Have any members had a successful incontinence sling?

[marlins1]

I have one pad a day incontinence that is an annoyance. Kegals no help. My hx : Pca 4+3, Robotic prostatectomy 2015, BCR and RT bed and pelvic 2018. PSA presently .02 NED. Recommendations of successful clinics in the SW USA? But would travel to get it right.

[GP24]

I recently read statistics how often incontinence occurs after surgery. One pad a day was defined as "continent".

[marlins1 in reply to GP24]

one pad "continent"? Subjective of course. Not my view. Thanks for the webinar.

[GP24]

Here is a webinar about slings and artificial urinary sphincters

youtube.com/watch?v=hsHW6Bf...(Not working as expected?)

[kaptank]

My advice is to avoid slings. I have one and nothing, nada. It is avoidable surgery in your case and does not work with men. My experience is that uros who recommend them are just experimenting on you. For serious incontinence an artificial sphincter. But 1 pad a day would be heaven!

[jimreilly]

I had male sling surgery all the way back in 2008 (after an RP left me incontinent) and went from several diapers a day (not pads, but diapers--in other words, pretty bad incontinence) to almost all of the time not even wearing a pad (took a while to get to that point). I still have to be careful leaning against a counter (puts pressure against the bladder), if I'm constipated, if I sit for too long without a bathroom break, if I drink alcohol or two many liquids before going to sleep, etc., and I limit coffee to the early part of the day. But what a positive difference the surgery made! The surgeon warned me ahead of time that it wouldn't be "perfect" but that it would most likely be a big improvement, and it was. Surgeon was Dr. Sean Elliott , U of M (Minnesota) Urology. I think you'll find that the experience of men who have had this surgery varies, mine is one of the success stories. I would assume the usual advice applies--find someone with a good track record. But I lucked out, used the same surgeon (because I liked him and trusted him) who had done my kidney cancer surgery a few years before (but a different doc than did the RP, although in the same office). The details are a little hazy now, it's a while ago, but I do remember the surgery was a setback (not as much as the RP itself) in erectile functioning, but only temporary--and I really didn't care as much bout erectile functioning while still losing urine right and left.

[TJGuy]

I have found that I have light incontinence when on Lupron and become continent when off Lupron. Determined it was ADT weakening all muscles including pelvic floor muscles.Alcohol has similar effect so cut back on that.

[B8ssist]

I was in a similar situation. Before IMRT, I had just about gotten dry, then after IMRT, I could not control it. Several soaked pads a day. I tried for 9 months to regain continence, but couldn’t achieve it. I ended up getting an AUS 800 implanted which totally changed my life and gave me back my QOL. After researching and talking to my MD here in San Antonio, TX it was the better way to go for me.

[E2-Guy in reply to B8ssist]

According to everything that I have read, the AUS is far more successful than the sling. If I ever visit The States again, I will have Medicare buy me a portion of the AUS!

I would have it installed in Thailand; however, no insurance here.

[thudson1965]

I had the male urethral sling surgery in Sept 2021 - 12 months after my RARP in Sept 2020

I went from leaking 17 ounces a day down to 0.25 ounce at night.

I would have the sling surgery again even given that my recovery was not easy. I was not able to pee the next day or the following week at the doctors office so I had Foley catheter for 2 weeks (which is not typical). At the second week, I was able to pee, but not completely empty my bladder. I made sure that I was taught how to intermittent self-catheterize and given a supply of catheters. By week 6, I was self-cathing once a day and by 4 months once a week. I expect the urologist to have me stop self-cathing when I see him this week for my 6 month visit.

Everyone's experience is different. My urologist had not had anyone like mine. I was a database programmer and kept track of voids, retention amounts, etc.

To ensure a successful recovery I took the following

Docusate Sodium (Colace) 100mg twice a day (stool softener)

store brand Miralax in my morning coffee daily for 2 weeks, and half a dose for 4 more weeks

NO HEAVY lifting or heavy exercise for 8 weeks - I did walk 1.5 miles 4 times a week after the third week

The feeling of cleaning out my garage for 3 hours and not having a spot of urine in my underwear - AMAZING!

[marlins1 in reply to thudson1965]

Great job, have to admire your determination.

[TWTJr]

I had a sling. No help whatsoever. Additionally, there is a risk of pudendal neuropathy secondary to the surgery. Google pudendal neuropathy for an explanation of this painful complication.

[marlins1 in reply to TWTJr]

Did you get pudendal neuropathy? and how often is that complication? Sounds like an operative misadventure.

[ck722]

It can take a year or more to regain control.

[Miket218]

I deeply regret getting a sling. My incontinence was a lot worse than yours. The surgeon didn’t tell me that I will lose another inch of penis length. Had already lost one to the RP.I should’ve gone directly to the artificial urineary

spinchter. Hopefully you will have better luck.

[Miket218]

Oh, and did I mention that every time there’s surgery in that area you lose some of the nerves affecting sensation in your penis. Thanks to all the surgeries I now have about 15% of the original sensation. Sex isn’t even worth the effort anymore. Damn!

[marlins1]

Wow, lost two inches and sensation.? What hospital was that done, so I can avoid it!