15 months after my RP I still leak between 40 and 150 grammes a day (mainly depending on my activity level). I've been offered additional surgery to address this problem. One option is an artificial sphincter. I can get this under the NHS. In principle the other option is a sling. I'm told that currently this is not NICE approved since there is no robust evidence that it is effective. So I'm told that I cannot elect to have this on the NHS. But I'm a bit puzzled that other people have had this op. On the NHS? Are some health trusts not following NICE guidelines?
However, there is currently a trial being conducted to compare the two techniques and I've been offered a place on this. So I have three options:
1) Go for a sphincter on the NHS
2) Go for a sling, privately (I assume I can get this)
3) Go for the trial and only find out what has been done to me when I wake up from the anesthetic.
Tricky one!
The case for 1) is that it is a tried and tested method that has a high chance of working. On the downside it will mean that having a pee will henceforth be a fiddly process involving poking switches embedded in my scrotum. AND hanging about after a pee waiting for the sphincter to close (a minute or more). I'm a keen walker so nipping into the bushes won't be an option. LOL!
The case for 2) is that IF it works it won't have the above mentioned downsides. But it will cost and probably has a lower chance of success than 1), meaning another gruesome op to install a sphincter may be necessary.
The case for 3) is that since I torn between 1) and 2) I'll let someone else make the choice.
I'd be pleased to hear from others who have had to face this choice and what the outcome was.
Other general comments on my dilemma are also welcome. But, please, no comments to the effect that I ought to consider myself lucky not to be dying of prostate cancer. They spoil my day!
Roger