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Comparing Male Slings for Incontinence

bigxbadxjohn
Posts: 15
Joined: Oct 2009

I am a mid-sixties male that underwent a prostatectomy approximately ten years ago. I remain cancer free but have required 1-2 pads per day for the urinary incontinence that resulted from this surgery. I did not require radiation or chemotherapy due to early detection. This made me the perfect candidate for male sling surgery.

I was implanted with a Coloplast Virtue Male Sling approximately 3 1/2 months ago. It has been a disaster for me. The pain has been continuous and intolerable. The majority of the pain originates from five areas. The scrotum skin continues to feel inflamed to the touch. There is major burning and irritation where the lower mesh arms pass under, but near, the creases between my legs and groin. The worst discomfort is on my bottom side where the lower mesh arms, of the Coloplast sling, are wrapped around the pubic rami or lower pelvic bones on both sides of my lower pelvis. This wrapped area causes bilateral abnormal “raised areas”, on the lower pelvic bone, which compresses tissue, causing intolerable pain, when I am seated.

My bottom side throbs continuously and feels deeply bruised. Sitting sometimes becomes impossible due to pain. The lower mesh arms are tightly tensioned and wrapped around the lower pelvic bones. This simulates the pain one would expect when sitting for an extended period of time on a broom handle or hard rope. The pain continues when I try to lie on my back in bed at night. I continue to use Vicodin to enable some degree of rest at night but sleep continues to be very difficult. My urologist has suggested nerve blocks or stronger narcotic painkillers but I do not want to live doped up on pain killers.

To make matters worse, I went from normally 1 pad per day pre-surgery to 3-4 pads per day post-surgery. The pain and discomfort continue to make intercourse unthinkable.

My health and well-being was great before this procedure so I am 100% convinced neither my anatomy nor my health was a factor in this failed procedure.

I had two appointments at The Cleveland Clinic, earlier this week, in search of ending my pain and suffering. They are scheduling me for surgery ASAP to remove as much of this Coloplast implant as possible. I was warned that the pain and stinging, in my pelvic area, may continue for as long as one year post-surgery due to the trauma to the nerves in my lower pelvic area.

I will be evaluated for AMS's AdVance sling procedure during the surgical procedure to remove the Coloplast sling. If my condition is favorable, an AdVance sling will be implanted during this surgery. The AdVance sling appears to be much less invasive than the Copoplast sling. It has only two mesh extensions routed upward to lift the neck of the bladder and compress the urethra. It does not require the lower arms, wrapped around the lower pubic rami, nor the hard mesh platform, currently inside my scrotum, that are causing me continuous pain. I am anxiously waiting for my surgery, which should occur in 4-6 weeks.

Following my implant surgery, I discovered this Coloplast Virtue male sling is in Stage IV of FDA Clinical Trials. One of the purposes, of the Stage IV Clinical Trials, is to learn if this device can be tolerated in the human body. I would be interested in learning if others have had such a negative experience with this relatively new Coloplast Virtue male sling. Please leave a message at: male_sling_problems@yahoo.com

lewvino's picture
lewvino
Posts: 1007
Joined: May 2009

Wow, Was not aware of side effects with the sling. One man at our local prostate cancer support group had some device put in that clamps the urinary tract shut. Urine builds up in the bladder as normal. Some type of device is placed in the testicule. He squeezed this device which release the cuff and the urine flow for about 45 seconds and then shuts on its own. He has had this for going on 10 years and loves it.

Good luck on your reparative surgery.

Larry

bigxbadxjohn
Posts: 15
Joined: Oct 2009

I believe your friend was implanted with an artificial sphincter valve. It has been referred to as the Gold Standard treatment for male incontinence. But it does require squeezing a valve, that is located inside the scrotum, to urinate.

I have high hopes the AdVance sling surgery will result the the cure that I am hoping for. Unlike the Coloplast Virtue male sling, AMS's AdVance sling should be undetectable inside my body and should allow for natural urination. I will soon find myself in the unenviable position of being able to directly compare these two substantially different devices from actual implants.

lion1
Posts: 240
Joined: May 2007

I am sorry to hear about your experience, however, your post is extremely important. As those of us decide what course of action we will take to relieve our incontinence, the longer we wait seems like new treatments keep springing up. Sounds like your body has rejected that type of Sling, maybe the advance will help.

