Like many men, Peter Barton had to deal with urinary incontinence after prostate surgery and was among those who don’t see the problem improve over time. After years of using pads as the problem got worse, Peter decided to try a surgical treatment – the male sling.
PETER: As a fit farmer aged 65 it was a great shock when I was diagnosed with prostate cancer back in 2008. My wife and I examined all the options for treatment and opted for robotic assisted surgery, which was then still in its early development in the UK.
The surgery went well. My excellent urologist had said that we’d just got the tumour before it had broken out of the prostate and my family were much relieved as he confirmed the cancer was unlikely to return.
I was out of hospital in two days but had to wear a catheter for two weeks – these were pretty miserable weeks. It wasn’t painful at all, but it was awkward. It kept getting caught up on things and was constantly leaking. Things improved when the catheter was removed however I was left incontinent.
To begin with it was really bad. For the first two months, it required two to three size two pads. This later reduced to just one apart from when I tried to get back to riding my bike, which caused a lot more leakage. After surgery in that area, there is a lot of damage and you’re very numb. When you get off the bike after a ride, you’re so numb you don’t even know if you’re urinating or not, so you can have disastrous and very embarrassing accidents. However, a new saddle designed for men with prostate problems, which I found on the internet, helped with that.
For the next nine years life was good but, although I followed instructions about pelvic floor exercises, which I know work for some men, my incontinence slowly worsened. For the first year or two I was using a size one pad – the lightest. After two years, I’d moved on to the number two and by the last few years I was on a number three, which needed changing several times a day. Each of these can hold a considerable amount of urine.
I was amazed by how positive and confident [the surgeon] was
Eventually, after attending a support group meeting on incontinence after surgery, I sought the advice of the specialist surgeon who was speaking there. I was amazed by how positive and confident he was when he said that there was no need for anyone to suffer from this. He told me about two surgical treatments for persistent urinary incontinence in men who have had prostate surgery, the artificial urinary sphincter (AUS) and the male sling.
We discussed the two options at great length. Like all treatments, there can be side effects as well as risks from the surgery. He was very careful in counselling me about whether this was the right thing for me and gave me a lot of information comparing the known risks of the artificial urinary sphincter against the less known long-term risks of the sling procedure.
As a private patient, I was able to choose and after painstaking online research, I opted for the sling. I had to go through a screening process to assess how well my bladder was working, then I underwent surgery in August 2017. I had a spinal block instead of the normal general anaesthetic, which led to a swift recovery. I was about to leave the next morning but found, after the removal of the overnight catheter, that I could not urinate. I was one of the patients who have this problem due to extreme irritation of the surgery site. I had very little pain – just discomfort.
Before the procedure I could only play [sport] for about half an hour, then I’d have to change a pad. Now I’m back to normal.
Another catheter had to be fitted, which was very worrying. I thought: ‘Oh no, what have I done?’ But after a week it was removed and to my great joy I was fully continent and able, with some difficulty, to urinate. This difficulty persisted for nearly a month but after nine weeks I was completely continent, using no pads and able to pass urine without trouble.
I was utterly amazed when I realised that the procedure had worked – over the moon. Urinating is still a slightly different experience, but I’ve got my life back. I play a lot of sport and before the procedure I could only play for about half an hour, then I’d have to go and change a pad. Now I’m back to normal.
I wanted to share my experience with other men because it’s great to have something positive to say about incontinence after prostate cancer treatment. I’m not saying every man will have such a good outcome, but both I and a close friend who has also had the procedure are very, very happy with our experience.