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Coloplast Virtue Male Sling

tpelle
Posts: 154
Joined: Aug 2003

lion1 and others suffering from incontinence: Have you seen what appears to be an alternate sling product to the AMS AdVance Sling. Looks like it's installation may be less invasive. It's relatively new to the U.S. Check out:

http://www.utmedicalgroup.com/pages/pr_VirtueSlingWake.html

lion1
Posts: 240
Joined: May 2007

TPELLE,

You are a wealth on information and this is very good news! Becasue as I and others move forward trying to decide what route to take with this incontinence demon,it seems the longer we wait something that maybe just right will come along.

I have not been back to my Doc since Jun 09----however, I plan on calling him in a few weeks and I will mention this to him. Heck, this procedure is less invasive than the Advance SlING. MAYBE if I wait long enough they will discover a pill that works on guys like me??

I have to wonder if Dr George Webster has started doing this surgery, he always seems to be on the cutting edge---no pun intended--when it comes to new procedures.

Maybe Dr McCammons is getting in on this.

Thanks-----------Keep these posts coming!

Lion1

tpelle
Posts: 154
Joined: Aug 2003

lion1: I have an E-mail out to the manufacturer trying to find out which surgeons in the U.S. are doing the Coloplast sling surgery. The announcement of the new procedure was February 09. We need to know what has happened since then. My thoughts are like yours. My two pads per day are annoying but not unbearable. I just hope the "pill" solution comes soon. In the meantime it would be great to find Drs. Webster and McCammons on the list of those who are using the Coloplast procedure. tpelle

cgerhardt's picture
cgerhardt
Posts: 10
Joined: Oct 2009

I am 15 months post RP and incontinence and ED has been with me from the beginning with very little improvement. I have done post RP thearpy...kegals and rectal stimulator therapy with no significant improvement. Dry at night and usually when sitting in office chair. If walking or out and about very little to no control. I control during the day (office worker) with Cunningham Clamp and a pad. This is uncomfortable if doing any real activity but works. Nights I use depends just for safety with only a few drops. But, have to get up and go every 1 1/2 to 2 hours.
Just had the battery of tests Monday FUDS/cystoscopy etc. at U of Michigan. Dr. now recommends either AMS InVance Male Sling or Coloplast Virtue Male Sling She has done +70 InVance and only about 6 Virtue since it is relatively new. Says some have had pain (scrotum nerve) sensitivity from InVance and less chance of this with Virtue.
I am most likely headed for surgery in January and based on here recommendations so am doing all the research I can on alternatives and to see what others have experienced. Any comments would be helpful.

tpelle
Posts: 154
Joined: Aug 2003

cgerhardt: Sorry you continue to experience the two primary side effects of prostate surgery. You have been quite aggressive in trying to solve the problems prior to resorting to further surgery. My incontinence level is similar to yours -- no improvement since shortly after open surgery seven years ago. Dry at night and mostly while sitting, but leakage whenever standing -- total about 12 heavy duty Depands Guards for Men per week. Program Manager at Coloplast wrote me that since Virtue is newly introduced in the U.S. "we are still compiling the data from our clinical study and at this time I do not have any firm numbers to provide to you other than it is performing at least the same as the advance." I have not yet received the names of physicians in my area or in South Florida who are performing the Virtue surgery, but she is working on it. I've also asked her if Drs. Webster and McCammons (the AdVance proponents) or anyone at Walter Reed are doing the Virtue.

I'm wondering why your doctor is recommending the AMS InVance as it seems that the later AMS Advance is often now preferred -- it doesn't use screws and reduces the after pain. A local surgeon told me that he dropped the InVance in favor of the AdVance. Did your doctor have anything negative to say about the AMS AdVance? And, has she tried the AdVance? Since there are so few postings regarding surgical solutions to incontinence, I certainly appreciate your post and hope that you will tell us of your research findings and eventually your decision.

lion1
Posts: 240
Joined: May 2007

Your situations are so close to mine, so we feel and understand each others pain.

First a few comments: I believe there might be a Coloplast Surgeon in Winter Park Florida--just North of Orlando.

Cgerhardt, my personal opinion is to stay away from the Invance Sling. I have just heard about to many after-effects in my readings. The Advance sounds encouraging and the Coloplast sounds even better.Did your urodynamics reveal if you had a contracting bladder??

Tpelle--I talked to my Doctor yesterday at Walter Reed--he going to schedule Botox injections for me. Here's the reason, if you remember in my previous post, he claims that a main driver in my incontinence is a contracting bladder, limiting capacity, the pills I have been on did not help. The Botox is the nex step. He did say that with my condition, that a Sling would help, but may not do the entire job. I like this Doc and his step by step approach is one I am willing to follow. So once I get the Botox, I'll let you know what happens. I also know if it works to some degree, it's only temporary. Remember, I had a collagen injection last year by another Doctor, it did nothing because it had no effect on my bladder because it was just suppose to thicken the bladder neck.

