Reconstructive Urology at AHN: Prioritizing Innovation and Preserving Quality of Life

Reconstructive urological experts at AHN are trained to address the most intricate conditions of the urinary and genital systems, employing state-of-the-art techniques and advanced methods of care. Among these is the ProACT™ Adjustable Continence Device Therapy for Men: a new, minimally invasive treatment offering for stress urinary incontinence patients at AHN.

How ProACT works

ProACT is now in the American Urology Association guidelines for non-radiated patients with mild to severe stress incontinence. These patients have previously been treated with slings and artificial urinary sphincters (AUS). ProACT is a new option that can be adjusted after implantation to meet the unique needs of each patient.

The implantation is a percutaneous procedure that uses fluoroscopy and cystoscopy to place two small, adjustable balloons bilaterally on either side of the urethra through two small perineal incisions. AHN surgeons then advance through the pelvic diaphragm and navigate with a blunt trocar to position the balloons at the bladder neck. The fluid-filled, silicone balloons provide support to help reduce stress incontinence and improve urinary control.

During follow-up office visits, the balloons can either be inflated or deflated to gradually optimize continence based on the patient’s progress and level of improvement in dryness.

Is ProACT right for your patient?

ProACT can work for any man with incontinence after prostatectomy. Since ProACT avoids dissection around the urethra, it’s an especially ideal option for patients who have undergone previous urethral surgery. It is also a great option for men with limited hand mobility who may have difficulty operating an AUS device.

“For patients who are too wet for a sling, but hesitant about an AUS, ProACT fills a critical gap in treatment options,” said Kiran Sury, MD, AHN reconstructive urologist. “This minimally invasive form of intervention is a way to meet patients where they are — with an adjustable approach that can be fine-tuned over time to adapt to their bladder control without additional surgery.”

While the adjustability presents a key advantage of ProACT, patients should understand the procedure doesn’t provide instant results or guaranteed dryness. Unlike a sling, which produces more immediate results, or an AUS which works as soon as it is activated, ProACT typically requires in-office adjustments by accessing small ports tunneled into the scrotum. It can take a few months before patients are satisfied, but Dr. Sury emphasizes that the adjustments only take about a minute and are generally well-tolerated by his patients.

AHN’s additional reconstructive and urological expertise

Before a patient is deemed a candidate for surgery, AHN urologists collaborate across disciplines to determine whether lifestyle modifications or medication may be effective treatment options on their own or in combination with surgery.

If surgical intervention is required to address incontinence and other urinary conditions, AHN’s expertise encompasses a broad spectrum of procedures — from minimally invasive endoscopic surgeries to those that are more complex, based on the patient’s symptoms and discomfort levels.

Supported by holistic pre-operative and post-operative care, AHN urologists regularly perform several procedures using state-of-the-art techniques and the latest surgical methods, including:

• Urethroplasty
• Ureteral stricture repair
• Penile prosthesis for erectile dysfunction
• Buried penis repair with skin grafting

How to refer

Urinary challenges are some of the most personal health issues, and our dedicated care team is equipped to provide compassionate support and expertise. To make a referral, call (412) 281-1757.