John's Story - An artificial urinary sphincter changed my life
In 2010, John Deady was diagnosed with prostate cancer. The cancerous cells were unable to be fully removed via operation, so he underwent radiation four times a week over eight weeks. However, a subsequent PSMA PET* scan showed there were still some cancerous cells present. This was treated by five doses of targeted radiation. Later when John’s prostate specific antigen (PSA) increased, he received twenty more doses of radiation. The radiation John received brought on urinary incontinence. To manage this, he was wearing six to seven pads a day.
“I would go out and be sitting down and suddenly, my pants would be wet. After four or five years of several pads a day, and wetting the bed at least once a week, it started getting me down.”
John was referred to Professor Lewis Chan, Head of Urology at Concord Repatriation General Hospital, who first suggested a bladder sling. However, due to the large amount of urine, they decided on an artificial urinary sphincter (AUS). This device includes a fluid-filled cuff that wraps around the urethra, a
pump in the scrotum and a balloon in the abdomen. The AUS tries to reproduce the function of the working urethral sphincter by opening and closing the urethra. When John turns off the device by pressing the button in his scrotum, the cuff deflates and releases pressure on the urethra, allowing John to urinate. The device was implanted in December 2021 and then he was given six weeks to heal.
The 6th of January 2022 was a ‘momentous day’ for John as the artificial urinary sphincter was activated. Pads have not been needed since. Indeed, John was so chuffed with the results, he emailed forty of his school peers whom he often meets with for dinner. They were very supportive and eager to pass on his story to others experiencing incontinence. John speaks of going to the bathroom sometimes being impractical (and a little messy!) because using the AUS often takes two hands. There is sometimes an accident, and sometimes the urine flows quitequickly, meaning there may need to be some
adjustments during this month’s checkup. Overall, he describes receiving the device as “one of the best things that ever happened to me”. As for his prostate cancer, on the 1st of April 2021 John’s PSA was 5.8, and in March 2022 it had decreased to 0.1. Onwards and upwards for the eighty-two-year-old.
“Oh what a feeling!”
*A PSMA PET is an examination of prostate-specific membrane antigen (PSMA) imaging using positron emission tomography (PET) to detect prostate cancer.
WHAT IS AN ARTIFICIALURINARY SPHINCTER (AUS)?
The urinary urethral sphincter is a muscle that helps control the flow of urine from the bladder. An artificial urinary sphincter (AUS) is a surgical treatment option for male urinary incontinence. It consists of a cuff that wraps around the urethra, a pump in the scrotum and a balloon in the abdomen that stores fluid and regulates the flow of fluid in and out of the cuff. The fluid inside the cuff prevents urine from leaking out, remaining closed until the need to urinate. Squeezing the pump in the scrotum causes the cuff to deflate by releasing the fluid into the balloon in the abdomen, allowing the passage of urine.
The prostate specific antigen (PSA) test measures the level of PSA made by the prostate gland in the blood. It is used to help detect or monitor prostate
cancer. The PSA can also increase with other noncancerous conditions like an enlarged prostate or prostatitis (an inflamed prostate). The test is not used to routinely screen for prostate cancer. Consult your doctor or health care professional to discuss the risks and potential benefits of PSA testing. For more information go to healthdirect.gov.au/prostate-specific-antigen-PSA-test