[Adjustable continence therapy balloons in women: Evolution of efficacy within the 24 months following implantation]. / Ballons ACT chez la femme : évolution de l'efficacité au cours des 24 mois suivant l'implantation.

PURPOSE: To analyze the functional outcomes over time of ACT balloon in women with stress urinary incontinence (SUI) secondary to intrinsic sphincter deficiency (ISD). METHOD: All patients with SUI secondary to ISD who underwent bilateral ACT balloon implantation between September 2008 and November 2015 and regularly monitored for a period of at least 24 months were eligible. The results were studied at 6, 12 and 24 months. Efficacy was defined as: Success - maximum 1 safety pad per day and visual analogue scale (VAS) rating≥9/10. Improvement - decrease in the number of pads used per day and VAS≥5/10. Failure - increase or stability of the number of pads used per day and/or VAS<5/10. Failure was considered as primary when it occurred without any success or improvement. It was considered as secondary when it occurred after an initial period of success or improvement. RESULTS: 18 patients were monitored during 24 months. The success rate was respectively 17 %, 33 % and 33 % at 6, 12 and 24 months of follow-up. The improvement rate was respectively 61 %, 39 % and 17 % at 6, 12 and 24 months of follow-up. The primary failure rate was 22 %. The secondary failure rate was 6 % at 12 months and 33 % at 24 months of follow-up. CONCLUSION: ACT balloon efficacy tends to decrease with time requiring a long-term follow-up of implanted patients. LEVEL OF EVIDENCE: 4.

[Pathology findings after radical prostatectomy for prostate cancer in patients eligible for active surveillance: Contribution of multiparametric MRI to treatment decision]. / Résultats anatomopathologiques après prostatectomie totale pour cancer chez des patients éligibles à une surveillance active : apport de l'IRM multiparamétrique dans la décision de traitement.

OBJECTIVES: To analyze, in patients with prostate cancer (PC) potentially eligible for active surveillance (AS), whether multiparametric-MRI (mp-MRI) predicts presence of clinically significant cancer on radical prostatectomy (RP) specimen. METHODS: We identified 77 men with PC eligible for AS (PSA≤15ng/mL, stage≤T2a, Gleason score≤6, up to 3 positive cores, maximal cancer core length≤5mm) who underwent RP between 01/2008 and 08/2015. All patients had prebiopsy mp-MRI followed by systematic±targeted biopsies. For each patient, the likelihood of the presence of cancer on mp-MRI was assigned using Likert scale (1 to 5). The predictive factors for the presence of significant cancer on RP specimen (Gleason score≥7 and/or tumoral maximal diameter>10mm) were evaluated using logistic regression. RESULTS: Median age was 61 and median PSA was 6.7ng/mL. Overall, 49 (64%) patients had a positive mp-MRI (score≥3). Clinically significant cancer on RP specimen was found in 45 (58%) patients (69% in MRI-positive patients vs 39% in MRI-negative patients). In multivariate analysis, a positive MRI was a predictive factor for the presence of significant cancer on the surgical specimen (OR=3.0; CI95% [1.01-8.88]; P=0.04), as was age (OR=1.17; CI95% [1.05-1.31]; P=0.004) and PSAD (OR=1.10; CI95% [1.01-1.20]; P=0.02). CONCLUSION: Mp-MRI is a useful exam for selecting patients eligible for AS even if the situation remains unclear after prostate biopsies including targeted biopsies. Upon confirmation by further studies, mp-MRI should be considered as an independent criterion before entering an AS program. LEVEL OF EVIDENCE: 4.