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.
