Adjustable dual-balloon therapy: quality of life after prostate incontinence treatment

To assess the quality of life (QoL) and surgical outcomes of adjustable dual-balloon continence therapy (DBACT), ProACT™ is a minimally invasive treatment for post-prostatectomy urinary incontinence.

In this retrospective, single-surgeon review conducted between September 2020 and March 2023, 21 patients with moderate-to-severe post-prostatectomy incontinence underwent ProACT™ placement at a Midwest academic center. A chart review was conducted to extract procedural and outcomes data. Postoperative QoL surveys, including pads-per-day (PPD) and incontinence QoL (IQoL) scores, were administered.

The average patient age was 70 years. Six (28.6%) of the 21 patients had prior radiation. The average operating time was 61.14 min. Patients needed an average of 3.33 adjustments post-surgery. The average decrease in PPD was 5.93, with 81% of patients achieving meaningful dryness with the use of ≤ 2 PPD. 76% of patients felt that ProACT™ helped their incontinence, improved their QoL, was worthwhile, and would recommend it to others. Of the 15 non-radiated patients, one had complications (6.67%). Of the 6 radiated patients, 5 (83.3%) had complications. There were no erosions in patients who were not previously radiated. There were no serious complications requiring prolonged hospitalization, such as sepsis or fistula formation.

ProACT™ is a safe and effective treatment for incontinence after prostatectomy with high patient satisfaction and a low complication rate in patients without prior radiation. For radiated patients, ProACT™ can be efficacious, but they should be counseled about slower improvement times and higher complication rates.