Artificial Urinary Sphincter Implant (AMS 800) -- help!!!

Greg Maze

Trew said:

AUS Surgery Date

My AUS was installed at the U of MI hospital on Aug 23, 2011.  So this August will be my  2 yr anniversay.  First real positive after that nasty PSA test that started all the trouble.

I should look into a recumbent bike but I enjoy off road biking a lot.  You are the 2nd person to recommend one. maybe that is what I need, or at least take a look at one.

If your father would be interested in talking to me on the phone about the AUS I would do that. 

-Trew

 

 

 

 

AMS 800

Greetings Trew:

Just joined the web site today.  I had my prostate removed over 4 years ago by DaVinci.  I'm another unlucky person as I still battle incontinence big time. I can easily go through 3 Depends diapers in a day and I mean soaked.  I'm over it.  I live in SW Fla and really don't want a Dr. here performing my surgery.  I noticied you went to U of M to have yours done?  I'm actually from Mich and know that U of M is a great medical school.  Can you give me the name of the Dr. that performed your surgery.  I would like to do some home work and ask him some questions?

Thanks,

bamaboy101

AMS 800

I just had the AMS 800 installed by Dr Arthur Burnett at Johns Hopkins in Baltimore, MD on 2/2/2016.  So far, it has been great for me.  I do have a very light leakage...only a few drops, and I had one time where I accidentally activated the device by sitting across a ridge.  You do have to be conscious about how you sit, etc.  I am 63 years old, had a prostatectomy in Sep 2012.  Many complications...urinary stricture surgery, incontinence (6 pads/day) which led to the AMS 800.  I am happy with the results so far...some other issues, but little by little.  I was a little surprised by the overall cost of the procedure.  I have good private insurance...typically pays 80-85%.  Just received a $24,000 bill from Johns Hopkins, Dr was another $3k and anesthesia another $2k or so.  So far my part has run around $5k out of pocket.

Josephg

bamaboy101 said:

AMS 800

I just had the AMS 800 installed by Dr Arthur Burnett at Johns Hopkins in Baltimore, MD on 2/2/2016.  So far, it has been great for me.  I do have a very light leakage...only a few drops, and I had one time where I accidentally activated the device by sitting across a ridge.  You do have to be conscious about how you sit, etc.  I am 63 years old, had a prostatectomy in Sep 2012.  Many complications...urinary stricture surgery, incontinence (6 pads/day) which led to the AMS 800.  I am happy with the results so far...some other issues, but little by little.  I was a little surprised by the overall cost of the procedure.  I have good private insurance...typically pays 80-85%.  Just received a $24,000 bill from Johns Hopkins, Dr was another $3k and anesthesia another $2k or so.  So far my part has run around $5k out of pocket.

Sitting Position

Yes, you need to be aware of how you sit and on what you sit on.  Remember where the cuff on the urethra is located (that nasty incision behind your scrotum).

If where/how you sit creates a pressure point in that area, it can compress the cuff and cause some minor leakage.

Hope that this helps.

hap4174

AMS 800

I am in my 13th year dealling with incontinence after prostate surgery. The last 2 years has been much worse (6-8 pads per day). I have considered the AMS 800

since the onset of incontence and recently had the procedure 5 days ago and am very concerned with the outcome. first I noticed a weak stream and trouble empting my bladder. then the swelling began big time and much pain. I was so looking forward to relief but so far it hasn't happened.

Has anyone had any similiar problems.

tpelle

hap4174 said:

AMS 800

I am in my 13th year dealling with incontinence after prostate surgery. The last 2 years has been much worse (6-8 pads per day). I have considered the AMS 800

since the onset of incontence and recently had the procedure 5 days ago and am very concerned with the outcome. first I noticed a weak stream and trouble empting my bladder. then the swelling began big time and much pain. I was so looking forward to relief but so far it hasn't happened.

Has anyone had any similiar problems.

