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Intermediate- and Long-term Results After Adjustable Transobturator Male System Implantation
Samra Jasarevic1, Doroteja Jankovic1, Georg C Hutterer1
1Department of Urology, Medical University of Graz, Graz, Austria.
Urology
|December 3, 2024
Summary
The Adjustable TransObturator Male System (ATOMS) significantly reduces pad usage for male stress urinary incontinence (SUI). However, about one-third of patients require device explantation, particularly those with recurrent or severe SUI.
Area of Science:
- Urology
- Surgical Innovation
- Male Continence Management
Background:
- Male stress urinary incontinence (SUI) significantly impacts quality of life.
- The Adjustable TransObturator Male System (ATOMS) is a device used for SUI treatment.
- Assessing ATOMS outcomes is crucial for patient selection and management.
Purpose of the Study:
- To evaluate the efficacy and safety of the ATOMS device in treating male SUI.
- To determine continence rates and complication profiles following ATOMS implantation.
- To identify risk factors associated with ATOMS explantation.
Main Methods:
- Retrospective analysis of 80 patients who underwent ATOMS implantation between 2010 and 2021.
- Primary endpoints included continence status and complication rates.
- Implant survival and explantation risk factors were analyzed using Kaplan-Meier and Cox regression models.
Main Results:
- A significant decrease in daily pad usage was observed post-implantation (4 to 2 pads/day).
- The 1- and 5-year implant survival rates were 0.89 and 0.71, respectively.
- Explantation occurred in 27.5% of patients, with higher risks noted for those with prior incontinence surgery, high Gleason scores (ISUP ≥4), and heavy preoperative pad use (>250g/day).
Conclusions:
- ATOMS implantation effectively reduces pad requirements in men with SUI.
- A notable rate of explantation (approximately 35% by Kaplan-Meier estimate) exists within intermediate-term follow-up.
- Patients with recurrent or severe SUI should be counseled regarding the increased risk of explantation.
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