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Medical Forum / Diseases and Disorders / Prostate Cancer / April 2007

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Invance Male Sling for incontinence?

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Wayne - 13 Apr 2007 02:51 GMT
Has anyone experience with the Invance Male Sling for incontinence?  

I am 68 now, and 2 years after RP surgery, and PSA is undetectable now,
which is good.  Incontinence varies with days and activity, sometimes
light, but sometimes heavy.  I call it one pad per day, but I cut them
in half, and it is usually two halves per day.  The pads are often
light, but with plenty of surprises, and quite necessary.  I think it
may be be getting a bit worse.   But manageable I guess, I'm used to it
now.

My urologist/surgeon wants to do this new sling thing, and says it has
great success, and assured me of no side effects.  I do trust him, and
would like some improvement, but find that I am a little hesitant about
more messing around down there.  :)  I believe the surgery to be
relatively minor, one night in the hospital, and have heard about
sitting discomfort for awhile, but my only concern is about long term
after effects.

The doctor just introduced this and said to go read up on it first.  It
was a new concept to me, and I wish I had thought of these questions
then, at the first visit. The best info I find online is with simple
Google search for keywords:    sling prostate    Not really much info.  

My understanding is that this sling acts as a clamp to squeeze the
urethra tube, to prevent the draining, and that it is particularly
effective at this.   But if it squeezes, and is tested with 60cm water
pressure, then how does one urinate?  Making this up, but do you have to
wait for full bladder pressure to start it?   I had blockage problems
immediately after surgery, and had to be dilated several times, and am
very leery about urination problems now. :)  

And what is the effect of all that squeezing several years out?  
Anything like permanent urethra damage?  Is this what is meant by
urethral erosion?  I'm thinking it is new enough they may not know about
long term.  

The numbers that I think I read say it is extremely effective for like
40%, very helpful for 40% more, not much help for 10%, and causes
problems for 10%.  10% harm seems rather high, not quite the same as no
side effects.  

But it would seem if the odds are so good, then why not?   Nothing is
decided yet, and I am in no hurry.  I still have to do a cystoscopy, to
verify if I am suitable for this.  

I would appreciate any comments from people with experience with this.
Heather - 13 Apr 2007 05:30 GMT
Wayne.....when using Google, put it in this way.....

prostate +sling

(no space between the plus sign and sling).  I got 166,000 hits with
that.  You could then narrow it down by using plus or minus signs.

Heather
> Has anyone experience with the Invance Male Sling for incontinence?
>
[quoted text clipped - 50 lines]
>
> I would appreciate any comments from people with experience with this.
Heather - 13 Apr 2007 05:41 GMT
Shouldn't post when tired.  Also add invance after sling like
so..........

prostate +sling +invance

Got 579 hits for that.

HF
> Wayne.....when using Google, put it in this way.....
>
[quoted text clipped - 29 lines]
>> I would appreciate any comments from people with experience with
>> this.
dave perry - 13 Apr 2007 15:08 GMT
Type "sling" into the Search This Group box and you'll get about
seventy hits.
Dave Perry

> Has anyone experience with the Invance Male Sling for incontinence?  
>
[quoted text clipped - 42 lines]
>
> I would appreciate any comments from people with experience with this.
Wayne - 13 Apr 2007 20:10 GMT
>Type "sling" into the Search This Group box and you'll get about
>seventy hits.
>Dave Perry

Thanks Dave and Heather.   In the recent year or two, a summary here sems
to be comments by Don C (satisfied) and David S (much less satisfied).

I am confused, and may be asking about something different.  I have not
figured out yet if this sling is something newer or not.  My doctor said it
was something new, and gave me a pamphlet dated 12/06 that doesnt actually
say anything at all, except does say AdVance Male Sling from
www.americanMedicalSystems.com.  However that web site calls it InVance.
So yesterday, I had assumed InVance was the right name, because that name
matched the few links that I found, and seemed to be the product they
offered.

