If you know my story, you are aware that I was diagnosed with Stage 3 bladder cancer in 2004, resulting in the removal of my bladder and subsequent creation of a new bladder, a "neobladder" from a portion of my small intestine. This artificial bladder has served me adequately since my surgery but I've struggled with a persistent issue for seventeen years as a result of this life-saving procedure, i.e. incontinence or leakage of urine, especially at night. As a result, I've had to sleep wearing an adult diaper practically every night.
I've tried a couple of medications to alleviate this problem without success. At one point, I was put on imipramine (Tofranil) which is a drug used to treat childhood bedwetting. However, this was stopped after several weeks without providing the desired result. Within the past year, another urologist attempted a more modern pharmacological agent, tolterodine (Detrol), but it also provided no help.
In addition, I've attempted non-phamacologic ways to deal with the nighttime incontinence, e.g. emptying my bladder right before I go to sleep. Nevertheless, the urine leakage has remained an issue.
Furthermore, I've had some issues with some urine leakage during the day, making me wear a small pad underneath my undergarments. Plus, the fear of urine leakage has caused me to wear dark pants only in case I wet my pants even the slightest amount during the day (not quite as noticeable when wearing dark clothes).
However, in March 2020, I attended a urology seminar to obtain continuing education credits as a nurse practitioner. During the course of the day, I spoke with one of the urologists and mentioned how incontinence has plagued me for such a long time in spite of several failed therapies. He mentioned how having an artificial urinary sphincter might be of some assistance to me.
What is an artificial urinary sphincter? It is a surgical device with an inflatable cuff that fits around the urethra close to the point where it joins the bladder. Basically it squeezes the urethra shut so that no urine can leak out. In addition, a balloon device is placed in the pelvic area and a pump secured in the scrotum to control the opening and closing of the inflatable cuff. If the patient needs to urinate, he squeezes the pump in the scrotum, thus releasing the pressure on the urethra for about ninety seconds and allowing the urine to flow.
Therefore, after pondering this decision for some time (mainly waiting for COVID issues to settle down at my hospital), I underwent placement of an artificial urinary sphincter on May 20, 2021. The surgery was done as an outpatient. I was off work for about two weeks to recover. The urology nurse practitioner later activated the device about four weeks after the surgery.
What has been the result? The artificial urinary sphincter has been an absolute game changer! I no longer have to sleep with the embarrassment of a diaper. I only leak a few drops at night (if any). I do still wear a small pad, i.e. a "male guard", during the day because I sometimes have mild leakage when I cough or sit down in a chair. However, the incontinence is about 97.5% controlled. I couldn't be more happy about the results.
