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13.06.2023 | Original Article

Adjustable continence therapy (proACT) for the treatment of male stress urinary incontinence post-prostatectomy: a systematic review and meta-analysis (2023 update)

verfasst von: Thibault Tricard, Qi-Xiang Song, Pierre Munier, Jia Yi Li, Jing Leng, Christian Saussine, Jia Hua Pan, Wei Xue

Erschienen in: World Journal of Urology | Ausgabe 7/2023

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Abstract

Purpose

Stress urinary incontinence (SUI) is a key factor for post-prostatectomy (RP) quality of life. Current international guidelines struggle to find the adequate place for each kind of surgeries. The aim of this systematic review and meta-analysis considering updated evidence is to assess the efficacy and safety of proACT in treating male patients with post-RP SUI.

Methods

A review of the literature was performed by searching the PubMed database. We narrowed included studies with adult male patients with SUI; outcomes included pads or pad weight per day and quality of life (QOL) questionnaires, as well as safety outcomes.

Results

18 studies involving 1570 patients mean age of 68.8 (EC 2.1) were included. The mean follow-up reported was 34.7 months (EC 17.7; median 38.5; range 1–128 months). An average of 60.7% (EC 27) and 40.4% of patients suffered from mild-to-moderate and severe incontinence, respectively. The overall dryness rate was 55.1% (EC 19.3) while respecting the definition of 0–1 pads per day, and the mean dryness rate was 53% (EC 0.2). The mean overall complication rate was 31.2% (EC 18.3%), including an explantation rate of 26.5% (EC 15.3) and a reoperation rate of 22.7% (EC 8.7). The methodological quality of the 18 studies was very heterogeneous.

Conclusion

Implantation of proACT adjustable balloons is a minimally invasive technique that provides medium outcomes (53%) with a strict definition of dryness (0–1 PPD) and important complication rate (31.2%). Past of irradiation is a negative predictive factor for incontinence.

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Titel: Adjustable continence therapy (proACT) for the treatment of male stress urinary incontinence post-prostatectomy: a systematic review and meta-analysis (2023 update)
verfasst von: Thibault Tricard
Qi-Xiang Song
Pierre Munier
Jia Yi Li
Jing Leng
Christian Saussine
Jia Hua Pan
Wei Xue
Publikationsdatum: 13.06.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 7/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04452-6

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Adjustable continence therapy (proACT) for the treatment of male stress urinary incontinence post-prostatectomy: a systematic review and meta-analysis (2023 update)