Urodynamic Effects of Volume-adjustable Balloons for Treatment of Postprostatectomy Urinary Incontinence

Elaine Utomo, Jan Groen, Irene Vroom, Ron Mastrigt, Bertil Blok

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17 Citations (Scopus)

Abstract

OBJECTIVE To evaluate the urodynamic changes in patients treated with Adjustable Continence Therapy for men (ProACT) for postprostatectomy incontinence and to explore the clinical and urodynamic preimplantation parameters as predictors of clinical outcome. MATERIALS AND METHODS Patients underwent urodynamic studies before and after ProACT implantation. ProACT was considered successful if patients used none or 1 dry precautionary pad and nonsuccessful if the patient reported >= 1 wet pad/d. The pre- and postimplantation assessments were retrospectively compared within and between the success and nonsuccess groups. Multivariate logistic regression analysis was performed to investigate the association between the preimplantation variables and the cli RESULTS A total of 49 patients were included, 37 with successful and 12 with nonsuccessful clinical outcome. Postimplantation urodynamic studies were performed a median of 9 months after ProACT implantation. In the successfully treated patients, maximum free flow rate, bladder contractility index, maximum of bladder contractility parameter W, and bladder voiding efficiency were significantly lower after implantation. The detrusor pressure at maximum flow rate, postvoid residual urine volume, and CONCLUSION ProACT implantation with successful clinical outcome resulted in greater urethral resistance during voiding and reduced bladder contraction strength. A longer duration of incontinence, the use of >5 pads daily, and a smaller cystometric bladder capacity were independent predictors of unsuccessful clinical outcomes, suggesting ProACT implantation should be considered sooner, rather than later, after conservative treatment of postprostatectomy incontinence has failed. (C)3 2013 Elsevier
Original languageUndefined/Unknown
Pages (from-to)1308-1314
Number of pages7
JournalUrology
Volume81
Issue number6
DOIs
Publication statusPublished - 2013

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