Treatment of stress urinary incontinence after prostatectomy with the adjustable transobturator male system (ATOMS®) with preattached scrotal port

Esquinas, Cristina; Arance, I.; Pamplona, Javier; Moraga, A.; Dorado, Juan F.; Angulo, Javier

doi:10.1016/j.acuroe.2018.06.005

Cited by 8 publications

(13 citation statements)

References 27 publications

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“…We confirm the major complications that can be anticipated for AUS are urethral erosion, urethral atrophy and mechanical failure [5,6,22]. On the other hand, the most likely complications for ATOMS are port erosion, infection and postoperative pain [9,15,23,24]. One of our findings is that pain in the early postoperative period is very similar with both devices.…”

Section: Discussionsupporting

confidence: 80%

“…ATOMS (Agency for Medical Innovations GmbH, Feldkirch, Austria) is composed of a central silicone cushion connected to a port and a two-arm mesh anchored through the transobturator passage on both sides, thus compressing the bulbar urethra only on its ventral side and preserving urethral vascularization. It requires no manipulation by the patient and can be adjusted postoperatively in the office by a simple port injection without need for anaesthesia [8,9]. A meta-analysis revealed treatment with ATOMS resulted in 67% dryness, 90% improvement and 5.8% explantation [10].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of a Series of Patients with Post-Prostatectomy Incontinence Treated with an Adjustable Transobturator Male System or Artificial Urinary Sphincter

et al. 2020

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Introduction: A prospective evaluation of outcomes in a series of patients with post-prostatectomy incontinence (PPI) treated with two different devices is presented. Methods: Consecutive patients with PPI underwent interventions with an adjustable transobturator male system (ATOMS) or artificial urinary sphincter (AUS). Decisions were based on patient preference after physician counselling. Patient characteristics and operative and postoperative parameters including dryness, satisfaction, complications, revision and device durability were evaluated.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Outcomes of a Series of Patients with Post-Prostatectomy Incontinence Treated with an Adjustable Transobturator Male System or Artificial Urinary Sphincter

et al. 2020

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“…The complications reported in studies with old-generation devices (mainly inguinal port [IP]) have little to do with studies that predominantly or exclusively report pre-attached scrotal port devices [14,30,31]. One study with the first-generation inguinal titanium port device described a high complication and explantation rate, but patient satisfaction was very high and 56% of the patients in this cohort would recommend the system to their best friends [32].…”

Section: Discussionmentioning

confidence: 99%

Adjustable Transobturator Male System after Failed Surgical Devices for Male Stress Urinary Incontinence: A Feasibility Study

et al. 2018

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Objectives: Feasibility study to evaluate the efficacy and safety of Adjustable Transobturator Male System (ATOMS) after failed surgical devices for male stress urinary incontinence (SUI). Materials and Methods: Thirty patients were implanted with ATOMS after they were implanted with surgical device/s previously. SUI severity was evaluated as dryness (0–1 pad/day), mild (2 pads/day), moderate (3–5 pads/day), or severe (≥6 pads/day). Change in pad-test and pad-count after adjustment, operative parameters, patient satisfaction, and number and grade of complications were investigated. Results: Previous failed treatment methods were artificial urinary sphincter (AUS; n = 19), Advance (n = 10), and Virtue (n = 1). Six cases had multiple previous treatments. Preoperative SUI was mild 6 (20%), moderate 11 (36.7%), and severe 13 (43.3%). Median pad-test decreased from 435 mL baseline to 10 mL after adjustment and pad-count from 4 to 0. Dry-rate was 76.7 and 83.3% declared satisfied. Postoperative SUI distribution was mild in 3 (10%) and moderate in 4 (13.3%). No patient had urinary retention after catheter removal. Complications presented in 4 (13.3%; 3 grade-I, 1 grade-II). After a median of 24 months follow-up, no system experienced infection or urethral erosion and 1 (3.3%) was removed for inefficacy. Conclusion: Based on short-term efficacy and patient satisfaction, ATOMS can be a realistic alternative for male SUI after other failed systems, including AUS. The absence of urethral erosion and limited infective problems makes this alternative attractive for cases with previous failed treatments.

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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%

“…Table 1 also reveals the complication rate registered in 9 of 10 studies included in the quantitative synthesis, which ranged from 7 to 33% and were uniformly registered following Clavien Dindo classification within 90 days postoperatively [ 12 , 24 , 25 , 26 , 33 , 35 , 36 , 37 , 38 ]. The percent of explant rate ranged between 0–19%, depending mainly on the length of follow-up and in different patterns of rescue treatment proposed.…”

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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Treatment of stress urinary incontinence after prostatectomy with the adjustable transobturator male system (ATOMS®) with preattached scrotal port

Cited by 8 publications

References 27 publications

Outcomes of a Series of Patients with Post-Prostatectomy Incontinence Treated with an Adjustable Transobturator Male System or Artificial Urinary Sphincter

Outcomes of a Series of Patients with Post-Prostatectomy Incontinence Treated with an Adjustable Transobturator Male System or Artificial Urinary Sphincter

Adjustable Transobturator Male System after Failed Surgical Devices for Male Stress Urinary Incontinence: A Feasibility Study

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

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