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Posted 10/25/2014 11:38 PM (GMT -5)
As you can see from my profile, I had surgery in August 2013, and was almost continent before starting RT in January 2014. Then reverted to incontinence in May and have remained that way since. I weigh pads and am leaking 250 to 300 mls per day with occasional spikes to as high as 500mls so an average day is 5 pads and a bad day about 8 or 9.

My Uro accepts this is now unlikely to improve and agrees I need some surgical intervention.

While he does do slings and AUS, because of my RT and strictures, he has referred me to a Uro in Sydney (3 hours drive away) who specialises in this area. I am seeing him on 30 October. My Uro also indicated that he did not think I would be a candidate for a sling because of the RT. Not completely sure why, but assume bone structures may be compromised by the RT.

Because this specialist was overseas when I made the appointment, his receptionist has booked me in for the initial consultation on 30th and assuming he would want to do a cystoscopy, has scheduled that for 31st.

I'd like advice on what information I should be providing and what questions I should be asking. I was with my Uro when he dictated the referral and it was fairly basic. I do have my full Urological history documented and will provide all that, but not sure what else he may need, and what info I should be seeking to elicit.

One concern I have is the return trip home. My wife doesn't drive, and while this initial visit shouldn't be a problem, not sure what I will do post surgery if an AUS is installed.

Also wondering what the impact of strictures has. I have already had one stricture dilated, but still have a very small stricture near the tip of the penis.

I have read BicMac's very helpful AUS thread so am not unaware of many of the issues, but would appreciate any further advice at this early stage of evaluation.

Many Thanks

Chas
Posted 10/26/2014 2:59 PM (GMT -5)
Hi Chas,
I see you read my thread about installing an AUS.

You mentioned your concern about driving home after the AUS is installed. I had a 1 hour drive home. My wife drove me and I was in total pain the entire trip. I felt every bump in the road and I was sitting on a soft pillow.

I was given a catheter after the surgery. My surgery was done on a Friday so I had to go back Monday to have the cath removed. If my surgery was a weekday, I could have had it removed the next day. As you must know, you shouldn't be driving with a catheter. I didn't drive for about 1 week because of soreness and swelling.

How far do you have to drive to have the AUS? You may want to just stay in a hotel until you feel up to driving if you can't have someone else drive you home. I did that after my DaVinci. Stayed in a hotel across the street from the hospital.

Email me if you have any other questions I can help you with, I would be glad to help another brother get dry!

Bill from Florida cool
Posted 10/26/2014 6:07 PM (GMT -5)
Hi Chask,

I'm a sling guy and am pleased with the results. That said, there are reasons why you might not be a candidate.

A good candidate for sling:
1) Leaks less than 200 ml per day.
2) Has good residual control. Meaning you can start and stop your stream and hold it for a few seconds.

You sound like you are way above the 200 ml limit and I am not sure about residual control.

Based purely upon your description, you will likely be better off with the AUS. It is the Gold Standard - or is it the "Golden" Standard?

Good luck to you.
Jeff
Posted 10/26/2014 9:14 PM (GMT -5)
Thanks Bill, I thought you would be one of the first to reply. Your AUS thread is a wealth of information and I am grateful for it, as I am sure are many others.

Yes the journey home post surgery is a concern. It will be a 3 hour drive. I seem to recall that your recovery was a bit more difficult than some others and have this optimistic hope that travel within a day or so of surgery, while pain killers are at their most potent, might be possible. I will discuss with the surgeon as I am sure he has treated patients in the same situation as me.

I could stay in Sydney for longer, but I am sure a week in a hotel would drive me nuts, and that assumes a week would be enough.

Jeff, thanks for your input. Yes, I think I am probably beyond the sling, though I do have good residual control provided I can keep the bladder full. First thing in the morning is best and I can stop/start very effectively.

Have a friend who had the sling, but it failed and he now has an AUS which works well, but he says he preferred the sling when it was working.

Just hoping that my overall circumstances don't limit the opportunity for an AUS.

Chas
Posted 10/29/2014 10:42 AM (GMT -5)
If you stay overnight, they may only cath you for one day. Or stay in a local hotel for a day or so.. On my first AUS surgery, they did not cath me. On the second implant, they did cath and I felt better about that.

The cath came out soon there after. Now, I did wear a Foley Cath for many months several times and drove the whole time. Not sure why you can not drive and wear a cath.. I went to work in a day or two.. Just sat to the side!! ha ha

NEO
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