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AUS 800 Surgery on February 6

tpelle
Posts: 146
Joined: Aug 2003

In an attempt to solve a continuing incontinence problem (2.3 Depends Pads per day) on Wednesday, Feb 6, 2013, Dr. Anthony Stone http://www.ucdmc.ucdavis.edu/publish/facultybio/urology/187 installed an American Medical Systems AUS 800.  I am 81 years, had RPS ten years ago at another Medical Center, with a <.01 PSA level since.  Surgery was at 1:30 P.M. at U.C.-Davis Medical Center in Sacramento.  On prior surgeries I had general anesthesia.  The anesthesiologist suggested that a spinal would be easier on the recovery.  We did the spinal.  I walked the hospital floor square early the next morning and was discharged at 11:30 A.M.

I've been taking Hydrocodone for pain relief three times per day.  But after five days I'm backing off to twice per day.  Hydrocodone makes me a bit wobbly and sleepy.  I'll see the Urology clinic later this week for a "wound check" and in six weeks for activation of the system. 

On my first visit in December, after Dr. learned of my amount and type of incontinence he said the solution was either the AMS AdVance Sling or the AMS800.  After cystoscopy, however, he said that no amount of Kegels, medications, bulking, or other treatments including a sling would have stopped the leakage.  I regret not knowing that many years earlier.  He showed me on the monitor where the sphincter was deformed and not closing. Then he asked if I was ready for the AMS800.  I was, and we scheduled the surgery.  He cautioned that while the AMS800 would be the best treatment available, there could be no guarantee that I would be dry or even near-dry.  I guess we will know in six weeks. 

Dr. Stone told me he has been at U.C.-Davis Med Center for 28 years!

tpelle

Samsungtech1
Posts: 350
Joined: Jan 2011

Tpelle,

I am at the point that the less I have to do with Dr's the better.  After almost three years I still wear a pad.  I have found that if I take percocet, 7.5 that I auffer wven worse leakage than at any other time.  If you are taking meds for pain, from my own experience, you will have problems, some embarrassing.  I can get by on one pad a day.  Good for me.  I take pain pill I might end up with wet pants that I do not feel.  No happy medium.

This is my own experience.  Under most circumstances I try not to take more than one pill a day.  I usually have 75 pills and refill every 90 days.  Dr. Said I was getting addicted to them.  Now gave me 50 pills for 120 days.  With the pain I have been in there is no way this will work, but the ATF is really on him.

What I was getting at is if you are taking pain pills you will have severe leakage, my own opinion,because it relaxes all muscles.  

 

Trew
Posts: 891
Joined: Jan 2010

Tpelle, I heard the same speech from my doctor.  when I came in for activation 6 weeks after surgery my figers were crossed, I was hoping for the very best  results from surgery.

And today- almost 2 yrs later (in august 2013) I am almost  perfectly dry most of the time.  I leak when bike riding, but overall, I am so happy with my AUS800.

 

And my doctor- Dr Latini who was at a that atthe U of Michian hospital-  she was so kind, gentle, nice hands, and actually nice to look at.

 

Be hopeful my friend.  Life is better with an AUS.

ob66
Posts: 214
Joined: Apr 2010

tpelle: Hope you are doing well. I remember one week out I was so swollen i thought I had descended from an elephant. Black and blue, swollen and surprisingly with the swelling early on the incontinence goes away. You are probably at the worst stage right now if your surgery was done the 6th....Things should start getting better, and three to four weeks out your incontinence will return as the swelling goes down, but at the same time your comfort level will increase...You might be wondering why you did this about now, for the first week or so is the worst...Hang in there, it will soon get better....Cheers.

tpelle
Posts: 146
Joined: Aug 2003

Thanks, ob66, for your comments.  At one week post-surgery, the purple and swelling of the scrotum are beginning to subside; however, there remains considerable pain in the scrotum and beneath the perineum incision.  I'm wondering if I have been tugging too hard to keep the pump/connecting tubes from retreating into the abdomen.  The instructions say to gently pull on the pump twice a day.  But, with all the scrotum swelling I'm not sure I have even had the pump in hand.  How long did you do this "gentle pull?"  Been sitting on the left or right side of the buttocks to avoid the tubing which bulges to the surface at the perineum.  Does any of this sound familiar?  Appreciate any further comments.  tpelle 

Trew
Posts: 891
Joined: Jan 2010

Just easy, gentle "tugging" is all that is needed.  You can feel where the contol switch is- just keep it home is all that is required. You don't want it to drift upstairs into never never land. 

 

I never had any tubing problems underneath.  Hummm...  My tubing comes down from a 2nd incision area that was made in the abdomen.  But the area underneath was certainly swellen for a good 2- 3 weeks after surgery and I did sit on a pillow for a week or two.

 

 

ob66
Posts: 214
Joined: Apr 2010

The idea of squeezing anything in your scrotum is nothing but a big "WHAT?".....You will slowly get used to the position, the movement, the manipulation of the AUS 800 over time...Right now you are probably still so swollen that it all feels foreign...Don't worry, it will all come into focus.....

tpelle
Posts: 146
Joined: Aug 2003

Ob66 and Trew:  It's four weeks today since the AUS800 Implant.  The one-week wound check went well.  The scrotum swelling subsided in the second week.  What I thought was tubing in the perineum was actually the scar ridge of the perineum incision.  Both incisions healed well with little lingering pain except when sitting on the incision ridge.  However, the scrotum pain continued at a higher level than expected.  Pain meds didn't help much.  Quite painful getting in and out of chairs, the bed and even walking - through the end of the third week.  By the beginning of the fourth week I had no problem finding the tubing/pump.  The deactivation button is quite evident.  I can feel the pump stroke area, but it seems not to be the flat spot as projected in the Video. 

