Department of Urology, Pitié-Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France.
J Urol. 2011 Jul;186(1):198-203. doi: 10.1016/j.juro.2011.03.016. Epub 2011 May 14.
We determined the functional results and morbidity of balloon (ProACT™) implants for the treatment of male stress urinary incontinence after prostate surgery.
Between 2002 and 2008 a prospective, noncontrolled study was conducted. The ProACT implant consists of 2 adjustable balloons placed on either side of the native striated sphincter. The implants are adjusted by inflation during followup visits. The primary efficacy end point was postoperative continence as defined by the use of 0 to 1 pad daily.
A total of 128 consecutive patients underwent implantation. Mean ± SD patient age was 71 ± 42.3 years (range 52 to 87). The severity of incontinence before ProACT was moderate (71), mild (40) and severe (17). Overall 25% of patients previously underwent pelvic radiotherapy. The mean number of daily pads per patient was 1.46 (vs 4.2 at baseline). Mean followup was 56.3 months (range 24 to 95). The functional result was success in 68% of patients with moderate/mild incontinence and the explantation rate was 18%. Among the 30 patients treated with radiotherapy before ProACT the success rate was only 46% and the incidence of urethral erosion was significantly higher (p = 0.005).
The ProACT implant appears to be an option for the treatment of moderate male stress urinary incontinence, especially given the minimally invasive modalities of insertion, the capacity to adjust the inflation of the balloons to achieve postoperative continence and the relative reversibility.
我们旨在评估前列腺手术后男性压力性尿失禁患者经球囊（ProACT）植入物治疗后的功能结果和发病率。
2002 年至 2008 年期间进行了一项前瞻性、非对照研究。ProACT 植入物由放置在固有横纹括约肌两侧的 2 个可调节球囊组成。在随访期间通过充气来调整植入物。主要疗效终点是术后使用每日 0 至 1 片尿垫的情况下的控尿情况。
共有 128 例连续患者接受了植入术。患者的平均年龄为 71 ± 42.3 岁（范围 52 岁至 87 岁）。植入前失禁的严重程度为中度（71%）、轻度（40%）和重度（17%）。总体上，25%的患者既往接受过盆腔放疗。每位患者每日尿垫的平均数量为 1.46 片（基线时为 4.2 片）。平均随访时间为 56.3 个月（范围 24 至 95 个月）。在中度/轻度失禁患者中，有 68%的患者功能结果成功，而取出率为 18%。在 30 例接受 ProACT 治疗前接受过放疗的患者中，成功率仅为 46%，且尿道侵蚀的发生率显著更高（p = 0.005）。
ProACT 植入物似乎是治疗中度男性压力性尿失禁的一种选择，特别是考虑到其微创的插入方式、可调节球囊充气以实现术后控尿的能力以及相对的可逆性。
