{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T03:02:32Z","timestamp":1773198152245,"version":"3.50.1"},"reference-count":16,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SJU"],"abstract":"<jats:p>Objective: To compare adjustable continence balloons (ProACT) implanted above the pelvic floor with or without subsequent placement of a third balloon (AP) with a modified technique placing balloons below the pelvic floor (BP).\nMaterials and methods: We retrospectively compared 38 men who underwent the BP procedure and 38 men who received the AP technique. Primary outcome was continence (\u22641 pad\/day or &lt;8 ml\/24 h leakage). Secondary outcomes included operative time, complications, number of balloon filling visits, and satisfaction.\nResults: Median age was 75.5 years (BP) and 70.5 years (AP) (p &lt; 0.0001). Groups were comparable in preoperative incontinence severity. Median surgical time was 15 min (BP) versus 20 min (AP) (p = 0.034). Early retention occurred in 18.4% (BP) versus 0% (AP) (p = 0.012). A third balloon was inserted in 39.4% of AP patients, and median number of fillings (6 vs. 10, p = 0.0006) was lower in BP group. Late complications consisting of migration, erosion, and balloon puncture were similar (23.7% BP vs. 36.8% AP, p = 0.32). Continence was achieved in 52.6% (BP) and 57.9% (AP) (p = 0.64), and satisfaction was reported by 71.1% (BP) and 57.9% (AP) (p = 0.34). On multivariate analyses, surgical method did not predict outcomes, and Cox regression shoved that BP was associated with a non-significant hazard of revision (HR: 1.60; 95% confidence interval [CI]: 0.53\u20134.85; p = 0.40).\nConclusions: ProACT placement below the pelvic floor yielded similar continence but reduced operative time and postoperative visits, at the cost of more early retention.<\/jats:p>","DOI":"10.2340\/sju.v61.45579","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T06:30:14Z","timestamp":1773124214000},"page":"38-43","source":"Crossref","is-referenced-by-count":0,"title":["Introduction of a modified surgical approach for ProACT balloon placement: a retrospective cohort study"],"prefix":"10.2340","volume":"61","author":[{"given":"Jakob Klint","family":"Axelsen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2414-962X","authenticated-orcid":false,"given":"Lars","family":"Boesen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6468-389X","authenticated-orcid":false,"given":"Rasmus","family":"Bisbjerg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3915-5248","authenticated-orcid":false,"given":"Nis","family":"N\u00f8rgaard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helene Reif","family":"Andersen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8963-4581","authenticated-orcid":false,"given":"Mikkel","family":"Fode","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"143492","doi-asserted-by":"crossref","unstructured":"Porto JG, Bhatia AM, Bhat A, et al. Evaluating transurethral resection of the prostate over twenty years: a systematic review and meta-analysis of randomized clinical trials. World J Urol. 2024;42:639. https:\/\/doi.org\/10.1007\/S00345-024-05332-3","DOI":"10.1007\/s00345-024-05332-3"},{"key":"143493","doi-asserted-by":"crossref","unstructured":"Gacci M, De Nunzio C, Sakalis V, et al. Latest evidence on post-prostatectomy urinary incontinence. J Clin Med. 2023 Feb 2;12(3):1190. https:\/\/doi.org\/10.3390\/JCM12031190","DOI":"10.3390\/jcm12031190"},{"key":"143494","doi-asserted-by":"crossref","unstructured":"Giannantoni A, Mearini E, Zucchi A, et al. Bladder and urethral sphincter function after radical retropubic prostatectomy: a prospective long-term study. Eur Urol. 2008;54:657\u2013664. https:\/\/doi.org\/10.1016\/j.eururo.2007.10.054","DOI":"10.1016\/j.eururo.2007.10.054"},{"key":"143495","doi-asserted-by":"crossref","unstructured":"Lardas M, Grivas N, Debray TPA, et al. Patient- and tumour-related prognostic factors for urinary incontinence after radical prostatectomy for nonmetastatic prostate cancer: a systematic review and meta-analysis. Eur Urol Focus. 