Trigo-Rocha Flavio, Gomes Cristiano Mendes, Pompeo Antonio Carlos Lima, Lucon Antonio Marmo, Arap Sami
Department of Urology, São Paulo University, São Paulo, Brazil.
Urology. 2006 May;67(5):965-9. doi: 10.1016/j.urology.2005.11.011.
To examine a new prosthesis, the Adjustable Continence Therapy (ProACT), to determine its ability to treat effectively post radical prostatectomy urinary incontinence. Urinary incontinence is one of the most significant complications of radical prostatectomy. Although the artificial urinary sphincter (AUS) is considered the standard treatment for this condition, many men seek a simpler and less expensive treatment option.
From November 2000 to March 2004, 25 patients with severe post radical prostatectomy urinary incontinence were treated using the ProACT device. The preoperative evaluation included pad count, Valsalva leak point pressure determination, and Incontinence Quality-of-Life scores. In the follow-up, the same parameters, as well as complications, were analyzed and compared with the baseline measurements to assess the efficacy.
The follow-up period was 6 to 48 months (mean 22.4). Of the 25 patients, 23 had follow-up data available for analysis. The improvements in pad count, Incontinence Quality-of-Life score, and Valsalva leak point pressures from baseline to the last follow-up examination were all significant (P <0.05). Overall, of the 23 patients followed up, 15 (65.2%) were continent using 0 to 1 pad daily and satisfied, 3 (13%) were improved but unsatisfied, and 5 (22%) did not have any improvement. Balloon adjustments were performed in all patents to achieve continence. Revision surgery was required in 4 (17%) of 23 patients.
The use of ProACT represents a safe and effective treatment for post radical prostatectomy incontinence with a good degree of patient satisfaction and a low complication rate. Postoperative adjustments were necessary in most patients and were undertaken as a simple outpatient visit.
研究一种新型假体——可调节控尿疗法（ProACT），以确定其有效治疗前列腺癌根治术后尿失禁的能力。尿失禁是前列腺癌根治术最严重的并发症之一。尽管人工尿道括约肌（AUS）被认为是治疗这种疾病的标准方法，但许多男性寻求更简单、更便宜的治疗选择。
从2000年11月至2004年3月，使用ProACT装置治疗了25例前列腺癌根治术后严重尿失禁患者。术前评估包括尿垫计数、瓦尔萨尔瓦漏尿点压力测定和尿失禁生活质量评分。在随访中，分析相同参数以及并发症，并与基线测量值进行比较以评估疗效。
随访期为6至48个月（平均22.4个月）。25例患者中，23例有可供分析的随访数据。从基线到最后一次随访检查，尿垫计数、尿失禁生活质量评分和瓦尔萨尔瓦漏尿点压力均有显著改善（P<0.05）。总体而言，在随访的23例患者中，15例（65.2%）实现控尿，每天使用0至1个尿垫且感到满意，3例（13%）有所改善但不满意，5例（22%）没有任何改善。所有患者均进行了球囊调整以实现控尿。23例患者中有4例（17%）需要进行翻修手术。
使用ProACT治疗前列腺癌根治术后尿失禁是一种安全有效的方法，患者满意度高，并发症发生率低。大多数患者术后需要进行调整，可作为简单的门诊就诊进行。
