Can MRI Predict Which Patients Are Most Likely to Benefit from Percutaneous Positioning of Volume-Adjustable Balloon Devices?

Stecco, Alessandro; Saponaro, A.; Crivellaro, Simone; Cotroneo, Antonio Raffaele; Frea, Bruno; Carriero, Alessandro; Kocjancic, Ervin

doi:10.1159/000091627

Cited by 15 publications

(10 citation statements)

References 8 publications

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“…The possibility of determining in advance which patients will benefit could improve the results and decrease the complications and necessary revisions. Stecco et al [19] studied the possibility of MRI to predict the ef-fectiveness of ACT TM (adjustable continence therapy for the treatment of SUI in women) and to determine the correct localization of the ACT balloons.…”

Section: Discussionmentioning

confidence: 99%

ProACT™ for Stress Urinary Incontinence after Radical Prostatectomy

Martens

Lampe

Heesakkers³

2009

Urol Int

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Introduction: Stress urinary incontinence is a bothersome complication of radical prostatectomy. Surgical treatment consists of the artificial urinary sphincter (AUS), the male sling and bulk injections. This study presents the results of the first series of implantations of ProACT^TM in the Netherlands. Materials and Methods: A non-validated questionnaire was sent to 29 male patients implanted with ProACT to determine Stamey score, pad count and questions about quality of life and satisfaction. Complications, revisions and explantations were registered. Results: Mean follow-up was 41 months. Based on Stamey score four patients are continent at the end and nine patients according to the pad count. The average pad count decreased significantly. Remarkable was the high rate of dislocations and revisions and patients’ satisfaction. Conclusions: ProACT is a less invasive treatment compared to the AUS. However, the procedure is associated with a substantial revision and explantation rate. ProACT can be part of a so-called step-up approach before opting for a more invasive treatment.

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Section: Discussionmentioning

confidence: 99%

ProACT™ for Stress Urinary Incontinence after Radical Prostatectomy

Martens

Lampe

Heesakkers³

2009

Urol Int

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“…La qualité des images échographiques et la vision avec une dimension spatiale de plus qu'avec une simple radiographie sont aussi mises en avant. Une autre équipe italienne [18] a cherché à démontrer l'intérêt d'une IRM préopératoire afin de prévoir, à partir de critères anatomiques, quelles patientes pourraient obtenir une bonne réponse aux ballonnets.…”