Lion1

tpelle
Posts: 154
Joined: Aug 2003

lion1; I'm glad to hear that you are following up with your Walter Reed doctor. Both you and cgerhardt are doing the right things in an attempt to solve the incontinence issue. All I did was take Imipramine then Cymbalta, anti depressions drugs, which, when used in low dosages, are supposed to have the side effect of soothing or relaxing a contracting bladder. And they also causes just the muscles at the bladder neck to strengthen. For me there was no significant improvement at that time. I see my urologist next week for my annual checkup and PSA results and will ask him about any new meds; or I may try the Imipramine again. In the early years I also had one collagen injection which made no improvement.

So I am most interested in what further steps you and cgerhardt take. When, and if, I hear further from Coloplast with the names of the Virtue surgeons, I'll post again. tpelle

bigxbadxjohn
Posts: 15
Joined: Oct 2009

Hello tpelle-

On 21 October 2009 you wrote in your posting that the Program Manager of Coloplast had written to you regarding the performance of the Coloplast Virtue male sling compared to the AdVance. Do you recall when he wrote yo you? Would you have a copy of his email to you that you could forward to me. My email address is: bigxbadxjohn2@yahoo.com I am having major difficulties with the Coloplast sling and am planning to have it surgically removed and replaced with an AdVance sling.

Thanking you in advance for your help, John

tpelle
Posts: 154
Joined: Aug 2003

BBJohn: Sorry, I deleted the Coloplast emails as I was disappointed in their response to my quest for information on the Virtue. I first wrote them in late September after seeing a February 2009 press release. I heard from the product manager, but I never did receive the names of the Virtue surgeons in the Northern California and South Florida areas. Nor did they tell me whether Drs. Webster and McCammons, or Walter Reed doctors are doing the Virtue. I would expect them to be sufficiently organized to provide such basic information without delay.

Have you seen the Sentara Webcase featuring Dr. McCammons doing the Advance? Here is the address:

http://www.orlive.com/sentara-profile/videos/incontinence-surgery-the-male-sling

I hope you will continue to post, letting us know how you solve what must be a most difficult health issue. Best of luck. tpelle

bigxbadxjohn
Posts: 15
Joined: Oct 2009

Hello tpelle-

He is some information I found on another message board posted by a person logged in as GeorgieBoy. I highly suspect he is a doctor and very possibly a urologist. The Coloplast sling was imlanted in my body several months ago. it has been a total nightmare. There are additional areas of intolerable pain not mentioned in GeorgieBoys posting. I am having the Coloplast sling removed ASAP. I have high hope that AMS,s AdVance sling will end my incontinence.

Here is GeorgieBoy's posting:

Posted 9/24/2009 7:00 PM (GMT -7) Quote This Post
Hello there - I have been doing quite a bit of research into the Virtue Sling from Coloplast. I found this site by doing a google.com search...Anyway, I wanted to share a couple things regarding the Virtue Sling with you that you should take into consideration before trying it. I swear by the AdVance Sling!

1) Clinical Trial - if you are part of a clinical trial - you are being used as a guinea pig. The Virtue Sling has NO DATA behind it. AdVance has been implanted in over 16,000 patients as has quite a bit of data behind it. Some of the most well-respected doctors in the world implant it, including Dr. George Webster at Duke University and Kurt McKammon in Virginia, among others.

2) The Virtue Sling is actually a lot different from the AdVance Sling. The AdVance Sling is completely NON-OBSTRUCTIVE. Obstructing via compression, the Virtue Sling can potentially damage important structures in the male pelvis, especially the nerves, including the posterior scrotal nerve, the superficial and deep scrotal nerves, and the pudendals, to name a few. The AdVance effects a proximal relocation of the urethral bulb...you don't want to compress the structures there.

3) The Virtue Sling is placed over the bulbospongiosum muscle. This is likely to cause a high level of pain post-op, versus the AdVance, which is not placed over the bulbospongiosum.

4) The follow-up data and outcomes with the AdVance are excellent - over 36 months of follow-up data, with success rates of around 85% for the average patient in "good pelvic condition".

5) Lastly, the mesh used in the Virtue Sling is very closely related to the mesh from a product called "ObTape" by Mentor - who sold their Urology business to Coloplast. Google "ObTape" to see what I am talking about. The mesh isn't exactly the same, but has very similar qualities.

lion1
Posts: 240
Joined: May 2007

Thanks for that important update.

Lion1

tpelle
Posts: 154
Joined: Aug 2003

This is my third attempt to respond to your message. Lost the first two.

GeorgieBoy certainly seems comfortable with medical terminology. As you suggest he's either a surgeon or urologist or maybe he has had an AdVance implanted or is considering AdVance over Virtue. Whether or not his information is verifiable, it's more info on Virtue that I've seen elsewhere. Coloplast still hasn't responded to my requests for the names of Virtue sergeons.

Any positive thought I might have had regarding Coloplast Virtue have been quashed by your experience and GeorgieBoy's notes. I'm hopeful that the Cleveland Clinic will solve your nightmare as well as your incontinence problem. Please let us know how it goes. tpelle

bigxbadxjohn
Posts: 15
Joined: Oct 2009

Hello tpelle,

Thanks for responding. I have actually tried to "tone down" the descriptions of my suffering and displeasure with the Coloplast male sling for the sake of believability. It has made my life a living hell. I am beginning to learn about others that are experiencing similar undesirable side-effects, post surgery, from this sling, such as continuous pain and from one respondent, numbness in the groin area.

