Adjustable continence therapy (ProACT™) after male sling failure for patients with post-radical prostatectomy urinary incontinence: a prospective study with one-year follow-up

Purpose To assess the effects of the ProACT™ device as a second-line treatment for persistent incontinence after male sling insertion. Methods Twenty consecutive patients were treated with the ProACT™ device due to persistent urinary incontinence following male sling insertion (9 AdVance™, 9 TOMS™,...

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Bibliographic Details
Published in:World journal of urology 2015-09, Vol.33 (9), p.1331-1336
Main Authors: Yiou, René, Butow, Zentia, Baron, Thierry, Salomon, Laurent, Audureau, Etienne
Format: Article
Language:English
Subjects:
Aged
Follow-Up Studies
Humans
Male
Medicine
Medicine & Public Health
Nephrology
Oncology
Original Article
Prospective Studies
Prostatectomy - adverse effects
Prostatic Neoplasms - surgery
Prosthesis Design
Prosthesis Failure
Reoperation
Suburethral Slings - adverse effects
Surveys and Questionnaires
Time Factors
Treatment Outcome
Urinary Incontinence - etiology
Urinary Incontinence - surgery
Urology
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Summary:Purpose To assess the effects of the ProACT™ device as a second-line treatment for persistent incontinence after male sling insertion. Methods Twenty consecutive patients were treated with the ProACT™ device due to persistent urinary incontinence following male sling insertion (9 AdVance™, 9 TOMS™, 2 InVance™). All balloons were implanted using a combination of fluoroscopic imaging and fibroscopic retrovision. Urinary symptoms were assessed prior to male sling insertion (T0) and before (T1) and 1 year after the ProACT™ insertion (T2) using questionnaires (ICIQ, USP, and ULCA-PCI-urinary bother) and by determining the number of pads used daily. Results The mean age of the study population at T1 was 68.6 ± 9 years. The mean volume of adjustment at T2 was 4.5 ± 2.7 mL. The previous sling did not cause any technical difficulties during ProACT™ insertion. Late wound infections occurred in the two patients who had been previously treated with the InVance sling and required removal of all implanted materials (Clavien–Dindo classification IIIb). Improvement in mean urinary scores was noted in the remaining patients ( n  = 18) through T0, T1, and T2, respectively: The ICIQ scores were 16.8 ± 2.6, 13.1 ± 3.4, and 5.7 ± 5.7 ( P  
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-014-1447-6