Section: Discussionunclassified

Résultats fonctionnels des ballonnets périurétraux ACT® chez la femme

et al. 2010

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Reçu le 14 mars 2010 ; accepté le 15 mars 2010 © Springer-Verlag France 2010Résumé Objectifs : Évaluation rétrospective des résultats de ballonnets périurétraux chez la femme et description d'un geste opératoire complémentaire : la rétrovision du col vési-cal par cystoscopie souple. Patients et méthode : Des ballonnets périurétraux ACT ® ont été implantés par le même opérateur, de janvier 2001 à février 2009, pour traiter une incontinence urinaire par insuffisance sphinctérienne chez 67 patientes. L'âge moyen était de 70,2 ans avec un suivi moyen de 24,8 mois (de 1 à 89 mois). Les résultats fonctionnels étaient appréciés sur la présence de fuites urinaires à la toux et à la poussée abdominale à l'examen clinique, sur le questionnaire Urinary Symptom Profile ® (USP ® ), et sur une échelle d'évaluation analogique globale de satisfaction. Résultats : Jusqu'à 90 % des patientes déclaraient une amé-lioration à au moins une consultation, et 60 % (40/67) en fin de suivi, avec un indice de satisfaction de plus de 80 % pour 24 patientes. Les fuites à l'effort de toux et de poussée ont disparu chez 58 % des patientes (36/62) à l'examen. Une amélioration du score de l'USP ® était constatée dans 76 % (19/25) des cas. Des complications ont eu lieu chez 37,3 % des patientes (25) avec un délai moyen de 10,8 mois. Les patientes traitées avec rétrovision auraient moins de complications et moins d'explantations. Conclusion : Le rapport bénéfice/risque rend cette technique attractive et pourrait représenter une option alternative au sphincter artificiel urinaire (SAU) dans certaines incontinences urinaires de prise en charge difficile. La rétrovision rendrait le geste chirurgical plus précis et plus sûr. Mots clés Ballonnets périurétraux ACT ® · Rétrovision du col vésical · Cystoscopie soupleAbstract Objectives: A retrospective evaluation of the results of Adjustable Continence Therapy ® (ACT ® ) in women by a study center and the description of a technique: bladder neck retrovision. Patients and methods: Between January 2001 and February 2009, 67 women had ACT ® implantation by the same surgeon for urinary incontinence arising from intrinsic sphincter deficiency. The mean age was 70.2 years and mean followup was 24.8 months (1 to 89 months). The evaluation of functional results was realized by the research of urinary leakage when coughing or increasing abdominal pressure, with the Urinary Symptom Profile ® (USP ® ) questionnaire (since 2007), and with an analogical global satisfaction evaluation. Results: More than 90% of the women (n = 67) showed improvement in at least one medical consultation and 60% (40/67) at the end of the follow-up. The satisfaction index was over 80% in 24 patients. Urinary leakage when increasing abdominal pressure disappeared in 58% (36/62). An improvement in the USP ® score was observed in 76% (19/25). Postoperative complications occurred in 37.3% (25 patients) with a mean period of 10.8 months after surgery. Conclusion: The ACT ® , indicated in stress urinary incontinence, is attractive because of the ...

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“…Among these minimally invasive alternatives, the ACT device seems to offer a promising approach [11] .…”

Section: Discussionmentioning

confidence: 99%

“…Stecco et al [11] assessed whether MRI can identify patients most likely to benefit from ACT. Within this study population (n = 25), 64% became continent and a further 20% significantly improved 12 months after sur-gery.…”

Section: Discussionmentioning

confidence: 99%

Adjustable Continence Therapy for Female Urinary Incontinence: A Minimally Invasive Option for Difficult Cases

Wachter

Henning²,

Roehlich³

et al. 2008

Urol Int

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Aim: To assess the role of Adjustable Continence Therapy® (ACT) as a minimally invasive treatment for women with urinary incontinence (UI) after failed previous incontinence surgery or when conventional surgical treatment was considered problematic. Material and Methods: The ACT device consists of two balloons implanted at the level of the bladder neck using a paraurethral/vaginal approach with the aim of coapting the urethra. Balloon filling can be adjusted postoperatively via a port placed in the labia majora. Results: 41 women with a mean age of 73 (range 42–93) years were evaluated. 15 (38%) women had failed previous UI surgery with 83% having undergone prior pelvic surgery. Mean follow-up was 25 (5–60) months. Adjustment of the ACT balloons was necessary in 28 women (69%). Overall, 44% of women became fully continent, 15% reported a significant improvement of UI, a further 29% had a slight improvement, while 12% indicated no change. ACT-related complications occurred in 16 (39%) patients, including balloon migration, transient urinary obstruction and balloon leakage. Conclusions: ACT is an attractive minimally invasive option for women with UI with previous failed incontinence surgery or when conventional incontinence surgery carries a high risk of failure.

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Can MRI Predict Which Patients Are Most Likely to Benefit from Percutaneous Positioning of Volume-Adjustable Balloon Devices?

Cited by 15 publications

References 8 publications

ProACT™ for Stress Urinary Incontinence after Radical Prostatectomy

ProACT™ for Stress Urinary Incontinence after Radical Prostatectomy

Résultats fonctionnels des ballonnets périurétraux ACT® chez la femme

Adjustable Continence Therapy for Female Urinary Incontinence: A Minimally Invasive Option for Difficult Cases

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