Artificial urinary sphincter, Aus,

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It has been 3 years since i joined the prostate cancer club, just under  3 since i joined the urinary incontinence club due to prostate removal. Now i find myself in another club, The Aus club. i have never been so popular!!!

Any other members out there who can advise, on a few things, I am just over one week post op, had my wounds checked yesterday 20/8/18, all good. I am still a bit swollen and uncomfortable and have been advised switch on is in 8 weeks.

So a couple of questions.....iv been advised to massage the area around the switch, just wondering what this achieves exactly, bit difficult while its so sensitive in that area.

Also the position of the switch in the scrotum is high up is the the same for everyone? My consultant advised me this was normal.

thanks

 

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  • Posted

    John,

    I had my AUS implanted in early November of last year, and it was activated at the beginning of January this year.  I think what you call a switch is generally called a pump.  (Were you given some plastic cards with a model of the pump?)   I was not instructed to massage the area around the pump, so not sure what that's about.  I would call and ask your doctor.  FYI my doctor does about 150 implants per year.   Mine is also mounted high in the scrotum, which is the standard location.  I'm sure it's to keep it away from the gonads. 

    I've been very happy with the result.   A real quality of life restorer!!

    Glenn

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    • Posted

      Glenn,

      Thanks for that, i will give the doc a buzz as in addition to above it almost feels like its rubbing on my scrotum wall making it a bit uncomfortable,  just making it known its there.......suppose its early days eh.

      Glad yours worked out well for you, i just have to sit tight for switch on now.

      The doc has supplied no info as of yet, i guess they do not  want me to mess with it until everything has healed.

      John

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    • Posted

      John,

      Just be patient.  You will be aware of the long perineum incision for around 4-6 months, when the sutures are absorbed.  I don't even think about it now, 9 months from the implant.  I was most aware of the bulb/reservoir for the longest time, as I'm fairly slim, and pressure from jockey underwear was across there.   I wear a light pad if we go out to dinner, a play or church, etc.   In the summer, it's been just shorts.  If I cough hard, it will push a bit of urine out... maybe a tsp.   

      Glenn, 

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  • Posted

    Welcome to the club.  My history mirrors yours pretty closely as I too had my prostate removed about 2.5 years ago and had an AUS put in 4 weeks ago.  (My activation date of the AUS pump is in 2 weeks.)  My doctor also had me massage the area of the pump and he said it was to prevent buildup of an obstruction layer. So far so good and my pump is located mid to high in my scrotum.  I also have a bit of rubbing on my scrotum wall making it a bit uncomfortable, I’m assuming as I adjust to things and stop wearing a large pad this will go away but I’ll ask my doctor about this when I go back in 2 weeks.  And Glenn77 thanks for your feedback, I’m hoping my results are as positive as yours.
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  • Posted

    John and Scott,

    I'm glad to hear that you both are getting close to the activation date.  I hope your AUS is a great success.

    Glenn

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    • Posted

      Glenn- I just had my AUS activated today, any advice?  (Sit or stand? What types of pads do you use? Anything you wish you knew? Etc...)

      Scott

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    • Posted

      Scott,

      I hope your AUS is working well for you.  Are you finding that the AUS is effective in controlling leakage for you?

      In my case, I find that I can get through most days without pads, especially in the summer when I'm wearing shorts. I do find that if I cough hard, it causes  a bit of leakage, maybe half a tsp, enough to create a small wet spot.   So if I'm dressing to go out socially, I wear a Depend Light pad just in case.   It's very light and thin, with a plastic backing and adhesive to keep it in place.   One pad lasts me all day, although it is a bit warm and doesn't ventilate due to the plastic backing.  When I take it off to dispose of it, there's no obvious collection of liquid.  Sometimes, it seems damp, possibly from sweating.   For the pads, you need jockey shorts rather than boxers.  If leakage is slight, another option is to wear cotton boxers that absorbs and disperses the liquid, so it can dry without penetrating the outer pants.

      One other thing that I've learned to avoid is sitting on our bar chairs at the kitchen island.  They have square corners, and if I forget and turn and slide down over the corner, it depresses the cuff, forcing the liquid back into the reservoir balloon.  It's the same as using the pump, so I can have a big leak in a second doing that.  It's not uncomfortable, but it's caused me to go change more than once because of a large wet spot in my pants.

