AMS 800 artificial urinary sphincter

Hello Rembrant,
I have been examined by 3 urologists & all agree that my only option to gain continence after PC surgery (1 1/2 yrs ago) is the AUS. I've visited Cleveland Clinic & am on their list for future surgery, if I elect to do so. I've asked locally but cannot locate any men who've had (or will discuss) this implant surgery. The only info I've located is this web blog but would like more current discussion. Have you had any luck in finding information? Have you had the surgery? I would appreciate a reply or you may contact me at redhouse77@aol.com. Any discussion would be greatly appreciated.
PeteHigg

I had an AMS 800 implanted in 2007. I've been riding my motorcycle ever since. What do you need to know?

Have incontinence going on 3 years after my prostate surgery it has never improved. I want my life back and deciding if I should go with ams. Please advise anyone who has had ams

First, you have to decide if your current quality of life, including the process(s) that you currently use to manage your incontinence, is acceptable to you. What 'can't' you do now, due to your incontinence, and how important are those 'can't do now' activities to you in your overall quality of life requirements?  How much of a PIA is your current process for managing your incontinence?

Nobody on this Forum can make that assessment for you, and I'm sure that I'm not saying anything that you do not already know.  I'm not trying to be a smart-*** here, but this is an important decision, one that requires as much assessment, unbiased thought and introspective as any other decision that you make regarding your PCa and any related treatment and/or post-treatment options.  That being said, the folks on this Forum can provide you with lots of unfiltered personal experiences and recommendations, based upon those experiences.

For me, my quality of life was not acceptable, due to my incontinence, after my RP surgery.  I went through 4+ pads per day, and I could not go out of my house and be semi-active (walking) for more than 2+ hours at a time, without my pad filling and overflowing through my underwear and pants (and onto whatever I might come into contact with, like a chair, or someone else's chair).  Forget about being active, like jogging or playing any kind of sporting activities, as I would not risk that associated level of personal discomfort and embarrassment.

I had the AMS implant surgery, and for me, it restored me to a completely acceptable quality of life.  The AMS implant does not restore me to 100% continence, but my surgeon told me prior to the implant surgery that his procedure would not achieve that, by his choice.  He advised me that to put that much cuff pressure on my urethra for 100% continence would result in premature urethra wall thinning, thus setting up the probability of future surgery to adjust the position on the cuff on the urethra.  As a result, I am socially continent, which is 85+% continence, and for me, I have not yet found an activity that I could do prior to my PCa that I cannot do now with my AMS implant in place.

I threw away my BVD's, and I wear Depends (could just as easily wear a pad), just so that any residual or movement/sitting-related leakage, no matter how small, is appropriately contained.  My job has me sitting most of the day, and the AMS implant does not hinder me in any way from being able to sit for hours at a time.  Yes, I can find a position or two, whereby I can feel some minute leakage taking place, due to exterior pressure from the chair being placed on the cuff, but that in no way limits my sitting or any other physical activities (gym 3 times per week, camping, hiking, boating, football, frisbee, etc).

I outlined my experiences for this device on these pages:

http://csn.cancer.org/node/188931?page=3 - 5 postings

http://csn.cancer.org/node/188931?page=5 - 1 posting related to the implant

It appears that you've already seen the postings made by Trew, who was my mentor and responsible for convincing me that the implant was a logical and appropriate next step to regain my quality of life.

For me, the AMS implant was absolutely and unquestionably a gamechanger in restoring my quality of life, resulting from my severe incontinence after RP surgery.

I've had my AMS implant for 2 years this month, and I do not have a single regret over choosing the implant procedure.

Good luck to you on your decision process.

Normal
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Shiredvd,

By now you probably have the AUS installed and will soon know the answers to many of the issues you posed. In as much as my AUS has been working well for several years I can positively state that (baring unforeseen circumstances) you will be very happy to have the device.

On this, and other sites, the same questions keep coming up over and over. A natural concern for anyone contemplating this procedure. However, each of us is unique and results can vary. Here’s my evaluation at this point in time:

As others have stated. I don’t have complete continence. I give it about 85 to 90 percent. I use the thin Depends Shields and can get a good 24 hours on just one. Even so, I often change it just for odor control. As do others, slight movements while sitting or standing can cause minor leaks. I am extremely active (for my age of 72) and ride my new Colnago CLX3 three or four days a week with 125 to 150 total miles…many hours on the saddle. On my old Trek and my new Colnago I use a Selle SMP TRK saddle that has a very large center split and a down turned nose. My point…the cuff is not a problem with the correct choice in saddles. I’ve stepped down from jogging 6 to 8 miles on the days I don’t ride because of leg problems (lymphedema and knee issues from the RRP) so now it’s just a power walk. That keeps me out for several hours at a time…minor leakage not requiring a pad change.

I had a revision because the original pump kept rotating back under the cuff and I could not access both ends to hold and activate it. My Urology Babe replaced the pump and tied it permanently into a horizontal position toward the front. It still pulls back in a little on occasion but has not presented a major problem in activation.

My original intent to get a tattoo has gone by the wayside. I’ve now had so many medical procedures, my tolerance for more (elective) discomfort is nonexistent. Chemo, surgery and radiation for non-Hodgkin’s, ablation for AFIB, lithotripter for kidney stones, hernia repair, and more have taken much of the entertainment value out of watching what my army of MD’s can do to keep me glued together. But, while many of these procedures have undoubtedly saved my life, I have told them all that the AUS is the thing that LETS ME LIVE.

I’d do it again in a heartbeat, and will do it again when this one wears out.

Picked up on your nice answers. I had daVinci prostatectomy 6/5/2010. Had a slightly elevated PSA last visit (0.05 to 0.07). Need radiation therapy. Am on three to four pads a day currently. Told it will not get better and could get worse with radiation. Doing the AUS sphincter surgery 5/10/2010. Any comments Harv? Worried about activation. Seems like a lot of warnings with regards to surgery---failure of appliance, infection, etc. Any comments? All help would be appreciated.