I understand that the foremost authority on these type of situations is Dr Webster at Duke University, I was scheduled to see him twice, but my insurance would not cover it, so now I am going to Walter Reed and actually seeing one of Dr Webster's diciples, he taking a very controlled approach with me. Actually pills didn't work---and Botox is next, but that's because I have a contracting bladder. Everyone has something different contributing to their incontinence.

The sad part is whatever treatment we have, we just don't know if it will have an adverse effect.

Is wearing 3-4 pads a day with no pain the right answer?? I don't know, for me I am still trying to answer that question.

THE BEST TO YOU---LET US KNOW WHAT HAPPENS----LION1

bigxbadxjohn
Posts: 15
Joined: Oct 2009

Hello Lion-

The doctors at The Cleveland Clinic did not detect ant signs of implant rejection. That basically leaves three possibilities, the device was improperly implanted in my body, this new Coloplast Virtue male sling has design faults that cause severe irritation to surrounding nerves and tissue or possibly both conditions combined.

If the removal of the Coloplast sling and replacement with AMS's AdVance male sling ends my continuous pain, it will become 100% conclusive to me that there were major problems with my first implant.

notforpublic
Posts: 3
Joined: Mar 2010

I note you were considering the advance male sling for your problem. I am currently looking into it as well. Did you have the procedure, and if so how has it worked?

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

and I am continent since day 60 post surgery...My surgeon puts them in every da vinci he does and has been doing it that way for about 3 years now and has very good incontinence stats...only 1-3% incontinence. I am not sure what sling he is using but it connects to the coopers ligament.

iam144
Posts: 3
Joined: Apr 2010

I had my prostate removed in January 2009 via an RPP. I was incontinent and impotent from the beginning and never fully recovered.

On April 1 this year, I had the AMS Male Sling AND the AMS penile implant. Ever since the surgery, I've had a serious problem with urinary retention. I cannot completely void my bladder and find as the day goes on, I can void less and less until I have to insert an intermittent catheter to be able to fully drain. Also the urge to void is so great that sometimes, I leak before I make it to the bathroom.

I was doing fair before the surgery with 2 to 3 pads a day and living a fairly "normal" lifestyle using a combination of pads and clamps. But now I feel home-bound and can't be more than a few dozen feet from the bathroom for fear of urinating myself.

Anybody else heard of this kind of retention problem after having the sling installed?

Thanks!

Trew
Posts: 892
Joined: Jan 2010

Iam, I remember my hopes were high for a successful surgery, that I would be fully continent and functioning in other ways. It never happened. I ended up on hormone shots 3 weeks after the cath was pulled and I have been leaking more or less since the cath was pulled on March 30, 09.

I am not interested in the sling, but I would be interested in the AMS 800 artificial urinary sphincter implant. That seems more dependable to me. But if it didn't work, I think the mental blow would be very severe to me. I suppose you had the same hope, too, before surgery. I may be projecting my own feelings into your situation, but your story just about has the tears flowing. I hope your future improves greatly.

ancelprice
Posts: 3
Joined: Sep 2011

I have had 4 artificial sphincter implanted and none even slowed the leaking, I am considering the Vietue sling any info on thata?

Trew
Posts: 892
Joined: Jan 2010

BigX, I do hope your condition improves. What I wrote to Iam above also applies from me to your case. Surgery has its risks. I wish we got one do over in this PC treatment stuff. I would not have surgery, just take the radiaiton and get the hormone shot. Or I would have considered 3 or 4 surgeons and then chosen one. But even then, would the results have been any different for me? I have red hair- really bright red when I was a kid. I had freinds who could play out in the sun all day and only get a tan. The same sun would burn and blister me in 30 minutes. I guess I am just one of those small statisical numbers in a doctor's record.

But what do I know about any of this? Too often I have felt more like a spectator to what is going on rather than the key player.