So, it's just now that I'm feeling that I will be ready for the activation in 19 more days.  One other thing, the leakage (drippage) after the implant was no different that before the surgery.  So, the swelling did not change my pad usage (~15/wk).  I did notice that the catheter tube which was in until the morning following surgery seemed a much larger diameter than the tubing used during the prostectomy.  I never did have a problem urinating. 

Thanks for your comments and support.  tpelle

Trew
Posts: 891
Joined: Jan 2010

Great step forward for you. 

And squeezing the pump to pee is about as painful as squeezing one of your fingers with medium pressure- its no big deal. I don't know about other guys but sometimes when I'm in a hurry and don't get a good centered finger lock on the device it squirts out from between my fngers like a mable and bangs into the guy next to him.  That does get my attention but a few times of shooting marbles and you just know how not to shot marbles.

 

For the rest of your life peeing will be an adventure- and I always keep my fingers on the device to feel the bulb inflating.  Step off too quiickly- before that sphincter is shut and you will do some dripping down the leg.  so much to learn- but its so simple too. 

Self-presrvation at its finest, for sure.

 

 

 

 

 

tpelle
Posts: 146
Joined: Aug 2003

Trew, ob66 and Josephg:  Thanks for your support through this AUS800 implant adventure.  After ten years of drippage since RPS, the AUS was implanted on February 6, 2013.  Today, at almost seven weeks out, Dr. Stone took about ten seconds to find the pump and activate the system.  Then, he gave me a few minutes to manipulate the pump, which was quite easy.    The fresh pad which I put on for the 40 mile trip home, then lunch with a glass of water and a glass of wine was dry at the end of three hours.  Two and a partial squeeze let the urine flow.  I am now pad-less for the first time in ten years.  I'll report further results later. 

The scrotum pain continues at a noticable and annoying level.  Seems mostly from the pump sloshing around in the scrotum.  Also, there is pain from sitting on the perineum incision.  Dr. Stone said it would diminish over the next four to five weeks.  I suspect not having the bulky pad in jockey shorts may reduce the scrotum irrritation too.  Again, thanks.

 

 

Trew
Posts: 891
Joined: Jan 2010

Tpelle, I have a big smile for you!!!Smile

 

Isn't it a wonderful sense of relief to be free from the dripping?  I love being back close to normal again.

 

thanks for the update.  I certainly remember how excited I was when the device was activated and I was dry.  Wow- so nice.

 

 

Trew
Posts: 891
Joined: Jan 2010

Tpelle, I have a big smile for you!!!Smile

 

Isn't it a wonderful sense of relief to be free from the dripping?  I love being back close to normal again.

 

thanks for the update.  I certainly remember how excited I was when the device was activated and I was dry.  Wow- so nice.

 

 

ob66
Posts: 214
Joined: Apr 2010

and please recall as Trew did the before and the after. It is nothing short of wonderful when you start out incontinent. We both described somewhat of a horror story going in, and to a certain extent it is, but the result is heaven. Noone, but the very meekest, should ever shy away from having this procedure. I am glad things are working out well for you, and bear in mind that it only gets better with time....Congrats!!!!!

tpelle
Posts: 146
Joined: Aug 2003

The AUS 800 was implanted on February 6 to solve a 10 year 2.3 pad/da urine drippage problem, following radical prostatectomy in 2003.  At age 81, the implant surgery itself went well.  The best part is that drippage has been zero since I departed the hospital.  What a great feeling to be able to go to the theatre, dine out, and do other every-day activities without having to wear a pad or even a liner.  The pump is ideally located in the scrotum and stays in position.  I have no problem securing the pump at the tubing with the left hand fingers and stroking the pump twice with the right hand fingers to release a strong urine flow emptying the bladder in seconds.   I find that taking a few moments to blot the residual drips of urine with toilet paper keeps the jockey shorts free from any dampness or stain. 

On the negative side of the ledger, there is still an annoying pain level resulting, I believe, from sitting on the tubing and/or cuff located between the scrotum and the anus.  These parts of the system are close to the surface.  I suspect that more generous buttocks would better hide these critical parts when in a sitting position. Maybe after more time this pain will subside.  Even if it doesn't, I am quite happy with the AUS 800 implant and resulting return to a dry state.

I hope that my experience, as well as the reporrts of others on this blog, will help those who are looking for an answer to continued incontinence following prostatectomy.  tpelle 

tpelle
Posts: 146
Joined: Aug 2003

Since my three-month AUS800 Implant update, there has been further improvement and enjoyment.  On June 10 I met with the surgeon to tell him about the continuing pain between the scrotum and annus.  I told him that tubing ran horizontally between the urethra and the surgical ridge, and that my sitting on it was causing some level of continuing pain.  He acknowledged my observation and showed me on a sketch how he runs the tubing in that area.  I told him I was not happy that the pain continues.  He said that with well over 600 AUS800 implants that he has done over the years only six have required revision, and that the pain in my case should stop at some point.  He prescribed 100 mg Amitriptyline HCL daily to counter the pain.  I soon cut those tabs in half taking only 50 mg each night at bedtime.  For the last two months I have been without pain and the AUS 800 system is working beautifully.  No leakage at all.  At some point I will stop taking the Amitriptyline to see if the pain returns.  Would I do the implant surgery again?  Definitely yes.  tpelle

ob66
Posts: 214
Joined: Apr 2010

Really glad to hear of your progress. The AUS procedure is a difficult one to consider going in, for the surgery is a bear. But hearing that you and Trew wound up with much the same end result as I did is great to hear. Time wounds all heals and heals all wounds. Congrats on your continuing success.

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