AMS 800

Hap:  Probably the swelling is causing the weak stream.  There is a lot of pain during the first couple of weeks, but it improves gradually.  Be sure you take the pain meds as prescribed.  There won't be any relief from the leakage until the unit is turned on.  For me that was at about the 7th week post surgery.  In the meantime you will still have to deal with leakage but it shouldn't be any more than you experienced before the surgery.  The pain should mostly be gone by the time the unit is activated.  That's been my experience.  tpelle

hap4174

tpelle said:

AMS 800

Hap:  Probably the swelling is causing the weak stream.  There is a lot of pain during the first couple of weeks, but it improves gradually.  Be sure you take the pain meds as prescribed.  There won't be any relief from the leakage until the unit is turned on.  For me that was at about the 7th week post surgery.  In the meantime you will still have to deal with leakage but it shouldn't be any more than you experienced before the surgery.  The pain should mostly be gone by the time the unit is activated.  That's been my experience.  tpelle

AMS 800

tpelle, thanks for your reply. I think you are right on about the swelling causing the weak stream as the problem has improved as the swelling improved. My doctor didn't warn me about what to expect after surgery so I was very concerned, his reply was oh I've seen much worse which wasn't all that comforting but now that I know I am dealing with it as best I can thanks to a wonderful wife who has been very supportive.

    When did you have the procedure..have you been satisfied with it?

     Hap

tpelle

hap4174 said:

AMS 800

tpelle, thanks for your reply. I think you are right on about the swelling causing the weak stream as the problem has improved as the swelling improved. My doctor didn't warn me about what to expect after surgery so I was very concerned, his reply was oh I've seen much worse which wasn't all that comforting but now that I know I am dealing with it as best I can thanks to a wonderful wife who has been very supportive.

    When did you have the procedure..have you been satisfied with it?

     Hap

AMS 800

Hello Hap:  My open radical prostatectomy was in 2003.  During the first ten years I was averaging 2.3 Depends pads per day.  At the end of the ten years I had the AMS 800 implanted.  As like you the biggest concern during the recovery period was not knowing what to expect.  However, several of the guys on this site were most helpful.  After activation, the unit worked beautifully for about 17 months, then failed, and I was back on 2.3 pads per day.  After a month or so I returned to the U.S.Med, Davis Urology Department for help.  The balloon had lost it's charge and the cuff was not closing.  Fifteen months ago the first unit was taken out and replaced.  The doctor discovered that the first balloon had a pin-sized leak and had lost it's fluid.  The new AMS800 has been functioning perfectly for the past thirteen months.  Although the second surgery was more extensive (removing the old and implanting the new), it seemed easier because I knew what to expect.  In a couple months when your AMS 800 is working, you'll feel that the post surgery trauma was worth not having to use pads.  Although, I still do wear a liner as from time to time there is a drip or two when I sit on an irregular surface.  Hope this helps.  I'll respond if you have further questions.  tpelle

hap4174

tpelle said:

AMS 800

Hello Hap:  My open radical prostatectomy was in 2003.  During the first ten years I was averaging 2.3 Depends pads per day.  At the end of the ten years I had the AMS 800 implanted.  As like you the biggest concern during the recovery period was not knowing what to expect.  However, several of the guys on this site were most helpful.  After activation, the unit worked beautifully for about 17 months, then failed, and I was back on 2.3 pads per day.  After a month or so I returned to the U.S.Med, Davis Urology Department for help.  The balloon had lost it's charge and the cuff was not closing.  Fifteen months ago the first unit was taken out and replaced.  The doctor discovered that the first balloon had a pin-sized leak and had lost it's fluid.  The new AMS800 has been functioning perfectly for the past thirteen months.  Although the second surgery was more extensive (removing the old and implanting the new), it seemed easier because I knew what to expect.  In a couple months when your AMS 800 is working, you'll feel that the post surgery trauma was worth not having to use pads.  Although, I still do wear a liner as from time to time there is a drip or two when I sit on an irregular surface.  Hope this helps.  I'll respond if you have further questions.  tpelle

aus update

Hi Tpelle, my aus was activated on May 17 and the device is amazing. I stay completely dry all day and night. Like you I wear a liner which I could get by without.

I wanted to thank you for previous replies..they were very helpful. I still have one problem..The device appears to be causing me some pain and can be very uncomfortable especially if I am on my feet very long. Did you experience this at all? I noticed in your last post your surgery was in 2003. That ws the same year I had mine..April 3 @ 9:00 am to be exact. It is definitely a life changer. It has been more severe for me due to a condition called diabetes Insipidious.  It causes excess urination which complicates an already bad situation.

