Incontinence after RP and ADT

[Runner1957]

I had a RO approximately 2 1/2 years ago with a recurrence 12 months later. I have had 37 sessions of radiotherapy and am in month 16 of 18 hormone therapy in the UK.

My incontinence seemed to solve itself around 12 months after RP but never fully. In the past 12 months I still suffer from minor involuntary incontinence. Although slower due to the ADT I still exercise regularly and am fairly active.

Has anyone had a urethral sling procedure and if so, did it work?

Are there any other options that are successful?

Thank you.

[Runner1957]

Thanks for your reply. Yes seems to have got worse with ADT, so hopefully next few months may improve.

[NewMan57]

Hi Runner,I had a Postatectomy in 2017, followed by radiation and ADT in 2018. I never fully recovered my continence following those procedures but kind of accepted it. It was manageable but a few drinks could easily cause unnoticed leakage.

I had a further round of radiation last year and am now on lifelong ADT. I still manage to exercise regularly so far so am happy about that, however since the 2nd round of radiation my incontinence has steadily got worse to the point that it is now a hassle to cope with and something I would really like to improve.

I am being assessed next month for either a Sling or AUS implant. I have heard success stories for both plus some failures with the simple slings. There is an ATOMS sling which is adjustable after implant these days which sounds interesting and I have heard some good reports. I think it might be a good option for me and would avoid the more complicated to use AUS . I will see what is recommended.

Regards

John

[Runner1957 in reply to NewMan57]

Thanks John information really appreciated. I had only heard of the slung so will look at the others.

[marlins1]

Yes, I had a similar profile as you had. I had the sling last year despite two Urologists saying it would not work well after salvage RT. It did help about 50-75%. Went from one mod pad a day to one shield daily. Not totally dry, but better. I am happy I did it. Would consider again if got another 50% improvement.

[notso2855 in reply to marlins1]

had Rp in 2014 almost back to norm 1 yr late then radiation on bed that led to 10 to 15 pads a day , NO fun . Had artificial urethral put in 4 yrs ago most days totally dry no pads , don;t waste time on a sling . good luck ; by the way had an implant at same time

[Runner1957 in reply to notso2855]

Thanks that's useful. What sort of implant?

[garyjp9 in reply to Runner1957]

Artificial Urinary Sphincter (AUS)

[Runner1957 in reply to marlins1]

Thanks marlins appreciated

[London441]

I had heavy incontinence so was advised against the sling. It may work for you but I do know its efficacy is inconsistent. I have a AUS. And couldn’t be happier with it. Although NewMan 1957 describes it as ‘more complicated to use’ I can tell you from having it for 2 years it couldn’t be any less complicated to use. You squeeze the tab, you pee, it closes itself.

That said, if my incontinence was light I might well have tried one of the other options.

[RMontana]

I went into RT IMRT with leakage that was less than 'one pad a day,' which is what was recommended to me by my surgeon...bad advise. I now have a permanent leakage of 10-25ml (cc's) a day. So I looked around for what I can do about this low level of leakage. My Urologist told me to not proceed with a sling or AUS...that they would not work for me. The sling is not recommended for RT patients; the Urethra I guess is compromised and the valve will cause erosion over time. The AUS is designed to take men with large leakages to 1 pad, not to make men w 1 pad dry...this is what I was told and what I learned from these two studies...so for me I will plan to have this level of leakage 'for the duration.' Let me know if you find otherwise. TNX

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[Runner1957 in reply to RMontana]

Thanks TNX will let you know what options I get offered. Had my last hormone injection 4 weeks ago so need to let that work its way through and then see.

[jjpeabody]

Hi Runner1957, I have had similar procedures and results as you. I always ware a pad at night just in case, also during the day if going somewhere important just in case. Extra coffee, cialis and trazodone 25mg for sleep, and fatigue can cause up to 1 or 2 tablespoons during deep sleep occasionally or a little with exercise in morning after coffee. Really is minor inconvenience vs the surgical options (for me it's just not that bad or worth it). I perform kegel exercises regularly whether helps or not at this point. It seems coffee and the few meds I take affect it mostly. Good luck.

[Runner1957 in reply to jjpeabody]

Thanks JJ that's where I am, undecided. Will let hormone therapy work its way out of my system and see how I am then.

[ron_bucher]

One of my friends who is an avid cyclist and runner had great success with the "male" sling. As with any procedure, I'd find someone who has done at least a couple hundred.

[Runner1957 in reply to ron_bucher]

Thanks Ron