Prostatectomy with an AUS (artificial urinary sphincter) in place

pachella

I have been diagnosed with prostate cancer. I will likely need radical prostatectomy surgery in the near future. I have an AUS (artificial urinary sphincter) already in place. Have any of you had this surgery with an AUS? Might such surgery result in damage to the AUS or its control reservoir, which is located in the abdomen?

pachella

I should have noted that I am 80 years old. PSA > 12; biopsy Gleason score 9, grade 5; perineural invasion: present (all sites); cribriform growth: present.

jc5549

Hi there,

Dont have an AUS in place. Working on improving my post prostatectomy continence and hoping not to need one in the future. Many guys on this site have a lot of knowledge. One thing that really helps is knowing what Gleason's score you have, grade group disease, PSA, age, MRI findings that lead to biopsy, all positive biopsy cores, what % positive and what location, and any additional information.

May I ask why you have an AUS currently? Have you had prior radiation to the pelvis for some other type of cancer? Did you have a prior prostate surgery for benign disease (TURP) that caused incontinence?

Thanks and hope to help,

jc

Old Salt

Yours is a very special case. I recommend that you discuss the issue with the surgeon you are contemplating using.

pachella

https://csn.cancer.org/discussion/comment/1716161#Comment_1716161

I had initially had a Rezum procedure (water vapor through the urethra at the prostate) that began my incontinence. That was followed by a TURP procedure, because of a blockage, after which my incontinence increased. The AUS has been wonderful; completely stopping all leakage.

pachella

I will do that. But, I am surprised and frustrated at the lack of urgency by my medical "team". My biopsy was posted onto my portal and then I have had to wait almost three weeks to get a PSMA PET scan. And my follow-up appointment isn't for two weeks after that.

jc5549

Agree with Old Salt, special case. If your PSMA Pet is negative for metastatic disease local aggressive therapy makes sense. I guess your TURP tissue was negative for cancer or low grade? Have you had a consultation with a Radiation Oncologist ?

centralPA

Sounds like whatever treatment you have, it will be a team sport. Expert in RALP and an expert in AUS standing by? I’d definitely ensure they are alking to each other.

Best of luck!

pachella

https://csn.cancer.org/discussion/comment/1716175#Comment_1716175

I will consult with an oncologist once I have the PSMA PET scan.

Josephg

https://csn.cancer.org/discussion/328180/prostatectomy-with-an-aus-artificial-urinary-sphincter-in-place

I am in the opposite situation that you are in. I had a radical prostatectomy that left me 100% vertically incontinent, so I had an AUS800 implant procedure. In my non-medical opinion, the AUS800 should not be an issue, unless the reservoir is located in one of the incision points for the robotic procedure (assuming that you will choose the robotic procedure over the open procedure). Even then, I believe that the surgeon can work around it.