Outcome and complications of adjustable continence therapy (ProACT TM ) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study
2019
textabstractAim: To evaluate the outcome of adjustable continence balloons in the treatment of
stress urinary incontinence (SUI) after transurethral resection of the prostate (TURP).
Methods: In two tertiary centers, adjustable continence balloons were
implanted in 29 patients with post‐TURP SUI between 2007 and 2018.
Endpoints of this retrospective multicenter study were patient‐reported changes
in pad count and complications. Dry was defined as no pad or one security pad.
Results: Preoperative urinary incontinence was mild in 7 (24%), moderate in 12
(41%), and severe in 10 (35%) patients. The median follow‐up duration was 21
(interquartile range [IQR], 11‐43) months. Within 30 days postoperatively, a
Clavien‐Dindo grade less than or equal to II complication occurred in 24% of the
patients. Reintervention rate was 24%. Six and 12 months after implantation, the
International Prostate Symptom Score (IPSS) quality‐of‐life item improved
significantly from 5 (IQR, 5‐6) preoperatively to 3 (IQR, 1‐4.5) and 1 (IQR, 0‐3),
respectively. At last visit (median 21 months after implantation), the outcome on
continence had improved in 76% of the patients, including, 45% dry patients. After
a median follow‐up of 28 months (IQR, 13‐63; N = 23), all but one patient reported
improvement on the Patient Global Impression of Improvement (PGI‐I) scale. In detail, 10 patients reported “very much better” condition compared with before the
implantation, 10 patients “much better,” two patients “a little better,” and one
patient “no change.” Daily pad use decreased from three (IQR, 2‐5) to one (IQR,
0‐2) pads/day (P < 0.001).
Conclusions: This is hitherto, the first study reporting results of adjustable
continence balloons in the treatment of post‐TURP SUI. The therapy was found
to be safe and efficient. The majority of our study population reported
improvement on their condition and greater than or equal to 50% reduction in
daily pad use.
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