AUS, yes or no?

[Bruins11]

I’d like some feedback from guys who have had an AUS for incontinence installed. Pros and cons.

im considering having it done. Thanks guys.

[RolandUK]

My first response after the AMS800 was activated was one of VERY great relief at no longer being pretty much 100% daytime incontinent and with a constantly damp and itchy crotch.

After the operation one has a 24/7 catheter inserted to give everything time to heal. Then back to the hospital for the Consultant to activate the device.

For about the first 6 to 8 weeks post activation I was leaking more than I'd hoped or expected [I started to think the device may be faulty]. The leakage amounts were, however, very small in comparison to pre-activation levels.

I was leaking whenever any pressure was put on the bladder by, for example, bending down, squatting or leaning over a table for a meal or when working at the computer keyboard.

I now think the initial "problems" were probably due to a couple of factors. Reduced flexibility of the cuff due to it's newness and my urethra's resistance to being compressed by the cuff.

However, after the 6 to 8 weeks period things have improved somewhat with both aforementioned “problems” and I've stopped thinking the device could be faulty.

The only times when I now wear a small pad is when, for instance, I know I'll be away from home for many hours especially if a meal out is involved …. OR …. when I may be doing lots of bending as in DIY or decorating mode.

So, quickly did I become used to having the AMS800 I tended to forget it was there and the only time that causes discomfort is when sitting on the toilet and forgetting to press the pump button before starting to push down.

The only other change to my pre-prostactomy routine is that I ensure I urinate before leaving the house for any reason. If at home all day I do “go” a bit more often to keep the bladder internal pressure low.

Hope this all helps. This is a VERY friendly Group so never be afraid to ask any questions.

Regards Roland J

[Bruins11 in reply to RolandUK]

Thanks so much for your very helpful and enlightening response. I keep hearing it’s the gold standard fix, but you reveal it’s not without some compromises.

How bad was your incontinence post RP?

[RolandUK in reply to Bruins11]

Post RP and AUS activation (around 6 weeks from its installation, if I remember correctly) there was no leakage. Absolute joy. Pre AUS I was having to use 6 or 7 pads a day.The op was in 2017 (TBC)

Currently I'm using one or two small pads per day depending mainly on my activity level. The biggest cause of leaking is the bladder getting squashed by virtue of standing up from a lying or sitting position. There's no doubt the AUS efficiency isn't what it was and I'm not looking forward to its final failure and replacement. But, nevertheless I'd thoroughly recommend the AUS ... a life enhancer.

[Bruins11 in reply to RolandUK]

Your input has been very valuable in making my decision. I leak a couple pads a day depending on activity. If I stay home and veg out doing very little ( which is very rare), I hardly peek at all . If I were 7/8 pads a day I’d be first in line at the AUS show.

It’s been over 6 years and I’ve tried the ProAct procedure 3 times in vain. I’ve decided to live my life as I am with the challenges that comes with it. Your input has been very revealing and helpful and I thank you again.

Stay well PCa brother(s)

[Mgtd in reply to RolandUK]

Great input!

[London441]

There are other options, but for heavy, insoluble incontinence the AUS is the best. I have had one for four years and it has been a great solution. Not perfect, but if you have experienced extreme and per many loss of control you will likely appreciate its function very much.

Some will turn to a sling, but it’s inferior for the tough cases. The AUS is easy to use and access. It leaks a small amount very occasionally, but that is mostly pressure on the perineum from exercise, getting out of certain chairs etc.

Also, it takes a little longer to close completely after peeing compared to the awesome external (natural) sphincter that is now a memory. So you shake it a bit longer. Most wear a pad that only needs changing daily or so to catch the little extra from these sources.

It also needs to be changed or replaced every 7-10 years on average. Another aspect of it that is ‘imperfect’.

Again, the uninitiated reading this may think it’s more trouble than it’s worth, but for those who have known acute, relentless incontinence it’s plenty perfect enough.

[Bruins11 in reply to London441]

Thank you for replying. My incontinence is

Considered mild using 2 pads on an active day.(I play golf a lot) . I’ve tried the ProAct procedure 3 times over the past 4 years with eventual failure, that’s why I’m looking into AUS. If I were 100% wet I’d proceed with AUS years ago .

So, as of right now and reading the replies, I’m going to put it on the back burner as I can function pretty well as I am. It’s a quality of life issue for sure and I hope you do well and I sincerely appreciate your help.

[London441]

You may want to look into the AUS if you want better performance, but as you see it's all relative. If I used only 2 pads on an active day I think I'd try to work around another invasive surgery.

I would also make jokes about describing golf as 'active' but that's just because I was so bad at it. It was a very active sport for me, a lot of strokes and hunting for lost drives. Good golfers make it look like lounging. Illusory I know. May you always be one of them.

[Don717 in reply to London441]

"A good walk spoiled"- Twain or whoever you wish to attribute the quote to!