Comparing Male Slings for Incontinence

bigxbadxjohn
bigxbadxjohn Member Posts: 15
edited March 2014 in Prostate Cancer #1
I am a mid-sixties male that underwent a prostatectomy approximately ten years ago. I remain cancer free but have required 1-2 pads per day for the urinary incontinence that resulted from this surgery. I did not require radiation or chemotherapy due to early detection. This made me the perfect candidate for male sling surgery.

I was implanted with a Coloplast Virtue Male Sling approximately 3 1/2 months ago. It has been a disaster for me. The pain has been continuous and intolerable. The majority of the pain originates from five areas. The scrotum skin continues to feel inflamed to the touch. There is major burning and irritation where the lower mesh arms pass under, but near, the creases between my legs and groin. The worst discomfort is on my bottom side where the lower mesh arms, of the Coloplast sling, are wrapped around the pubic rami or lower pelvic bones on both sides of my lower pelvis. This wrapped area causes bilateral abnormal “raised areas”, on the lower pelvic bone, which compresses tissue, causing intolerable pain, when I am seated.

My bottom side throbs continuously and feels deeply bruised. Sitting sometimes becomes impossible due to pain. The lower mesh arms are tightly tensioned and wrapped around the lower pelvic bones. This simulates the pain one would expect when sitting for an extended period of time on a broom handle or hard rope. The pain continues when I try to lie on my back in bed at night. I continue to use Vicodin to enable some degree of rest at night but sleep continues to be very difficult. My urologist has suggested nerve blocks or stronger narcotic painkillers but I do not want to live doped up on pain killers.

To make matters worse, I went from normally 1 pad per day pre-surgery to 3-4 pads per day post-surgery. The pain and discomfort continue to make intercourse unthinkable.

My health and well-being was great before this procedure so I am 100% convinced neither my anatomy nor my health was a factor in this failed procedure.

I had two appointments at The Cleveland Clinic, earlier this week, in search of ending my pain and suffering. They are scheduling me for surgery ASAP to remove as much of this Coloplast implant as possible. I was warned that the pain and stinging, in my pelvic area, may continue for as long as one year post-surgery due to the trauma to the nerves in my lower pelvic area.

I will be evaluated for AMS's AdVance sling procedure during the surgical procedure to remove the Coloplast sling. If my condition is favorable, an AdVance sling will be implanted during this surgery. The AdVance sling appears to be much less invasive than the Copoplast sling. It has only two mesh extensions routed upward to lift the neck of the bladder and compress the urethra. It does not require the lower arms, wrapped around the lower pubic rami, nor the hard mesh platform, currently inside my scrotum, that are causing me continuous pain. I am anxiously waiting for my surgery, which should occur in 4-6 weeks.

Following my implant surgery, I discovered this Coloplast Virtue male sling is in Stage IV of FDA Clinical Trials. One of the purposes, of the Stage IV Clinical Trials, is to learn if this device can be tolerated in the human body. I would be interested in learning if others have had such a negative experience with this relatively new Coloplast Virtue male sling. Please leave a message at: [email protected]
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Comments

  • lewvino
    lewvino Member Posts: 1,010
    Wow, Was not aware of side
    Wow, Was not aware of side effects with the sling. One man at our local prostate cancer support group had some device put in that clamps the urinary tract shut. Urine builds up in the bladder as normal. Some type of device is placed in the testicule. He squeezed this device which release the cuff and the urine flow for about 45 seconds and then shuts on its own. He has had this for going on 10 years and loves it.

    Good luck on your reparative surgery.

    Larry
  • bigxbadxjohn
    bigxbadxjohn Member Posts: 15
    lewvino said:

    Wow, Was not aware of side
    Wow, Was not aware of side effects with the sling. One man at our local prostate cancer support group had some device put in that clamps the urinary tract shut. Urine builds up in the bladder as normal. Some type of device is placed in the testicule. He squeezed this device which release the cuff and the urine flow for about 45 seconds and then shuts on its own. He has had this for going on 10 years and loves it.

    Good luck on your reparative surgery.

    Larry

    Comparing Male Slings for Incontinence
    I believe your friend was implanted with an artificial sphincter valve. It has been referred to as the Gold Standard treatment for male incontinence. But it does require squeezing a valve, that is located inside the scrotum, to urinate.

