ams 800

Hi Sandflylarry,

If it were me, I'd have a conversation with the surgeon, now.  You just had the surgery, and there is a tremendous amount of swelling in that area, so that may also have an impact on what you are experiencing.  The more usual issue is having the pump located too high within the scrotum, with the surgeon advising you to gently pull downward on the pump several time per day, in the first few weeks after surgery.  The ultimate position of the pump is critical for ease of operation.  Also, you don't want the pump hardware (tubes) to become entangled with the natural tubes, blood vessels and nerves that connect to the testicles within the scrotum.

My layman opinion is that perhaps you have too much pump tubing in the scotum, thus moving the pump into a horizontal position, versus hanging vertically within the scrotum (purely a guess on my part).

I believe that there is a limited window of opportunity to make adjustments to the pump position within the scrotum, before the opening created to drop the pump into the scrotum heals and closes around the pump's tubes.

You will experience some discomfort as the pump contacts the inside on the scrotum wall or the testicles for a while, until the sensitivity of that area subsides over time.

sandflylarry said:

pump in wrong position

Thank you for your input. The Homehealth nurse is coming back on Monday and I can run it by her. She really had no knowledge of this procedure untill I should her the paperwork that I had on this.  I think she can get direct contact with the Urology doctor or sombody in the office. Thanks again

I was never advised to do anything after my operation other than to let everything heal. When I went back for activation the doctor was very surprised that my pump was too high. It has been over a year and I still haven't decided what to do. Every time I try to activate the pump it goes even higher and sometimes I can barely reach it. I was advised to let eveything settle down and then decide what action to take.

sandflylarry said:

pump location

I asked the doctor while I was still in the hospital, where is the pump located?  He told me to not worry about it and he would show me when the swelling went down. He said that I could accidently activate the pump and to leave it alone. I really don't want it in the wrong position when it is time to activate.  Ease of use should be #1 priority after taking the step to have it done.

My first AMS800 implanted in January 2013 worked beautifully for 17 months, then failed as a result of a pin sized hole in the balloon/reservoir.  On January 14, 2015 the entire system was removed and replaced  -- three incisions to remove the old system and three new incisions to place the new system components in different locations.  Yesterday, at two days short of six weeks the second surgeon activated the new system.  The pump on the first AMS800 was placed very low in the scrotum, was easy to find and to manipulate.  The second AMS800 pump was placed very high in the scrotum making it difficult to differentiate the pump and tubes from flesh and cords.  I was instructed both times to tug on the pump at least a couple times each day to prevent it from migrating into the body cavity.  I did that, but this time I was warry of pulling not only the pump but also the balloon.  Yesterday, the surgeon told me that she had left sufficient tubing that reasonable pulling on the pump would not affect the balloon placement which she installed under a muscle.   For the past 24 hours I have been tuggin harder on the pump each time I urinate and it is now easier to grasp by the entry/exit tubes.  Although I have had several incidents of spraying my hands, legs, the toilet and the floor, I am making progress doing a three hand job with only two hands!  The pump remains in a vertical position and the system is operating well at this point -- no leaks.  Since the activation I have dumpted the Depends and am now using only a liner. 

tpelle said:

Lower the Pump

jimco, see my general response below.  Yesterday when the surgeon saw that the pump was very high in the scrotum making it difficult to grab and pump, she suggested that if it's current location doesn't work out for me she can lower it.  It would require  minor surgery to be performed in the hospital operating room, but only as an outpatient.  I told her I would do my best to tug it down to a manageable position so that no further surgery would be required.  It seems to be lowering.  tpelle

tpelle, thanks for the info.