Male Sling for Incontinence or AUS

[beachbumbob]

After prostatectomy and radiation I have some ED problems that are remedied with VED, but I have moderate pee leakage.
DR is recommending AUS or Male Sling.
Any advice about this is appreciated.
I am leaning towards the sling, but have had radiation and am concerned that sling doesn't work as well after radiation.
Any thoughts?

[LGXDownunder]

After prostatectomy and radiation I have some ED problems that are remedied with VED, but I have moderate pee leakage.
DR is recommending AUS or Male Sling.
Any advice about this is appreciated.
I am leaning towards the sling, but have had radiation and am concerned that sling doesn't work as well after radiation.
Any thoughts?

The sling could be a good choice. It may depend on the severity of your leakage and how it affects your quality of life.
I would consult a good surgeon who specialises in male continence problems and ask about the radiation concerns.
I had a radical prostatectomy for PC in 2022 but no radiation, zero PSA since.
But had a lot of problems with incontinence caused by the surgery. Early on it was terrible and very difficult to cope.
Progressively, after about 18 months it slowed to a very slow drip, and only triggered by certain types of exercise e.g. walking.
Trivial, but persistent and really bothered me as I still got uncomfortable and visible wet patches on underwear and clothing.
I hate wearing pads etc and had stopped using them except as a precaution for sustained, really strenuous activities, or occasions where a leak would be very embarrassing. So I was referred to a specialist uro surgeon who does slings, AUS and so on.
We did bladder diaries and urodynamics testing, which indicated an overactive bladder. Tried pills for that but they didn't help.
He told me that he couldn't do a sling for me. Due the trivial amount of leakage (about 6mm/day average) he said would not be able to get the tension correct. It could either make the leakage worse or cause urinary retention. Obviously I didn't want either outcome.
We also ruled out an AUS. It would be overkill for my symptoms and I was also considering an implant at the time, which would mean a lot of gear down there. In the end he did a bladder Botox procedure which helps calm the bladder and dry up the residual leakage.
That was about 16 months ago and it took me close enough to 100% continent.
I got my inflatable implant just over 7 months ago and that has had a side benefit of further improvement.
I very rarely have even a trivial leakage episode now.

[doctuth]

For the Uncircumcised Only

For those of you who suffer incontinence due to prostate cancer treatment, surgery, radiation, etc. you may want to read about my journey. What does that have to do with circumcision? Well, be patient and listen to what I have to say. First, I will refer you to my post in the Members Only section titled Controlling Incontinence with an IPP. That had to do with a Korean study where several men who had undergone prostatectomy and were suffering ED and urine leakage were implanted with IPPs. They were able to control their leakage by inflation of the implants from 30% to 90% depending on the severity. 72.2% were successful. It inspired me to try that protocol with great success. 30% worked for me. I then hit upon the idea of 100% at night while sleeping. That also worked and allowed me to be semi-flaccid during the day. I got reports from 3 other FT brothers that it also worked for them.

But there was a problem. During sneezing, coughing, and strenuous exercise or lifting, I would occasionally lose a drop or two, enough to leave an embarrassing wet spot on my pants. This was more apt to happen when I had not urinated for 2 to 3 hours. This led to the need for careful planning for extended activities. Pads were not an option. I hated them. Thank you for your patience. The main act follows.

I found a clear plastic cap from a hair product can that was 2 inches in diameter and 1 ½
inches long. It fit just right over my penis glans and a small amount of foreskin which provided for a hermetic seal when I burped out the trapped air. The remaining foreskin folded itself over the edge of the cap to ensure a seal so strong that no amount of pulling could dislodge it. It was totally comfortable, and I could wear it at all times and remove it quickly by retracting the foreskin to break the seal when I needed to urinate.

So now you know why your anatomy is so crucial. Unfortunately, if your foreskin has been surgically removed, you will not be a candidate for this solution. I have not been circumcised, but my foreskin has always been short covering only about one half of my glans when flaccid. Fortunately, that is enough to accomplish the deed. Those of you with a “loose” circ. may be able to get a seal if you can pull enough skin forward to engage the rim of the cup. I have tried to fully retract my foreskin and then place the cap, but the seal in inadequate and the cap falls off. With the above technique, I have never had a failure and am secure in never having wet spots on my pants.


OK, now for the drawbacks. As mentioned, the cap was only 1 ½ inches long, so in order to cover the glans and engage the foreskin I had to push it on so that it flattened the tip of the glans. I did not like the appearance of the blunt tip although it was not uncomfortable. In addition, since the cap had a flat end, it would show a corner on my bulge that was not natural. I decided I need a cap with a dome-shaped tip. I searched the stores and found some hair-spray products with rounded caps, but the diameter wasn’t right. Then I came upon the idea of a small display dome such as is used to display, watches, trinkets and dried flowers. I searched Amazon and found hundreds in all sizes. I found a clear plastic one 2.1 inches in diameter and 2.4 inches long. PERFECT! I ordered a package of 4 for about $9.00. The fit was perfect. No more crushed glans tip and there was plenty of length to seal the foreskin. In fact, I could leave a little air space at the tip as a reservoir if needed.

You can imagine my joy at being relieved of the worry while being totally comfortable. And there is one more serendipity! Since my implantation, I, like many others have lamented the lack if engorgement of the glans. I have discovered that the gentle suction provided to retain the cap has resulted in engorgement of the glans to the full diameter of the cap i.e. 2.1 inches. In addition, it has added ¼ inch to my length. And it remains so for hours after removing the cap. Long enough for some fun.

P.S. Obviously, this cap trick can be used by non-bionic men as well. Those with a ” conservative” circ. may be successful with a longer cap provided the remnant of foreskin can be mobilized enough. Another observation is that since the cap is round and the penis may not be, due to the corporal implants, more skin is needed to take up the slack. It is worth the try. Your size may not be the same as mine. I suggest you try caps from various products to get a functional diameter for your penis and then check out Amazon for a “Cadillac”.

P.P.S. My cap is so comfortable that I forgot to remove it on two occasions when urinating. I quickly noted my error and corrected it, but I did not lose a drop. This thing is secure! I’m happy to discuss this in person if you wish. PM me. We can talk on the phone or do a show and tell in the Denver area.

doctuth