Thanks again  for your help

Hap

tpelle

hap4174 said:

aus update

Hi Tpelle, my aus was activated on May 17 and the device is amazing. I stay completely dry all day and night. Like you I wear a liner which I could get by without.

I wanted to thank you for previous replies..they were very helpful. I still have one problem..The device appears to be causing me some pain and can be very uncomfortable especially if I am on my feet very long. Did you experience this at all? I noticed in your last post your surgery was in 2003. That ws the same year I had mine..April 3 @ 9:00 am to be exact. It is definitely a life changer. It has been more severe for me due to a condition called diabetes Insipidious.  It causes excess urination which complicates an already bad situation.

Thanks again  for your help

Hap

Pain From AUS800

Hello Hap.  It's good hearing that you have made substantial progress from those first few days following your AUS800 implant.  Those early days can be trying. My prostatectomy was on the first Thursday of 2003.  Was in the hospital for two nights.

I do have some pain in the cuff area by bedtime but it seems no worse after I'm on my feet working in the garden for six hours.   Here is my explanation -

The cuff on my first AUS800 implant in January 2013 was far back on the urethra nearer the anus - probably the recommended position.  That caused some irritation and minor pain when sitting as tubing somehow located under the cuff and close to the surface.  Surgeon prescribed daily 100 mg of Amitryptline (a anti-depressant med) to relieve the pain.  It work well.  On the second AUS800 implant in February of 2015 a different surgeon (the first retired) placed the cuff on the urethra nearer the scrotum to avoid any overlaping of the tubing.  It did, but having the cuff nearer the testicles causes chaffing and some pain in the scrotum by bedtime.  So I am continuing the Amitryptline.  This minor irritation and pain is a small price to pay for urinary continence.

I'll be happy if this second implant continues to function for a few more years.  

tpelle

 

hap4174

No regrets

I am so enjoying not carrying a pad in every pocket when I am out that the pain is minor. I have been thinking that the pump assembly inside  the scrotum has been my problem but the area around the cuff is very tender also so that coulld be very well be my problem also since pain is sometimes hard to pin point. My doctor tells me to give it time..maybe he is right.

   Thanks again for your help. Hope your garden does well.

Hap 

Bmmg

Sling or AUS 800

I had prostrate surgery 3 years ago and have incontinence issues 3-5 Tena underwear per day depending on the day.  I have read a lot on here about the AUS & am leaning to having that procedure done   Does anyone have experience with the other procedure which I believe is called the sling   The incontinence has not stopped me from doing everything but certai a lot of things   I dread social outings as I may have to change pads or leak but I have still attended football & hockey games I just have a clear path to the bathroom  complicating my issues is a colostomy which I recieved due to a bowel injury during the prostate removal.  So it has been a double dose of "fun".  

Thanks in advance & Happy Fathers Day!!

 

 

 

 

 

Josephg

Sling or AUS 800

I cannot give you any advice on the sling, other than when I was reviewing my options, I read a lot of negative reviews/experiences about the sling, basically stating that it was not all that effective.  I had the AUS 800 implant surgery in January 2013, and it completely took care of all the concerns/dreads that you mention in your post.  It has been a life game changer for me, and I wholeheartedly recommend it to anybody whose quality of life is suffering, due to incontinence.  I've listed some links below that detail my experiences in chronological order which you are welcome to review.

http://csn.cancer.org/comment/1324584#comment-1324584

http://csn.cancer.org/comment/1326323#comment-1326323

http://csn.cancer.org/comment/1339326#comment-1339326

http://csn.cancer.org/comment/1339561#comment-1339561

http://csn.cancer.org/comment/1344785#comment-1344785

http://csn.cancer.org/comment/1413239#comment-1413239

Please let me know if you have any additional questions.

Bmmg

Sling or AUS 800

Josephg thank you for all of the information.  I told my doctor today I will do the AUS. Hopefully that will happen in December.  

Josephg

Decision

I'm glad that the information that I provided to you assisted you in coming to a decision.  I wish you the best of success in your upcoming procedure and the resulting new life of continence.

Skid Row Tom

Bmmg said:

Sling or AUS 800

Josephg thank you for all of the information.  I told my doctor today I will do the AUS. Hopefully that will happen in December.  

