urinary sling

I had the male urinary sling procedure done on Dec. 2nd, 2022. Here is my 3 month post op report.

Background- Had RALP in June of 2020. PT for pelvic floor exercises for 6-8 weeks in July of 2020. Helped, but still leaked. Had a second round of PT for 12 weeks in summer of 2021. Still leaked, despite my best effort. Went through winter, spring, summer of 2021 leaking a consistent amount daily, which was later measured at 30ml/day. Not bad, but annoying nonetheless. Learned that sling procedure is most effective for those leaking 300ml or less/day. More than that, AUS is recommended. Since I was on the low end of this, decided to have the procedure done. About 2 1/2 years post RALP

Day surgery on a Friday. I kept a journal in days that followed, so I could have a record to share. 3 incisions, left groin, right groin, and between scrotum and anus. Very sore first 24 hours or so, especially the groin incisions. Pain controlled with oxycodene, but only needed 3 pain pills, before then switching to Tylenol. Lots of swelling in scrotum. I used ice packs. I had a catheter over the weekend, which, with the help of my wife, I was able to remove without incident on Monday morning. Began to urinate normally. I actually had a stronger stream and no leakage. Took it easy for a week or so, and pain/discomfort resolved fairly quickly. They recommend no bending or lifting more that 10 pounds for 6 weeks or so, which I tried to abide by. This is to allow the sling to get firmly anchored in place by healing and scar tissue.

I noticed improvement almost immediately. I was able to go pad free for the first time since my RALP. Really made a big difference. The only setback was because of an unrelated illness that caused severe coughing. With the terrible cough, the sling could not hold back the urine being forced out by the cough, so I had to go back to wearing the diapers. The sling needs to be able to expand and contract to both hold urine back and allow it to flow. Now that the cough has been resolved, things are much better. I'm not quite "as good as new", meaning before RALP, but I'd say 95% better. Some minor leakage occasionally, but I am pad free for most activities.

These surgeries do impact sexual function as well, as a lot gets disrupted in that area, I'm hoping for improvement in this also.

They say 5 - 10% of men who undergo RALP will experience incontinence and not be able to get dry. Another 10% don't admit it and just suffer through. If you're in those groups, and not leaking above 300ml/day the male urinary sling should definitely be considered. I'm very glad I had it done as it has improved the quality of my life. I'd be happy to answer any specific questions for those considering this procedure. Good luck with your journey