The main purpose was to assess the failure free survival of adjustable continence therapy ACT®/proACT® after continence was obtained and to seek factors influencing it.
Retrospective, single-center survival study of peri-urethral balloons implanted between 2007 and 2014. Efficacy was defined by the wearing of 0 or 1 safety pad per day. The primary end point was time to failure estimated from a survival curve (Kaplan-Meier). Factors that could influence failure free survival were: sex, age, radiotherapy, diabetes, number of pad before surgery, number of balloon inflation, early complications, mixed urinary incontinence and previous ACT®/proACT® placement. They were analyzed in a COX regression.
Of the 82 peri-urethral balloons placed, 41 were effective in 36 patients. The failure free survival was 50 % at 60 months. Radiotherapy, diabetes and previous peri-urethral balloon placement appeared to significantly decrease survival (P=0.031;P=0.025;P=0.029, respectively). Fifteen peri-urethral balloons were still effective at the last follow-up, one was lost to follow-up and 25 required re-intervention for loss of efficacy. The main cause of efficacy loss was system leakage. Fifty-two percent of peri-urethral balloons that became ineffective were replaced by new peri-urethral balloons and 28% by an artificial urinary sphincter.
Patients who became continent with adjustable continence therapy (ACT®/proACT®) had a 50 % new surgery probability at 5 years for a loss of efficacy. Radiotherapy seems to be the main risk factor of the efficacy loss.
IV.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2020 Dec 15 [Epub ahead of print]
A-S Bajeot, T Brierre, J-B Beauval, P Roulette, B Bordier, J Zgheib, É Huyghe, M Soulié, M Roumiguié, X Gamé
Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France. Electronic address: ., Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France.