Adjustable transobturator male system (ATOMS (R)) as treatment of stress urinary incontinence secondary to transurethral resection of the prostate

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Angulo, JC (Author) Other; Fonseca, J (Author) Other; Esquinas, C (Author) Other; Ojea, A (Author) Other; Rodriguez, A (Author) Other; Rabassa, M (Author) Other; Teba, F (Author) Other; Escribano, G (Author) Other; Francisco Cruz (Author) FMUP

Journal

Title: Actas Urologicas Espanolas

Vol. 42

Pages: 567-573

ISSN: 0210-4806

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 5 Citations

Scopus - 6 Citations

Other information

Authenticus ID: P-00P-V4P

DOI: 10.1016/j.acuro.2018.05.002

Abstract (EN): Objectives: Feasibility study to evaluate efficacy and safety of Adjustable Transobturator Male System (ATOMS (R)) for male stress urinary incontinence (SUI) after transurethral resection of the prostate. Materials and methods: Twenty patients were implanted ATOMS for SUI caused by transurethral resection of the prostate with or without radiotherapy. Incontinence severity was evaluated as mild (2 pads/day), moderate (3-5 pads/day) or severe (>= 6pads/day), and dryness as none or one security pad/day. Changes in pad-test and pad-count after adjustment were investigated, together with operative parameters, patient satisfaction with the procedure, and number and grade of complications (Clavien-Dindo). Results: Median age was 76.5 years. Five patients received previous pelvic radiation (3 prostate, 2 rectal cancer) and 2 (10%) previous failed artificial urinary sphincter with urethral erosion and mechanical failure, respectively. Preoperative SUI was mild in 4 (20%), moderate in 7 (35%) and severe in 9 (45%). Median filling of the system was 13.5 ml. Median pad-test decreased from 375 855 ml baseline to 10 +/- 31.5 ml and pad-count from 4 +/- 3 to 0 +/- 1.5 after adjustment (1 +/- 3fillings). Postoperative SUI distribution was mild in 2 (10%), moderate in one (5%) and severe in 2 (10%). Satisfaction rate was 80%, equal for transurethral resection of the prostate with/without previous radiotherapy. No patient had urinary retention after catheter removal. Complications presented in 3 (15%) patients, all minor. After median 38.5 mo follow-up no system has been removed, 19 (95%) self-considered better than before and 11 (55%) very much better. Conclusion: Based on short-term efficacy and patient satisfaction ATOMS can be considered a realistic alternative for SUI after transurethral resection of the prostate, even after irradiation. Absence of urethral erosion and very limited problems make this alternative especially attractive for cases with diminished dexterity, advanced age and previous failed treatments.

Language: Spanish

Type (Professor's evaluation): Scientific

No. of pages: 7