The male adjustable continence therapy (ProACT) system is an adjustable device for the treatment of stress urinary incontinence (SUI) in patients who underwent prostate surgery [1]. The SUI prevalence following open or endoscopic surgery for benign prostatic hyperplasia is about 1–2% and certainly represents just a small segment of patients treated [2]. Despite the incessant development of new surgical techniques, a prospective controlled non-randomized trial of patients undergoing radical prostatectomy (RP) in 14 centres using robot-assisted or retropubic strategy showed at 12 months a SUI of 21.3% vs. 20.2%, respectively [3]. It is important to standardize the concept of SUI; it has been defined by the International Continence Society as the involuntary leakage of urine on effort or exertion, sneezing or coughing [4]. This condition can strongly affect the patient’s quality of life after prostate surgery, especially in those young patients who could still have an active life after a radical prostatectomy. The ProACT system represents a valuable and safe solution for patients with postsurgical mild SUI, thanks to the transrectal ultrasound-guided implantation; this technique allows to avoid radiation exposure under fluoroscopic guidance and achieve a more accurate placement using multiplanar ultrasound imaging [1, 5].