AMS800

An earlier thread posted some of my history dealing with the aftermath of Prostate Cancer Surgery.  After living ten years (age 71 - 81) with <.01 PSA I decided to explore an artificial system to eliminate or slow gravitational drippage using 2.3 Depends Pads per day.  The head of Urology at U.C.Med-Davis, in Sacramento showed me where there was an area in the natural sphincter which was leaking--caused by damage to the sphincter during prostatectomy.  He told me there were no treatments which would stop or slow the flow other than the AMS800.  In February 2013 he did the installation.  Lots of swelling and pain which lingered for several months, but finally stopped.  He activated the system in six weeks and it worked beautifully for 17 months.  One night I went to bed with a working artificial sphincter, but on getting out of bed the next morning a gush of urine wet my pajamas.  But, I got to the toilet fast enough to allow the badder to empty.  It was obvious to me that the AMS800 had lost its (hydraulic) fluid.  From that point on there was no need to open the cuff to urinate; it was as if it were locked in an open position. 

In October 2014 I saw the new head of Urology at U.C.Med-Davis in Sacramento.  After doing an ultrasound and cystoscopy she agreed that the fluid had leaked out of the system.  After being dry for 17 months I knew I did not want to return to leaking 2.3 pads per day of urine.  After consultation, the surgeon felt we should replace the failed system.  I thought it might be a matter of finding the leak and repairing that particular area.  Last Wednesday, January 14, the failed system was removed and a new AUS800 was implanted.  One might think that it would could be a less intrusive surgery.  But, there was an incision in the perineum to remove the old cuff and a new incision to place the new cuff closer to the scrotum.  Another incision was made in the lower right abdomen to remove the old baloon/reservoir; and a nearby incision made to install the new balloon, this time under a muscle.  Finally a new incision, I believe, to place the pump in a slightly different place in the scrotum. 

All this had to be accomplished because of the failure of the first balloon/reservoir.  The team tested the old balloon/reservoir holding it under water in a pail of water, similar to how we tested bicycle tire tubes in our youth.  A pin-point leak was immediately evident.  A representative of AMS was on hand to observe the balloon test and was sending the unit back to the factory for evaluation.

Today, on the eight day following surgery to remove the old system and install the new, I returned to the Urology Clinic for the standard "wound check."  To this point all is going as planned.  There seemed to be more pain this time.  However, I read my notes from twenty three months ago and found that I was complaining about pain then too.  It's probably easier on this second surgery because I was aware of the procedure, although the surgical staff were all new.  

I must say that we are most impressed with the Urology Clinic Surgeon, her assistants, office and hospital personnel and the hospital facility itself at U.C.Med-Davis, in Sacramento.  When we arrived early for appointments, seldom did we have to wait to be seen, even if it were before appoint time.  In both cases I was in a one-person private hospital room with toilet and shower.  The nurses were efficient, pleasant and answered questions.  It was an overnight stay and I was released by 9 A.M. the following morning after making sure I could walk about 400 feet and could produce a urine specimin.

So, at this point I am pleased with the replacement of the faulty AMS800.   More reports to come.  tpelle