Post Prostatectomy Incontinence and ED
Hello everyone
I am 56 years old and had nerve sparing radical prostatectomy 20 months ago.
I had a Gleason score of 7 (3+4) and negative margins on my post-op biopsy.
I have had undetectable PSA since surgery. I consider myself fortunate regarding my cancer,
but unfortunate with the consequences.
The major volume incontinence only slowed down about 3 months ago.
I now have a generally dry first 8 hours of the day, only a few drips.
Then I can go through 2-3 large pads as the evening goes on.
I did 8 weeks of pelvic floor therapy and still do 1/2 hour of exercises every morning.
Of course the more active I am the more chance of leakage.
I have experienced major penis shrinkage and complet ED
I have taken Sildenafil, trying both 50 and 100mg every other day
With very minor results and bad headaches.
I have a meeting with a reconstructive urologist soon and am considering
Surgery for both issues. I have seen so many varied reports on this forum and others
Regarding the “sling” and AUS.
Has anyone here used them in combination with a penile implant?
I am hoping not to go the route of having both but wanted see if any one has tried this.
Feeling pretty frustrated because I am almost over the incontinence
And wondering if more surgery is the right thing, since I still want to lead an active life
All advice much appreciated , thanks.
Hi
. First, let me say that it is good to hear that your PSA is undetectable. Second, your frustration is certainly understandable. Too often we hear of men that were not adequately informed of all of the potential side effects. I can't personally speak to these procedures, but I do want to share with you this article on the combination surgery which concludes "Even in complex cases with multiple conditions and the need to double device implantation, the simultaneous procedure seems to be a good and viable option for the patient to address at the same time UI and ED:" https://www.sciencedirect.com/science/article/pii/S259008972300018X. Here is another abstract that provides guidance on the dual surgery and seems to make the argument that it is underutilized: https://jovs.amegroups.org/article/view/28349/html. Of course, we are not medical professionals and cannot offer medical advice and, certainly, some procedures are not right for some cases, but I want to share the information to inform upcoming conversations with your doctors. Hopefully anyone with more direct knowledge will chime in with their thoughts/experiences. Best, Richard (Team Member) Thank You- and yes, anyone with experiences to share of either procedure would be welcome. I know the dual procedure exists but is not as common.
I realize your post is over a year old, and you may have already made your decision regarding sling or AUS surgery and penile implant. I had both procedures done, in separate surgeries, about a year apart. Both the sling and the implant have worked very well and my only regret was not having it done sooner. The sling was done 3 years post surgery and the implant 4 years post surgery. If anyone has questions regarding either procedure, I would be happy to answer them.
Hi
. Thanks for chiming in here with what has helped you. It is always great to see the way men here try to help each other out. Best, Richard (Team Member)
Sorry I initially missed your response
So like my response below to CommunityMemeber63df37
I have these questions regarding the implant surgery:
1- how long was your recovery after the implant?
(Just for general mobility- not implant inflation)
2-do you still have enough sensation
To have an orgasm during sex?
3-Do you have any pain during sex
With the implant?
Also I am wondering what everyday life is like with the implant not in use.
Is bike riding an issue for example?
Any experiences with infections?
And how long we can expect these things to last as we age.
Thanks so much for responding
I just had both devices implanted at the same time on June 24th after over 2 years of complete incontinence and zero erections post prostatectomy. It seems that the nerves just never grew back. The AUS has me completely out of diapers though I do still have to wear a pad because I can push through the cuff by coughing, sneezing, push-pull, ect. The IPP works perfectly (though I did loose another inch - lost an inch in the original surgery). any questions - I'm an open book.
Thanks for your reply. It has been a challenge getting feedback on this. So I went with the Sling with great success 9 months ago. I am now basically dry. I still wear a thin pad for the occasional drip. Only after a very long physical day do I have to change a pad.
Now considering the implant in January. My urologist is telling me that I am a good candidate for it.
One concern is that I have experienced major shrinkage from the original surgery.
So much so that urinating past the testicles is a challenge at times. I am hoping that the implant might give just a bit more clearance in the non- erect state, and enough length to perform with an erection.
A few questions for you:
1- how long was your recovery after the implant?
(Just for general mobility- not implant inflation)
2-do you still have enough sensation
To have an orgasm during sex?
3-Do you have any pain during sex
With the implant?
Pills did nothing for me and
I tried Injections which achieved an erection but intercourse was painful.
Hoping the implant will be not as bad.
Thanks again for responding
Its quite the journey