    I have high hopes the AdVance sling surgery will result the the cure that I am hoping for. Unlike the Coloplast Virtue male sling, AMS's AdVance sling should be undetectable inside my body and should allow for natural urination. I will soon find myself in the unenviable position of being able to directly compare these two substantially different devices from actual implants.
  • lion1
    lion1 Member Posts: 241

    Comparing Male Slings for Incontinence
    I believe your friend was implanted with an artificial sphincter valve. It has been referred to as the Gold Standard treatment for male incontinence. But it does require squeezing a valve, that is located inside the scrotum, to urinate.

    I have high hopes the AdVance sling surgery will result the the cure that I am hoping for. Unlike the Coloplast Virtue male sling, AMS's AdVance sling should be undetectable inside my body and should allow for natural urination. I will soon find myself in the unenviable position of being able to directly compare these two substantially different devices from actual implants.

    John
    I am sorry to hear about your experience, however, your post is extremely important. As those of us decide what course of action we will take to relieve our incontinence, the longer we wait seems like new treatments keep springing up. Sounds like your body has rejected that type of Sling, maybe the advance will help.

    I understand that the foremost authority on these type of situations is Dr Webster at Duke University, I was scheduled to see him twice, but my insurance would not cover it, so now I am going to Walter Reed and actually seeing one of Dr Webster's diciples, he taking a very controlled approach with me. Actually pills didn't work---and Botox is next, but that's because I have a contracting bladder. Everyone has something different contributing to their incontinence.

    The sad part is whatever treatment we have, we just don't know if it will have an adverse effect.

    Is wearing 3-4 pads a day with no pain the right answer?? I don't know, for me I am still trying to answer that question.



    THE BEST TO YOU---LET US KNOW WHAT HAPPENS----LION1
  • bigxbadxjohn
    bigxbadxjohn Member Posts: 15
    lion1 said:

    John
    I am sorry to hear about your experience, however, your post is extremely important. As those of us decide what course of action we will take to relieve our incontinence, the longer we wait seems like new treatments keep springing up. Sounds like your body has rejected that type of Sling, maybe the advance will help.

    I understand that the foremost authority on these type of situations is Dr Webster at Duke University, I was scheduled to see him twice, but my insurance would not cover it, so now I am going to Walter Reed and actually seeing one of Dr Webster's diciples, he taking a very controlled approach with me. Actually pills didn't work---and Botox is next, but that's because I have a contracting bladder. Everyone has something different contributing to their incontinence.

    The sad part is whatever treatment we have, we just don't know if it will have an adverse effect.

    Is wearing 3-4 pads a day with no pain the right answer?? I don't know, for me I am still trying to answer that question.



    THE BEST TO YOU---LET US KNOW WHAT HAPPENS----LION1

    No rejection of polypropylene mesh material
    Hello Lion-

    The doctors at The Cleveland Clinic did not detect ant signs of implant rejection. That basically leaves three possibilities, the device was improperly implanted in my body, this new Coloplast Virtue male sling has design faults that cause severe irritation to surrounding nerves and tissue or possibly both conditions combined.

    If the removal of the Coloplast sling and replacement with AMS's AdVance male sling ends my continuous pain, it will become 100% conclusive to me that there were major problems with my first implant.
  • notforpublic
    notforpublic Member Posts: 3
    Advance Male sling
    I note you were considering the advance male sling for your problem. I am currently looking into it as well. Did you have the procedure, and if so how has it worked?
  • randy_in_indy
    randy_in_indy Member Posts: 496 Member

    Advance Male sling
    I note you were considering the advance male sling for your problem. I am currently looking into it as well. Did you have the procedure, and if so how has it worked?

    I had sling put in at time of Da Vinci
    and I am continent since day 60 post surgery...My surgeon puts them in every da vinci he does and has been doing it that way for about 3 years now and has very good incontinence stats...only 1-3% incontinence. I am not sure what sling he is using but it connects to the coopers ligament.
  • iam144
    iam144 Member Posts: 3
    Problems too
    I had my prostate removed in January 2009 via an RPP. I was incontinent and impotent from the beginning and never fully recovered.

    On April 1 this year, I had the AMS Male Sling AND the AMS penile implant. Ever since the surgery, I've had a serious problem with urinary retention. I cannot completely void my bladder and find as the day goes on, I can void less and less until I have to insert an intermittent catheter to be able to fully drain. Also the urge to void is so great that sometimes, I leak before I make it to the bathroom.