2022;8:674\u2013689. https:\/\/doi.org\/10.1016\/j.euf.2021.04.020","DOI":"10.1016\/j.euf.2021.04.020"},{"key":"143496","doi-asserted-by":"crossref","unstructured":"Canning A, Raison N, Aydin A, et al. A systematic review of treatment options for post-prostatectomy incontinence. World J Urol. 2022;40:2617\u20132626. https:\/\/doi.org\/10.1007\/S00345-022-04146-5","DOI":"10.1007\/s00345-022-04146-5"},{"key":"143497","doi-asserted-by":"crossref","unstructured":"Green R. Experiences and management of urinary incontinence following treatment for prostate cancer: disrupted embodied practices and adapting to maintain masculinity. Health (London) 2024;28:489\u2013506. https:\/\/doi.org\/10.1177\/13634593231185266","DOI":"10.1177\/13634593231185266"},{"key":"143498","doi-asserted-by":"crossref","unstructured":"Cornu J-N, Zantek P, Burtt G, et al. Minimally invasive treatments for benign prostatic obstruction: a systematic review and network meta-analysis. Eur Urol. 2023;83:534\u2013547. https:\/\/doi.org\/10.1016\/j.eururo.2023.02.028","DOI":"10.1016\/j.eururo.2023.02.028"},{"key":"143499","doi-asserted-by":"crossref","unstructured":"Winck-Flyvholm L, Fode M, Marsh A, et al. Transurethral microwave thermotherapy with the CoreTherm\u00aeConcept in men with prostates larger than 100 grams \u2013 a consecutive case series. Scand J Urol. 2025;60:23\u201328. https:\/\/doi.org\/10.2340\/sju.v60.42784","DOI":"10.2340\/sju.v60.42784"},{"key":"143500","doi-asserted-by":"crossref","unstructured":"Averbeck MA, Woodhouse C, Comiter C, et al. Surgical treatment of post-prostatectomy stress urinary incontinence in adult men: report from the 6th International Consultation on Incontinence. Neurourol Urodyn. 2019;38:398\u2013406. https:\/\/doi.org\/10.1002\/NAU.23845","DOI":"10.1002\/nau.23845"},{"key":"143501","doi-asserted-by":"crossref","unstructured":"Gacci M, Sakalis VI, Karavitakis M, et al. European Association of Urology Guidelines on Male Urinary Incontinence. Eur Urol. 2022;82:387\u2013398. https:\/\/doi.org\/10.1016\/j.eururo.2022.05.012","DOI":"10.1016\/j.eururo.2022.05.012"},{"key":"143502","doi-asserted-by":"crossref","unstructured":"Tricard T, Song QX, Munier P, et al. Adjustable continence therapy (proACT) for the treatment of male stress urinary incontinence post-prostatectomy: a systematic review and meta-analysis (2023 update). World J Urol. 2023;41:1793\u20131802. https:\/\/doi.org\/10.1007\/S00345-023-04452-6","DOI":"10.1007\/s00345-023-04452-6"},{"key":"143503","doi-asserted-by":"crossref","unstructured":"Moore K, Allen M, Voaklander DC. Pad tests and self-reports of continence in men awaiting radical prostatectomy: establishing baseline norms for males. Neurourol Urodyn. 2004;23:623\u2013626. https:\/\/doi.org\/10.1002\/NAU.20067","DOI":"10.1002\/nau.20067"},{"key":"143504","doi-asserted-by":"crossref","unstructured":"Kj\u00e6r L, Fode M, Norgaard N, et al. Adjustable continence balloons: clinical results of a new minimally invasive treatment for male urinary incontinence. Scand J Urol Nephrol. 2012;46:196\u2013200. https:\/\/doi.org\/10.3109\/00365599.2012.660986","DOI":"10.3109\/00365599.2012.660986"},{"key":"143505","doi-asserted-by":"crossref","unstructured":"Abrams P, Constable LD, Cooper D, et al. Outcomes of a noninferiority randomised controlled trial of surgery for men with urodynamic stress incontinence after prostate surgery (MASTER)[Formula presented]. Eur Urol. 2021;79:812\u2013823. https:\/\/doi.org\/10.1016\/j.eururo.2021.01.024","DOI":"10.1016\/j.eururo.2021.01.024"},{"key":"143506","doi-asserted-by":"crossref","unstructured":"Meisterhofer K, Herzog S, Strini KA, et al. Male slings for postprostatectomy incontinence: a systematic review and meta-analysis. Eur Urol Focus. 2020;6:575\u2013592. https:\/\/doi.org\/10.1016\/j.euf.2019.01.008","DOI":"10.1016\/j.euf.2019.01.008"},{"key":"143507","doi-asserted-by":"crossref","unstructured":"Angulo JC, Sch\u00f6nburg S, Giamm\u00f2 A, et al. Systematic review and meta-analysis comparing Adjustable Transobturator Male System (ATOMS) and Adjustable Continence Therapy (ProACT) for male stress incontinence. PLoS One. 2019;14. https:\/\/doi.org\/10.1371\/JOURNAL.PONE.0225762","DOI":"10.1371\/journal.pone.0225762"}],"container-title":["Scandinavian Journal of Urology"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/SJU\/article\/download\/45579\/53073","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/SJU\/article\/download\/45579\/53073","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T06:30:25Z","timestamp":1773124225000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/SJU\/article\/view\/45579"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":16,"URL":"https:\/\/doi.org\/10.2340\/sju.v61.45579","relation":{},"ISSN":["2168-1813"],"issn-type":[{"value":"2168-1813","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]}}}