Since all of the treatments for Prostate Cancer have similar cure rates at 15 yrs many patients base their choice of treatment on the potential for side effects.
For instance:
- If you absolutely could not tolerate total incontinence don’t choose surgery as this has the biggest risk for that complication.
- If you are worried that you could be totally impotent as a possibility don’t choose surgery. I am not saying it will occur you just have a higher chance of total loss of erectile function with surgery as opposed to radiation.
- Radiation negatively affects erections but not quickly or dramatically. It has a negative effect over time.
- Radiation patients don’t have total incontinence but do get urgency and frequency.
You get the drift…my advice?
Choose the treatment that you feel gives you the best chance of cure with the least side effects that matter most to you i.e. a patient…
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Prostate Diaries 
Eighteen months ago I (76) had my Prostate removed after over three years of active surveillance. The Gleason score had jumped from six to eight. It was “adjusted” to seven after the surgery, but that’s another story.
Voiding is now not a problem, but incontinence is and I’m seriously considering an artificial sphincter. I’m aware that 1) it may not work perfectly or even at all; 2) there’s risk of infection; and 3) it will probably need to be adjusted after five or six years. Are there any other downsides I should know of?
Thanks.
Jon
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It actually sounds like your doctor has given you a fair appraisal of the downside. The AMS website has a lot of resources for you and in particular the potential of complications such as erosion into the urethra.
You might look up Coaptite-a bulking agent. It does not always work but when it does it saves more extensive treatments. Google the male sling and its pros and cons.
With all this in hand you can make an informed incision.
Ps commonly the type of procedure that is best is dictated by the degree of incontinence you are having..i.e. the male sling is for mild/mod and the sphincter is for mod/severe. Coaptite probably best if mild / moderate. Remember Coaptite can be done as an out pt, no incision, rarely the need for a catheter so even if it doesn’t work one might agree it was worth trying.
Good luck. JM
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