Treatment of incontinence after prostatectomy using a new minimally invasive device: adjustable continence therapy

OBJECTIVE To evaluate the safety and efficacy of a new minimally invasive urological implant for incontinence after prostatectomy. PATIENTS AND METHODS The adjustable continence therapy device (ProACTTM, Uromedica, Plymouth, MN, USA) consists of two balloons placed via a perineal approach bilaterally at the bladder neck in patients after prostatectomy. Titanium ports, attached via discrete tubing to each balloon, are placed in the scrotum, allowing for separate volume adjustments of the balloons at any time during and after surgery. Changes in a quality‐of‐life questionnaire (I‐QoL), pad usage and a subjective continence grading score were assessed in 117 consecutive men after implanting the Pro‐ACT, at baseline and at 1, 3, 6, 12 and 24 months. RESULTS After a mean (range) follow‐up of 13 (3–54) months and with a mean of 3 (0–15) adjustments, 67% of men were dry, using at most one ‘security’ pad daily; 92% were significantly improved, and 8% showed no improvement. The I‐QoL score improved from a median of 34.7 to 66.3 after 2 years (42 men; P