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Can anyone share their experience with ProACT (an AUS)?

Posted by lavender560 @lavender560, Oct 26, 2024

My 71 year old husband had prostatectomy surgery in August 2023 followed by 6 weeks of radiation therapy which finished the end of January this year. Since the conclusion of the radiation he’s been left completely incontinent. He’s taking orgovyx. Kegals haven’t helped. His urologist wants him to continue with the hormone treatment until January and then test his PSA (it’s currently 0) to determine if he’s cancer free. To tackle the incontinence the urologist suggested a device called ProACT might work for him and could be done in January when he feels everything internal would be as healed as possible. Does anyone have this device and if so, has it helped you, would you recommend? Thanks for any feedback!

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jimchs | @jimchs | 2 days ago
In reply to @tommylee3 "@jeffmarc Hello and thanks to you and everyone else who have contributed to this discussion about..." + (show)
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@jeffmarc Hello and thanks to you and everyone else who have contributed to this discussion about ProACT.

I wanted to share my story, in hope for receiving additional insights on my particular situation.
Following a radical prostatectomy in 2023, my PSA was undetectable for 1 year. But cancer recurrence required 6 weeks of radiation and hormone therapy. My incontinence following both procedures was mild to moderate. Using 1-2 regular pads/day. I researched all stress urinary incontinence options and landed on ProACT.
Procedure completed in January, 2025 and 7 adjustments made to date. However, I was still leaking (1-2 ounces per day). My goal was to just have drips. Maybe — completely dry.
However, my leakage worsened — having to change my thin Depend liner twice in a day, leaking more than 2 ounces. I was bummed. My surgeon (Dr Flynn - UCHealth) deflated both balloons and ordered an MRI. Results showed one of the balloons was not positioned correctly. He suggested revision surgery.
I was aware of the potential for device failure because of my radiation therapy. I’m now in a weird position — and would value any input. Should I proceed with revision surgery? Thank you all — I appreciate your thoughts. TL3

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@tommylee3
I also had radical and, radiation in 2015. Not a drop until 2024 when I had stricture surgery. Since then 100% leakage. Leak surgeon wanted to do ProAct. Obviously I was hesitant since he put me in this position. Since then saw 3 other surgeons. All said no to ProAct. AUS was the only way to go because of radiation. I have now resigned myself to AUS and, the fact I have to push a button. Not a great option but, can't go on with a day clamp and, all night leakage.

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tommylee3 | @tommylee3 | 2 days ago

@jeffmark — Many thanks for your informative feedback. I’ll take your advice and collect some more intel from an unbiased doc. I would like to learn more about your AUS experience next year. Thanks again for your speedy reply.

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tommylee3 | @tommylee3 | 2 days ago
In reply to @jimchs "@tommylee3 I also had radical and, radiation in 2015. Not a drop until 2024 when I..." + (show)
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@tommylee3
I also had radical and, radiation in 2015. Not a drop until 2024 when I had stricture surgery. Since then 100% leakage. Leak surgeon wanted to do ProAct. Obviously I was hesitant since he put me in this position. Since then saw 3 other surgeons. All said no to ProAct. AUS was the only way to go because of radiation. I have now resigned myself to AUS and, the fact I have to push a button. Not a great option but, can't go on with a day clamp and, all night leakage.

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@jimchs — My gosh, it sounded like you had a clear
runway following your two
operations. Unfortunate that things went south on you. I do appreciate your advice. Now I’m more hesitant than ever to proceed with revision surgery.
Wearing my “freedom” clamp right now watching football. Cant wait to lose that damn thing! Thanks again.

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jimchs | @jimchs | 2 days ago

Clamp is the only way I can still keep working and, have a life not tied to pads, somewhat. It's not so bad.

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bmcleod | @bmcleod | 1 day ago

I asked my neurologist about reliability of this implanted clamp. He said “3 years”! I decided to stay with an Afex external clamp which works fine and is easy to control over last 4 years.

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jeff Marchi | @jeffmarc | 1 day ago
In reply to @bmcleod "I asked my neurologist about reliability of this implanted clamp. He said “3 years”! I decided..." + (show)
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I asked my neurologist about reliability of this implanted clamp. He said “3 years”! I decided to stay with an Afex external clamp which works fine and is easy to control over last 4 years.

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@bmcleod
The AUS has a usual life of 10 years. It puts a ring around the urethra. In some cases, they do have to redo the ring due to deterioration.

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bmcleod | @bmcleod | 15 hours ago

10 years is a lot better than I was quoted 3 years ago. I didn’t like the idea of having to go back in. FYI. The Alex clamp just uses foam. There are external clamps that are water proof for use in swimming pools and hot tubs.

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bmcleod | @bmcleod | 15 hours ago

Correction: The one I use daily is the Bard Cunningham clamp, not Afex.

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