    I was doing fair before the surgery with 2 to 3 pads a day and living a fairly "normal" lifestyle using a combination of pads and clamps. But now I feel home-bound and can't be more than a few dozen feet from the bathroom for fear of urinating myself.

    Anybody else heard of this kind of retention problem after having the sling installed?

    Thanks!
  • Trew
    Trew Member Posts: 931 Member
    iam144 said:

    Problems too
    I had my prostate removed in January 2009 via an RPP. I was incontinent and impotent from the beginning and never fully recovered.

    On April 1 this year, I had the AMS Male Sling AND the AMS penile implant. Ever since the surgery, I've had a serious problem with urinary retention. I cannot completely void my bladder and find as the day goes on, I can void less and less until I have to insert an intermittent catheter to be able to fully drain. Also the urge to void is so great that sometimes, I leak before I make it to the bathroom.

    I was doing fair before the surgery with 2 to 3 pads a day and living a fairly "normal" lifestyle using a combination of pads and clamps. But now I feel home-bound and can't be more than a few dozen feet from the bathroom for fear of urinating myself.

    Anybody else heard of this kind of retention problem after having the sling installed?

    Thanks!

    Iam, What can be said?
    Iam, I remember my hopes were high for a successful surgery, that I would be fully continent and functioning in other ways. It never happened. I ended up on hormone shots 3 weeks after the cath was pulled and I have been leaking more or less since the cath was pulled on March 30, 09.

    I am not interested in the sling, but I would be interested in the AMS 800 artificial urinary sphincter implant. That seems more dependable to me. But if it didn't work, I think the mental blow would be very severe to me. I suppose you had the same hope, too, before surgery. I may be projecting my own feelings into your situation, but your story just about has the tears flowing. I hope your future improves greatly.
  • Trew
    Trew Member Posts: 931 Member
    Ouch!!
    BigX, I do hope your condition improves. What I wrote to Iam above also applies from me to your case. Surgery has its risks. I wish we got one do over in this PC treatment stuff. I would not have surgery, just take the radiaiton and get the hormone shot. Or I would have considered 3 or 4 surgeons and then chosen one. But even then, would the results have been any different for me? I have red hair- really bright red when I was a kid. I had freinds who could play out in the sun all day and only get a tan. The same sun would burn and blister me in 30 minutes. I guess I am just one of those small statisical numbers in a doctor's record.

    But what do I know about any of this? Too often I have felt more like a spectator to what is going on rather than the key player.
  • ANightCoder
    ANightCoder Member Posts: 1
    Sorry to hear of your sling problems
    John,

    Am new to the Cancer Survivors' Network. Came across your post when looking for information re: the AMS Advance Male Sling. Hope you have recovered from your earlier problems and are doing better now!!

    Just had my Advance sling procedure performed at Brigham and Women's Hospital in Boston on Thursday, 29-Apr-2010. (Had my prostate removed at the same hospital on 25-Mar-2008.) So far so good, although have some pain/bruising from the operation. After experiencing mild incontinence since my earlier surgery, am pleased with my progress so far but have learned not to get my hopes up. Have had some minor leakage when sneezing/coughing and woke up around 4:00 am today a little wet. Otherwise quite dry. Just wondering how my experience compares to that of others. Any information you can provide will be greatly appreciated.

    Thanks in advance for your help and good luck with your recovery!!

    Best,

    Brian
  • Bill V
    Bill V Member Posts: 1
    Male Sling after RP
    I am considering the AdVance male sling. However, I use 5 to 7 pads a day and see that it is meant for mild pad usage. Has anyone that uses this many pads tried this solution? If so, did it work?
  • skirk07631
    skirk07631 Member Posts: 4

    Sorry to hear of your sling problems
    John,

    Am new to the Cancer Survivors' Network. Came across your post when looking for information re: the AMS Advance Male Sling. Hope you have recovered from your earlier problems and are doing better now!!

    Just had my Advance sling procedure performed at Brigham and Women's Hospital in Boston on Thursday, 29-Apr-2010. (Had my prostate removed at the same hospital on 25-Mar-2008.) So far so good, although have some pain/bruising from the operation. After experiencing mild incontinence since my earlier surgery, am pleased with my progress so far but have learned not to get my hopes up. Have had some minor leakage when sneezing/coughing and woke up around 4:00 am today a little wet. Otherwise quite dry. Just wondering how my experience compares to that of others. Any information you can provide will be greatly appreciated.

    Thanks in advance for your help and good luck with your recovery!!