I suspect that I will become Coloplast's unwilling the Guinna pig regarding having as much of the Colpolast sling mesh surgically "dug" out of my body as possible in an attempt to end my suffering.

I would sincerely appreciate hearing from other Copoplast Virtue male sling recipients that are experiencing undesirable or intolerable post surgery complications from the Coloplast Virtue sling. My email address is: bigxbadxjohn2@yahoo.com

joe-57
Posts: 4
Joined: Nov 2009

Hi John,
Am sorry to hear of your pain, but must tell you that your description of it matches mine perfectly. I am part of the North American study that is testing the new 4 pronged sling. I was told by my Doctor that I am the only one among the 15 patients he has operated on that is experiencing pain and is in need of medication to treat it. I needed to be in the hospital for 2 days post surgery. When I was released I went home with a prescription for Dilaudid (narcotic). Because my pain continued in spite of it, and in fact got worse after the 1st week when everyone's was getting better, I had to change my medication. Since week 2 I have been on Supeudol (narcotic), Codeine and Naprosyn (anti-inflammatory). And yet my high level of pain continued for 4 weeks, at which time a psychiatrist friend of mine informed me that a low dose (25mg) of a tricyclic anti-depressant is sometimes used to treat pain i.e. Tofranil. I immediately asked my Doctor for a prescription and low and behold, the intense pain was reduced and I was able to get a better night's sleep. I am presently into week 9 of recovery and still in enough pain to keep me from work. Taking baths has been helpful. Still cannot bend too easily, or walk too fast, and sex is still out of the question. I am hoping that the pain will continue to diminish allowing me to get back into the activities I once enjoyed. Good luck with your management. Joe

tpelle
Posts: 154
Joined: Aug 2003

Your postings are greatly appreciated. I'm sorry that you have to report such unbearable and overwhelming pain following the Virtue Sling. I had hopes that it could be a choice solution for those of us with continuing incontinence. Other than the totally unacceptable pain, did you experience any improvement in your incontinence? tpelle

joe-57
Posts: 4
Joined: Nov 2009

Hi Tpelle,

Unlike BBJohn's condition mine did in fact improve. Prior to surgery I had been living with my incontinence problem for 5 years following the RP surgery in 2004. In the last year of my incontinence I was using between 1 and 2 pads per day. Nights were dry as were sit downs, but the problem was exasperated during activities like tennis, gardening etc.. The other situation I had to be very careful about revolved around drinking wine or beer. This would go through me whether I was standing or sitting. In any case, since my sling operation Sept. 11, 2009, I no longer need to use any pads. Of course, this is good but I did not count on the extreme pain. I'd also like to add that of the 15 patients my Doctor in Montreal, Canada operated on, I am the only one who is in this position. Before anyone makes a decision about which type of operation is best for them, they need the numbers on success rates, failures, definitions of each of these terms etc. My case is interesting from this definitional point of view, in that, on the one hand, it can count as a success in terms of the incontinence but a failure from the viewpoint of the pain. I say failure because if this pain were to persist fro another 2 or 3 months, I would be forced to make the decision to have the sling removed. For 9 weeks I have been improving, but my life is really on hold. I'm existing, but I cannot really call it living in the fullest sense. Hope these comments help. Joe

cgerhardt's picture
cgerhardt
Posts: 10
Joined: Oct 2009

Lion 1
No, I do not have a contracting bladder.

cgerhardt's picture
cgerhardt
Posts: 10
Joined: Oct 2009

Pardon my late response. I have not been back to this forum since I made the first post back in October. My Doctor is Dr. Latini at U of Mich. She specializes in fixing incontinence. She has done about 70 of the AMS slings both Advance and InVance. Not sure of the mix between the two. She has also done 6 Coloplast Virtue. She recommends either InVance or Virtue for me since she describes my condition after reviewing all the test as "moderate". She recommends Advance for "mild to moderate" and does not feel it will offer enough result based on her experience. She said the only downside to InVance was that some patients had some discomfort/irritation in the scrotum following surgery.I called six of her patients (list she gave me) all with either Advance or InVance and all were quite satisfied and two were thrilled with the results.
The literature she gave me from AMS shows Advance for "mild" and InVance for "mild to moderate" and AMS 800 (pump) for "moderate to severe" incontinence.
I really appreciate the information about Virtue and now makes me much more cautious. I have little or no control during the day and get by with a Cunningham clamp. Nights or when sitting at home are dry.....and this is getting old after 17 months post RP. Scheduled for surgery to do the sling last week of January so must make an informed decision as to which one to go for.

cgerhardt's picture
cgerhardt
Posts: 10
Joined: Oct 2009

I have not seen a post since I did mine on 12/14/09. After reading the information here and also posts on healingwell.com I am wondering if I should forget doing a sling and go for the AMS 800 pump instead of taking the risk with any of the slings.....expecially the Virtue since it seems to be a bit unproven.
Did any of you watching this forum consider the AMS 800 pump. If so what do you consider the pros and cons. The thread I read on Healing well seemed to say that pump users seem almost completely satisfied with the results.
Has anyone heard from bbjohn? We tried tried to talk by phone but did not make contact before he went in for his surgery to have Virtue removed.

