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

Manso, Margarida; Alexandre, B.; Antunes-Lopes, Tiago; Martins-Silva, Carlos; Cruz, Francisco

doi:10.1016/j.acuroe.2018.03.008

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…For the adjustable sling ATOMS (A.M.I. Co, Austria), for example, Manso et al 13 has demonstrated good continence and satisfaction rates (64% dry + 8% improved) even in centers with low levels of expertise. In the USA, the decline of AUS implantations in the beginning of this century is already evident along with increasing numbers of male sling procedures 14 .…”

Section: Discussionmentioning

confidence: 99%

High/low‐volume center experience predicts outcome of AMS 800 in male stress incontinence: Results of a large middle European multicenter case series

Queissert

Hüsch

Kretschmer

et al. 2020

Neurourology and Urodynamics

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Aim To analyze the influence of implantation volume of artificial sphincters (AMS 800) on outcome in a large central European multicenter cohort study. Methods As part of the DOMINO (Debates on Male Incontinence) project, the surgical procedures and outcomes were retrospectively analyzed in a total of 473 patients who received an artificial sphincter (AMS 800) between 2010 and 2012. Clinics that implanted at least 10 AMS 800 per year were defined as high‐volume centers. Results Sixteen centers had a mean rate of 9.54 AMS 800/y of which five clinics were identified as high‐volume centers. They implanted significantly more double cuffs (55% vs 12.1%; P < .001), used the perineal approach significantly more often (78% vs 67.7%; P = .003) and chose larger mean cuff sizes (4.63 cm vs 4.42 cm; P = .002). With a mean follow‐up of 18 months, the revision rate was significantly higher at low‐volume centers (38.5% vs 26.7%; P = .037), urethral erosion being the main reason for revision. Social continence (0‐1 pads/24 h) was achieved significantly more often in high‐volume centers (45.5% vs 24.2%; P = .002). Conclusions Our study showed significantly better continence results and lower revision rates at high‐volume centers, confirming earlier results that are still true in this decade. We, therefore, recommend surgery for male incontinence at qualified centers.

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Section: Discussionmentioning

confidence: 99%

High/low‐volume center experience predicts outcome of AMS 800 in male stress incontinence: Results of a large middle European multicenter case series

Queissert

Hüsch

Kretschmer

et al. 2020

Neurourology and Urodynamics

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“…Table 1 shows the pooled data of 1515 patients from the 10 studies with SSP ATOMS that focused on the evaluation of results [ 12 , 24 , 25 , 26 , 33 , 34 , 35 , 36 , 37 , 38 ].…”

Section: Atoms Resultsmentioning

confidence: 99%

Update on Adjustable Trans-Obturator Male System (ATOMS) for Male Incontinence after Prostate Cancer Surgery

et al. 2023

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(1) Background: The adjustable trans-obturator male system (ATOMS) is a surgical device developed to treat post-prostatectomy incontinence (PPI) after prostate cancer treatment. We review the current literature on this anti-incontinence device with the intention of assessing the effectiveness, safety and duration of the silicone-covered scrotal port (SSP) ATOMS, the only generation of the device that is currently available. (2) Material and Methods: Non-systematic literature review is performed. Forty-eight full-text articles are assessed for eligibility. Case reports, expert opinions or commentaries without specific data reported (n = 6), studies with patients who underwent intervention before 2014 (IP or SP ATOMS; n = 10), and studies with incontinence after transurethral resection of the prostate (TUR-P; n = 2) are excluded for analysis. Thirty studies with SSP ATOMS are included in a qualitative synthesis that incorporates systematic reviews (n = 3), articles partially overlapping with other previously published studies (e.g., follow-up or series updates; n = 9), and studies focusing on specific populations (n = 8). Only articles revealing outcomes of SSP ATOMS were included in the quantitative synthesis of results (n = 10). (3) Results: the pooled data of 1515 patients from the 10 studies with SSP ATOMS confirmed very satisfactory results with this device after adjustment: dry rate: 63–82%, improved rate: 85–100%, complication rate: 7–33%, device infection rate: 2.7–6.2% and explant rate: 0–19%. The durability of the device is reassuring, with 89% of devices in place 5 years after implantation. (4) Conclusion: Despite the absence of randomized controlled studies, the literature findings confirm results of SSP ATOMS appear equivalent to those of artificial urinary sphincters (AUSs) in terms of continence, satisfaction and complications, but with a lower rate of revision in the long-term. A prospective study identified that patients with daily pad test results <900 mL and a Male Stress Incontinence Grading Scale (MSIGS) of not 4 (i.e., early and persistent stream or urine loss) are the best candidates. Future studies centered on the elder population at higher risk of impaired cognitive ability and in patients including radiation as prostate cancer treatment are needed.

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“…Published studies showed close to two-thirds of patients were dry 58 – 60 with the mean adjustments per patient expected up to four times. 61 , 62 However, device removal following infection is not uncommon and has been reported to be as high as a third of cases (30,6%).…”

Section: Clinical Findingsmentioning

confidence: 99%

Contemporary male slings for stress urinary incontinence: advances in device technology and refinements in surgical techniques

Chung

2023

Therapeutic Advances in Urology

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Synthetic male sling (MS) is considered an effective surgical treatment to restore male stress urinary incontinence. The modern MS can be categorised into adjustable or non-adjustable types, while the surgical techniques can be divided into retropubic or transobturator approaches. This narrative review paper evaluates the contemporary MS devices in the current commercial market regarding clinical outcomes and refinements in surgical techniques. Scientific advances in device design and technology, coupled with further surgical refinements will enhance the clinical outcomes and improve the safety profile of MS surgery. The newer generation of modern MS not only provides direct compression of the bulbar urethra but also allows for proximal urethral relocation by realigning the mobile sphincter complex to provide further urethral sphincter complex coaptation. Strict patient selection, use of MS with proven clinical records, adherence to safe surgical principles and judicious postoperative care are critical to ensure a high continence rate, good patient satisfaction and low postoperative complications.

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

Cited by 5 publications

References 29 publications

High/low‐volume center experience predicts outcome of AMS 800 in male stress incontinence: Results of a large middle European multicenter case series

High/low‐volume center experience predicts outcome of AMS 800 in male stress incontinence: Results of a large middle European multicenter case series

Update on Adjustable Trans-Obturator Male System (ATOMS) for Male Incontinence after Prostate Cancer Surgery

Contemporary male slings for stress urinary incontinence: advances in device technology and refinements in surgical techniques

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