Transrectal Ultrasound–Guided Implantation of Adjustable Continence Therapy (ProACT): Surgical Technique and Clinical Results After a Mean Follow-Up of 2 Years

Gregori, Andrea; Romanò, Ai Ling; Scieri, F.; Pietrantuono, F.; Incarbone, G.P.; Salvaggio, A.; Granata, Antonio Maria; Gaboardi, Franco

doi:10.1016/j.eururo.2009.11.031

Cited by 64 publications

(54 citation statements)

References 23 publications

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“…One of the most recent treatments, which has the advantage of being minimally invasive, is the insertion of adjustable continence balloons, ProACT (ProACT Ô , Uromedica, Plymouth, USA), as first described by Hübner and Schlarp in 2005 [4]. These operations have shown promising results [5][6][7][8][9]. The objective of this article is to evaluate the results of the Danish experience with ProACT.…”

Section: Introductionmentioning

confidence: 99%

Adjustable continence balloons: Clinical results of a new minimally invasive treatment for male urinary incontinence

Kjær

Fode

Nørgaard

et al. 2012

Scandinavian Journal of Urology and Nephrology

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Section: Introductionmentioning

confidence: 99%

Adjustable continence balloons: Clinical results of a new minimally invasive treatment for male urinary incontinence

Kjær

Fode

Nørgaard

et al. 2012

Scandinavian Journal of Urology and Nephrology

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“…It is inserted transperineally under fluoroscopy or transrectal ultrasound to the level of the urethrovesical anastomosis bilaterally. Surgical technique has been previously published [48][49][50]. Currently, there are no publications relating to combination surgery with this device with penile prosthesis but given that access is gained via a transperineal route, this easily can be incorporated.…”

Section: Pro-act Devicementioning

confidence: 97%

Combination Surgery for Erectile Dysfunction and Male Incontinence

2011

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With favorable prognosis, radical therapy for pelvic malignancy no longer is just about oncological control, but is important in achieving the trifecta of oncological clearance with acceptable sexual function and urinary outcomes. As we face the prospect of escalating urogenital dysfunction following our radical interventions, we need to carefully assess these functional outcomes and their impact on the quality of life of our patients. In men, this includes urinary impairments with stress urinary incontinence, various types of voiding dysfunction, and sexual impairments (primarily erectile dysfunction and orgasmic dysfunction). Based on appropriate clinical and diagnostic assessments of severity of adverse outcomes depending on patient preference, combination surgery for treatment of erectile dysfunction and stress urinary incontinence is effective and durable and has an established, definitive role to address this not uncommon problem. This article reviews the prevalence of the problem, the available therapeutic options, and evidence of efficacy of these therapies in combination.

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“…The introduction of the hand-guided ultrasound technique as Gregori et al [16] decreased the intraoperative and early rates of complications (3.7% compared with 7.8–12.8%). Possibly, the previously suboptimal placement using fluoroscopic guidance necessitated higher balloon volumes and therefore increased the risk of early complications such as infection and migration.…”

Section: Discussionmentioning

confidence: 99%

“…Ideally, the balloons should be at 9 o’clock and 3 o’clock to create a triangular coaptation of the urethra between the two balloons and the pubic symphysis [15,16]. Distances from the ideal location of the balloon to the pubic symphysis, ischiopubic rami, urethra and probe in the transversal view (fig.…”

Section: Methodsmentioning

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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Transrectal Ultrasound–Guided Implantation of Adjustable Continence Therapy (ProACT): Surgical Technique and Clinical Results After a Mean Follow-Up of 2 Years

Cited by 64 publications

References 23 publications

Adjustable continence balloons: Clinical results of a new minimally invasive treatment for male urinary incontinence

Adjustable continence balloons: Clinical results of a new minimally invasive treatment for male urinary incontinence

Combination Surgery for Erectile Dysfunction and Male Incontinence

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

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