joe-57
Posts: 4
Joined: Nov 2009

Hi Lion1
Just to let you know that I have had the same experiences as "big bad john" who commented on 5 types of pain after his sling surgery. I am into my 9th week post surgery and the pain and discomfort continue. Unlike john, I have been on pain medication since my operation, as I found the pain especially in the first 4 weeks,unbearable. I was originally supposed to be back at work after 8 weeks, but have not been able to due to the pain that continue, though somewhat reduced since week5, Good luck in your search. Joe

amm1
Posts: 2
Joined: Sep 2010

I have read you did not have success with Virtue Sling. Did you consider trying the Advance sling? Did you use Dr. Nitti at NYU? I am scheduled to have a sling inserted in Janaury.

strausz
Posts: 1
Joined: Nov 2009

Am 75, 3 years post robotic prostatectomy, PSAs all neg., ED not too bad, but leaking a lot - mostly when walking. Considering Virtue, Invance, Advance. Have just noted severe problems after Virtue - how often do these occur with Virtue, and after the other two types of slings?

Am a retired MD, also pretty new to chatrooms and internet searches for info...
Seems there are reports of terrible outcomes after most any intervention - not excatly news, but sobering all the same.
Thanks.

tpelle
Posts: 154
Joined: Aug 2003

Strausz: I believe Coloplast in still in Clinical Trials with the Virtue. No results yet other than a general statement from them that it is performing as well as the AdVance. Nothing from them regarding post surgery serious pain like that experienced by BBJohn, above. You have read my note above about a local doctor discontinuing use of the InVance (screw anchoring) in favor of the AdVance. My personal urologist/surgeon is recommending a a non-screw sling (hammock he calls it), but it's not the AdVance procedure. So, there may be more sling procedures in addition to Virtue, InVance and AdVance. Finally, watch Sentara's webcast featuring Dr. Kurt McCammons and the AdVance.

http://www.orlive.com/sentara-profile/videos/incontinence-surgery-the-male-sling

There may be some data there that will help answer your questions. I've read where the AdVance has in some cases produced minimal positive results, no improvement at all, and in come cases even made the incontinence worse. As another member said, "it's a crap shoot". Sometimes, we just have to take the shot. But, I'm not ready yet. tpelle

lion1
Posts: 240
Joined: May 2007

Tpelle,

Just wanted to give you an update. A few weeks ago URO recommended the Botox INJECTIONS---HOWEVER, the problem I have been experiencing is simply getting to talk to him, I have actually been trying to connect with him for the last two months. Everytime I talk to his nurse, she says he hasn't called you yet? I know he is busy, but he won't schedule the injections until he talks to me. His nurse has asked twice now and he says he wants to talk to me. So I sit and wait, so much time is being wasted. I am giving him until Dec 15. If he doesn't call, I'll go to TRICARE for an in-state referral. It's bad enough going through this crap, but even worse when you can't get care.

I am getting frustrated!

Lion1

tpelle
Posts: 154
Joined: Aug 2003

lion1: Remind us what the Botox injection(s)is supposed to accomplish? Is it similar to the collagen procedure? Your're urologist has already recommended Botox. Why does he need to talk with you again? Can't he just schedule the procedure? Is he the Walter Reed doctor? Frustration appears justified. tpelle

lion1
Posts: 240
Joined: May 2007

Tpelle,

It is suppose help eliminate the contractions of the Bladder. It can be successful and give up to a year relief to excessive leaking.

Yes, you're right what's up with this discussion he wants to have??? If this is the next step then schedule the procedure and talk to me before it occurs. My wife and I are baffled.

Yes, this is the Walter Reed Doctor and as far as I could tell he is very good, My wife and I talked to him and we both like his approach-----it's just getting in touch with him is what's frustring.

I heard he's been made the Chief of Urology not only at Walter Reed, but also Behtesda.

That's some big shoes to fill.

Lion1

lion1
Posts: 240
Joined: May 2007

The doctor contacted me today, his explanation was very important and he was very thorough, he told me all the in's and out's and the direction he wants to take me. He did apologize for the delay. His nurse will call me Thursday, I will probably have the injections done sometime in January. Again, know this Doctor is very good and I gained more respect for him because of his thoroughness. Maybe this wil provide some needed relief.

More to follow.........Lion1

bigxbadxjohn
Posts: 15
Joined: Oct 2009

I was implanted with a Coloplast Virtue male sling approximately 3 1/2 months ago. It has been a terrible experience for me. My incontinence worsened dramatically and the pain continues to be intolerable. The mesh that is wrapped around the rami (bones in my lower pelvis) feel like I am sitting on a broomstick. This is becoming more painful each day. My scrotum skin continues to burn and sting to the touch. My entire bottom side throbs continually. My urologist could only offer nerve medicine, nerve blocks or very strong narcotic pain killers. I do not wish to live doped up on pain medication.

