Urologist was against it. I'm going with the "gold standard". I scheduled an AUS 800 inplant for September. I've done a lot of research on this, and reading the results of others, I'm expecting a good result. I even watched a Youtube video of the surgery, which was pretty interesting. This forum answered a lot of my questions. Especially on using the device. My surgery takes place Sept. 4th. I intend to share all the details. Right now I'm trying to imagine just how much discomfort, and how long my recovery will be. Activation should occur in November. So, details of your experience are very helpful. Activation in 4 weeks would be great, but I’m expecting 6. I quit running 3 years ago. I trained constantly for 13 years starting in 2004. After completing 8 marathons, (5 in Missoula), I wasn’t getting any faster, so I quit. I’m giving it another go, training for a half in Missoula next year. Your return to running is encouraging. My Urologist is at Great Falls clinic.

" I'm like the paper work says squeeze the sides first like you did when we try last time. Oh you don't have to do that just squeeze the bottom soft part so I tried "

"The part about squeezing the sides is to "activate" it. I have never personally "activated" or "deactivated" mine"

The side squeezing is a way to refill the pump bulb if someone like your doc didn't bother to take the time let the bulb completely fill after squeezing. To explain this more, if you or your doctor wanted to deactivate your cuff the procedure would go like this. You would squeeze the bulb repeatedly (about three times) until it was compleatly flat. then you would wait twenty seconds and press the button to lock. Lets say you only waited 10 seconds and pressed the button, then the bulb would still be fairly flat ( too flat) and would not have enough fluid in it to be able to "pop" the button which is what happens with you re-activate after being de-activated. So, if you or your doctor feels the bulb and it is too flat to make the pop then it needs more fluid then he or she can bypass the locking valve by squeezing the sides of the hard end of the pump to fill the bulb more completely. During the healing time it may now be more customary for doctors, to leave the bulb flatter and there by leave the cuff less filled until activation. I say this because only after my last revision did my doctor have to sneeze to bypass for more filling.
I am sure y'all wanted to know all that.
As an update to my last report, on my current revision, I am trying the old school "anti-atrophy" routine of de-activating every night so hopefully I can slow down the inevitable atrophy. My original doctor , Dr. T. Boone, published a paper about a combined study where his patients never de-actiaved and the other doctor in the trial had his patients do like I am doing. His conclusion was that de-activation did not help the atrophy issue , but who knows for sure, I am going to keep doing it. My new doctor, former associate did not discourage this.

Post Edited (knotreel) : 8/29/2019 1:55:29 PM (GMT-6)