The AUS and Hernia Surgery

The is just an FYI on my very recent experience with the subject topic.

I’ve had a discomfort in my left groin for about 4 years, something that became more noticeable after the RALP I had in 2018. A month or two after that surgery I had an ultrasound that diagnosed an inguinal hernia that the attending PA in urology said was probably caused by the RALP. I saw a surgeon who said that it was so minor that he didn’t recommend fixing it at that time. I agreed but over the past 4 years it became more of an issue, usually after a long run of 5-8 miles. A few months ago, after I’d spent longer times on my feet, I started getting a burning sensation and a small bulge. I saw my new regular doctor and he sent me for another ultrasound. While waiting for the results I went to Italy for a couple of weeks. Over there, it seemed to get worse since I did lots of walking and the standing requiring me to find a place to sit, lie back, and push things back inside.

When I returned, my regular doc referred me to surgery. The closest appointment I could get was 5 weeks out which was this past Thursday. In the meantime I used Dr. Google to research an apparatus to hold things in place and bought an nice one off Amazon and it really did work. In fact, I started running again, something I hadn’t done in a while.

On Thursday I saw the surgeon and he said it had progressed to where I either wear this girdle thing forever or I get it fixed. I opted to get it fixed and we discussed the open method vs. laparoscopy with me preferring that latter. He said he’d try that but let me know that due to the RALP he might have to switch to the open which was fine with me. Knowing that they are really backed up at this hospital, I thought we’d be looking at the end of August but he checked his schedule and had an opening for the next day, Friday. So, about 12 hours ago I was in surgery getting this fixed and they were able to do the laparoscopy.

Where my artificial urinary sphincter fits into this saga is that most of the providers I worked with through this had heard of it but were unfamiliar with where its parts are and how to deflate it. The surgeon said that if in the unlikely event I needed to be catheterized, they get someone from urology to take care of that. OK, as long as they can do that, great. But, as I went through the pro-op stuff, it was clear that I really needed to make sure they knew where the parts were. To complicate things, they just did a conversion of their records database and the AUS doesn’t even show as a potential issue like it should. The surgeon came back in and did an exam because the location of one of the lap ports he intended to site was approximately where the “saline balloon” is for the AUS.

The surgery went well and I feel fantastic. The level of discomfort feels like I did a few too many sit ups and Tylenol takes the edge off. BTW, the surgeon said that the hernia had been there since birth and was not related to RALP although that procedure didn’t improve it.

The bottom line is that we have to be our own advocates and don’t assume that the system is going to take care of everything for us.

Vince - Just take it easy for a few months now. My inguinal hernia refused to show up on ultrasound and CT but when it finally caused problems, it could be easily observed by any doctor. Surgeon said that happens with hernia scans sometimes since it is difficult to stress the hernia while laying on your back for a scan. Scans also indicate hernias that don't cause problems as well. The usual medical crap shoot with scans and diagnosis.

JNF, thanks. Here I sit, having my morning cocoa and I feel pretty good, only 16 hours out of surgery. I’ll get my shoes on and go out for a walk a little later.…..

Just got back from a 30-minute walk, a bit more than a mile. I feel fine.

My wife told me that when the surgeon told her that while he was in there that he tried to scope over to look at the right side to check for hernia there but due to past surgeries it wasn’t an easy path so he just felt from the outside and didn’t note anything.

Glad you're doing well after the hernia repair. You did mention the Italy trip in your OP and yes, I've been pulled over by TSA because my AUS shows up like I was the underwear bomber. Even without a language barrier, the agents weren't at all interested in what it is and how it functions (and why I wear the bracelet). I've found it's not a situation for jokes, as we often do here about the joys of ADT and such.

I'm learning about other hindrances to travel in the modern world. Boarding a cruise ship I discovered that the steel orthotics in my shoes also set off metal detectors. Now if only I were fit enough to bend over and tie my shoes without losing my breath. Thank you for the well wishes.

fiddlecanoe, it was the same with me. My GP noted a “weakness” in that area and said to keep a watch on it. I know that I did nothing to exacerbate it other than turning lots of calendar pages since then. ;-)

I’m on day 3 post-hernia surgery and feel pretty good. Experience from the RALP and AUS adventures have helped with navigating the tenderness and other issues. The swelling on the first day must have been pressing on the urethra since my flow was down, even opening the AUS all the way. It seems normal now, The bowels did their thing on day 2 so that isn’t worrying me. I started downing softeners and Metamucil as soon as I knew I was headed for surgery. The La-Z-Boy, which I didn’t have access to after RALP, is my best friend. Walks are a daily routine.

I’ll follow the doctor’s orders and not lift anything greater that 15-pounds for 6-weeks. The upside is that I get out of mowing, etc. but the downside is that I had to put my motorcycle back where I keep it for winter storage and it is the height of riding season here.