(138) Adjustable Continence Therapy for Stress Urinary Incontinence in Women: Clinical Outcomes and Impact on Sexual Function

Abstract Introduction Stress urinary incontinence (SUI) affects 35–50% of women and significantly impacts quality of life. Leakage during sexual activity can cause embarrassment, reduced libido, and orgasmic dysfunction. While lifestyle, therapy-based, and surgical treatments exist, limited data address how incontinence interventions affect sexual function. Adjustable Continence Therapy (ACT™), an investigational adjustable periurethral balloon implant, is a surgical treatment currently undergoing clinical trials for female SUI secondary to intrinsic sphincter deficiency. Objective This study evaluates ACT™ effects on continence and sexual function in women with SUI due to sphincter deficiency. Methods We conducted a prospective chart review of fourteen patients who underwent ACT™ implantation between July 2023–October 2024. Balloon volume was adjusted every 4–6 weeks until continence or maximum volume was reached. Incontinence was assessed via daily pad counts and provocative pad tests; patients were “dry” if post-op pad weight was 0 g. Treatment success was defined as 50% reduction in pads/day (PPD) or ≥ 50% decrease in pad weight. Sexual function was measured with the Incontinence Quality of Life survey and by rating “I worry about having sex” from 1 (extreme worry) to 5 (no worry). Descriptive statistics and t-testing were used to assess patient characteristics and group differences. Results Fourteen women underwent ACT™ placement. Mean age was 67 years, mean BMI 26.7, and 12 had prior sling surgery. Pre-op median pad use was 5.8 PPD (range: 1–12) and median pad weight 88.6 g (0.1–312.9). Median sexual score was 2 (mild worry). At last follow-up, 11 patients achieved treatment success and 5 were dry; 13 retained their devices with median balloon volume 2.4 mL. One patient experienced left balloon erosion requiring explant. Median pad use decreased to 2.5 PPD (p 0.05, range: 0–5.5) and median pad weight to 2.0 g (p 0.001, range: 0–215). Median sexual scores improved to 5 (no worry), with significant improvement at 6 and 12 months (p 0.05), suggesting durable quality-of-life gains. Conclusions ACT™ is a safe, feasible option for women with SUI due to sphincter deficiency. It was associated with high treatment success and significant improvements in continence and sexual worry. ACT™ may restore continence and enhance sexual well-being. Larger studies using validated measures are needed to confirm the impact on sexual health. Disclosure No.