I had appointments at The Cleveland Clinic two weeks ago and they will be surgically removing the Coloplast implant ASAP. They warned me that the pain and stinging sensations may continue for one year, following surgery, due to nerve irritation and possible nerve damage from this device. I will be evaluated for AMS's AdVance sling when the Coloplast sling is being removed. If my condition permits, an AdVance sling will be implanted at that time. The AdVance sling is much less invasive than the Coloplast sling.

I do not anticipate any problems with the AdVance sling since only two mesh supports are routed upward from the bladder and it does not requite the tightly tensioned rigid mesh arms that are wrapped around my lower pelvic bones nor does it require the hard feeling mesh platform that is causing intolerable nerve irritation inside my scrotum.

I will soon be in the unenviable position of comparing both implants from personal experience.

dleffert
Posts: 1
Joined: Nov 2009

I have been doing some research on the new Virtue Male Sling and am finding very little. I did have 2 consults with urologists. One is now using the procedure and recommending it over the AdVance Male Sling, the other has never heard of the Virtue. Obviously the second one is no longer a 'contender'.

I'm trying to decide which procedure I want. I am a condidate for either. On the one hand, the AdVance is a proven benefit. On the other, the urologist is recommending the Virtue because the 'mesh' is larger than the AdVance and is more stable because it has 4 points of connection instead of 2 in the AdVance. The downside, however, is that he has done only 3 or 4 Virtue procedures and that makes me a bit nervous. Also the Virtue is brand new and I cannot find many results. I did read some negative above, but that is all so far. Apparently the Virtue has been in use for some time in Europe.

Any comments or suggestions out there?

bigxbadxjohn
Posts: 15
Joined: Oct 2009

I received the following email from a sling suffer from Montreal today. I continue to wonder how many others are suffering in silence with this potentially tortuous device?

Hi John,
Though it was regrettable to read of your suffering after your operation, it was also a relief to learn that I was not the only one who was experiencing such pain. I have posted a few messages on the CSN discussion board. At this time I'd like to know if you have any thoughts on whether neural imaging would be helpful in detecting the cause of our pain. Some people swear by it, whereas my Dr. says it won't show anything. This pushes me to go private at a cost of around $500 for the test at a private clinic. I'm coming from Montreal Canada. Looking forward to hear from you. Joe

I would appreciate hearing from others that are experiencing prolonged pain or other complications from this device. My email is: bigxbadxjohn2@yahoo.com

bigxbadxjohn
Posts: 15
Joined: Oct 2009

Hello

You may cut and paste the following Government website to learn about Coloplast Virtue male sling incident reports to the FDA.

http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/results.cfm?start_search=1&searchyear=&productcode=&productproblem=&devicename=&knumber=K&pmanumber=P&manufacturer=coloplast&brandname=virtue&eventtype=&reportdatefrom=01%2F01%2F2008&reportdateto=11%2F30%2F2009&pagenum=10&key_count=0

I would appreciate hearing from others that are experiencing prolonged pain or other complications from this device. My email: bigxbadxjohn2@yahoo.com

joe-57
Posts: 4
Joined: Nov 2009

Hi Tpelle.
This is just to let you and every other viewer know that the new sling you are referring to at this website is the Virtue male sling... the very one that has caused a living hell for both bbjohn and myself. As far as I can discern, it is still in trials. Can't seem to find much data around outcome. Be prudent and learn to ask the right questions.

tpelle
Posts: 154
Joined: Aug 2003

joe-57: Have you experienced any improvement in the pain level in the last week or so? Are you of the opinion that the pain level will subside eventually to a satisfactory level without pain medication and without any salvage procedures? Other than pain relief medications does Coloplast or your surgeon have a back-up plan to correct the situation? Or are you expected to just live with the pain? Has he given you a prognosis as to if and when the pain will subside?

Has your surgeon or Coloplast recognized the after-Virtue pain issue and modified the procedure on future installations?

Your being the only one of his several Virtue recepient who has experienced the pain nightmare doesn't make the pain any less of a problem for you. My surgeon told me last week that his record of incontinence following open prostatectomy is 1-2 percent. And, he has not performed any sling surgeries on his post-prostatectomy patients. Unfortunately, I was part of that inglorious 1-2 percent statistic. I'm still hoping for a solution to my 1 - 2 pad per day problem. tpelle

bigxbadxjohn
Posts: 15
Joined: Oct 2009

Hello tpelle,

This is a huge and a life changing decision. It is extremely important to research as much as possible and ask questions to protect yourself. When you do decide, make certain your "informed consent" form, that you sign, is very explicit regarding what you have agreed to.

My doctor described an AdVance type sling (and procedure) to me in great detail and then implanted the Coloplast Virtue sling without my knowledge or consent. This device has been tortuous 24/7 for over four months now. It will be surgically removed at The Cleveland Clinic as quickly as I can be scheduled for surgery. I will be the happiest person on Earth to get this contraption out of my body. Perhaps a Christmas present to myself.

