Interventional Ultrasound-Guided Treatment of Urinary Incontinence: Insertion of ProACT

Abstract

The male adjustable continence therapy (ProACT) system is an adjustable device for the treatment of stress urinary incontinence (SUI) in patients who underwent prostate surgery [1]. The SUI prevalence following open or endoscopic surgery for benign prostatic hyperplasia is about 1–2 % and certainly represents just a small segment of patients treated [2]. Despite the incessant development of new surgical techniques, the prevalence of SUI after radical prostatectomy still ranges in literature between 5 and 50 % and represents a constant challenge for the urologist [3–5]. It is important to standardize the concept of SUI; it has been defined by the International Continence Society as the involuntary leakage of urine on effort or exertion, sneezing or coughing [6]. This condition can strongly affect the patient’s quality of life after prostate surgery, especially in those young patients who could still have an active life after a radical prostatectomy. The ProACT system represents a valuable and safe solution for patients with postsurgical mild SUI, thanks to the transrectal ultrasound-guided implantation; this technique allows to avoid radiation exposure under fluoroscopic guidance and achieve a more accurate placement by the use of multiplanar ultrasound imaging [1, 7].