ANightCoder
Posts: 1
Joined: May 2010

John,

Am new to the Cancer Survivors' Network. Came across your post when looking for information re: the AMS Advance Male Sling. Hope you have recovered from your earlier problems and are doing better now!!

Just had my Advance sling procedure performed at Brigham and Women's Hospital in Boston on Thursday, 29-Apr-2010. (Had my prostate removed at the same hospital on 25-Mar-2008.) So far so good, although have some pain/bruising from the operation. After experiencing mild incontinence since my earlier surgery, am pleased with my progress so far but have learned not to get my hopes up. Have had some minor leakage when sneezing/coughing and woke up around 4:00 am today a little wet. Otherwise quite dry. Just wondering how my experience compares to that of others. Any information you can provide will be greatly appreciated.

Thanks in advance for your help and good luck with your recovery!!

Best,

Brian

skirk07631's picture
skirk07631
Posts: 4
Joined: Aug 2010

Hi All,

I am new to the network. I just had the AMS Advance sling implanted on July 8,2010. I was very tender & in mild pain in my testicles for the first three weeks. I had an infection in one of the holes that was made but since have gotten rid of it with antibiotics. Before the surgery I would leak whenever I coughed,sneezed, or laugh heavly. I am now in my 4th week post surgery and i havent leaked at all. i am still somewhat a little uncomfortable sitting but i'm very satisfied thus far with the procedure. i also had a radical prosectomy 2 years ago and am still cancer free.

Wishing all the best

Sylvester

Trew
Posts: 892
Joined: Jan 2010

Skirk, thanks for sharing and welcome to our fellowship.

And just so you have no doubts about my position around here, I hate PC!!

Now you know.

I never wanted to be talking about pads and slings and AUS implants or surgery or radiation or hormone shots or hot flashes or ED or ........

I just want to be normal again. Will never happen. sigh.

so, more surgery........

But I sure do appreciate hearing the experiences of others.

papa2
Posts: 2
Joined: Feb 2011

Shirk, I am also new to the network. I had robotic surgery 2 1/2 yrs ago, I am cancer free but was incontinent for almost a year. Less then a year ago I stopped wearing pads put had a mild stress incontinence and a little dribble after urination. I wanted to be normal again so this Friday Feb 18, 2011 I had the AMS Advance sling implanted. Today is day two after the surgery and I have slight dribbling and urge. Just wondering if you had the same symptoms or if anyone who reads this had the same symptoms. And if so does it get better.

Thanks for your time

Papa2

papa2
Posts: 2
Joined: Feb 2011

Had the procedure on that Friday and Tuesday I was back at the Doctor's office suffering from severe incontinence 4 to 5 pads a day. Remember I wasn't wearing any pads, just had mild stress incontinence with certain movements and a little dribble after urination. I was told that this should not be and the sling was somehow causing the bladder muscle not to close properly. So this last Tuesday March 15 I had it removed and the TOM sling was put in which is positioned further up on the urethra. Well I’m in a lot more pain than the first procedure and I am still incontinent but now it’s only 1 to 2 pads day. “Remember I wasn't wearing any pads”. So now I have to go back to see the Doctor on March 29th. The way I feel right now is to remove the Damn Sling, hopefully go back to how I was and have collagen injections. Even if I have to get them two or three times a year, it’s better than what I am going through right now.
I was considered the perfect candidate for the Advance Male Sling. I read hundreds of reviews by fellow prostate cancer survivors who had positive results and only a handful had negative results. With my luck I fall in with the negatives. If anyone is thinking of having the procedure, try the collagen injections first. That’s what I should have done.

Bill V
Posts: 1
Joined: Jul 2010

I am considering the AdVance male sling. However, I use 5 to 7 pads a day and see that it is meant for mild pad usage. Has anyone that uses this many pads tried this solution? If so, did it work?

bigxbadxjohn3
Posts: 20
Joined: Dec 2009

Hello Billy V

I was implanted with an AdVance male sling last December at the Cleveland Clinic. It is working fantastic! I have not requires a pad since the December surgery which followed ten years of pad usage.