I highly recommend that you talk with or schedule an appointment with one of the top experts regarding male sling procedures. A couple of examples are Dr. Kenneth Angermeier, The Cleveland Clinic and/or Dr. Kurt McCammom, Sentara Hospital, Norfolk, Va. You can also watch a very informative video by Dr. McCammom at Sentara Hospital's website.

The most important thing to remember, you are making a life changing decision. Your quality of life will be much improved of much worse, mostly contingent on your research, willingness to travel, and your final decisions.

I cannot overstress the importance of "getting it right" the first time around. Second and third surgeries to fix bungled initial procedures are most unfortunate and expensive.

I wish you the best possible outcome.

John

my email: bigxbadxjohn2@yahoo.com

lion1
Posts: 240
Joined: May 2007

John,

I agree with the research and more importantly having a doctor you feel you can trust. It is unfortunate as Tpelle explained that a Doctor may tell you that 99% of his patients required no aftercare/ procedures for incontinence, but when you're that 1% it doesn't mean squat.
But, the reality is one could only tolerate the incontinence for so long before it drives you to a decision. In my case 3 1/2 years later, my new doctor is taking me down a road that could very well lead up to a Sling. With that said, next for me is Botox treatments probably in Jan 10, but there is a risk. 1 out of 20 people have to be catherized, for as long as two weeks. For some it could cause worse problems. I hope I am not that 1 in 20. Hell, I was the 1% already who was left incontinent. Maybe the pendulum will swing my way this time.

With all that being said, you don't have to regret your decision. You did what you had to do. It is not easy making these decisions, we all just want to get well, and we are putting a tremendous amount of trust in our Doctors.

I pray that we all in the near future are talking about our successes and not remaining in the 1% group.

Lion1

lion1
Posts: 240
Joined: May 2007

John,

I agree with the research and more importantly having a doctor you feel you can trust. It is unfortunate as Tpelle explained that a Doctor may tell you that 99% of his patients required no aftercare/ procedures for incontinence, but when you're that 1% it doesn't mean squat.
But, the reality is one could only tolerate the incontinence for so long before it drives you to a decision. In my case 3 1/2 years later, my new doctor is taking me down a road that could very well lead up to a Sling. With that said, next for me is Botox treatments probably in Jan 10, but there is a risk. 1 out of 20 people have to be catherized, for as long as two weeks. For some it could cause worse problems. I hope I am not that 1 in 20. Hell, I was the 1% already who was left incontinent. Maybe the pendulum will swing my way this time.

With all that being said, you don't have to regret your decision. You did what you had to do. It is not easy making these decisions, we all just want to get well, and we are putting a tremendous amount of trust in our Doctors.

I pray that we all in the near future are talking about our successes and not remaining in the 1% group.

Lion1

lion1
Posts: 240
Joined: May 2007

John,

I agree with the research and more importantly having a doctor you feel you can trust. It is unfortunate as Tpelle explained that a Doctor may tell you that 99% of his patients required no aftercare/ procedures for incontinence, but when you're that 1% it doesn't mean squat.
But, the reality is one could only tolerate the incontinence for so long before it drives you to a decision. In my case 3 1/2 years later, my new doctor is taking me down a road that could very well lead up to a Sling. With that said, next for me is Botox treatments probably in Jan 10, but there is a risk. 1 out of 20 people have to be catherized, for as long as two weeks. For some it could cause worse problems. I hope I am not that 1 in 20. Hell, I was the 1% already who was left incontinent. Maybe the pendulum will swing my way this time.

With all that being said, you don't have to regret your decision. You did what you had to do. It is not easy making these decisions, we all just want to get well, and we are putting a tremendous amount of trust in our Doctors.

I pray that we all in the near future are talking about our successes and not remaining in the 1% group.

Lion1

lion1
Posts: 240
Joined: May 2007

John,

I agree with the research and more importantly having a doctor you feel you can trust. It is unfortunate as Tpelle explained that a Doctor may tell you that 99% of his patients required no aftercare/ procedures for incontinence, but when you're that 1% it doesn't mean squat.
But, the reality is one could only tolerate the incontinence for so long before it drives you to a decision. In my case 3 1/2 years later, my new doctor is taking me down a road that could very well lead up to a Sling. With that said, next for me is Botox treatments probably in Jan 10, but there is a risk. 1 out of 20 people have to be catherized, for as long as two weeks. For some it could cause worse problems. I hope I am not that 1 in 20. Hell, I was the 1% already who was left incontinent. Maybe the pendulum will swing my way this time.

With all that being said, you don't have to regret your decision. You did what you had to do. It is not easy making these decisions, we all just want to get well, and we are putting a tremendous amount of trust in our Doctors.

I pray that we all in the near future are talking about our successes and not remaining in the 1% group.

Lion1

lion1
Posts: 240
Joined: May 2007

John,

I agree with the research and more importantly having a doctor you feel you can trust. It is unfortunate as Tpelle explained that a Doctor may tell you that 99% of his patients required no aftercare/ procedures for incontinence, but when you're that 1% it doesn't mean squat.
But, the reality is one could only tolerate the incontinence for so long before it drives you to a decision. In my case 3 1/2 years later, my new doctor is taking me down a road that could very well lead up to a Sling. With that said, next for me is Botox treatments probably in Jan 10, but there is a risk. 1 out of 20 people have to be catherized, for as long as two weeks. For some it could cause worse problems. I hope I am not that 1 in 20. Hell, I was the 1% already who was left incontinent. Maybe the pendulum will swing my way this time.

