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

[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.

[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.

[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