Skip to main content

Advertisement

SpringerLink
Log in

Functional outcomes of adjustable continence therapy (ACT™) balloons in women aged >80 years and suffering from stress urinary incontinence caused by intrinsic sphincter deficiency

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Objective

To determine the functional outcomes of adjustable continence therapy (ACT™) balloons in elderly women suffering from stress urinary incontinence (SUI) caused by intrinsic sphincter deficiency (ISD).

Material and methods

A monocentric retrospective study included all non-neurological women aged >80 years who suffered from SUI due to ISD and undergoing ACT™ balloon placement between 2000 and 2013. Early post-operative complications were reported according to the Clavien–Dindo classification. Continence was assessed subjectively by the patients.

Results

A total of 52 female patients were included, median age 83 years (IQR 81–85). Among them, 35 (67.3 %) had already undergone previous surgery for SUI. Balloon implantations were achieved under local anaesthesia for 33 (63.5 %) patients. Clavien grade I–II early post-operative complications occurred in five (9.6 %) patients. Median follow-up was 10.5 months (IQR 3–24.25). Eleven patients (21.1 %) were lost to follow-up. At last follow-up, seven patients (13.5 %) declared themselves fully continent after the first implantation, 13 patients (25 %) had an >80 % improvement rate (10 patients after first implantation, two after second implantation and one after third implantation). Four patients (7.7 %) found the procedure unsuccessful even after several consecutive implantations. Ten patients (19.2 %) reported a partial result and were still having successive balloon inflations. Explantation occurred in 22 patients, caused by infection, erosion or balloon migration. In intention-to-treat analysis, the failure rate was 42.3 %.

Conclusion

Although the success rate of ACT™ balloons in women aged >80 years is lower than that reported for younger women, it remains satisfactory because these patients would not otherwise have benefited from another surgical treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Abrams P, Cardozo L, Fall M et al (2002) The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178. doi:10.1002/nau.10052

    Article  PubMed  Google Scholar 

  2. Reynolds WS, Dmochowski RR, Penson DF (2011) Epidemiology of stress urinary incontinence in women. Curr Urol Rep 12:370–376. doi:10.1007/s11934-011-0206-0

    Article  PubMed  Google Scholar 

  3. Coyne KS, Wein AJ, Tubaro A et al (2009) The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: Epiluts. BJU Int 103(Suppl 3):4–11. doi:10.1111/j.1464-410X.2009.08371.x

    Article  PubMed  Google Scholar 

  4. Chartier-Kastler E, Van Kerrebroeck P, Olianas R et al (2011) Artificial urinary sphincter (AMS 800) implantation for women with intrinsic sphincter deficiency: a technique for insiders? BJU Int 107:1618–1626. doi:10.1111/j.1464-410X.2010.09610.x

    Article  PubMed  Google Scholar 

  5. Lucas MG, Bosch RJL, Burkhard FC et al (2012) EAU guidelines on surgical treatment of urinary incontinence. Eur Urol 62:1118–1129. doi:10.1016/j.eururo.2012.09.023

    Article  PubMed  Google Scholar 

  6. Wachter J, Henning A, Roehlich M et al (2008) Adjustable continence therapy for female urinary incontinence: a minimally invasive option for difficult cases. Urol Int 81:160–166. doi:10.1159/000144054

    Article  PubMed  Google Scholar 

  7. Vidart A, Cour F, Committee on Women’s Urology and pelviperineology, French Association of Urology (2010) Guidelines for the treatment of non-neurological urinary incontinence in women using periurethral balloons. Prog Urol 20(Suppl 2):S150–S154. doi:10.1016/S1166-7087(10)70010-5

    Article  PubMed  Google Scholar 

  8. O’Connor RC, Nanigian DK, Patel BN et al (2007) Artificial urinary sphincter placement in elderly men. Urology 69:126–128. doi:10.1016/j.urology.2006.09.021

    Article  PubMed  Google Scholar 

  9. Vayleux B, Rigaud J, Luyckx F et al (2011) Female urinary incontinence and artificial urinary sphincter: study of efficacy and risk factors for failure and complications. Eur Urol 59:1048–1053. doi:10.1016/j.eururo.2011.03.006

    Article  PubMed  Google Scholar 

  10. Trigo-Rocha F, Gomes CM, Pompeo ACL et al (2006) Prospective study evaluating efficacy and safety of adjustable continence therapy (ProACT) for post radical prostatectomy urinary incontinence. Urology 67:965–969. doi:10.1016/j.urology.2005.11.011

    Article  PubMed  Google Scholar 

  11. Hübner WA, Schlarp OM (2007) Adjustable continence therapy (ProACT): evolution of the surgical technique and comparison of the original 50 patients with the most recent 50 patients at a single centre. Eur Urol 52:680–686. doi:10.1016/j.eururo.2006.10.054

    Article  PubMed  Google Scholar 

  12. Chartier-Kastler E, Costa P, Ben Naoum K et al (2007) French multicentre prospective study of the use of ACT balloons (Uromedica Inc, Plymouth, Min, U.S.A.; Medtronic, Minneapolis, U.S.A.) for the treatment of female stress urinary incontinence. Prog Urol 17:1372–1377

    Article  PubMed  Google Scholar 

  13. Aboseif S, Sassani P, Franke E et al (2011) Treatment of moderate to severe female stress urinary incontinence with the adjustable continence therapy (ACT) device after failed surgical repair. World J Urol 29:249–253. doi:10.1007/s00345-010-0589-4

    Article  PubMed  Google Scholar 

  14. Aboseif SR, Franke EI, Nash SD et al (2009) The adjustable continence therapy system for recurrent female stress urinary incontinence: 1-year results of the North America Clinical Study Group. J Urol 181:2187–2191. doi:10.1016/j.juro.2009.01.039