With all that being said, you don't have to regret your decision. You did what you had to do. It is not easy making these decisions, we all just want to get well, and we are putting a tremendous amount of trust in our Doctors.

I pray that we all in the near future are talking about our successes and not remaining in the 1% group.

Lion1

lion1
Posts: 240
Joined: May 2007

John,

I agree with the research and more importantly having a doctor you feel you can trust. It is unfortunate as Tpelle explained that a Doctor may tell you that 99% of his patients required no aftercare/ procedures for incontinence, but when you're that 1% it doesn't mean squat.
But, the reality is one could only tolerate the incontinence for so long before it drives you to a decision. In my case 3 1/2 years later, my new doctor is taking me down a road that could very well lead up to a Sling. With that said, next for me is Botox treatments probably in Jan 10, but there is a risk. 1 out of 20 people have to be catherized, for as long as two weeks. For some it could cause worse problems. I hope I am not that 1 in 20. Hell, I was the 1% already who was left incontinent. Maybe the pendulum will swing my way this time.

With all that being said, you don't have to regret your decision. You did what you had to do. It is not easy making these decisions, we all just want to get well, and we are putting a tremendous amount of trust in our Doctors.

I pray that we all in the near future are talking about our successes and not remaining in the 1% group.

Lion1

lion1
Posts: 240
Joined: May 2007

John,

I agree with the research and more importantly having a doctor you feel you can trust. It is unfortunate as Tpelle explained that a Doctor may tell you that 99% of his patients required no aftercare/ procedures for incontinence, but when you're that 1% it doesn't mean squat.
But, the reality is one could only tolerate the incontinence for so long before it drives you to a decision. In my case 3 1/2 years later, my new doctor is taking me down a road that could very well lead up to a Sling. With that said, next for me is Botox treatments probably in Jan 10, but there is a risk. 1 out of 20 people have to be catherized, for as long as two weeks. For some it could cause worse problems. I hope I am not that 1 in 20. Hell, I was the 1% already who was left incontinent. Maybe the pendulum will swing my way this time.

With all that being said, you don't have to regret your decision. You did what you had to do. It is not easy making these decisions, we all just want to get well, and we are putting a tremendous amount of trust in our Doctors.

I pray that we all in the near future are talking about our successes and not remaining in the 1% group.

Lion1

cgerhardt's picture
cgerhardt
Posts: 10
Joined: Oct 2009

I have not seen a post on this site since before Christmas. I would really like to get an update. I go in for sling surgery on February 3rd. At this point I am planning to do the AdVance sling but would like to hear if anyone has heard any more about Virtue.
Tallman

lion1
Posts: 240
Joined: May 2007

cgerhardt,

Good Luck on the Sling Surgery, I hope it improves and even better yet cures your incontinence. I'll be praying for you. Please let us know how it goes and the stages you go through along the way.

I'll be getting Botox Injections this week. I hope a Sling is not in my future, but if it is, you'll be a wealth of knowledge. I will post by next weekend and let you know how things turn out on my end.

Lion1

randy_in_indy's picture
randy_in_indy
Posts: 493
Joined: Oct 2009

I have a sling they put in during my Da Vinci. It seems to be working fine...I think I can feel it sometimes but who knows it could also just be the surgery on day 26. I cannot remember what mine was called but my surgeon has been putting them in every patient for the last two years...he's trying to set up a blind study that would have patients agree not to know if they had the sling or not prior to surgery and then an oustide agency would do followups with all patients also not knowing who did or did not have the sling to determine the value of placing slings during the prostectomy. I am I would consider barely incontinent currently with only small leaking during the day and virtually none at night rising to pee twice or three times each night. ...I am just glad my body/mind is telling me to get up each night prior to going. I just wonder about the long term effects of the sling....I know when women have historectomies they often need slings because there is nothing to keep the bladder from dropping and causing incontinent problems....I wish you the best of luck with the botox...never heard of that...are they shooting it into the bladder next or sphincter to beef it up ??

Randy in indy - age 52

cgerhardt's picture
cgerhardt
Posts: 10
Joined: Oct 2009

Randy in Indy,
I have not heard of anyone doing a sling at the same time as RP. This would lead one to believe that incontinence is a lot more common that many would lead you to believe. Why don't you received. It may be helpful to post that here. I don't know enough technical stuff to understand how they could implant a sling during RP surgery. The incision for sling is between the scrotum and anus. Robotic RP is north of that area so unless you had open RP I don't know how they would get a sling below the urethera. Perhaps if someone reads this that better understands the technique they could explain. Anyway, glad to hear that you are doing well.
cgerhardt

