If you have had an AUS implanted after receiving radiation are you satisfied with your decision and has it improved your quality of life? Or do you regret having an AUS implanted and if so why?
I have had both a prostatectomy and salvage radiation (see profile). I regained continence after the prostatectomy. But about 6 months after the salvage radiation I started leaking due to stress incontinence and it has gotten progressively worse. I did several weeks of Pelvic Floor Rehab but with no improvement. I then consulted with a urologist that specializes in implanting AUS's. She practices in a regional cancer center that is affiliated with Dana Farber. She recommended an AUS. But she also told me that in her experience AUS's only last 6 to 7 years in men who have had radiation rather then the 8-10 years for men who have not had radiation. She also told me that in her experience, men who have had radiation have more complications, especially urethral erosion compared to men that have not had radiation.
As you can imagine, I don't want to jump out of the frying pan and into the fire. So I am looking to hear from men who have had both radiation and AUS to better help me decide whether to just stick with pads or have an AUS implanted.
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Alturia
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I had my AUS fitted after Prostatectomy and Radiation, it was a real help and I had no problems until 2 years ago, after urodynamics to check and a consultation with urologist it has been diagnosed as still working but my uretha has changed in size. I am waiting for surgery to replace and adjust to my uretha. It was fine for nearly 9 years. One of the reasons for this failure may be down to further radiation I have had over the last 2/3 years (SABR and salvage), which could have been the cause for the damage to the uretha.
I had a AUS implanted in April 2021. It works well and is very easy to use. It is not perfect but it is close. It is true that they fail eventually and have to be replaced.
So be it!
Most who fail with pelvic floor exercises (beware of those who push for them if you've already given them a diligent try) decline the AUS choose a sling instead, or use a clamp. The sling doesn't work for heavier incontinence. Some will turn to a clamp, or even a catheter. Permanent use of either of these I don't understand and don't want to.
Men with chronic incontinence who avoid the AUS have probably not lived with it long enough to be able to appreciate the difference it can make. I could not be happier.
I had an AUS implanted 2 and a half years ago at MSK by a surgeon who specializes in this. I wanted someone with a lot of experience even though there was a surgeon at a well-known hospital near me who offered to do the procedure but said she also did other urological surgeries, including for women. The AUS was a life changer for me because I had severe incontinence ever since a RP (which was followed by radiation). Now I use one thin pad a day if I'm out and about or in the gym. At home I don't use any.. There have been no problems with the AUS so far, but even if they were to develop within the next few years I would probably have a new device implanted. The short term discomfort following surgery is worth the long term benefit in my view. A year ago I did develop a mild form of gross hematuria (a paradoxical formulation, which means that there was visible blood in my urine, but it happened only once every couple of weeks and involved no more than a 2-3 drops of blood from the look of it; it was still unnerving). This was apparently due to radiation cystitis in my bladder from the pelvic radiation I got ~6 years ago and which typically takes time to develop. It may also have been aggravated by straining. I just finished 40 sessions of hyperbaric oxygen treatment (a tedious and time-consuming, but painless procedure), which has a good record of healing radiation cystitis in the bladder, and have not seen any blood in over 2 months. I have also changed my diet significantly to include more fiber to prevent straining. I will have the original AUS surgeon do a scan and cystoscopy in the near future to examine the condition of my urethra and bladder and am hoping that all will look OK. I don't feel or see anything problematic now.
I had radiation and then about a year later the AUS. No regrets. It is a painful surgery w a long recovery but I’m much better not perfect but managing. I still use 3-4 pads a day with an active lifestyle.
DH had an AUS implanted 10 years ago, 3 months after the conclusion of radiation. The recovery was not bad and the device was activated about 6 weeks after the surgery. It was life changing surgery. It is still working 10 years later, but not as effectively. He had more leaking after about 8 years, but with his PSA rise, the urologist is reluctant to replace it because of his overall health. He would definitely do it all over again. Best wishes to you.
I am glad to read these testimonials; helps me make a decision as well. I am reluctant to pull the trigger as I am told by all that the AUS is meant to bring a man from needing diapers to using pads, NOT to reduce a 1-pad a day man to no pads (totally dry)...hope this is clear. Right now I use 1 pad; was using 1 pad when I was radiated (long story). But will the AUS be worth it for me at 1 pad, or will I still leak and need 1 pad, even after the implant...
If anyone can chime in great. I have found this study which leads me to believe the former about the AUS; its not meant to take a 1-pad a day man and make him dry...comments? TNX Rick
I currently use 3 to 5 heavy Tena pads a day depending on how active I am. The urologist told me that if I got an AUS I would probably need 1 light pad a day. She said I would never be 100% dry but would probably always leak a couple of drops a day. So if you are only using 1 pad a day I doubt that an AUS would improve things much.
I am glad you are so forthcoming...I have had others on this site tell me that after AUS implants w prior leaking they were "D.R.Y.", no leaks at all, but that is not what I read. This is particularly so if you have had radiation...so, thanks for confirming this issue. Looks like I need to learn to live with what I have. TNX Rick
Good for you. But two points. First, the amount of time one spends in pelvic floor rehab has nothing to do with the amount of time and the number of kegels one does. One could spend 1, 3, 6 months or more before starting pelvic floor rehab. And one could continue doing kegels after stopping pelvic floor rehab. Second, kegels don't solve incontinence for every man. This site is replete with posts from men who report doing loads of kegels for substantial period of time and still leak.
I had a few weeks of pelvic floor rehab after my prostatectomy. After 6 months of extensive kegels I was continent. I continued doing kegels after getting continent. Nine months after the prostatectomy I had salvage radiation. During this entire time I did kegels. When I started leaking 6 months after radiation I increased the number of kegels for another 4 months. When that did not improve the leaking I had a second round of pelvic floor rehab for a few weeks. But after several weeks that included bio feedback, the rehab technician told me she couldn't do more for me and advised me to consult a surgeon.
Rick, I don't have an AUS but know several men who do. If I were in your shoes, and using only 1 pad a day, I would not do it. Aside from the possibility of complications, you could well come out of it still needing the one pad. Your conclusion from the research is right.
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