Javier C Angulo1, Ignacio Arance2, Antonio Ojea3, Manuel Carballo3, Andrés Rodríguez4, Javier Pereira4, Miguel Rebassa5, Antoine Teyrouz5, Gregorio Escribano6, Fernando Teba7, Blanca Madurga8, Francisco E Martins9, Francisco Cruz10. 1. Departamento Clínico, Hospital Universitario de Getafe, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Carretera de Toledo Km 12.5, Getafe, 28905, Madrid, Spain. jangulo@futurnet.es. 2. Departamento Clínico, Hospital Universitario de Getafe, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Carretera de Toledo Km 12.5, Getafe, 28905, Madrid, Spain. 3. Hospital Alvaro Cunqueiro, Vigo, Spain. 4. Hospital Arquitecto Marcide, Ferrol, Spain. 5. Hospital Son Llatzer, Palma de Mallorca, Spain. 6. Hospital Universitario Gregorio Marañón, Madrid, Spain. 7. Hospital Universitario de la Princesa, Madrid, Spain. 8. Hospital Universitario Puerta del Mar, Cádiz, Spain. 9. Hospital de Santa María, Lisbon, Portugal. 10. Centro Hospitalar São João, Oporto, Portugal.
Abstract
BACKGROUNDS: Patient-reported outcome measurements are important for urinary incontinence. We analyze self-assessed patient satisfaction and define the clinical profile of patient with highest satisfaction with the adjustable transobturator male system (ATOMS). METHODS: Patient perception of results was evaluated in a series of 181 patients after ATOMS adjustment. Baseline incontinence severity was defined in pads-per-day (PPD) as mild (2), moderate (3-5) or severe (≥ 6), and dryness as use of none or one security PPD. Post-operative pain at discharge was evaluated by 0-10 visual analogue scale and complications by Clavien-Dindo classification. Multivariate analysis was performed to anticipate "very much better" than baseline perception on patient global impression of improvement and a predictive nomogram was developed. RESULTS: Dryness was achieved in 80.7% (94.9% mild, 80.8% moderate and 65.8% severe groups). Mean pad-test and pad-count decrease with respect to baseline was 458 ± 330 ml and 3.2 ± 1.9 PPD, respectively (both p < .0001). Complications presented in 25 (13.8%). The proportion of patients that self-declared satisfied with the procedure was 87.1%; 90.6% perceived their situation "better" and 48.1% "very much better" than before. Multivariate analysis revealed best perception is defined by dryness after adjustment (p < .0001), baseline severity of incontinence (p = .007), low post-operative pain at discharge (p = .0018) and lack of complications (p = .007). CONCLUSIONS: Self-assessed satisfaction with ATOMS is very high. Factors that predict best perception of improvement include dryness, baseline SUI severity, presence of complications and pain level during admission. Radiotherapy and device generation were not independent predictors. A nomogram to predict patients that are completely satisfied with ATOMS after adjustment is proposed.
BACKGROUNDS: Patient-reported outcome measurements are important for urinary incontinence. We analyze self-assessed patient satisfaction and define the clinical profile of patient with highest satisfaction with the adjustable transobturator male system (ATOMS). METHODS:Patient perception of results was evaluated in a series of 181 patients after ATOMS adjustment. Baseline incontinence severity was defined in pads-per-day (PPD) as mild (2), moderate (3-5) or severe (≥ 6), and dryness as use of none or one security PPD. Post-operative pain at discharge was evaluated by 0-10 visual analogue scale and complications by Clavien-Dindo classification. Multivariate analysis was performed to anticipate "very much better" than baseline perception on patient global impression of improvement and a predictive nomogram was developed. RESULTS: Dryness was achieved in 80.7% (94.9% mild, 80.8% moderate and 65.8% severe groups). Mean pad-test and pad-count decrease with respect to baseline was 458 ± 330 ml and 3.2 ± 1.9 PPD, respectively (both p < .0001). Complications presented in 25 (13.8%). The proportion of patients that self-declared satisfied with the procedure was 87.1%; 90.6% perceived their situation "better" and 48.1% "very much better" than before. Multivariate analysis revealed best perception is defined by dryness after adjustment (p < .0001), baseline severity of incontinence (p = .007), low post-operative pain at discharge (p = .0018) and lack of complications (p = .007). CONCLUSIONS: Self-assessed satisfaction with ATOMS is very high. Factors that predict best perception of improvement include dryness, baseline SUI severity, presence of complications and pain level during admission. Radiotherapy and device generation were not independent predictors. A nomogram to predict patients that are completely satisfied with ATOMS after adjustment is proposed.
Entities:
Keywords:
Adjustable transobturator male system; Male stress urinary incontinence; Patient-reported outcome measurement; Satisfaction
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