My pad usage was not as great as yours so my good outcome is not a realistic comparison. It could be a good idea to be evaluated by an AdVance sling expert such as Dr. Angermeier at the Cleveland Clinic. He should be able to give you very helpful advice regarding expectations. You can see his bio by Googling: Cleveland Clinic Angermeier

Best wishes,

John

Trew
Posts: 892
Joined: Jan 2010

I use 7- 10 pads a day, avg. I will be getting an eval at U of MI very soon and get their expert opinion. From what I have read, I don't think I am interested in a sling at all. neither wold my local uro recommend it. He likes the AUS much better.

Bizman
Posts: 4
Joined: Aug 2010

I had robotic surgery in January 2009 but developed an ileus that returned me to the hospital for 12 days. The catheter was left in for six weeks due to continued leakage from the bladder neck. Year and a half later, I use 1-2 pads per day and I'm looking for at the InVance sling thinking my bladder neck is scarred or damaged. Friend had one installed after three years of 2-3 pads a day and he remains dry. However, he had considerable pain after the procedure. My urologist suggests his screws were not placed properly causing nerve irritation.

On the erection side of the equation, I can obtain a 75% to 85% erection on my own and near 100% with Viagra. However, I was never informed about the decrease in length of my penis after surgery or the inability of the penis to fill to obtain the same diameter as it once did. Additionally, while orgasmic feelings are back to normal, I shoot pee rather than semen.

Here's the question: Does the InVance sling prevent urine leakage during an orgasm?

Pads I can take, peeing during sex is a huge problem.

bigxbadxjohn3
Posts: 20
Joined: Dec 2009

Hello Bizman,

I have not had any experience with AMS's InVance sling. I understand it was pretty much replaced by AMS's AdVance sling.

I was implanted with the AdVance sling last December. It is working fantastic for me. I had been using 1-2 pads per day for the last ten years. I have not required a single pad since the day following the AdVance implant.

I cannot answer you question about leakage during an orgasm since I am dealing with other issues unrelated to the AdVance sling. But I can tell you there is NO leakage when I cough, sneeze, lift heavy objects or do any other activity that could aggravate leakage.

I am 100% certain my answer would be NO if not for the other issues.

Best wishes,

John

Bizman
Posts: 4
Joined: Aug 2010

My urologist is not wild about the newer AdVance sling. He says the failure rate is very high. It seems as though the patient feels so good after a few weeks that they start doing lifting/sports/exercises before they should causing the failure. Who knows?

My friend with the InVance is still complaining about pain (6 months after surgery) and has started to leak again. I spoke to my urologist about the pain and he says many doctors don't insert the screws in the precise locations causing nerve irritation.

I'm beginning to wonder whether it is worth the risk or not.

bigxbadxjohn3
Posts: 20
Joined: Dec 2009

Hello Bizman,

I can only speak from my own experience but I was extremely cautious for six weeks following the implant of the AdVance sling last December. I did not engage in ANY strenuous activities/exercises and did not lift anything heavier than 5 pounds. I followed all of the recommended guidelines.

My reward..... I am now 100% dry and free of pads for the first time in ten years. My urination is basically normal with the exception of a slightly smaller stream after the first pee in the morning. For me, the AdVance sling has become a wonderful device.

Best wishes,

John

amm1
Posts: 2
Joined: Sep 2010

Can you tell me the name of the surgeon you used to put in the Advance sling? Thanks.

bigxbadxjohn3
Posts: 20
Joined: Dec 2009

Hello Amm1

My surgeon for the AdVance sling implant last December was Dr. Kenneth Angermeier at the Cleveland Clinic, Cleveland, OH.

The urology department at the Cleveland Clinic is often rated number 1 or 2 in the USA.

You can GOOGLE Dr. Angermeier's bio buy entering key words:
Cleveland Clinic Kenneth Angermeier.

It is my understanding that the AdVance sling by American Medical Systems is the only male sling that is used at the Cleveland clinic.

You may email or call me if I can help with more information.