    Best,

    Brian

    So far Not Bad
    Hi All,

    I am new to the network. I just had the AMS Advance sling implanted on July 8,2010. I was very tender & in mild pain in my testicles for the first three weeks. I had an infection in one of the holes that was made but since have gotten rid of it with antibiotics. Before the surgery I would leak whenever I coughed,sneezed, or laugh heavly. I am now in my 4th week post surgery and i havent leaked at all. i am still somewhat a little uncomfortable sitting but i'm very satisfied thus far with the procedure. i also had a radical prosectomy 2 years ago and am still cancer free.

    Wishing all the best

    Sylvester
  • bigxbadxjohn3
    bigxbadxjohn3 Member Posts: 20
    Bill V said:

    Male Sling after RP
    I am considering the AdVance male sling. However, I use 5 to 7 pads a day and see that it is meant for mild pad usage. Has anyone that uses this many pads tried this solution? If so, did it work?

    Male Sling's operating range
    Hello Billy V

    I was implanted with an AdVance male sling last December at the Cleveland Clinic. It is working fantastic! I have not requires a pad since the December surgery which followed ten years of pad usage.

    My pad usage was not as great as yours so my good outcome is not a realistic comparison. It could be a good idea to be evaluated by an AdVance sling expert such as Dr. Angermeier at the Cleveland Clinic. He should be able to give you very helpful advice regarding expectations. You can see his bio by Googling: Cleveland Clinic Angermeier

    Best wishes,

    John
  • Trew
    Trew Member Posts: 931 Member
    Bill V said:

    Male Sling after RP
    I am considering the AdVance male sling. However, I use 5 to 7 pads a day and see that it is meant for mild pad usage. Has anyone that uses this many pads tried this solution? If so, did it work?

    Bill,
    I use 7- 10 pads a day, avg. I will be getting an eval at U of MI very soon and get their expert opinion. From what I have read, I don't think I am interested in a sling at all. neither wold my local uro recommend it. He likes the AUS much better.
  • Trew
    Trew Member Posts: 931 Member

    So far Not Bad
    Hi All,

    I am new to the network. I just had the AMS Advance sling implanted on July 8,2010. I was very tender & in mild pain in my testicles for the first three weeks. I had an infection in one of the holes that was made but since have gotten rid of it with antibiotics. Before the surgery I would leak whenever I coughed,sneezed, or laugh heavly. I am now in my 4th week post surgery and i havent leaked at all. i am still somewhat a little uncomfortable sitting but i'm very satisfied thus far with the procedure. i also had a radical prosectomy 2 years ago and am still cancer free.

    Wishing all the best

    Sylvester

    Skirk, thanks for sharing
    Skirk, thanks for sharing and welcome to our fellowship.

    And just so you have no doubts about my position around here, I hate PC!!

    Now you know.

    I never wanted to be talking about pads and slings and AUS implants or surgery or radiation or hormone shots or hot flashes or ED or ........

    I just want to be normal again. Will never happen. sigh.

    so, more surgery........

    But I sure do appreciate hearing the experiences of others.
  • Bizman
    Bizman Member Posts: 4
    Trew said:

    Bill,
    I use 7- 10 pads a day, avg. I will be getting an eval at U of MI very soon and get their expert opinion. From what I have read, I don't think I am interested in a sling at all. neither wold my local uro recommend it. He likes the AUS much better.

    Slings
    I had robotic surgery in January 2009 but developed an ileus that returned me to the hospital for 12 days. The catheter was left in for six weeks due to continued leakage from the bladder neck. Year and a half later, I use 1-2 pads per day and I'm looking for at the InVance sling thinking my bladder neck is scarred or damaged. Friend had one installed after three years of 2-3 pads a day and he remains dry. However, he had considerable pain after the procedure. My urologist suggests his screws were not placed properly causing nerve irritation.

    On the erection side of the equation, I can obtain a 75% to 85% erection on my own and near 100% with Viagra. However, I was never informed about the decrease in length of my penis after surgery or the inability of the penis to fill to obtain the same diameter as it once did. Additionally, while orgasmic feelings are back to normal, I shoot pee rather than semen.

    Here's the question: Does the InVance sling prevent urine leakage during an orgasm?

