The surgery was Friday morning.  They did two procedures.  One was the cysto
to go in an open up the opening at the anatomists.  It was about one third
the size that it should have been.  The second procedure, of course, was the
implant of the artificial urinary sphincter.  I went in knowing that the AMS
800 does not mean complete dryness.  The surgeon told me that about one
third of his patients over the last 20 years he has been doing this do not
use any absorbent pad at all.  Most wear a liner instead of a high
absorbency pad like the Depends Guards.

The surgery went well but I came within 15 minutes of getting a catheter
because I could not urinate.  I had a spinal and the one area of my body
where I could not feel was in the genital area.  A couple hours after the
surgery the doctor told me that if I could not pee in four hours it would
mean that I needed a catheter.  Well, it took 3 hours and 45 minutes, on IV
bag number 3, and four cokes later, but Willie finally gave up the golden
fluid that saved me from another experience with Mr. Foley and gave me my
ticket home.   Home with four prescriptions.  Oxycodone for pain relief, two
antibiotics, and a stool softener (which I take anyway without any
prescription??).

I cannot say this was without pain, but I want to be careful not to scare
anyone off from having the surgery.  I have been taking the pain relief
medicine, and I suspect that is what is making me groggy and making me sleep
as much as I have.  I do not hurt just sitting or lying down.  Getting up
and down is when it hurts.  The discomfort is in the incision, between the
anus and testicles, and my right side where the reservoir was implanted.  It
looks like I have one big testicle that is black and blue.  Today I ventured
a feel down there and found the pump in the testicle sack.  The penis is
doing its turtle head routine which has made urinating a bit difficult so I
have taken to doing that sitting down.  Yesterday the urine was going all
over the place, reminiscent of post RRP days, and I definitely do not pee
like a race horse, at least not yet.

The dressings consisted of an athletic supporter with one of my Depends
Guards and some gauze placed toward the back to cover the incision area.
There was blood yesterday, not a lot, but it was there.  They warned me that
i would leak a lot more than normal, although I have not observed that so
far, but it is early.  I know what you are thinking.  tDub's experience with
going dry after having the strictures removed.  Believe me, after reading
that on Wednesday last week I wondered about that.  At Ron B's wise counsel
I did call my doctor.  I got two responses.  The first is probably obvious
and predictable, "cannot comment on the other patient's experience without
knowing all the details".  Okay, fair enough.  The main answer was that
there are more than one type of incontinence.  They said that one treatment
for overflow incontinence is removing the scar tissue in order to allow the
patient to empty the bladder when urinating.  My studies showed that I was
emptying the bladder when I urinated, so that was not my problem.  I had
stress incontinence, just getting up from a chair caused me to leak, so my
problem was due to a sphincter that was not functioning properly.  Let's
wait and see.  So far I am not leaking much.  Just trying to report the
facts here for what hopefully will be for the benefit of the next guy facing
this decision.  I think it is safe to say that it would be prudent to have
the scaring at the anatomists fixed first, and then with continued leaking
have a go at the AMS 800.

I will report in again.  Today I am starting to wean off the oxycodone and
switching to ibuprofen.  So far so good.

Thank you.

David S.