Is the adjustable transobturator system ATOMS® useful for the treatment of male urinary incontinence in low to medium volume urological centers?

• Published in: Actas urológicas españolas (English ed.) Vol. 42; no. 4; pp. 267 - 272
• Main Authors: Manso, M, Alexandre, B, Antunes-Lopes, T, Martins-da-Silva, C, Cruz, F
• Format: Journal Article
• Language: English; Spanish
• Published: 01.05.2018
• ISSN: 2173-5786
• DOI: 10.1016/j.acuro.2017.07.011

INTRODUCTIONUrinary incontinence (UI) is a complication of radical prostatectomy (RP) and transurethral resection of the prostate (TURP). The gold-standard treatment is the artificial urinary sphincter, however, new treatments have been investigated. OBJECTIVETo examine the outcome of an adjustable transobturator male system (ATOMS®) in men with UI after prostatic surgery in a low to medium volume continence center. MATERIALS AND METHODSTwenty-five men with UI were implanted with ATOMS® system between 2012 and 2014. The most common indication was UI after RP (92%), followed by UI after TURP (8%). Eleven patients (44%) had received adjuvant external beam radiotherapy (RT). Patients were considered to be 'dry' if they stopped wearing pads or needed just one protective pad per day; and improved if the daily number of pads used decreased by at least half. The Incontinence Quality of Life questionnaire (ICIQ-SF) was used, adding a verbal question about the satisfaction of the patient considering the outcome. RESULTSAfter a mean follow-up of 21.56 months, 64% were dry and 8% revealed a significant improvement. The success of the procedure was negatively correlated with the severity of the previous UI and with previous treatment with RT. Concerning patients satisfaction, 84% of the patients would repeat the procedure. CONCLUSIONATOMS® offers good rates of cure and improvement of UI after prostatic surgery with a reasonable rate of minor complications. The results of this study, performed in a low to medium volume continence center, are comparable to the results achieved in high volume continence centers.