Best wishes,

John

ddysright
Posts: 1
Joined: Apr 2013

TREW,

I am new and was wondering what you did to stop the horrible burning and itching that comes with using so many pads. I use 8 to 10 pads a day and leak constantally. I have tried lots of creams and have used several prescription creams but the leakage is so bad i stay raw all the time. I want to get the male sling but have only 6 months into this since i had robotic surgery. I am miserable and hope you or someone can give me helpful sugestions. I have tried the texas condoms with the uring bag. I have used the J-CLAMP but these devices have to be removed at night because they cause bad irration if you leave them on to long and can get infected. What to do---What to do.

     

 

Jeffery82
Posts: 1
Joined: Jul 2011

BillV,
Wanted to check to see if you had the sling implanted & results. I had robotic surgey last Sept. & have been a heavy leaker like you going thru 6 pads a day. My Dr. has recommended the procedure & wanted to hear of your experience. Thanks

Trew
Posts: 892
Joined: Jan 2010

Exactly why I refuse to consider a sling. thanks for the reinforcement.

You do have my sympathy.

JR1949
Posts: 230
Joined: Jun 2009

I had a radical prostatectomy March 2009, my PSA has been zero since (0.008). I still have some incontinence but is better last 9 months or so, I was using average of 6-7 pads at first, but now averaging 4 during the day and 1 overnight. I have discussed this with my uro and have decided that I can live with this because I have the fear that I could have problems like some of the guys posts I have read over the years such as still being incontinent and worst of all the infection or rejection of my body to a foreign material. Therefore I do not want go through another surgery and risk the chance of the possible side effects and maybe be more incontinent than I was post surgery and also have scar tissue that can cause a problem. I think this is something that we all have to look at the facts and decide what is best for you.

JR

lion1
Posts: 240
Joined: May 2007

JR1949,

I understand completely where you are coming from and feel the same way. My current incontinence problem is cauased by an overactive bladder and nothing has worked. I am living with it---at least no physical pain.

Lion1

memorial
Posts: 1
Joined: Aug 2011

I had the Radical Prostate surgery 6 years ago. Initially I had to use many pads per day due to bladder leakage. After 2 years, my pad use was reduced to one or two per day. I also had an overactive bladder.
Six months ago, two medicines were prescribed (Detrol and Imipramine)which helped my over active bladder and also slightly reduced my leakage. Since I was still using one pad per day, I had an advance male sling installed 10 days ago. Perhaps it is too soon to judge, but the results thus far have been poor. My urine stream is weak, I dribble, and I'm back to 4 pads a day.

steve55555
Posts: 2
Joined: Apr 2011

What brand of pads are you currently using?

lion1
Posts: 240
Joined: May 2007

I have tried all the medicines--none of them worked.

yurko
Posts: 1
Joined: Apr 2012

I had surgery in dec 2000 and suffered incontinence for 7 years. 4-5 pads/day. Little control in the AM but then downhill. Three years ago I had the male sling AdVance put in. It was like a miracle. I use a male guard since there is occasional drip but I am very happy and no side effects from the surgery. I did have some pain while sitting down so I used a doughnut for about a month. While I am happy, a friend had the same doctor and AdVance and no sucess, so the results vary.

pbbraun
Posts: 1
Joined: Jun 2013

I had Robotic Surgery about 6 years ago and have mild leakage, with one pad a day.   My urologist recommends the Advance sling procedure but I have declined based on the numerous problems addressed here and on other sites.   I have found some relief taking Korean Ginseng Powder (1tsp daily), which I take with hot Crystal Light.   It doesn't completely resolved the leakage but has reduced it significantly.  I was very surprised that the first day when I took the Ginseng and exercised on the treadmill, my leakage was significantly reduced and I didn't experience nearly as much "squirting" as I exercised.   If anyone else has tried Ginseng or other homopathic methods I would be very interested in their experiences.

lmaye
Posts: 2
Joined: Feb 2013

Hope my comment helps someone's decision.  Had robotic prostate surgery Jan. 2006.  Had bad incontinence problem afterwards.  Six years later (2012) I had the virtue sling procedure.  It has truly been a living nightmare.  Still had incontinence problem (some improvement). But, I have a severe scrotual sensitivity problem.  Covering my scrotum with litodurm patches has really helped, but can only use them about 8 hours a day or suffer the consequences (rashes).  Been to 7 different urologist and no help.  Still hoping for relief.

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