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after AMS 800 AUS pad use

Posts: 7
Joined: Oct 2012

To those of you with an AUS, do you still have to wear a pad?

I had DaVinci RP in February 2010. A year later I was down to one pad per day, and it wasn't very used. So I decided to have the Advance sling implanted, figuring that would solve the incontinence. Well, that surgery actually backfired. Although I still only use one pad per day, it's usually pretty used up. And I have to wear an incontinence clamp to play golf, or else it would take two or more pads to get through 18 holes.

I've seen the urologists at Duke, to get their input for my alternatives. They immediately recommended the AUS. But if the AUS does not eliminate the need for a pad, then I may not have the procedure. (I don't mind wearing a pad to golf, but I'd like to not have to wear the clamp.)

BTW - I learned a new term while I was at Duke. "Social Continence". According to the urologists of the world, if you are only using one pad per day, you are considered "socially continent". I guess this helps their statistics. I told them this is like being "slightly pregnant".

Posts: 241
Joined: May 2007

Sorry my keyboard locked up. What I was going to say is it sounds like your surgery was a complete success, but you wanted to get completely dry and be off pads. I am guessing your Doc said the sling may do trick and make everything right? The reason I am commenting is because I have been incontinent for 6 yrs-4 pads a day. If I needed only one pad a day I would consider that normal. I have tried a number of procedures to make things right, however, nothing worked. Which brings me to my point-I have rejected having a sling or AUS for the very reason, that things might get even worse. A doctor told me a while back, sometimes if you try to correct everything, you may have to live with more than you bargained for.

Just adding perspective--wish you the best---and yes the golf thing---same thing here.


Posts: 7
Joined: Oct 2012

Thanks, Lion1 for the feedback.

As I started down the PCa road, I promised myself that I would do everything in my power to get back to pre-surgery condition. Having the AUS implant would be the final step, since it is the gold standard. But I'd like more feedback from those who have the AUS prior to making my decision. I've lost a bit of confidence in the outcomes quoted by doctors (see my original post regarding "socially continent").

Posts: 241
Joined: May 2007

Totally understand your comments and concerns and drive to get it all right......Lion1

Posts: 54
Joined: Jun 2003

Hi Folks,
Had the AUS installed in 2007. Went from 6-8 pads a day down to one (partial)
Last year the leakage started to increase and got up to 2-3 full pads a day.
Last month I had the AUS replaced and the Doc changed to smaller cuffs
Now back to one partial pad a day and enjoying life again.

Posts: 227
Joined: Apr 2010

Your expectations seem to be perfection. The AUS may, and I emphasize may, fall short of perfection. There are many instances during the course of a day when we are either in a hurry, or do things that will cause slight malfunctions to the AUS. To name a couple----there may be times when you are a bit hurried, and you do not wait for complete closure or the urethra.. Say you are playing golf and don't want to hold up your foursome at the next tee box. Hurry. Slight dripping, but very slight. Wearing light pants and no pad, and possibly an unpleasant surprise.
Another situation could be sitting on a hard chair, say wooden, and when you arise from the chair it activates the AUS. Again, less than perfection.
So for situations like these, I wear a TENA pad during the day. It is probably more for my mental well being, than any physical effects of wetting yourself, but nevertheless important. At the end of the day any leakage is almost negligible. It is not as if you are dripping slightly all day, but more that certain situations can lead to a momentary mild failure.
To carry this further, at night I wear NO protection, and never arise wet or wet my PJ bottoms in any way, unless I get up in the middle of the night and again arise from the toilet too quickly.

Hope this helps. I find the AUS to be great. Not perfect, but great. Hope if you so decide that you have as much success as I have had for the last two years (prior to AUS placement, I was down to 4 or 5 pads from 8 to 10 after much physical therapy and time.

Posts: 931
Joined: Jan 2010

Before the AUS I was using between 4- 12- 14 pads a day. totally unpredictable. I dont wear any pads now. Its not perfect- but I had stage iv prostate CA- life will never be the same.

But the AUS has helped a lot to return to me something of normality.

Posts: 72
Joined: Aug 2010

Well I had an excellant first AUS nearly no leakage except for when i was doing physical labor and then it was wear a light pad and I was ok. The replacement isnt quit as good and I wear a light pad if I am leaving the house just in case!. In my opinion you will play 18 holes and stop at the 19th with no problems but i suspect a minumum of leakage.When you get a cold and cough you will prob have light leakage but it beats the heck out of the 100 guards I used to use every 7 days!.

Posts: 227
Joined: Apr 2010

Right on the money guards. Not perfect, but oh so good. So much better than anything that has gone before. Is it "absolutely" like before any prostate surgery? NO. But it is very close? YES. So from that it becomes one's choice. My pad is nothing more that for my 100% mental security. Light leakage every day? YES. A problem? NO.

Posts: 11
Joined: Jun 2012

Had the AMS800 installed May 30 after 12 years of 3 to 6 full pads a day and MANY, MANY tries at getting dry. I still wear one pad a day because I will leak if my bladder capacity approaches 200ml. It's my opinion that the size of the cuff and the pressure the MD charges the system with is the determining factor in how dry you become. In my case it's probably a good thing I can void thru the cuff because the pump is too far in (fill tubes were install too long) and sometimes rotates completely under perineum to the point that I can't operate it, so I have to just sit there and let it dribble out. I'm scheduled to have it repositioned next month so it doesn't do this...and perhaps increase the charge pressure to get completely dry.

Like so many others, I highly recommend this device. It changes your life in a very positive way...but it ain't cheap. My 23 hour hospital stay was $57,000 knocked down by the insurance company to $32,000 not counting the doctor's fees.

On a secondary note for those who have given up bicycle riding...get a Selle SMP TRK with the giant split down the middle and a dropped (eagle beak) nose. I have well over 700 miles on mine and it works great. No pressure on the cuff at all. Eighty bucks well spent.

Posts: 5
Joined: Nov 2012

Hello I had DaVinci RP seven years ago and after 3 years I had a Advance Sling installed without much help. 5 years after RP my cancer came back and I was treated with Proton Therapy. 2 years after Proton my sphincter got worse 5 pads per day and I had a ASU installed on Nov.2011 6 months after this operation I am “Social Continence” One large gard pad will last all day if I work hard or light pad if not. I am a happy 74 year old with my one pad and would recommend this operation to anyone, As for the bulb in my sack it is not noticeable from the inside or out side. After a few months I have learned to step up to the Urinal with the other guys, The technique I use is to lift my sack over the top of my shorts which controls the aiming angle so I can use both hand to squeeze the bulb.My ASU bulb placement is at the very top right hand side of my sack. The reason for two hands is the bulb very slippery inside the sack, one light touch will open it for flow. I use Tri Mix to take care of my other friend down there. Would be happy to answer any questions and give info on my Dr. in South Fla. Lychee

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