A minimally invasive surgical option for male stress urinary incontinence, particularly following prostate surgery. Two small, fluid-filled balloons (ProACT) are precisely positioned adjacent to the bladder neck or membranous urethra to provide passive compression. A key clinical benefit is their post-operative adjustability via an easily accessible subcutaneous scrotal port, allowing for precise, volume-based adjustments in the clinic to optimize long-term dryness.

Clinical Indication

This procedure is highly indicated for patients experiencing structural anomalies, severe localized scar tissue, or functional blockages that fail to resolve with initial conservative therapeutic adjustments.

Surgical Objective

The principal objective is the complete restoration of physiological form, functional urinary path independence, or mechanical integrity, maximizing long-term outcomes while minimizing systemic downtime.

The ProACT™ Adjustable Continence Therapy consists of two small silicone balloons implanted bilaterally on either side of the bladder neck / proximal urethra. Each balloon is connected to an individual titanium port positioned just under the skin in the scrotum. ProACT provides a unique advantage: continence can be titrated postoperatively in the clinic setting by injecting or withdrawing small amounts of fluid through the scrotal port using a fine needle, tailoring urethral coaptation over time.

Clinical Indications & Patient Selection

Indicated for men with post-radical prostatectomy stress urinary incontinence who desire an adjustable, non-mesh, non-pump solution.

Post-Prostatectomy SUI: Mild to moderate leakage refractory to pelvic floor physical therapy.

Desire for In-Office Adjustability: Patients who want the ability to tighten or loosen support over time without repeat surgical incisions.

Non-Radiated Anatomy: Optimal in non-radiated urethral tissue beds with healthy mucosal vascularity.

Surgical Technique & Procedural Nuance

Conducted under light sedation or general anesthesia using fluoroscopic and transrectal ultrasound guidance.

Perineal Trocar Placement: Small puncture incisions in the perineum guide curved trocars to the lateral bladder neck under real-time biplanar imaging.

Dual Balloon Seating: Balloons are seated precisely in the periurethral space and filled initially with 1 to 1.5 mL of isotonic contrast fluid.

Scrotal Port Placement: The small titanium injection ports are positioned in the anterior scrotal wall for easy in-office palpation.

Postoperative Pathway & Recovery Timeline

An outpatient ambulatory procedure with discharge within a few hours.

Catheter: Foley catheter is pulled either in the recovery room or within 24 hours.

Healing Phase: Balloons remain at baseline volume for 6 weeks while the surrounding tissue capsule matures.

Postoperative Titration: At 6 weeks, the doctor palpates the scrotal port and injects 0.5 to 1 mL of fluid to incrementally achieve dry continence.

Outcomes, Durability & Clinical Evidence

Provides customizable continence control with minimal anatomical disruption.

Pad Reduction: Most patients use far fewer pads, or become dry, after one to three adjustments.

Reversibility: The system can be easily deflated or explanted if voiding dynamics change or if alternative therapies become necessary.

The ProACT™ Adjustable Continence Therapy consists of two small silicone balloons implanted bilaterally on either side of the bladder neck / proximal urethra. Each balloon is connected to an individual titanium port positioned just under the skin in the scrotum. ProACT provides a unique advantage: continence can be titrated postoperatively in the clinic setting by injecting or withdrawing small amounts of fluid through the scrotal port using a fine needle, tailoring urethral coaptation over time.

Clinical Indications & Patient Selection

Indicated for men with post-radical prostatectomy stress urinary incontinence who desire an adjustable, non-mesh, non-pump solution.

Post-Prostatectomy SUI: Mild to moderate leakage refractory to pelvic floor physical therapy.

Desire for In-Office Adjustability: Patients who want the ability to tighten or loosen support over time without repeat surgical incisions.

Non-Radiated Anatomy: Optimal in non-radiated urethral tissue beds with healthy mucosal vascularity.

Surgical Technique & Procedural Nuance

Conducted under light sedation or general anesthesia using fluoroscopic and transrectal ultrasound guidance.

Perineal Trocar Placement: Small puncture incisions in the perineum guide curved trocars to the lateral bladder neck under real-time biplanar imaging.

Dual Balloon Seating: Balloons are seated precisely in the periurethral space and filled initially with 1 to 1.5 mL of isotonic contrast fluid.

Scrotal Port Placement: The small titanium injection ports are positioned in the anterior scrotal wall for easy in-office palpation.

Postoperative Pathway & Recovery Timeline

An outpatient ambulatory procedure with discharge within a few hours.

Catheter: Foley catheter is pulled either in the recovery room or within 24 hours.

Healing Phase: Balloons remain at baseline volume for 6 weeks while the surrounding tissue capsule matures.

Postoperative Titration: At 6 weeks, the doctor palpates the scrotal port and injects 0.5 to 1 mL of fluid to incrementally achieve dry continence.

Outcomes, Durability & Clinical Evidence

Provides customizable continence control with minimal anatomical disruption.

Pad Reduction: Most patients use far fewer pads, or become dry, after one to three adjustments.

Reversibility: The system can be easily deflated or explanted if voiding dynamics change or if alternative therapies become necessary.

Related Conditions & Patient Recovery Protocols

Clinical Subspecialty Hub: Urinary Incontinence & Voiding Restoration →

Underlying Clinical Condition: Male Urinary Incontinence →