Functional outcomes of adjustable continence therapy (ACT™) balloons in women aged >80 years and suffering from stress urinary incontinence caused by intrinsic sphincter deficiency
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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.
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 %.
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.
KeywordsStress Urinary incontinence Adjustable Elderly Sphincter deficiency
Conflict of interest
The authors declare that they have no conflict of interest.
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