In a nutshell
This study looked at treating urinary incontinence with the ProACT balloon device following prostate surgery. This study found that the ProACT balloon is a safe and effective treatment.
Some background
Prostate surgery is one treatment option for an enlarged prostate. Stress urinary incontinence (SUI) is a common side effect of prostate surgery, affecting up to 60% of patients. SUI is when urine leaks after coughing, sneezing, lifting heavy objects, or other activities that place stress on the bladder. The standard treatment for SUI after prostate surgery is called the artificial urinary sphincter. However, this treatment requires invasive surgery.
Adjustable balloon surgery such as ProACT is a less invasive alternative. ProACT places two inflatable balloons, one on either side of the neck of the bladder. The safety and effectiveness of adjustable balloon surgery for an enlarged prostate are unclear.
Methods & findings
This study looked at records from 240 patients who underwent adjustable balloon surgery for SUI following prostate surgery. Patients were evaluated by wearing a pad for 24 hours. The pads were weighed before and after use. Patients whose pre-surgery urine leakage was over 400 grams were considered to have “severe” SUI. After surgery, patients who had less than 8 grams were considered “dry.” Patients whose urine leakage was reduced by at least 50% were considered “improved.”
After 24 months, 29.6% of patients were dry and 37.5% of patients were improved. 32.9% were not improved. For patients with severe SUI, 65.4% of patients were dry or improved. On average, urine leakage was reduced by 66.5%.
22.5% of patients had complications. These included balloon failure and puncturing the bladder. 30 patients (12.5%) had one or both balloons removed due to complications.
The bottom line
This study found that the ProACT balloon is a safe and effective treatment for patients with an enlarged prostate. After 2 years, most patients had improved urinary incontinence.
The fine print
Patients who had previously had radiation had a significantly lower success rate. 26% of these patients were considered dry or improved.
Published By :
Neurourology and urodynamics
Date :
Jul 14, 2019
