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AMS800

tpelle
Posts: 184
Joined: Aug 2003

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

 

 

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Dear tpelle,

 

Thanks for sharing.

 

I wish you well, a speedy recovery, with excellent function

 

Best,

Josephg
Posts: 167
Joined: Jan 2013

I am very pleased to read that all is going well at this time with your replacement AMS800.

Your decision to have a replacement implanted serves as testimonial on how much of a life gamechanger it can be.

I wish you continued good luck on your journey.

Josephg

VascodaGama's picture
VascodaGama
Posts: 3041
Joined: Nov 2010

Great post on the the AMS800 replacement possibilities. I whish you fast healing and improvements and continuous good quality living.

Your story before AMS is here; http://csn.cancer.org/node/171366#comment-673282

After AMS implant; http://csn.cancer.org/node/188931#comment-1314580

VG

tpelle
Posts: 184
Joined: Aug 2003

Thanks, guys, for your comments.  I hope those who are considering an AMS800 implant and those who may be wondering what happens if the first one fails will understand that revisions are possible and can be successful.  tpelle

tpelle
Posts: 184
Joined: Aug 2003

For those interested in AMS 800 installations and their aftermath, here is an update.  It has been five months since removing and replacing my first AMS 800 which was installed in February 2013.  As noted in my earlier postings, the first one failed after seventeen months as a result of a pinhole-sized leak in the reservoir.  Lost all of the hydraulic fluid. 

On the first installation the cuff was in the perineum immediately in front of the annus.  And the pump was almost at the bottom of the scrotum, with well more than an inch of tubing available for grasping.  On the second installation the cuff is away from the annus and much closer to the scrotum and the pump is very high above the right testicle.  When I first saw the pump location the morning after the surgery I told the surgeon that "it will never work there."  I was wrong.  After the swelling passed and after lot of tugging on the pump I was able to grasp the tubing at the top of the pump with my left forefinger and thumb and squeeze the pump with my right forefinger and thumb, while still aiming the flow.  The surgeon told me she substantially reduced the amount of tubing and made the cuff wrap tighter.  I am able to empty the bladder after only one and one-half squeezes of the pump, allowing the cuff to close in less than a minute.  There has been no drippage; yet I still wear a liner during the day but pajamas only at night.  Having the cuff near/behind the scrotum caused a more painful and longer recovery.  About six weeks after surgery, there was no pain in the morning but it became moderate by evening, I believe as a result of chafing from walking.  It appears that the scrotum is now acclimated to the intrusion of the pump, tubing and cuff, and the pain is almost gone.  So, the replacement seems to be a solid success for which I am most grateful.  I'll soon be age 84, so I hope this systems lasts as long as I last.    tpelle

Josephg
Posts: 167
Joined: Jan 2013

Outstanding news, Tpelle!!

I'm toasting you with a glass of red wine.

The best of luck with your 2nd unit.

tpelle
Posts: 184
Joined: Aug 2003

Thanks, Josephg:  We'll return the toast with a glass of full bodied 2010 Petite Syrah, produced by CHAIM GUR-ARIEH, Proprietor and Winemaker of his small Di Arie Vineyards and Winery here in the foothills of El Dorado County in Northern California.   He produces a full range of reds.   He's a master at blending.  Check his website.  He distributes in most states.  In the ten years when I was using pads, wine drinking had to be limited.  Thanks again.  tpelle

seasontickets's picture
seasontickets
Posts: 5
Joined: Apr 2018

Are these covered by Medicare hmo's?Also how severe can infections get?Anyone hear anyone getting flesh eating bacteria type infection?

seasontickets's picture
seasontickets
Posts: 5
Joined: Apr 2018

Wil a Medicare him cover this procedure?And how many complications and worse case scenaro come from these?

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