Ed's AdVance Male Sling Procedure

Well, my AdVance Male Sling surgery is scheduled for tomorrow, 9-05-08, at 11:30 AM at Strong Memorial Hospital in Rochester, NY by Dr. Robert Mayer.

Of course, after reading Skydaver's Journey, I'm very worried about retention, but I'm going to trust my surgeon and continue on this path.

I'm currently leaking about 180 ml per day or about 2-3 pads per day. (See my signature, below). Of course, leakage varies depending on what I do during the day, from as low as 35 ml to as high as 300 ml.

I will update this thread every couple of days. Wish me luck!

Ed

Well,I had the Advance Male Sling procedure yesterday, 9-05-08.

I was scheduled to go into the OR at 11:30 AM, but they didn't take me till 1:30, and it was almost 10:00 PM before I was sent home.

The procedure itself was not a real problem, except that I have severe arthritis in both hips (Total Hip replacement in Nov.).While they  were gentle with my leg placement. the most pain I had when I woke up was from the arthritis.Your legs are up and spread.In addition, the two small incisions in the inner thighs added to the pain but still, very little pain.A couple of Vicodin overnight and that might be enough.

They had trouble waking me up from the general anaesthetic and when I did wake, had severe chills and shaking. It took 3 heated blankets and 3 hot drinks to get over the chills. The staff and nurses were wonderful. The nurse wheeled me into the parking garage right to the car door for my very patient wife to drive me home. I couldn't get through this without her!

Unfortunately (but not a complete surprise), when the catheter was removed. I couldn't urinate after they infused 300ml of liquid. The surgeon put the catheter back in over the weekend. He didn't want me to have to go to emergency over the weekend. I go back to see him Monday or Tuesday to get the catheter out (I hope!).

Of, course, there's no way to know if I'm dry or not, but I'm keeping my fingers crossed.

I intend to camp out in front of the TV this the weekend (The surgeon's suggestion).

I"ll update again soon.

Ed

I saw the urinary nurse today ( Doc's out of town) to get the catheter removed.

Unfortunately it's still in. This is my third day since surgery.

She did a void test by infusing 120 ml of liquid into my bladder and asked me to drink a lot a water (600 ml), and come back and try to void. I did all that and was able to void out 100 ml of urine with about 60 ml retained. (There's about 28 ml in an ounce)

Luckily, she wasn't satisfied and asked me to drink lots more water and come back in about 30 minutes. I went through two large bottles of water (40 ounces or about 1200 ml, total) and went back I was unable to produce more than a few drops! We tried again later, still no results. I was retaining almost 500 ml of liquid in my bladder, so I'm back on the catheter.

She'll have the Doctor call tomorrow. I'll keep in touch.

Ed

Ed, in my expert opinion as a patient , I think you should ask them to show you how to do self-catheterization, and give you a half dozen catheters (you can re-use them; the process is one where you simply need to be clean, not sterile)

I'm still not voiding all that well, but it's getting slowly better (larger volume when I pee, smaller volume when I catheterize)

My doctor told me that no one has had the problems you and I are having past about 6 weeks. Hang in there!

I went for another voiding test, today, Tuesday, Sept 16. This was the best test so far, voiding out 250 ml after a 250 ml infusion.

I finally saw the uro who suggested self-catheterization. So far, it's no problem. I'm also dry!  (but I've only been home for 4 hours).

I am able to void out a few drops on my own, and then finish with the catheter (like SkyDaver).

The uro said that this would get my bladder used to working on its own, and it's certainly better than wearing a catheter  24/7. I am feeling some spasms (feeling like I should go when I know I'm empty), but he said that should pass. I recall having the same problem after the prostate surgery.

Ed

SkyDaver,

For my last voiding test, I got out what they put in. But that's unusual since with the previous tests I was retaining at least 100ml.

I'm not out of the woods, but I'm a lot better than 2 days ago.

I can usually urinate at least 100-150 ml on my own. I'm only using the catheter first thing in the AM and just before bed.

I usually get out another 100 ml or so with the catheter. Except for this AM, in which I got out 450ml (!) with the catheter.Don't know what that's all about, maybe has something to to with just getting up in the AM.

The other problem is frequency and urgency. I can only last 1 to 1/2 hours between urinations. (If I use the catheter, I can go much longer). But, I'm only getting up twice at nite and then I can go on my own.  The urgency seems to lead to minor urge incontinence, something new for me.