      Outslde of that, I find I can side in padded chairs, etc., with no leakage.

      I haven't gone back to riding my bike, although I did see a seat on-line that should allow me to do that.

      I assume you are still sensitive from the sutures that are still absorbing.  I sometimes rubbed on an antibiotic cream that seemed to sooth the soreness a bit.

      In using the pump to empty the bladder, I found that using the recommended approach of securing the two tubes at the top of the pump with one hand is a requirement for me.  Otherwise, the pump slips away.

      If you have any other questions, let me know.

       

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    • Posted

      Glenn-  Thanks for the quick reply and tips and while it's only been about 18 hours since my AUS was activated so far so good, no leaking.

      I'm wearing my normal heavy depends pad for now and once I get confident that the AUS is working my hope is to either go to no pad or try the light pad as you recommended.

      Thanks for the tip on the bar chair/stool, I've heard of similar problems so hopefully I'll be able to avoid this.

      For now I'm good but I'll bug you with more questions if anything comes up.

       

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    • Posted

      Glenn-  Thanks for the quick reply and tips and while it's only been about 18 hours since my AUS was activated so far so good, no leaking.

      I'm wearing my normal heavy depends pad for now and once I get confident that the AUS is working my hope is to either go to no pad or try the light pad as you recommended.

      Thanks for the tip on the bar chair/stool, I've heard of similar problems so hopefully I'll be able to avoid this.

      For now I'm good but I'll bug you with more questions if anything comes up.

       

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  • Posted

    HI all, quick update

    Currently 5 weeks post op and just over 3 weeks  until switch on,  Oct (any longer and i think the Lord Mayor would be doing it with the Christmas lights) :-)

    The scars have healed up nicely, just two things to note:

    The pump switch is still rubbing away internally in my scrotum, im still wearing pads so no doubt that is not helping. Although with the pump switch positioned so high in the scrotum it naturally tends to push against the wall, going forward after successful activation(have to be positive) i was wondering has anyone changed their style of underwear to improve comfort taking into account the pump switch?

    Also iv noticed the rear of my penis is a bit numb, i know its still early days post op but just wondering has anyone else experienced this?

    Other than that my health is good, still leaking like a sieve but light at the end of the tunnel now,

    John

     

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    • Posted

      John-

      I'm 7 weeks out from surgery and have had my AUS activated for 1 week and so far so good.  I don't know how I lived without it as it's been life changing; no leakage and no worrying about having a leak mid-meeting.

      I still get a very minor irritation from rubbing but with activation I changed to a much smaller pad, just for drips, and I think the smaller pad has helped. (The irritation is very minor and most of the time not noticeable and well worth the tradeoff for bladder control.) I still wear boxer briefs most days and have tried boxer shorts at night and when I'm home for an extended time. I asked my Dr. about the rubbing and he said it was normal but you might check with yours when you get it activated.

      My AUS is about mid-scrotum and I can activate it with one hand, though I've heard some people need two.  (It is a little slippery so in the shower is a challenge.)

      I was surprised how much force it takes to activate the switch, not a ton but pretty moderate pressure. 

      I have not had any numbness at the rear of my penis.

      Hope your activation goes well and Glenn your the veteran in all of this, any thoughts?

      Scott

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  • Posted

    Scott,

    So glad that you've had a good outcome.  You will have some irritation  and sensitivity for some months,   The irritation was at the incisions along the perineum and where the reservoir is placed.  I found that gently applying some antibiotic ointment also the incisions helped a bit.

    I prefer cotton briefs rather than boxers, as they absorb any dribbles if I cough, and cause a slight leak.  They also are better for holding the Depend lite pads I use for social situations, just in case.  I have had a couple of times when getting out of the car, for example, my clothing caused the pump to press hard again the gonad causing a bit of brief pain.

    After two summers of being in Depends or a legbag for a condom catheter, I have lived this summer in shorts!  It's like I've regained my quality of life!

    Glenn 

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    • Posted

      I 100% agree Glenn, there are some very minor challenges with an AUS but overall well worth it, and then some, and life changing.  I'm going to a Craft Beer Festival Saturday and too not have to worry about where the bathroom is, when to go, or how many pads to take is very liberating.

      John, I hope your activation and life with an AUS goes well.

      Scott

      Scott

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