Incontinence-now 100% Dry

Bob_S

I had my RP 3 years ago and thank God I've been cancer free since. I'm 68 years old, fairly active, and was moderately incontinent using 2-3 pads a day. I decided that I wanted to be dry. Last month I had a Cystoscopy and a Urodynamic test and the results showed that I have Stress Incontinence. My Uro and I decided on the InVance Sling System. He predicted a 92% effectiveness. Last week I had the operation, and the following is my post op status that I sent to my Uro:
Dear Dr. Steele,
It's been over a week now since you inserted my InVance Sling, and I'm delighted to say that I am 100% dry. It far exceeded my expectations. On the day of my proceedure I packed 6 pads to take care of my overnight. I never had to unpack them. I have not used or needed a pad since the day of my operation. I have not had the slightest drip or leak.
As instructed I have completed the 7 days of antibiotics, and have avioded heavy lifting. I've increased my walking every day. Yesterday I went to Newport, RI and walked 5 miles, had lunch with a friend, had a beer, and never bothered to bring pads. I was in total control. At this point the only the only discomfort I have is when I'm sitting on a hard chair, but that gets less and less each day. I'm on no pain medication whatsoever.
I have an appointment to see you in a couple of weeks so until then - Thank you, thank you, a thousand times thank you!

Bob

tpelle

Hi Bob_S. Most encouraging to hear that the InVance Sling works so well for you. Is your success the norm or were you a particularly good choice as a patient. Anyway, contratulations! I was unaware of the InVance Sling by AMS and have been half-heartedly considering their AMS 800 Artificial Sphincter. Was Dr. Steele your regular urologist/surgeon or a specialist to whom you were referred? Had you known/talked with others who have had similar success with the InVance? Is InVance relatively new?

It's been three years since my RP and I have drippage whenever I am standing, particularly while exercising and doing yard work and using 1 to three pads per day. I would appreciate any additional comments you might have and any advice or recommendations. tpelle

Bob_S

tpelle said:

Hi Bob_S. Most encouraging to hear that the InVance Sling works so well for you. Is your success the norm or were you a particularly good choice as a patient. Anyway, contratulations! I was unaware of the InVance Sling by AMS and have been half-heartedly considering their AMS 800 Artificial Sphincter. Was Dr. Steele your regular urologist/surgeon or a specialist to whom you were referred? Had you known/talked with others who have had similar success with the InVance? Is InVance relatively new?

It's been three years since my RP and I have drippage whenever I am standing, particularly while exercising and doing yard work and using 1 to three pads per day. I would appreciate any additional comments you might have and any advice or recommendations. tpelle

Hi tpelle, Another week has passed and still no leaks. My wife says that my personality has improved 100%. I'm her old Bob again. I'll try to answer your questions as best as I can. The surgeon who performed my RP was Dr. J. Ricci head of Urology at Brigham & Women's Hospital. After the operation he recommended (many times) to see his associate Dr. Steele regarding my incontinence. I think I was so happy to be cancer free that I could put up with the task of managing my incontinence. Finally, after 3 years I got it through my thick skull that things weren't going to improve so I made the appointment with Dr. Steele. He was teriffic! He said that fixing this will be a life changing experience. He gave me 2 tapes describing in detail the Sling System and the 800 Artificial Sphincter. The AMS people claim about a 85% success rate. Dr. Steele said he inserted about 200 Slings and they all dramatically improved. Most were 100% dry. He said that a Cystoscopy and a Urodynamics test would determine if I'm a good candidate for the procedure and I was. Apparantly, there are different types of incontinence and my type (stress incontinence) lends itself to either procedures. He offered to give me names of doctors that he treated that would describe their experience in detail,but I had already made up my mind and I wanted to go for it. Why sling vs 800. Sling is fairly new and designed for a low to moderate problem(2-3 pads a day). If it didn't work Plan B was the 800 AMS system. Google the AMS website, it's quite good at explaining the two alternatives. Then find a Doc who has done many of them with good success. Hoped this helped.

tpelle

Bob_S said:

Hi tpelle, Another week has passed and still no leaks. My wife says that my personality has improved 100%. I'm her old Bob again. I'll try to answer your questions as best as I can. The surgeon who performed my RP was Dr. J. Ricci head of Urology at Brigham & Women's Hospital. After the operation he recommended (many times) to see his associate Dr. Steele regarding my incontinence. I think I was so happy to be cancer free that I could put up with the task of managing my incontinence. Finally, after 3 years I got it through my thick skull that things weren't going to improve so I made the appointment with Dr. Steele. He was teriffic! He said that fixing this will be a life changing experience. He gave me 2 tapes describing in detail the Sling System and the 800 Artificial Sphincter. The AMS people claim about a 85% success rate. Dr. Steele said he inserted about 200 Slings and they all dramatically improved. Most were 100% dry. He said that a Cystoscopy and a Urodynamics test would determine if I'm a good candidate for the procedure and I was. Apparantly, there are different types of incontinence and my type (stress incontinence) lends itself to either procedures. He offered to give me names of doctors that he treated that would describe their experience in detail,but I had already made up my mind and I wanted to go for it. Why sling vs 800. Sling is fairly new and designed for a low to moderate problem(2-3 pads a day). If it didn't work Plan B was the 800 AMS system. Google the AMS website, it's quite good at explaining the two alternatives. Then find a Doc who has done many of them with good success. Hoped this helped.