    Article  PubMed  Google Scholar 

  15. Kocjancic E, Crivellaro S, Ranzoni S et al (2010) Adjustable continence therapy for severe intrinsic sphincter deficiency and recurrent female stress urinary incontinence: long-term experience. J Urol 184:1017–1021. doi:10.1016/j.juro.2010.05.024

    Article  PubMed  Google Scholar 

  16. Nacir M, Ballanger P, Donon L et al (2013) ACT® device: what place in the treatment of female urinary incontinence? Progrès en Urologie 23:276–282. doi:10.1016/j.purol.2013.02.002

    Article  CAS  PubMed  Google Scholar 

  17. Mitropoulos D, Artibani W, Graefen M et al (2012) Reporting and grading of complications after urologic surgical procedures: an ad hoc EAU guidelines panel assessment and recommendations. Eur Urol 61:341–349. doi:10.1016/j.eururo.2011.10.033

    Article  PubMed  Google Scholar 

  18. Rechberger T, Futyma K, Jankiewicz K et al (2010) Body mass index does not influence the outcome of anti-incontinence surgery among women whereas menopausal status and ageing do: a randomised trial. Int Urogynecol J 21:801–806. doi:10.1007/s00192-010-1116-2

    Article  PubMed  Google Scholar 

  19. Choo G-Y, Kim DH, Park HK et al (2012) Long-term outcomes of tension-free vaginal tape procedure for treatment of female stress urinary incontinence with intrinsic sphincter deficiency. Int Neurourol J 16:47. doi:10.5213/inj.2012.16.1.47

    Article  PubMed Central  PubMed  Google Scholar 

  20. Schierlitz L, Dwyer PL, Rosamilia A et al (2012) Three-year follow-up of tension-free vaginal tape compared with transobturator tape in women with stress urinary incontinence and intrinsic sphincter deficiency. Obstet Gynecol 119:321–327. doi:10.1097/AOG.0b013e31823dfc73

    Article  PubMed  Google Scholar 

  21. Pugsley H, Barbrook C, Mayne CJ, Tincello DG (2005) Morbidity of incontinence surgery in women over 70 years old: a retrospective cohort study. BJOG Int J Obstet Gynaecol 112:786–790. doi:10.1111/j.1471-0528.2004.00522.x

    Article  Google Scholar 

  22. Costa P, Poinas G, Ben Naoum K et al (2013) Long-term results of artificial urinary sphincter for women with type III stress urinary incontinence. Eur Urol 63:753–758. doi:10.1016/j.eururo.2012.03.008

    Article  PubMed  Google Scholar 

  23. Phé V, Benadiba S, Rouprêt M et al (2014) Long-term functional outcomes after artificial urinary sphincter implantation in women with stress urinary incontinence. BJU Int 113:961–967. doi:10.1111/bju.12360

    Article  PubMed  Google Scholar 

  24. Faerber GJ (1996) Endoscopic collagen injection therapy in elderly women with type I stress urinary incontinence. J Urol 155:512–514. doi:10.1016/S0022-5347(01)66436-X

    Article  CAS  PubMed  Google Scholar 

  25. Chapple CR, Wein AJ, Brubaker L et al (2005) Stress incontinence injection therapy: what is best for our patients? Eur Urol 48:552–565. doi:10.1016/j.eururo.2005.06.012

    Article  PubMed  Google Scholar 

  26. Van Kerrebroeck P (2006) The motion: injectables are justified as a first option for stress urinary incontinence. Eur Urol 50:857–858 discussion 860

    Article  PubMed  Google Scholar 

  27. Cody JD, Jacobs ML, Richardson K et al (1996) Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev 10:CD001405

  28. Kocjancic E, Crivellaro S, Smith JJ III et al (2008) Adjustable continence therapy for treatment of recurrent female urinary incontinence. J Endourol 22:1403–1408. doi:10.1089/end.2008.0027

    Article  PubMed  Google Scholar 

  29. Vayleux B, Luyckx F, Thélu S et al (2010) Adjustable continence therapy in women, middle term follow-up and a new technique for balloon positioning. Progrès en Urologie 20:520–526. doi:10.1016/j.purol.2010.01.010

    Article  CAS  PubMed  Google Scholar 

  30. Kaboré F-A, Gaillet S, Blanc J et al (2014) Initial results of adjustable periurethral balloons (ACT™ and pro ACT™) in the treatment of adults stress urinary incontinence by intrinsic sphincter deficiency. Progrès en Urologie. doi:10.1016/j.purol.2014.08.004

    PubMed  Google Scholar 

  31. Phé V, Nguyen K, Rouprêt M et al (2013) A systematic review of the treatment for female stress urinary incontinence by ACT(®) balloon placement (Uromedica, Irvine, CA, USA). World J Urol. doi:10.1007/s00345-013-1117-0

    Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Pitié-Salpêtrière Academic Hospital, Department of Urology, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, 47-83 Boulevard de l’Hopital, 75651, Paris Cedex 13, France

    Claire Billault, Emmanuel Chartier-Kastler, Morgan Rouprêt & Véronique Phé

  2. Rothschild Hospital, Department of Physical Medicine and Rehabilitation, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France

    Gilberte Robain

Authors
  1. Claire Billault
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emmanuel Chartier-Kastler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Morgan Rouprêt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gilberte Robain
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Véronique Phé
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Véronique Phé.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Billault, C., Chartier-Kastler, E., Rouprêt, M. et al. Functional outcomes of adjustable continence therapy (ACT™) balloons in women aged >80 years and suffering from stress urinary incontinence caused by intrinsic sphincter deficiency. World J Urol 33, 1897–1903 (2015). https://doi.org/10.1007/s00345-015-1520-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-015-1520-9

Keywords

Search

Navigation