Treatment of male stress urinary incontinence with the adjustable transobturator male system: Outcomes of a multi-center Iberian study

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

Authors

Angulo, JC (Author) Other; Francisco Cruz (Author) FMUP; Esquinas, C (Author) Other; Arance, I (Author) Other; Manso, M (Author) FMUP; Rodriguez, A (Author) Other; Pereira, J (Author) Other; Ojea, A (Author) Other; Carballo, M (Author) Other; Rabassa, M (Author) Other; Teyrouz, A (Author) Other; Escribano, G (Author) Other; Rodriguez, E (Author) Other; Teba, F (Author) Other; Celada, G (Author) Other; Madurga, B (Author) Other; Alvarez Ossorio, JL (Author) Other; Marcelino, JP (Author) Other; Martins, FE (Author) Other

Journal

Title: Neurourology and Urodynamics

Vol. 37

Pages: 1458-1466

ISSN: 0733-2467

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 32 Citations

Scopus - 33 Citations

Other information

Authenticus ID: P-00N-XGX

DOI: 10.1002/nau.23474

Abstract (EN): Aim: To evaluate effectiveness and safety of the adjustable transobturator male system (ATOMS) for male stress urinary incontinence (SUI). Material and Methods: A retrospective multicenter study was conducted in nine Iberian institutions using a board-approved database for 215 patients intervened between 2012 and 2017, with no case excluded. Continence status, patient satisfaction, number, and grade of complications (Clavien-Dindo) and factors affecting dry rate at adjustment were evaluated. Multivariate analysis defined the population at best success rate. Incontinence recurrence due to device failure and/or explant was evaluated and Kaplan-Meier curve for durability performed. Results: Adjustment was achieved at a mean 1.4 +/- 1.9 fillings. Dry-rate after adjustment was 80.5% (96.2% mild and 75.3% moderate-severe), 121 (56.3%) used no pads, and 52 (24.2%) a security pad with urine loss under 10 mL. Mean basal daily pad-test and pad-count decreased from 484 +/- 372.3 mL and 3.9 +/- 2 pads to 63.5 +/- 201.2 mL and 0.9 +/- 1.5pads (both P < 0.0001). Satisfaction rate was 85.1% (94.3% mild and 82.1% moderate-severe). Factors associated to dryness were: lesser severity of SUI (P <.0001), absence of radiotherapy (P = 0.0002) and device generation (P = 0.05). Multivariate analysis revealed absence of radiation (OR = 3.12; 1.36-7.19), mild (OR = 19.61; 3.95-100), and moderate (OR = 2.48; 1.1-5.59) SUI were independent predictors. Complications presented in 33(15.35%); 66.7% grade 1, 9.1% grade 2, and 24.2% grade 3. At 24.3 +/- 15 mo mean follow-up device was explanted in seven (3.25%) and SUI worsened after adjustment in nine (4.2%). Dry-rate at follow-up was 73% and durability of device in dry patients at adjustment was 89.8% (82.9-94) at 2-years. Conclusions: This study confirms ATOMS device is safe and achieves high treatment efficacy and patient satisfaction in a multicenter setting. Significantly better results are achieved in less severe and non-irradiated cases. Durability of the device is reassuring in the short-term.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9