But today, I find http://www.amsadvance.com/about.htm which clearly says
InVance was first, and then AdVance followed, also from
AmericanMedicalSystems.  Their page at http://www.amsadvance.com/news.htm 
has two good articles (last 2 of the 4) which are very hard for me to read,
but descibes something installed with "needles", and is extremely different
than the "six titanium screws" described by most links about the InVance
sling. See pictures page 5 & 6 at
http://www.amsadvance.com/80179Z%20UT%20AdVance_final.pdf

I suppose AMS is AmericanMedicalSystems too - if you click on the AMS logo
in upper right, it takes you to americanmedicalsystems.com, but which
doesnt mention this AdVance sling.  I'm very puzzled, but I think I meant
to ask about the AdVance Male Sling, not the InVance sling.
Buttercup's Dad - 25 Apr 2007 17:19 GMT
Wayne:
  There are several "new" sling procedures.  All my uro said is that
it was a procedure developed in Europe about three years ago.  He too
told me that it was very successful.  How the various procedures are
different I do not know.  Your doctor should be able to fill you in on
that.  Apparently I was the first patient where the new procedure did
not work for my doctor, and at this point no one knows why.
  When I did some net searching I found a procedure where the sling
was adjustable without requiring further surgery.  That way the doctor
could loosen it or make it tighter depending on whether the patient
still leaked or had difficulty urinating.  You may want to ask about
that one.
  Good luck.
David S.

> I suppose AMS is AmericanMedicalSystems too - if you click on the AMS logo
> in upper right, it takes you to americanmedicalsystems.com, but which
> doesnt mention this AdVance sling.  I'm very puzzled, but I think I meant
> to ask about the AdVance Male Sling, not the InVance sling.
Wayne - 27 Apr 2007 19:20 GMT
>Wayne:
>   There are several "new" sling procedures.  All my uro said is that
[quoted text clipped - 10 lines]
>   Good luck.
>David S.

Thanks David.  About the only mention I find about the "new" "AdVance Sling"
(vs the older Invance Sling with Six Titanium Screws) is just marketing
material, for example http://www.amsadvance.com/news.htm  but which is very
encouraging. I would very much like the absense of the associated pain from
the screws. I like that it does not work by compressing the urethea, but
instead (I think) just holds it higher. I think tension is no longer an
issue, but my knowledge is still very naive.

My urologist/surgeon, who I do trust, said this AdVance Sling is something
very recent, and that it offers very great probability of satisfying success
(for patients with mild incontinence). I am making up problems, but my only
little concern is about side effects, like trouble peeing later, etc, which
might make it worse insted of better.  My doctor says that wont happen, no
side effects.

I have been stalling, but think I want to do this, so I just need to get up
my courage to go do the cystoscopy to see if I qualify.  The doctor said to
read up on it and we'd go over any questions then.  He has said the new one
offers great probibility of satisfying success, and about all that could go
wrong is normal infection risks of surgery, etc.

If this easy and great, it surprises me that there isnt any talk of it here.
Steve Kramer - 13 Apr 2007 22:12 GMT
> Has anyone experience with the Invance Male Sling for incontinence?
>
> I am 68 now, and 2 years after RP surgery, and PSA is undetectable now,

Sorry, no comment on the sling, but (assuming this is Wayne F.), I'm pretty
happy to see the undetectable.

Congratulations.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA  <.1  <.1  <.1  .27  .37  .75            PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32                       PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA  .07 .05 .06 .09 .08 .132 .145       PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05
Non Illegitimi Carborundum

Wayne - 13 Apr 2007 23:24 GMT
>Sorry, no comment on the sling, but (assuming this is Wayne F.), I'm pretty
>happy to see the undetectable.

Thanks Steve.  Yes, Wayne F, RP 3/29/2005.  PSA is working out OK so far, no
issues.   It is always a worry, but also the bright spot.
 
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