AUS is "the gold standard"

I agree with Joseph.  I'm on my second AUS.  My urologist said the AUS is "the gold standard", and I found out he was right.  You've  made the right decision.

DLB3

ams 800

Looking for some direction. In 2005 I had a Radical Prostatectomy ( cut from the bellybutton to to the pubic line ) recovery was long and painful. My doctor advised me about 1 % were incontinet. Two and a half years later after taking every medication available doing Cagels (what a wast of time) I was told that the AMS 800 was the answer to to my problem. I had the procedure and had good result for a couple of years and then the leaking started getting worse. I returned to my doctor and was told I was not leaking enough to add a second cuff. I went to a cancer center and talked with a doctor that said he wanted to scope my urethra. I was able to see on the screen that the inside of my urethra was white. The doctor said that the cuff needed to be repositioned. So five years after the first device was implanted it was removed and another AMS 800 was implanted. Another year passed with good results ( not great but good). The leakage started getting worse. I returned to the cancer center and the same doctor stated he wanted to replace the cuff only. So another operation nine years after the prostatectomy. Again good results ( some leakage but workable ).  Now 2016 eleven years after the first operation I am having an increasing amount of leakage. I am seeing a new doctor that is closer to me as the cancer center is four to five hours away from my home.  I have been doing test on my intake and discharge of fluids, taking new medication and have had botox injections in my bladder.  Not much help. Now my doctor has recomended The InterStem system that places a wire in to my spine with a control that sends an electrical charge through my spinelcord to my brain to control my blader spasems. At this point ( 09/2016 ) I am feeling like a ginny pig and have not  made up my mind about having the InterStem system implanted. Any input?   

ob66

Skid Row Tom

Would you care to comment on having the second installation after the first has had to be replaced? I am not there yet after my first install in June 2010, but do have recollections, and have shared them here or the surgery. Is it just the same the second time? The swelling and pain for about 3 weeks? Do you have to wait for any urethra healing from having the sleave thereon? Thanks for any help. I am hoping mine will last forever, but am not so naive'.

Whitehorse

AMS 800 pump migration

I had a radical prostatecomy 8/18/11 with EBRT following.  I tried many remedies for incontinence without success. I had the AMS 800 implant 9/14/16. When it I found out the pump had rotated and in upside down.  I am planning on having it corrected, but don't have any information on recovery from this procedure. I am told it is a 10 minute procedure with general anestesia. If anyone know about restrictions, weight limits or recovery time away from work, I would appreciate it.

Thank you

Clevelandguy

Still hope

Hi,

 

At 13 months he might want to wait a few months longer to see if he heals even more.  I had mild but steady improvement the first year after surgery but more improvement during the second year.  I went from one maxy depends pad a day to a light pad today.  Still dribble a little when I pee or strain but much improvement in the second year.  Everyone heals differently.  You could always do the slings at a later date.

Dave

3+4

dga5151

tpelle said:

Pain From AUS800

Hello Hap.  It's good hearing that you have made substantial progress from those first few days following your AUS800 implant.  Those early days can be trying. My prostatectomy was on the first Thursday of 2003.  Was in the hospital for two nights.

I do have some pain in the cuff area by bedtime but it seems no worse after I'm on my feet working in the garden for six hours.   Here is my explanation -

The cuff on my first AUS800 implant in January 2013 was far back on the urethra nearer the anus - probably the recommended position.  That caused some irritation and minor pain when sitting as tubing somehow located under the cuff and close to the surface.  Surgeon prescribed daily 100 mg of Amitryptline (a anti-depressant med) to relieve the pain.  It work well.  On the second AUS800 implant in February of 2015 a different surgeon (the first retired) placed the cuff on the urethra nearer the scrotum to avoid any overlaping of the tubing.  It did, but having the cuff nearer the testicles causes chaffing and some pain in the scrotum by bedtime.  So I am continuing the Amitryptline.  This minor irritation and pain is a small price to pay for urinary continence.

I'll be happy if this second implant continues to function for a few more years.  

tpelle

 

Pain from AUS 800

tpelle,

i had AUS800 implant at Mayo 6 weeks ago. It's being activated this week. I continue to experience pain, especially in late afternoon and evening. As you describe it is more like irritation, or chaffing. Has your pain improved, or is it something you just learn to live with? I'm hoping it'll improve.

dga5151