Maximum Urethral Closure Pressure Increases After Successful Adjustable Continence Therapy (ProACT) for Stress Urinary Incontinence After Radical Prostatectomy

Reuvers, Sarah H.M.; Groen, Jan; Scheepe, Jeroen R.; Blok, Bertil

doi:10.1016/j.urology.2016.04.019

Cited by 15 publications

(11 citation statements)

References 20 publications

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“…Besides, opting for more invasive procedures is still possible after removal. The working mechanism of adjustable continence balloons with a successful outcome is contributed by an increase in urethral resistance and increased maximum urethral closure pressure …”

Section: Discussionmentioning

confidence: 99%

“…The working mechanism of adjustable continence balloons with a successful outcome is contributed by an increase in urethral resistance and increased maximum urethral closure pressure. 19,20 The ICI reviewed the literature with results of AUS in the treatment of male SUI. Most of the studies included men with post-prostatectomy incontinence related to benign and malignant disease.…”

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confidence: 99%

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Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Noordhoff

Finazzi‐Agrò

Scheepe

et al. 2019

Neurourology and Urodynamics

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AimTo evaluate the outcome of adjustable continence balloons in the treatment of stress urinary incontinence (SUI) after transurethral resection of the prostate (TURP).MethodsIn 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.ResultsPreoperative 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).ConclusionsThis 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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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Noordhoff

Finazzi‐Agrò

Scheepe

et al. 2019

Neurourology and Urodynamics

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“…Recent literature showed that successful treatment with ProACT was associated with a significant increase of maximum urethral closure pressure (from median 58.0 to 79.0 cmH 2 O) and that increased in static urethral pressure has contributed to the working mechanism of the ProACT device (64). …”

Section: Methodsmentioning

confidence: 99%

Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery

Chung¹

2017

Transl. Androl. Urol.

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Male stress urinary incontinence (SUI) remains a debilitating condition that adversely impacts all domains of quality of life and is associated with significant social stigma and health economic burden. The incidence of post-prostatectomy urinary incontinence (PPI) depends on the definition of urinary incontinence and the length of patient follow up. In patients with persistent PPI following failure of conservative measures, surgical treatment is recommended although there is no published guideline on when surgery should be performed, and what the best surgical option is. Male slings (MS) can be divided into adjustable or non-adjustable types, and offers an attractive option for patients who wish to avoid mechanical handling during urinary voiding. Published intermediate data supports good safety and efficacy rate in men with mild to moderate degree of SUI. The AMS 800 artificial urinary sphincter (AUS) remains the standard of treatment for complete continence and has the longest efficacy and safety records. Other AUS-like devices are designed to address current AMS 800 limitations but themselves are fraught with their own issues.

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“…Recent article revealed that satisfied management with Pro-ACT was related to a significant increase in maximum urethral closure pressure (from a median of 58.0 to 79.0 cm H2O) and that increased static urethral pressure devoted to function of the instrument [84]. Previous publications about Pro-ACT revealed a meaningful enhancement in patient dry rates after an average of 3 balloon volume modifications [81].…”

Section: Adjustable Continence Therapy (Pro-act) (Uromedica Inc Plymentioning

confidence: 99%

Artificial Urinary Sphincter for Postradical Prostatectomy Urinary Incontinence — Is It the Best Option?

Yoo

2019

Int Neurourol J

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Male stress urinary incontinence (SUI) can undoubtedly reduce quality of life and promote personal distress and psychosocial alienation. The frequency of postprostatectomy urinary incontinence (PPI) counts on the characterization of urinary incontinence and the periods of patient follow-up. Operational therapeutics, for instance, urethral male slings and artificial urinary sphincters, are well-chosen as adequate and secure surgeries for male SUI in men with continual PPI when conservative treatment is ineffective. Over the former 2 decades, surgery has progressed regarding both operative approach and sling architecture. However, there are no guidelines about when surgery should be carried out and which is the most appropriate surgical option. In this review, we summarize recent advances in implantable devices for PPI and also discuss traditional surgical care. When we are planning the male PPI surgery, careful preoperative work-up should be performed and surgical method should be chosen according to the severity of the disease. Male sling is preferred in mild and moderate symptomatic patients with normal detrusor pressure and it is recommended to select traditional artificial urinary sphincter device in those with severe symptoms. It is expected that effective devices without adverse events will be developed with technical advances in near future.

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Maximum Urethral Closure Pressure Increases After Successful Adjustable Continence Therapy (ProACT) for Stress Urinary Incontinence After Radical Prostatectomy

Cited by 15 publications

References 20 publications

Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery

Artificial Urinary Sphincter for Postradical Prostatectomy Urinary Incontinence — Is It the Best Option?

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Maximum Urethral Closure Pressure Increases After Successful Adjustable Continence Therapy (ProACT) for Stress Urinary Incontinence After Radical Prostatectomy

Cited by 15 publications

References 20 publications

Outcome and complications of adjustable continence therapy (ProACTTM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Outcome and complications of adjustable continence therapy (ProACTTM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery

Artificial Urinary Sphincter for Postradical Prostatectomy Urinary Incontinence — Is It the Best Option?

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Product

Resources

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Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study