cgerhardt's picture
cgerhardt
Posts: 10
Joined: Oct 2009

Lion
I will definitely post my progress. I completed the pre operative physical this week and everything is go for my surgery next Wednesday at NYU. Flying there from Michigan to have the sling done by a doctor that has done a large number of them. I will hold off a final decision about doing either the AdVance or the Virtue sling until after consultation with the doctor on Tuesday. I am leaning pretty far toward the AdVance because there is just not enough data available on Virtue. Moreover, the doctors are very guarded about pushing Virtue probably because of some of the pain problems like bigbadjohn has experienced. AdVance seems much safer but seeems the Virtue may be a "stronger" fix.
Thanks for keeping me in your thoughts and especially prayers.
Cgerhardt

lion1
Posts: 240
Joined: May 2007

Randy,Cgerhardt,

Thanks for your replies. I too didn't know they did Slings at the same time as Prostate surgery. It just goes to show that doctors are trying new and numerous methods to get us well.

My Botox injections were today. It went well and in the next few days I'll post again to let you know if I see any improvement. I am retired military and had this done in a military hospital. Botox for Bladders is not FDA approved, that's why you don't hear much about it. But, doctors are performing these injections in military hospitals and they are showing great promise. Although, a temporary fix it can provide much needed relief. I believe soon that this will become standard practice and approved by the FDA in the near future.

Lion1

lion1
Posts: 240
Joined: May 2007

Randy,Cgerhardt,

Thanks for your replies. I too didn't know they did Slings at the same time as Prostate surgery. It just goes to show that doctors are trying new and numerous methods to get us well.

My Botox injections were today. It went well and in the next few days I'll post again to let you know if I see any improvement. I am retired military and had this done in a military hospital. Botox for Bladders is not FDA approved, that's why you don't hear much about it. But, doctors are performing these injections in military hospitals and they are showing great promise. Although, a temporary fix it can provide much needed relief. I believe soon that this will become standard practice and approved by the FDA in the near future.

Lion1

randy_in_indy's picture
randy_in_indy
Posts: 493
Joined: Oct 2009

I am thinking I have a ROCK STAR surgeon at least he thinks he is....That's why I picked him...I have been in very competitive sports all my life at a very high level and anyone that comes across like he did when I grilled him on everything is the one that won my business and vote. He and Dr. Scott have been implanting slings for at least two years on any Robotic they have done if not Three years. My sling is attached and anchored to the Coopers Ligament. I started doing some research and find that it is used in females getting slings also attached to the same ligament. I am still in continent but I am now as I am feeling better drinking more beer...that has to be a problem...when I start to have to travel for my job and it becomes a hassel I am certain I will buckle down and start following thier rules better but until then I am enjoying my life as I always do...Heck the COLTS are in the SUPER BOWL...I cannot stop drinking cold turkey now...LOL

Don't know if I said it here or not but my surgeons are trying to get a study going that will not let the patient know whether or not they get a sling...along with another educational surgeon in town that is also renowned for his prostate robotic success Dr Michael Koch at Indiana University Medical Center. They will have an outside agency do follow-ups for a number of years following the surgery with every patient...sling or no sling and see what the results of incontinence are...My surgeon is convinced he has a better rate of others because of implanting at the time of the Prostectomy. DR David W. Hollensbe and Dr. John W. Scott of Urology of Indiana are the two that are doing the slings with every prostectomy they are doing. Here is their Triage nurse's number if you would like to contact them. Terri at 317-564-5132

Hope this helps.

Randy in Indy

cgerhardt's picture
cgerhardt
Posts: 10
Joined: Oct 2009

Hi Guys,
I just returned from NYC and had Virtue sling surgery Wednesday. So far I am very pleased with the results. I have posted all the details on healingwell.com prostate cancer forum under Coloplast Male Sling. You can see the details there. If anyone prefers I can copy the information here as well.

bigxbadxjohn3
Posts: 20
Joined: Dec 2009

I was implanted with a Coloplast Virtue male sling July 2009. It has been a nightmare for me.

For beginners, I knew absolutely nothing about the Coloplast Virtue sling, did not know it had just begun clinical trials to learn if it was effective in reducing or ending incontinence or could be tolerated in a human body. I never gave my consent to have a Coloplast Virtue male sling implanted in my body. I never consented to being a Guinna pig. I was suppose to be implanted with a simple "U" shaped piece of mesh, not a four armed Quadratic (their description, not mine) surprise.

It not only made my incontinence much worse but I have suffered continuous pain originating from this implant. I was fortunate to have a portion of the Virtue polypropylene mesh removed from my scrotum last December. This lessened the pain and discomfort inside my scrotum but my scrotum skin remains VERY painful to the touch.

To make matters worse, the polypropylene mesh that is wrapped around my lower pelvic bones (rami) causes intolerable pain when I am seated. It feels like I am sitting on a piece of hemp barn rope. When I shift my weight, in an attempt to lessen the pain, the mesh feels like it is tearing the tissue deep inside my pelvis. For understanding, equivalent pain could be walking with a marble under your foot in both shoes.

I am in the process of scheduling surgery to have as much of the Virtue mesh scrapped or cut from my pelvic bones as possible. Hopefully, in time, I will be able to enjoy sitting again like a normal person.

Best wishes,

John

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