title: Functional outcomes of adjustable continence therapy (ACT™) balloons in women aged >80 years and suffering from stress urinary incontinence caused by intrinsic sphincter deficiency.
abstract: OBJECTIVE
  To determine the functional outcomes of adjustable continence therapy (ACT™) balloons in elderly women suffering from stress urinary incontinence (SUI) caused by intrinsic sphincter deficiency (ISD).
  
  
  METHODS
  A monocentric retrospective study included all non-neurological women aged >80 years who suffered from SUI due to ISD and undergoing ACT™ balloon placement between 2000 and 2013. Early post-operative complications were reported according to the Clavien-Dindo classification. Continence was assessed subjectively by the patients.
  
  
  RESULTS
  A total of 52 female patients were included, median age 83 years (IQR 81-85). Among them, 35 (67.3 %) had already undergone previous surgery for SUI. Balloon implantations were achieved under local anaesthesia for 33 (63.5 %) patients. Clavien grade I-II early post-operative complications occurred in five (9.6 %) patients. Median follow-up was 10.5 months (IQR 3-24.25). Eleven patients (21.1 %) were lost to follow-up. At last follow-up, seven patients (13.5 %) declared themselves fully continent after the first implantation, 13 patients (25 %) had an >80 % improvement rate (10 patients after first implantation, two after second implantation and one after third implantation). Four patients (7.7 %) found the procedure unsuccessful even after several consecutive implantations. Ten patients (19.2 %) reported a partial result and were still having successive balloon inflations. Explantation occurred in 22 patients, caused by infection, erosion or balloon migration. In intention-to-treat analysis, the failure rate was 42.3 %.
  
  
  CONCLUSIONS
  Although the success rate of ACT™ balloons in women aged >80 years is lower than that reported for younger women, it remains satisfactory because these patients would not otherwise have benefited from another surgical treatment.
authors.affiliation: Pitié-Salpêtrière Academic Hospital, Department of Urology, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, 47-83 Boulevard de l'Hopital, 75651, Paris Cedex 13, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Billault
authors.affiliation: Pitié-Salpêtrière Academic Hospital, Department of Urology, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, 47-83 Boulevard de l'Hopital, 75651, Paris Cedex 13, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chartier-Kastler
authors.affiliation: Pitié-Salpêtrière Academic Hospital, Department of Urology, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, 47-83 Boulevard de l'Hopital, 75651, Paris Cedex 13, France.
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
authors.affiliation: Rothschild Hospital, Department of Physical Medicine and Rehabilitation, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France.
authors.forename: Gilberte
authors.initials: G
authors.lastname: Robain
authors.affiliation: Pitié-Salpêtrière Academic Hospital, Department of Urology, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, 47-83 Boulevard de l'Hopital, 75651, Paris Cedex 13, France. veronique.phe@gmail.com.
authors.forename: Véronique
authors.initials: V
authors.lastname: Phé
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011312:Pressure; D019736:Prostheses and Implants; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000503:physiopathology*; D001743:Urinary Bladder / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology*
keywords: Adjustable; Elderly; Sphincter deficiency; Stress; Urinary incontinence