I'm virtually dry (18 ml). I'm pretty sure the leaks are happening when I don't quite get to the bathroom on time.(I was leaking at 180 ml/day prior to the sling.)

There's no evidence of stress incontinence. (Of course, I'm still restricted to 10 pounds lifting or less, so I don't really know.) But no leaking doing normal things, e.g. getting up from a chair.

I see the Uro again next week.

Glad to hear your off the catheter.

Ed

It seems like too much of a coincidence the we should both have similar side effects after the operation.
Has anyone else out there experienced similar symptoms after sling surgery? I.e strong urges to urinate every hour? If so, did it finally resolve itself?
By the way, this is the 2nd day after the catheter came out and I'm totally dry compared with the 2-3 pads a day I was using prior to the procedure. Of course, I haven't done anything strenuous yet either.
Ed

KW,

In my opinion, your problems with the AdVance Male Sling are a cautionary tale to other considering the procedure.

If one is considering this, it's best to have a surgeon that has done some number of them before. I don't have a good feel for what that number should be, but certainly above 10. It's sort of like the radical prosatectomy (of any flavor), it's best if you aren't one of the first 200 patients.

How surgeons are to get to that level of expertise in any surgery is of course a problem, but I'll not volunteer to be one of the folks being worked on as the surgeon makes their way up the learning curve.

Ed ... how are you doing?

Happy to hear that you and sky daver are progressing well.  My husband is also doing well 2 months after the sling surgery.  He is still dry unless cough or sneeze with a full bladder.  He went back to the gym which sometimes causes a little leakage - Dr. said this is from the reduction  of swelling from the operation.  but this is from him living no control at all after 2 pm and using 10 or more pads a day.  Our lives are changed - he is more relaxed and willing to go places without fear of an accident.  plus on a lighter note - my pocketbook is not stuffed with pads.  Let us know how both of you are doing   mrs D

oh no - the doctor said that my husband may ( not would ) have some leakage after his surgery.  What ever leakage he has, he had a few days after the surgery.  He has slight leakage if he excercises or coughs or sneezes. This is compared to his 12 plus pads a day, and remember he did not use a catheter after the operation.  He has increased his excercises ( stationary bike ) but still does not lift anything heavy so not to strain the healing sling area.  Also - he is keeping his blood sugars in line.  I believe that his elevated blood sugars did not allow the Kegels or bladder muscles to correct the leakage after his first operation in that there was increased urine flow with the high blood sugars, which also decreases healing.  I also believe that an elevated sugar count can impede the recovery with the sling.  In addition, some readings indicate that an operation can trigger high blood sugars, in someone who did not have a problem before.    I only bring this to your attention so you can review your sugar numbers on your blood work.  Sometimes the doctors are so focused on the prostate issues, other issues like blood numbers, are not discussed.  Hopefully I have answered your question, if not let me know - We are glad to see you are doing well  - Mrs D

Egor, I'm Glad you are doing so well.
KW

I would like to contact those who have had a successful sling implant to find out who their docs were. I am in the NY/NJ/PA area and would consider having the operation if I could find an experienced Doc that I like.

How does one contact someone on the forum?

Hello, gents....

I had the Advance Sling procedure a little over a week ago, at Burlington Vermont's Fletcher Allen Health Care facility.  This follows a laproscopic robot-assisted prostatectomy in August 2007.  At the time of the sling procedure, I was going through 1-3 pads a day, depending on activity level, stess level, etc.  After the sling surgery, I had the catheter removed after one day in.  NO leakage to speak of since!  Of course, my activity level is greatly diminished since and I struggle with discomfort while sitting, even with the "donut" to sit on.  My biggest concern right now is the difficulty with eliminating....prior to the prostatectomy and given the enlarged prostate, flow was lousy.  After that procedure, I could knock a candle out at 10 paces.  Since the sling procedure, flow is GREATLY reduced, and I struggle getting anything out during sleep hours (I am up 2X per night).  I am hoping/assuming the swelling from the sling surgery will subside in coming weeks and I will return to a more normal urination.  I am trying to be patient about listening to my body and keeping it at rest as much as possible to heal.  Bottom line, I am glad I did the procedure. 

Would like to hear from others who have had this particular procedure done (not the Invance procedure) who now have more weeks, months, years in since you had it done, particularly regarding your ability to eliminate easily and fully.

Zpiddler