Hi Bob_S: Thanks for your encouraging response. I'm sure that dryness or near dryness would improve my personality too. After your first message, I was on the AMS site (and others) for hours. One further question - since the sling puts pressure on the uretha, have you had any problem starting urine flow? At this point, this is the only concern that I have. Best of luck for your continued dryness! tpelle

Bob_S

tpelle said:

Hi Bob_S: Thanks for your encouraging response. I'm sure that dryness or near dryness would improve my personality too. After your first message, I was on the AMS site (and others) for hours. One further question - since the sling puts pressure on the uretha, have you had any problem starting urine flow? At this point, this is the only concern that I have. Best of luck for your continued dryness! tpelle

Hi tpelle, Starting urine flow about an hour after my cathiter came out was a challenge. I am a total chicken and getting the courage for my 1st p was unnecessarly stessful. Once I started,I was quite surprised to find how easy it was. From my second p on, it was just like before my RP. I hope I don't make it seem too easy, after all, it is a medical proceedure with a foreign object being placed in your body. You have to give it time to heal. This is day 15 and I still feel a great deal of discomfort sitting on hard wooden chairs and the whole area from anus to testicles is very sensitive, and sometimes it throbs; however, each day it improves, and I have no problem sleeping. Last week my wife and I went to the movies (DaVinci Code), I've been driving my car alone for a week, and Thursday, I mowed my lawn (1/3 acre). In my opinion, the minor discomfort now is a small price to pay for the freedom I have from this operation.
This Wednesday I meet with Dr. Steele for post op discussion, and Friday I meet with Dr. Ricci for my 6 month PSA reading. If all goes well, who knows, maybe next week - boxer shorts.
I wish you well, and God Bless! Bob

RonPowell

Dear Bob_S. Congrats. I had my prostate out 3-01-05 via laproscopic. Was incontinent since using 1-4 pads daily. Found Dr here that did sling and highly recommended it. Along with my brother, we both had it done on 3-31-06. We wore a super pubic catheter until about 2 weeks ago when they inserted a catheter via penis. During all this time, I was unable to urinate on my own. I removed catheter 4 days ago now and am urinating but have a very hard time starting in the morning. I still continue to leak all day and night causing me to use 3-4 pads daily. He says it will get better! My brother on the other hand had his sling wear a hole in his uretha and urine flowed into his scrotum area. They removed the sling and cut a large hole in scrotum to allow collected urine to escape. He spent several weeks in hospital (some in ICU) and he is still not well by a long shot. All in all, I cannot see the good in this sling. I was never told about any test to run prior to see if I (we) were good candidates. Since I am still using pad, you can see I am still bitter. any suggestions? thanks - Ron Powell

tpelle

RonPowell said:

Dear Bob_S. Congrats. I had my prostate out 3-01-05 via laproscopic. Was incontinent since using 1-4 pads daily. Found Dr here that did sling and highly recommended it. Along with my brother, we both had it done on 3-31-06. We wore a super pubic catheter until about 2 weeks ago when they inserted a catheter via penis. During all this time, I was unable to urinate on my own. I removed catheter 4 days ago now and am urinating but have a very hard time starting in the morning. I still continue to leak all day and night causing me to use 3-4 pads daily. He says it will get better! My brother on the other hand had his sling wear a hole in his uretha and urine flowed into his scrotum area. They removed the sling and cut a large hole in scrotum to allow collected urine to escape. He spent several weeks in hospital (some in ICU) and he is still not well by a long shot. All in all, I cannot see the good in this sling. I was never told about any test to run prior to see if I (we) were good candidates. Since I am still using pad, you can see I am still bitter. any suggestions? thanks - Ron Powell

Hello Ron: Obviously your June 30 message puts a different light on the InVance Sling. I can't offer any suggestions. Hopefully during the past three weeks the outcome of the sling surgery on you and your brother has improved. Bob_S's positive report on his surgery was most encouraging. Was your surgeon highly experienced in this procedure? Was he recommended by your prostatectomy surgeon? What does he say caused the initial unacceptable result? I (and others I'm sure) would appreciate an update. tpelle

Bob_S

RonPowell said:

Dear Bob_S. Congrats. I had my prostate out 3-01-05 via laproscopic. Was incontinent since using 1-4 pads daily. Found Dr here that did sling and highly recommended it. Along with my brother, we both had it done on 3-31-06. We wore a super pubic catheter until about 2 weeks ago when they inserted a catheter via penis. During all this time, I was unable to urinate on my own. I removed catheter 4 days ago now and am urinating but have a very hard time starting in the morning. I still continue to leak all day and night causing me to use 3-4 pads daily. He says it will get better! My brother on the other hand had his sling wear a hole in his uretha and urine flowed into his scrotum area. They removed the sling and cut a large hole in scrotum to allow collected urine to escape. He spent several weeks in hospital (some in ICU) and he is still not well by a long shot. All in all, I cannot see the good in this sling. I was never told about any test to run prior to see if I (we) were good candidates. Since I am still using pad, you can see I am still bitter. any suggestions? thanks - Ron Powell

Dear Ron, I just got back from vacation. I'm so sorry to hear about your bad experience with the Invance Sling System, and I'm still positive about my experience. It's been over 2 months now and I've resumed all my activities including bicycle riding. I have not needed a pad since the operation on May 25th; however, I cannot truthfully say 100% dry. Many times after 24 hours of greater than normal activity I have a unine spot about the size of a quarter in my jockey shorts. I'll take that anytime, but I hope this is not a trend. I'll let all know if this significantly increases. Ron, I have a question. What is a super pubic catheter and why was it kept in so long. Looking back at some of my AMS material it says "Your doctor may insert a catheter through your urethra to drain your blatter immediately after the surgery. This catheter is usually removed the same day, or within 24 hours." (Mine was removed the next day or within 24 hours.)
Your experience was not at all like mine, and I don't know why. Have you called the AMS people. They must be aware of all the studies done on this product. Perhaps they could help. In my documentation they say to visit www.visitAMS.com or call 1-800-328-3881.
I sincerely hope things improve for you and your brother, and God Bless!
Bob

blkdog

Bob_S said:

Dear Ron, I just got back from vacation. I'm so sorry to hear about your bad experience with the Invance Sling System, and I'm still positive about my experience. It's been over 2 months now and I've resumed all my activities including bicycle riding. I have not needed a pad since the operation on May 25th; however, I cannot truthfully say 100% dry. Many times after 24 hours of greater than normal activity I have a unine spot about the size of a quarter in my jockey shorts. I'll take that anytime, but I hope this is not a trend. I'll let all know if this significantly increases. Ron, I have a question. What is a super pubic catheter and why was it kept in so long. Looking back at some of my AMS material it says "Your doctor may insert a catheter through your urethra to drain your blatter immediately after the surgery. This catheter is usually removed the same day, or within 24 hours." (Mine was removed the next day or within 24 hours.)
Your experience was not at all like mine, and I don't know why. Have you called the AMS people. They must be aware of all the studies done on this product. Perhaps they could help. In my documentation they say to visit www.visitAMS.com or call 1-800-328-3881.
I sincerely hope things improve for you and your brother, and God Bless!
Bob

Hello Bob
Congrats ! I had my RP 25 months ago and have had leaking since. Though, I am down to 2 pads a day. I will give it another few months then I am thinking of getting the sling.My urologist does not have any experience with the sling. Does your doctor at the Brigham still accept patients?
I am just west of the city.
What was the recovery time? I operate my own company and time away can be troublesome.
Thanks

Bob_S

blkdog said:

Hello Bob
Congrats ! I had my RP 25 months ago and have had leaking since. Though, I am down to 2 pads a day. I will give it another few months then I am thinking of getting the sling.My urologist does not have any experience with the sling. Does your doctor at the Brigham still accept patients?
I am just west of the city.
What was the recovery time? I operate my own company and time away can be troublesome.
Thanks

Hi blkdog,
I don't know if he accepts new patients, but Dr. Graeme Steele's email address is gsteele@partners.org. Won't hurt to ask.
I'm still doing well. I walk and exercise daily, and take 20 mile bike rides a couple times a month. I have occasional leaks when playing/lifting my grandchildren. Never serious enough to require pads.
Hope this helps!
Bob

duque

RonPowell said:

Dear Bob_S. Congrats. I had my prostate out 3-01-05 via laproscopic. Was incontinent since using 1-4 pads daily. Found Dr here that did sling and highly recommended it. Along with my brother, we both had it done on 3-31-06. We wore a super pubic catheter until about 2 weeks ago when they inserted a catheter via penis. During all this time, I was unable to urinate on my own. I removed catheter 4 days ago now and am urinating but have a very hard time starting in the morning. I still continue to leak all day and night causing me to use 3-4 pads daily. He says it will get better! My brother on the other hand had his sling wear a hole in his uretha and urine flowed into his scrotum area. They removed the sling and cut a large hole in scrotum to allow collected urine to escape. He spent several weeks in hospital (some in ICU) and he is still not well by a long shot. All in all, I cannot see the good in this sling. I was never told about any test to run prior to see if I (we) were good candidates. Since I am still using pad, you can see I am still bitter. any suggestions? thanks - Ron Powell

Dear Ron: I will go on male sling surgery in 10 more days, can you give some tips of what to do about pain after surgery? thanks Duque