Post radical prostatectomy incontinence - Sling vs Artificial Urinary Sphincter Device

Does anyone have any insight in an AdVance Sling or Artificial Urinary Sphincter Device for urinary incontinence after a radical prostatectomy? I had previously had open inguinal hernia surgery and believe I had read that the Sling is not as effective after this surgery. Any insight is appreciated.

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  • I had the sling surgery after an RP and it helped a lot, albeit I still have some mild incontinence (before I was very incontinent). My understanding is that the Artificial Urinary Sphincter surgery is more difficult, with a longer recovery, and of course one has the device with one (in one) forever. Since I've had several other surgeries (besides the RP) with recoveries of varying difficulty I wanted something as easy to get through as possible. I'm pretty satisfied with my choice, but of course who wouldn't like to be perfect? As far as the hernia issue, I don't know anything about that.

  • I must admit I'm leaning toward the sling, if anything at all. Another surgery is just not welcome. Thanks for your input.

  • I had the AUS 800 implanted, (Artificial Urinary Sphincter) three years after my Open Radical Prostatectomy Surgery only took about one hour, healing time before use was 6 weeks. It is not a 100% guarantee that you wont leak, ie; hard coughing, waiting too long to go to the bathroom, heavy lifting, and so on. I am one of the ones that the Kegal exercises do not help with urinary incontinence, no matter how much I tired. The AUS 800, for me, has been a great help in the control of my urinary incontinence. If you have any questions on the AUS 800 please feel free to email me.

  • Thanks for sharing your experience. I dread any further surgery but hate wearing the pads. I can't seem to find any meaningful discussion on the efficacy of the Sling procedure. Did you consider that?

  • My doctors at that time told me that my best chances for an ALMOST complete recovery for urinary incontinence was the AUS 800 implant. I have no regrets on my implants.

  • Hey PCGeorge,

    I'm Jim from Louisiana... I did extensive research on both devices. After talking to my doctor and a friend of mine (RN) both recommended the AUS. I opted for the AMS800. Supposed to be the best.

    Little history, Had radical prostatectomy done in 02. Started with one pad little dripping. Gradually as time passed it worsened to 4 pads a day, on a good day. I wouldn't go anywhere or do anything for fear of leakage. Walking in the mall or park, every hour had to change pad. I was always carrying a backpack with spare pads. I was in church service one sunday and when I stood I'd leaked through and wet spot on bench. Enough was enough. I'd discussed with my Uro many times before but fear and monetary crises always in the way.

    I had the valve job done on 07/13/16. My gosh I was in pain for a week and half. Scrotum did swell to the size of grapefruit make that a cantaloupe. For a couple of days after surgery, then decreasing. And getting better every day. I had a super-pubic cath in so peeing was no problem. That was plugged up after 3 weeks and I was peeing on my own, still leaking like a faucet. Now the story gets better.

    Cath removed and AUS Activated on 08/06/16. WOW! I wore a pad home just in case, didn't need to dry. Slept with one, didn't need to dry. Took some getting used to but I don't know why I waited so long to get this done. I Love it. No worries so far........

    Went swimming with grandkids again! Playing golf again! Sleeping naked again (missed that the most) Walking in the mall and park with no problems. My circle of friends, Daughter, Son and grandkids keep me busy enough. Threw away that backpack. Living somewhat of a normal life again.

    It looks like I have 3 nuts down there, but hay, more to play with. My long time husband, the bastard, left me 3 months after the surgery because he couldn't live with someone with ED problems. He wanted to come back after 2 years, but I said (putting it nicely) talk to the hand and refused his calls from that day on. It's very difficult dating with these problems. I guess you know that.

    Anyway, I love the AUS800 and recommend it highly (ask for it by name).

    If you have anymore questions, just ask...

    Merry Christmas and Happy New Year to you and your family.....

    Jim.....

  • I had the the sling mesh implanted 6 years ago at the Cleveland Clinic.in Weston, FL. What a BIG MISTAKE ! From the moment I woke up from the anesthesia, my scrotum hurt like hell. When I got home (a hundred miles back and forth) the catheter fell out! I had to return to the emergency room (another hundred mile) to have them put in a catheter, but they didn't even have the same kind that was implanted! In the same Hospital they couldn't get the same catheter from the same supply room? WTF And when I got back, it was leaking outside of the tube from my penis. So I eventually went to my local hospital and they inserted a better catheter. Obviously, I returned to the Cleveland Clinic, and had the catheter removed, with 100% incontinence and just touching my balls lightly is painful. I would never recommend that hospital to anyone. Always scheduling and waiting preped for surgery disasters.

    In the summer of 2015, I had the AUS implant put in. In worked fine! Pinching the third nut to allow me to pee, while painful because of the failed sling surgery is worth it. I had this procedure done at Johns Hopkins University of Medicine. Dr Jacyk Mostwin.

    However, Because of a failed back surgery and all the opioids I had to take, I now dribble at stress times, like lifting, coughing. Now that I have had that problem fixed with a stimulater plant in my spine, this month, (at the Univ of Miami) I am starting to do my keels to see if that helps. I have become very week everywhere, because I could hardly move. So back to walking, then the treadmill and other machines. It's gonna be slow, but it beats the alternative.

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