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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20388
Experience:  Specializing in general urology and reconstructive urology.
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I had a prostatectomy in May 2011. despite physio i continued

Customer Question

I had a prostatectomy in May 2011. despite physio i continued to use 2 tena level 2s daily. i had a Advanc sling fitted on 15th Jan (not the press button type). All was well until swelling subsided, then leakage began albeit at a slower pace. I am having a review with surgeon in 3 weeks. Can he retension the sling? If so will it be done through the the groin puncture wounds(now healed) or will he have to incise the perinium leading to the urethra.
Submitted: 3 years ago.
Category: Urology
Expert:  Dr. Y. replied 3 years ago.
Hello and thanks for trusting me to help you today. I look forward to working with you.

No, this sling cannot be retensioned.

How many pads are you going through a day now?

Did you do any squatting or strenuous activity since surgery for the sling?
Customer: replied 3 years ago.

Prior to the Advance I was soaking 2 level 2 Tena pads and that was with the aid of Dribblestop clamp. Since the swelling subsided I would soak 1/2 , Tenas . If I use the Dribblestop I am dry and use none.Certainly the Advance has slowed things down. In fact i would be dry until 2 in the day. Am dissapointed the Advance has not worked 100 percent. Three weeks after surgery i pulled a suitcase on wheels through an Airport lounge. Nothing more strenous that . Is the Surgeon likely to open me to reposition the Advance. The urodynamic test showed that my incontinence is only marginally greater than Stress. Thanks Richard.

Expert:  Dr. Y. replied 3 years ago.
No, the sling cannot be re-tightened through a re-operation.

The definition of success with an Advance sling is the use of 1 or less pads per day. Some men have to still wear a couple pads and change them periodically for a bit of leakage. From what you describe, it sounds like you are improved, but not completely dry. This does not sound like a failure of this sling. Very few men become completely dry after a sling.

An artificial urinary sphincter may get you even drier that you are now, but this can still result in the ruse of a safety pad each day.

I would recommend giving this 3-4 months to watch and see just how wet you still are to determine if you want to consider an artificial sphincter in the future. Hope this helps.
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Customer: replied 3 years ago.

thank you so much. Your reply clarifys a lot. The Advance was only inserted on 15th Jan and I still have some numbness and tenderness in the perinium area. As you say I will have a clearer picture in 3/4 months as the system beds in and subsequent healing occurs.The surgeon concluded from a reading of the urodynamics test , that the Advance would be adequate and not embark on the more invasive surgery that is A U S. I expect neither system will do the same job as the muscle I lost in the prostatectomy. Should I continue to have internal muscle massage with my Physio , and do daily pelvic floor exercises prescribed by her. Both these courses of action brought me from 35% to 65% muscle bulk. The Advance to date has increased that to 90%. these are my own estimates. So thanks again. Richard .

Expert:  Dr. Y. replied 3 years ago.
Yes. Continued physical therapy will likely improve your results even more over time.