Transrectal Ultrasound Guided Implantation of the ProACT Adjustable Continence Therapy System in Patients With Post-Radical Prostatectomy Stress Urinary Incontinence: A Pilot Study

Gregori, Andrea; Simonato, Alchiede; Lissiani, A.; Scieri, F.; Rossi, Roberta; Gaboardi, Franco

doi:10.1016/j.juro.2006.07.041

Cited by 34 publications

(11 citation statements)

References 21 publications

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“…The ProACT device and procedure are still under development. Gregori et al [20] researched the possibility of implanting ProACT using transrectal ultrasound (TRUS). It is possible to implant ProACT using local anesthetics, although no results have been published.…”

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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“…The ProACT device was first developed in 2000 and has been reported extensively since that time [7,8,9,10,11,12,15]. Regardless of the different techniques of implantation (under fluoroscopic or TRUS control) dry rates have been described around 62–67%.…”

Section: Discussionmentioning

confidence: 99%

“…The implantation technique has been described using either fluoroscopic imaging [7,8,9,10,11] or transrectal ultrasound (TRUS) guidance [12]. Both techniques allow for identification of generic anatomic landmarks but no measurable and reproducible referral points for the implantation.…”

Section: Introductionmentioning

confidence: 99%

Geometrical Stepper-Guided Navigation System for ProACT Implant under Transrectal Ultrasound Control: Preliminary Data

et al. 2012

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Purpose: To describe a new geometrical stepper-guided navigation system for positioning ProACT®. Methods: The sizing of the stepper-guided navigation system was calculated using the distance from the ideal position of the device to anatomic referral points previously measured by ultrasound. The trocar and subsequently the device were maneuvered to the ideal position in accordance with the navigation system. Measurements: Treatment efficacy was evaluated with daily pad count, 1-hour pad test, Incontinence Quality of Life questionnaire (IQoL), visual analog scale and overall impression. Complications, balloon volume and number of adjustments were reported at 1, 3, 6 and 12 months follow-up visits. Results: Mean follow-up was 12 (range 3–19) months. Daily pad count showed 30 patients (71%) dry and 9 patients (21%) improved. 1 hour pad test showed 28 patients were dry (66%) and 11 patients improved (26%). IQoL increased from an average of 35.3 to 80. Average visual analog scale score was 8. Complications requiring device removal occurred in 3 patients (7%). Mean balloon volume was 3.1 ml. Conclusions: The stepper-guided navigation system to implant ProACT is feasible and extremely reproducible making this procedure more standardized.

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“…Diese Erfahrungen wurden inzwischen durch zahlreiche Publikationen bestätigt [9,10,11]. In jünge-rer Zeit wurde die Methode um die Mög-lichkeit der TRUS-gesteuerten Implantation erweitert [12].…”

Section: Introductionunclassified

Adjustable systems for the treatment of male incontinence

Hübner

2010

Urologe

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The principle of adjustment with the possibility to react to changing needs of specific patients even years after placing an implant is convincing. Experience has taught that urodynamic parameters as well as personal demands of a patient may change individually for instance as a result of resuming physical activities. Such demands can be met by simple adjustment.Results of Argus and Remeex can be considered equally sustainable as first publications date back from 2006 and 2004. With follow-up periods of more than 2 years realistic success rates of up to 90% have been observed. Adjustment will be needed in one third of cases.The ProAct balloons are attractive by virtue of the low invasiveness of both implantation and adjustment. A series published in 2005 revealed a success rate of 77%; these experiences have been confirmed by several other papers. Limiting factors for ProAct are irradiation therapy and scarred bladder neck.

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Transrectal Ultrasound Guided Implantation of the ProACT Adjustable Continence Therapy System in Patients With Post-Radical Prostatectomy Stress Urinary Incontinence: A Pilot Study

Abstract: ProACT system implantation is feasible using transrectal ultrasound for guidance. Transrectal ultrasound enables excellent imaging of all anatomical landmarks during the entire procedure and it seems to provide considerable advantages over fluoroscopy in terms of safety and accuracy.

Cited by 34 publications

References 21 publications

ProACT™ for Stress Urinary Incontinence after Radical Prostatectomy

ProACT™ for Stress Urinary Incontinence after Radical Prostatectomy

Geometrical Stepper-Guided Navigation System for ProACT Implant under Transrectal Ultrasound Control: Preliminary Data

Adjustable systems for the treatment of male incontinence

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