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Outcome and complications of adjustable continence therapy (ProACT™) after radical prostatectomy: 10 years’ experience in 143 patients
Author(s) -
Noordhoff Toscane C.,
Scheepe Jeroen R.,
Blok Bertil F.M.
Publication year - 2018
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23463
Subject(s) - medicine , prostatectomy , urinary incontinence , quality of life (healthcare) , surgery , urinary continence , urology , concomitant , complication , prostate , cancer , nursing
Aims To evaluate our outcomes of the adjustable continence balloons ProACT™ for the treatment of male stress urinary incontinence after radical prostatectomy. Methods Between May 2007‐August 2016 the ProACT™ was implanted in 143 patients without a history of radiotherapy. Endpoints were patient‐reported changes in pad counts and complications. Treatment was considered successful if no pad or just one “security” pad per day sufficed, and improved if daily pad use was reduced by ≥50%. Results Incontinence before implantation was mild in 36 (25%), moderate in 57 (40%), and severe in 50 (35%) patients. Complications within 30 days were classified by the Clavien‐Dindo classification; eight (5.6%) grade I, three (2.1%) grade II, three (2.1%) grade IIIb, and 129 (90.2%) patients had no complication. Revision was done in 43 (30%) patients. The IPSS quality of life item improved significantly from 5.0 (IQR 4.0‐5.0) preoperative to 2.0 (IQR 1.0‐4.0) and 1.0 (IQR 0.0‐3.0) 6 and 12 months after implantation, respectively. After a median follow up of 56 months (range 28 to 79, n = 112), 72 (64%) patients were improved, including 51 (45%) patients were successful. Daily pad use decreased from 3.0 to 1.0 (67% reduction). The median outcome on the Patient Global Impression of Improvement scale was “much better,” and 97 (87%) patients perceived improvement. Conclusions The minimally invasive ProACT™ device showed a clear beneficial continence outcome in patients with stress urinary incontinence after radical prostatectomy. The majority of the patients were satisfied and perceived improvement ≥50% on daily pad use on the long term.