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Posted 12/3/2019 1:19 PM (GMT 0)
Randy had AUS surgery on 11/19. All went well with the surgery and we went home the next day. Randy felt really good and on the Friday after Thanksgiving. I had to 'get on to him' for overdoing it. At 3:30 am Sunday morning, Randy woke me up to tell me he couldn't pee, and it hurt to try. There was also some new swelling in the groin area. It seems he hadn't gone since about 4:30 pm Saturday afternoon. I called the docs answering service and the doctor on call said to take him to the ER at the hospital where the surgery was performed. So, we hopped in the car and made the 2 hour journey to Atlanta. They inserted a catheter, (removed just over a liter of fluid) told us to follow up with the surgeon on Monday and sent us home.

Monday, we made the drive back to Atlanta to see the surgeon. They removed the catheter, pushed fluid into Randy's bladder and asked him to try to void the fluid. He did. No problem, no pain. They declared all was well and sent us home. about an hour after we got home, Randy tried to go, and found the same problem all over again. He couldn't empty his bladder (it just dribbled) and it hurt to try. I called the surgeon's office, and was told to go to the local ER to have a catheter placed. We have our original post-op appointment on Wednesday, where we are scheduled to see the PA.

The surgeon, and ER doc both said they didn't think that Randy's over-doing it was the cause of the problem, but neither had any idea as to what may have caused this after 11 days of everything going great. The AUS isn't activated and there is no sign of infection. We're at a loss, and worried that nothing will be resolved on Wednesday, since it's a late afternoon appointment with a PA. I have an email in to the surgeon expressing our worry and asking about next steps. Did any of you guys who have an AUS experience anything like this? Anybody have any ideas?

Thanks, Donna.
Posted 12/3/2019 4:00 PM (GMT 0)
You may have already done this, but if you google (no quotes):

AUS urinary retention after

that pulls up a number of articles about this problem, which seem to describe what Randy is experiencing.

I looked at a few of the articles, and thought the following seemed to have helpful information:

https://urology.stanford.edu/content/dam/sm/urology/jjimages/publications/a-systematic-approach-to-the-evaluation-and-management-of-the-failed-artificial-urinary-sphincter.pdf

(Technically, this article was written with female patients in mind, but its discussion of AUS problems (see p.3) looks like it applies to all AUS applications)

and this one is pretty technical, but gives some interesting stats involved with AUS failures:

https://www.gavinpublishers.com/articles/research-article/journal-of-urology-and-renal-diseases-issn-2575-7903/early-complications-after-artificial-urinary-sphincter-insertion

Other articles called up talk about infection being a primary cause of AUS-related urinary retention, and also something called "erosion," and other articles which the above search calls up may also be helpful.
Posted 12/3/2019 9:47 PM (GMT 0)
Not completely familiar with the whole AUS thing, but would the urologist allow you to self catheter? I mean rather than have to drive two hours on a full bladder? That had to be agony, especially riding in a vehicle. I'm having some flow issues since my seeds were sewn, but due to other past issues was familiar with selfing and
although not comfortable, it has to be better than holding it. I wish Randy the best.
Posted 12/3/2019 10:00 PM (GMT 0)
I had my AUS installed last June, activated in August, all is working fine. During my research prior to the surgery I read that some guys noticed their incontinence improved after the surgery, before activation. I experienced the same thing and this is because of all the swelling that occurs down there that presses on the urethra. It went away after a few days and my incontinence returned.
If he has been overdoing it that could be adding to the inflammation and/or slowing down the healing process. I took it really easy for the first two weeks. After that I did return to swimming and longer walks but avoided any lifting. At 4 weeks the doc activated it and said I could return to all normal activities which, for me, means running 20-miles or so per week.
Posted 12/3/2019 10:05 PM (GMT 0)
Pontiacwild,

I don't know. We are going back to see the surgeon tomorrow, so, hopefully, we'll get some answers then. If not, I'll ask about self-cath. Thanks.
Posted 12/3/2019 10:11 PM (GMT 0)
Vince, I did ask about him over-doing it (he was), and the doc didn't seem to think that would have caused almost total retention unless he's been 'moving furniture' (he wasn't). Randy has a very physical job and is used to going non-stop until bedtime. I'm really hoping that it's just swelling and will resolve itself. As an aside, his AUS won't be activated until the 6 week mark. The surgeon said the extra time is needed when the patient has had radiation treatments.
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