Can MRI predict which patients are most likely to benefit from percutaneous positioning of volume-adjustable balloon devices?

Purpose: To assess whether magnetic resonance imaging (MRI) is useful in predicting which patients affected by stress urinary incontinence (SUI) will benefit from a new anti-incontinence therapy named adjustable continence therapy (ACT™). Methods: We prospectively evaluated a group of 25 female patients affected by SUI and treated with ACT. Before and after treatment all patients were clinically assessed by physical examination, urodynamic evaluation and pad test. All patients had an MR examination before and 3 and 12 months after ACT surgery to compare the position of the bladder neck in relation to the pubococcygeal line (PCL). Results: 21/25 (84%) patients were improved; 16 (64%) of these patients were dry and 5 (20%) significantly improved. Before treatment, the mean PCL distance was significantly different (p < 0.01) between the responsive and the non-responsive groups. Conclusions: MRI provides an effective radiological method to predict the efficacy of the ACT.