urinary sling

[Bruins11]

Has anyone had the urinary sling procedure done and how did it work out?

[jimreilly]

I had it done a year and a half after an RP that left me more incontinent that was practical for me to live with and still work and get around easily. The surgeon warned me that it was not perfect--they could very well still be some leakage afterwards but that there be significant improvement. And yes, there was a great improvement, though not "perfection". As surgeries go (I've had plenty) it was an easy one, outpatient, not a painful recovery at all. I'm very glad I did it. I understand that not everyone has such good results, but I think many people do. Find a surgeon who does a lot of them.

[gedupont in reply to jimreilly]

My RP was done in Fall 2006 by Dr. Claus Roherborn at University of Texas Southwestern Medical Center. I went through Physical Therapy in 2007 CY which really didn't help much. Sometime in 2008 I had a sling procedure done - what a waste of time, money, physical inconvenience! University of Texas Southwestern Medical Center, very shortly after I had mine done, ceased doing them since they were not successful.

[Bruins11 in reply to gedupont]

thanks very much for ur reply, I’ve heard a lot of negative about the sling. I guess it’s not for me.

[Bruins11 in reply to jimreilly]

thank you for your reply.

[gamma909 in reply to jimreilly]

Glad it's worked out for you. Are you physically very active? My urologist thought I was a good candidate (RP only, in good shape, 1-2 pads per day) although was very clear that it would be an improvement but not perfect. However, I am a lifelong runner which creates quite a bit of internal plumbing movement/stress so I told him I was concerned that sling or AUS would not withstand the pounding. There are no longitudinal studies on runners with these devices (not that I expected to find any) so have to rely on experiences like yours. Thanks.

[jimreilly in reply to gamma909]

I think "are you physically very active" is addressed to me and not someone else on the chain--yes, I am very physically active, especially for someone my age (now 79). Swimming, walking, weight training, biking (have never owned a car), and professional singing (a quite physical activity involving the abdominal muscles, and yes, I am still doing this in public); this is part of why I wanted to deal with the incontinence, which made physical activity more problematical. The successful sling surgery made possible an easier continuance of the kind of life I want to lead as long as I am able to otherwise.

[gamma909 in reply to jimreilly]

Thanks - good to hear. Like you, I'm also a performing musician so it's one more activity I really have to plan for. I manage various activities as best I can and try not to dwell on it too much. Still on the fence - I may see if things get worse as a trigger to get the sling. Running still worries me - not so much experiencing some leakage during running but rather in somehow fouling up the sling itself so that it no longer functions properly.

[jimreilly in reply to gamma909]

well, I don't run (two artificial knees here--sever other parts in my body not the originals, lol) but biking hasn't messed it up--but of course biking is less pounding and more smooth motion

[Peppertree602]

I had ProAct done and helped 99%

[Bruins11 in reply to Peppertree602]

interesting. I had ProAct done “twice” without success. Balloons migrated away from target both times. That’s why I am checking out the sling. Thx for ur reply

[Peppertree602 in reply to Bruins11]

interesting

My good friend is the urologist that did mine and has said I was a slam dunk due to skinny and no radiation only RP done by Vip Patel in Orlando but others he did were problematic due to radiation

He put only 2 cc in each balloon and very pleased w results pads always be a part of life but drip 1-2 drops per day only

[BettyandBob in reply to Peppertree602]

Hi Peppertree602 - I’m contemplating having the ProACT procedure. Following RP in 2022 and radiation therapy in early 2024 (recurrence was a blow) I have had mild leakage. I’ve moved from a pad to a light shield in the past year. Usually only have to change the shield 1x/day. If I play golf or do any heavy lifting, play with grandkids - I wear a “larger capacity” pad.

My SUI is mild yet I don’t like the hassle of having to wear any protection. I have investigated the urinary sling, but ruled that out because of more negative reports on performance. My question is — will the ProACT totally eliminate the need for any pads, regardless of activity?

I appreciate your insights and suggestions as I move forward to find a solution to my SUI. Many thanks for your feedback.

[Peppertree602 in reply to BettyandBob]

I had mine done before reoccurrence because I was told it might not work after radiation due to everything being burned up down there. But even then I am 99% dry and still have a dribble or two when doing heavy things. My buddy the urologist who did mine also did 2 guys the same day who had radiation already and theirs did not work

[BettyandBob in reply to Peppertree602]

Thanks for the quick reply, PT602 — I really appreciate it. I’m meeting with a surgeon today and your report on the unsuccessful procedure with RT patients is extremely important. Thanks again. Wishing you continued good health.

[Bruins11 in reply to BettyandBob]

Sorry, I had a RP surgury. Never had RT (radiation). Anyway, good luck!

[Bruins11 in reply to Bruins11]

Sorry, wrong guy

[dadzone43]

One of the men in my support group had it and is very happy with the outcome. I will forward your entry to him.

[BettyandBob in reply to dadzone43]

Hi dadzone43 - I’m contemplating the ProACT procedure. Would you be so kind to forward my entry to the gentleman in your support group who had the surgery? Many thanks.

[PKLA]

Seems like "success" depends upon the person, the surgeon, and other factors. Had RP with Roehrborn at UTSW in 2019, and considering what's next for me, including Proact, to minimize the incontinence.

[BettyandBob in reply to PKLA]

Hi PKLA — I’m contemplating the ProACT procedure. Did you have the surgery? And if so, I would appreciate you sharing any feedback. Many thanks.

