Adjustable continence therapy for treatment of recurrent female urinary incontinence.
OBJECTIVE
The Adjustable Continence Therapy (ACT) device has been developed for the treatment of recurrent stress urinary incontinence resulting from intrinsic sphincter deficiency (ISD) by increasing urethral coaptation. We critically evaluated the technique and its results.


METHODS
The ACT device consists of two balloons each attached to an injectable port placed in the labia majora. The port enables postoperative adjustment in balloon coaptation pressure. All 49 patients had previously failed anti-incontinence surgery. Each patient was implanted with the ACT device and assessed by preoperative and postoperative overall impression, incontinence quality of life questionnaire, and visual analog scale; 38 of the 49 subjects had a minimum of 1 year of data collected, including pad use, number of adjustments needed, and complications.


RESULTS
Mean operative time was 20.3 minutes (range 10-30 minutes), with 88% of implantations performed using local or regional anesthesia. Balloon adjustments were needed in 62%; 68% of patients reported being dry and 16% improved. Complications included migration (12%), balloon failure (3.6%), and erosion (4%).


CONCLUSIONS
The ACT device provided significant improvement in at last 70% of patients with recurrent stress urinary incontinence.
Kocjancic
Ervin
E
Clinica Urologica, Azienda Ospedaliero Universitaria, Udine, Italy. crivellaro76@hotmail.com
Crivellaro
Simone
S
Smith
John Joseph
JJ
Ranzoni
Stefania
S
Bonvini
Daniele
D
Frea
Bruno
B
D002404:Catheterization / Q000295:instrumentation*; D005260:Female; D006801:Humans; D012008:Recurrence; D013525:Surgical Instruments; D014546:Urinary Catheterization; D014549:Urinary Incontinence / Q000517:prevention & control* / Q000628:therapy*