Categorized | Bladder Treatment

Adjustable Balloon Implant Alleviates Male Incontinence

Men suffer from stress incontinence – approximately 1% after transurethral resection and up to 87% after radical prostatectomy.

The standard treatment for postoperative sphincter incompetence in men is artificial urinary sphincter but it involves complex intraoperative procedure which may be associated with significant complications.

Minimally invasive alternatives include injected bulking agents or stem cells, bone-anchored and re-adjustable bulbourethral slings, and the adjustable ProACT continence system.

The ProACT implant consists of two balloons placed on either side of the native striated sphincter. These are adjusted by inflation during follow-up visits.

French researchers report that the ProACT implant helps alleviate moderate male stress incontinence following surgery.

According to the study, 128 men who received ProACT implants were evaluated.  Of the 128 men, 40 had mild incontinence, 71 with moderate severity and 17 with severe incontinence.  Thirty patients had undergone pelvic radiotherapy.

Mean follow-up was for more than 5.5 years. The mean number of balloon adjustments was 2.33 and daily pad count decreased from a mean of 4.2 at baseline to 1.46. At the end of follow-up, 23 (18%) balloons had been removed and 17 of the explanted balloons had been reimplanted.

The functional result was a success in 68% of patients with moderate/mild incontinence. The figure for those with severe incontinence was 60%. Altogether 75% of patients believed there was improvement.

However, the objective success rate was only 46% in the patients previously treated with radiotherapy, and their incidence of urethral erosion was significantly higher.

The ProACT implant is a minimally invasive alternative that provides durable functional results in patients with mild/moderate incontinence. Potentially appropriate candidates include those with moderate leakage, no previous radiation and/ or no urethra scar.

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