[PKLA in reply to BettyandBob]

I did not have it...still thinking about it and looking for doctor in Dallas area who has done a lot of them. My incontinence is not severe, mainly annoying...seems worse when I'm tired, or lifting, all the normal stuff. I am uncertain if it would be much better with the PROACT procedure. I'm 5+ years out from surgery. I do use smaller, thin pads that I buy on Amazon...look for TENA Men Protective Shield Light Bladder Weakness Pads. Adhesive strip on one side to hold them in place in your underwear. If you have any luck with the PROACT procedure, I'd love to know about it. THnaks for reaching out.

[BettyandBob in reply to PKLA]

Many thanks for your speedy response !

I’ve been cancer free for nearly a year— three consecutive PSA labs of <0.01, so I’m now looking at a solution to eliminate my SUI.

I’ve using the same shields you use. I also wear a penile clamp when golfing, fishing, hiking (any activities of 4 hours +)

I’m meeting with docs in the Denver area to find one who has performed hundreds of ProACT procedure. I’ll let you know when I finalize plans. Thanks again for your feedback.

[PKLA in reply to BettyandBob]

Let me know if you find a good doctor there. I would happily come to Denver. Be careful with the penile clamp. I used one early on as well, and when I told my urologist, he told me the clamp was not a good idea as it was not good for blood circulation to the penis, and might cause damage to your urethra if on too tight for too long. He is head of urology at UT Southwestern in Dallas...very well known urologist. So, I stopped. Great news on your PSA labs...mine are the same...5 years now...praying it stay that way.

[jimreilly]

Since there does seem to be a mixture of results as far as the sling surgery--from mine (quite good) to "waste of time and money" I wonder what the stats are? I'm not sure if even at the time, 10+ years ago, I saw any, but I think my surgeon said what his rate of success was, although I no longer remember it; I do remember that he was very honest about what he thought the outcome would be (good but not perfect) and he was right on . I was lucky that he did them fairly often and that he was in the same office as the surgeon who did my RP, and I already knew him because he had been involved in my early kidney surgery; from that experience I felt he was competent and I got along with him well. And of course I was lucky it turned out well. Right now I'm swamped with work (still working at 79, partly thanks to good surgeons!) so I can't go hunting for statistics, but if someone else has the time it would be good to have those around for future sling candidates. Anecdotal responses are great, but the stats might give a better bpic of whether a surgery is worth taking a chance on.

[Bruins11 in reply to jimreilly]

My urologist here in Naples did my first ProAct 3 years ago and was unsuccessful . The balloons migrated out of position . He also was very negative about the sling procedure.

My 2nd ProAct was done at Tufts in Boston last September . Same result as the first . Quite discouraging. My leakage is not severe, 1-2 pads a day, but it does impact QOL on a daily basis and I was hoping the ProAct , being a fairly simple procedure , would make sense.

Back to square one.

[Wynnsts]

I personally chose the route of the Auxiliary Urinary Sphincter route and it work’s fantastic.

[Bruins11 in reply to Wynnsts]

glad to hear. May I ask how bad was your incontinence issue before the AUS? Mine is 1-2 pads daily which is not a severe problem.

[Don_1213]

I explored having the sling done with a doctor recommended by Boston Scientific as one of the leading practitioners experienced with the surgery and the device.

He suggested I not consider doing it. He said success with it on patients with radiation as their primary treatment has not been great. That was due to weakened muscles in the area due to the radiation.

He felt there was at least a 50% chance that it could cause the continence issues to become worse, and he would only do it if I agreed if it failed to have an artificial sphincter installed. He said there was no way to know in advance if the device would help or harm the issue, that it would only be known after the surgery, and the surgery was not reversible.

I've been passing up the artificial sphincter option since I'm somewhat old, and can easily foresee a time when manipulating a pump in my scrotum might be an issue, and asking someone else to do it would likely result in either getting punched out or at a minimum laughed at.

Meanwhile, I'm continuing pelvic muscle therapy by inducing kegal exercises electronically.

[julianc]

Yes in 2017 2 years after RP.Incontinence 95+% fixed, occasional minor leak.

But my stream is often very weak, I often don't fully empty and stop start a fair bit.

Also I get periods of irritation where I want to go a lot. I don't know if that's sling related or some narrowing I now have in lower urethra.

Get an experienced surgeon as there is a fine balance. I was discharged with catheter and sling is probably on the tight side.

I believe an adjustable version now exists, which obviously would require minor surgery to adjust.

Good luck, when my irritation annoys me I just recall standing in a bar feeling the flow into the pad, contracting just making it worse, its better than that!

[Bruins11 in reply to julianc]

thanks for your reply. I don’t think the sling’s for me.

[j-o-h-n]

Hey Hamy.....what advice do you have regarding peeing?.... "Well tis nobler in the mind to suffer the slings and arrows of outrageous fortune or not to be".

j-o-h-n <===<<< Senior management is about to spike my spikes....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 04/18/2023 6:59 PM DST

[Bruins11 in reply to j-o-h-n]

could you be more specific? What are you asking?

[j-o-h-n in reply to Bruins11]

Is it going to be Laertes or Claudius who's going to fling Ham's sling?

j-o-h-n <===<<< Senior management is about to spike my spikes....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 04/18/2023 7:21 PM DST