    Pads I can take, peeing during sex is a huge problem.
  • bigxbadxjohn3
    bigxbadxjohn3 Member Posts: 20
    Bizman said:

    Slings
    I had robotic surgery in January 2009 but developed an ileus that returned me to the hospital for 12 days. The catheter was left in for six weeks due to continued leakage from the bladder neck. Year and a half later, I use 1-2 pads per day and I'm looking for at the InVance sling thinking my bladder neck is scarred or damaged. Friend had one installed after three years of 2-3 pads a day and he remains dry. However, he had considerable pain after the procedure. My urologist suggests his screws were not placed properly causing nerve irritation.

    On the erection side of the equation, I can obtain a 75% to 85% erection on my own and near 100% with Viagra. However, I was never informed about the decrease in length of my penis after surgery or the inability of the penis to fill to obtain the same diameter as it once did. Additionally, while orgasmic feelings are back to normal, I shoot pee rather than semen.

    Here's the question: Does the InVance sling prevent urine leakage during an orgasm?

    Pads I can take, peeing during sex is a huge problem.

    male sling's effectiveness
    Hello Bizman,

    I have not had any experience with AMS's InVance sling. I understand it was pretty much replaced by AMS's AdVance sling.

    I was implanted with the AdVance sling last December. It is working fantastic for me. I had been using 1-2 pads per day for the last ten years. I have not required a single pad since the day following the AdVance implant.

    I cannot answer you question about leakage during an orgasm since I am dealing with other issues unrelated to the AdVance sling. But I can tell you there is NO leakage when I cough, sneeze, lift heavy objects or do any other activity that could aggravate leakage.

    I am 100% certain my answer would be NO if not for the other issues.

    Best wishes,

    John
  • Bizman
    Bizman Member Posts: 4

    male sling's effectiveness
    Hello Bizman,

    I have not had any experience with AMS's InVance sling. I understand it was pretty much replaced by AMS's AdVance sling.

    I was implanted with the AdVance sling last December. It is working fantastic for me. I had been using 1-2 pads per day for the last ten years. I have not required a single pad since the day following the AdVance implant.

    I cannot answer you question about leakage during an orgasm since I am dealing with other issues unrelated to the AdVance sling. But I can tell you there is NO leakage when I cough, sneeze, lift heavy objects or do any other activity that could aggravate leakage.

    I am 100% certain my answer would be NO if not for the other issues.

    Best wishes,

    John

    My urologist is not wild
    My urologist is not wild about the newer AdVance sling. He says the failure rate is very high. It seems as though the patient feels so good after a few weeks that they start doing lifting/sports/exercises before they should causing the failure. Who knows?

    My friend with the InVance is still complaining about pain (6 months after surgery) and has started to leak again. I spoke to my urologist about the pain and he says many doctors don't insert the screws in the precise locations causing nerve irritation.

    I'm beginning to wonder whether it is worth the risk or not.
  • bigxbadxjohn3
    bigxbadxjohn3 Member Posts: 20
    Bizman said:

    My urologist is not wild
    My urologist is not wild about the newer AdVance sling. He says the failure rate is very high. It seems as though the patient feels so good after a few weeks that they start doing lifting/sports/exercises before they should causing the failure. Who knows?

    My friend with the InVance is still complaining about pain (6 months after surgery) and has started to leak again. I spoke to my urologist about the pain and he says many doctors don't insert the screws in the precise locations causing nerve irritation.

    I'm beginning to wonder whether it is worth the risk or not.

    Comparing male slings
    Hello Bizman,

    I can only speak from my own experience but I was extremely cautious for six weeks following the implant of the AdVance sling last December. I did not engage in ANY strenuous activities/exercises and did not lift anything heavier than 5 pounds. I followed all of the recommended guidelines.

    My reward..... I am now 100% dry and free of pads for the first time in ten years. My urination is basically normal with the exception of a slightly smaller stream after the first pee in the morning. For me, the AdVance sling has become a wonderful device.

    Best wishes,

    John
  • amm1
    amm1 Member Posts: 2

    Comparing male slings
    Hello Bizman,

    I can only speak from my own experience but I was extremely cautious for six weeks following the implant of the AdVance sling last December. I did not engage in ANY strenuous activities/exercises and did not lift anything heavier than 5 pounds. I followed all of the recommended guidelines.

    My reward..... I am now 100% dry and free of pads for the first time in ten years. My urination is basically normal with the exception of a slightly smaller stream after the first pee in the morning. For me, the AdVance sling has become a wonderful device.

    Best wishes,

    John

    advance sling
    Can you tell me the name of the surgeon you used to put in the Advance sling? Thanks.