artificial urinary sphincter (AUS)

Hi Sammy

My diary of experiences with an AMS-800 AUS can be found here : https://community.prostatecanceruk.org/posts/t11152-Artificial-Sphincter--AUS----Diary-of-experiences

Looking at your points :

How long does an AUS last and do they work?  Mine has been working since mid 2015 and is still working as well as when it was installed.  Note, my AUS does reduce my incontinence by a really significant amount.  There are occasional leaks if I have a cough or sit in the wrong position (see bike below).  I am not medically qualified, but looking back to my engineering training, the device has to fail safe and so permit some flow under stress so that there is not a back-up to the kidneys.  For me, it is almost, but not quite as good as my original natural sphincter (and that was as tight as a bulldog clip).  The device is guaranteed I think for 5 years.  I seem to remember papers written on the ongoing effectiveness of an AUS - try a Google search.

Is it easy to turn on and off when I need a pee?   Yes, but an AMS-800 is difficult to use with one hand, so you can be a bit more modest by avoiding the urinal in the gents' loo.  Also it is slightly difficult to use if you are carrying a shopping bag at the same time.  Five to six sqeezes of the pump releases the cuff fully, and it closes by itself over about 45 seconds.  I use a very light Tena pad just to catch the drips.

Last but not least, will I be able to ride my bike? I have asked this question quite a lot but not received a definite reply.  The cuff on my installation is quite a long way forward because it had to avoid the site of the previous bulbar sling attempt to handle incontinence.  Consequently it is not protected as much as one installed further back.  I am going to grit my teeth and try the bike soon.  There are saddles that spread the load and have a void in the middle, but are relatively expensive.  The other time that the cuff can distort is when I'm sitting on a hard wooden bench or chair and I rock forwards.  However these leaks feel worse than they are and are easily caught in the light Tena.  I've only had to use more than one pad in a day when I have had a filthy cold and cough.

Any other side effects or outcomes?  Before I had the AUS fitted. I was extremely fed-up and may have been heading for depression over the level of incontinence.  The main side effect of the AUS is that now I feel a lot better, and, wait for it, if it wasn't for Brexit, I might even be feeling cheerful.

Has anyone had severe incontinence for this long and then recovered to a large extent?   I live in hope, but I'm afraid the answer is probably no.

Hope this helps.  Any other questions, please put on this thread or send me a personal message.

Hi Sammy   I've had two years of non-improving incontinence. I went back to my surgeon who arranged for a cystoscopy which showed that my bladder sphyncter was partially open all the time (possibly damaged during prostatectomy) so no amount of pelvic floor exercises would have helped. I was sent to 2 consultants to discuss male sling and AUS and in the end opted for the former. Have you considered this rather than the AUS? After two "top-ups" of the sling reservoir I am now virtually dry and only wear a shield (lightest pad) for a few dribbles and because it's difficult to believe that it's finally worked. Anyone who has had a prostatectomy should ask for this sort of help if they are still incontinent after two years.

🤣🤣🤣  Best post in weeks! 

The probe in the back passage is very small and has something to do with measuring pressure. The test I had involved laying on my back, the technician filled the bladder, I had to say when I wanted to urinate and at that point the table was rotated so I was in the standing position. I do recall having to empty the bladder before leaving not just to make sure you can but also to get rid of a dye or something they used. All pretty straight forward. 

Thanks Chris.

Hello Zumerset_lad    hope you see this. Thank you for your message, they won't let me message you privately as a reply because I have not been active enough on the general site. I don't know the answer to this as I don't want to put my e-mail address in this message and don't know how to contact you directly. regards

B-rock

Debbie

Debbie,

looks like l can't private message any site member until l, as a new member, have contributed to the public domain.

David

Hello David and co

Sorry, I missed this post in March.  The sling is like a pillow wrapped around the pelvic bone trapping the urethra against the muscles. To get the correct pressure against the urethra the consultant has to gradually keep topping up the pillow with liquid until continence is achieved. To top up he inserts a needle into the pillow valve which is located in the scrotum. This does two things firstly he can measure the back pressure of the liquid and guauge whether he is near full top-up (a bit like car tyre pressures), secondly, if the patient has reported that he still has some incontinence he can then inject some more liquid into the valve and thence into the pillow to increase the pressure against the urethra. Obviously, he has to err on the side of caution in case the pressure has been increased too much and the patient cannot then pee easily. After a gradual increase in incontinence over the last two years my top-up in January instantly made me dry again, probably better than i've been since it was fitted 5 years ago. I can now completely forget about incontinence and get on with my life. I have an open door to go back if I ever need a top-up again.

ive done some research after your post and am I right in thinking it was the ATOMS sling you had fitted B-Rock? I can only find the Royal Berkshire that seems to use that type, the others listed all seem to use the standard mesh only sling.  From what I’ve read the ATOMS sling seems a better option so we will ask about it when we get the appointment.  We are in Lancashire but I do believe we could ask to be referred to a different hospital if needed.

Debbie

Thank you Mark…can I ask, do you live in the Reading region or were you referred to Mr F from out of area because of his speciality, via NHS?

I see that he does also have a private practice (as do many of the surgeons).

thanks

Debbie