At 62 I had da Vinci robotic surgery (transurethral resection) to remove my prostate after a minuscule amount of cancer was detected through two needle biopsies (a higher-than-usual PSA precipitated the biopsies). My doctor had performed approximately 50 or 60 of these operations. I chose this method since the "experts" said it would significantly reduce my chances of incontinence and long-term (ie, permanent) impotence.

The da Vinci surgery left me totally (100%) incontinent. I'm not talking about "stress" incontinence or "urge" incontinence. I simply cannot retain urine. What goes into my bladder exits via my penis. The surgeon said my prostate was quite enlarged and had impinged upon my bladder long enough to cause my bladder walls to thicken--much as the heart muscle will do in cases of vascular congestion. Pre-surgery I did have some difficulty urinating, but I would not call it severe.

I (not my doctors) finally suggested the possibility of using a "Texas catheter" or "condom catheter" to eliminate having to pickle my gonads in urine 24/7. My surgeon said that was okay, so I obtained (eventually via mail order) a supply of condom catheters plus a leg bag. This constricts my activities somewhat (one cannot wear shorts or go swimming while wearing one of these things), but it's far better than the alternative. I wear Depend underwear at night, although it's possible to connect a "night bag" to the condom catheter if you tend to pass a lot of urine. My incontinence abates when I'm lying down, however.

Nonetheless, it gets worse.

After several weeks of doing Kegels with absolutely no improvement, I sought help from my urologist. After doing some urodynamic testing, she determined I was a good candidate for artificial urinary sphincter (AUS) surgery. Do a Google search if you're unfamiliar with this device. This is supposed to be a relatively simple procedure with a high rate of success. My urologist, who would perform the surgery, had something on the order of 150 successful AUS procedures under her belt, with only one failure during surgery when she inadvertently nicked the fellow's urethra and had to close it up and come back later. One failure out of 150. That's a failure rate of six-thousandths of a percent.

I was failure number two, and I remain devastated to the point of becoming suicidal. I'm back in psychological counseling in part as a result of this experience.

My urologist/surgeon--who had given me a lot of optimism pre-surgery--has been unable to explain to me just what went wrong. My own layman's opinion is that this failure came about because (1) she was not as skilled as I/she perceived, (2) no measures were taken in recovery to reduce what I considered (but my surgeon did not) significant swelling (aggravated by several extremely painful attempts on the part of the doctors to make sure the device was open after I was unable to urinate post-sugery) and (3) the catheter inserted during surgery was not left in place longer to allow the implant area to stabilize (typically, it's removed 24 hours later).