Alessandro Giammò1, Enrico Ammirati2, Annarita Tullio3, Giuseppe Morgia4, Sandro Sandri5, Carlo Introini6, Giorgio Canepa6, Luca Timossi7, Cristina Rossi8, Cristina Mozzi8, Roberto Carone1. 1. CTO/Unipolar Spinal Cord Unit, Department of Neuro-Urology, Città della Salute e della Scienza, Turin, Italy. 2. CTO/Unipolar Spinal Cord Unit, Department of Neuro-Urology, Città della Salute e della Scienza, Turin, Italy - ammirati.enrico@gmail.com. 3. Department of Clinical Hygiene And Epidemiology, S. Maria della Misericordia University Hospital, Udine, Italy. 4. Department of Urology, Vittorio Emanuele University Hospital, Catania, Italy. 5. ASST Ovest Milanese, Fornaroli Hospital, Magenta, Milan, Italy. 6. Department of Urology, Galliera Hospitals, Genoa, Italy. 7. Department of Urology, International Evangelical Hospital of Genoa, Genoa, Italy. 8. Department of Urology, ASL Alessandria, San Giacomo Hospital, Novi Ligure, Alessandria, Italy.
Abstract
BACKGROUND: The aim of this study was to evaluate efficacy and safety of the ATOMS system for the treatment of postoperative stress urinary incontinence (SUI). METHODS: We included all consecutive male patients referring for postoperative SUI and treated with ATOMS system from June 2013 to July 2017. Patients received anamnesis, 24 h Pad Test, Pad count, physical examination, urodynamic evaluation, ICIQ-UI SF questionnaire. We excluded patients with low bladder capacity and compliance, uncontrolled detrusor overactivity. RESULTS: We treated 98 patients with median age of 70.21±10.02 years. The most common cause of SUI was open radical prostatectomy in 79 patients. Ten patients had undergone urethrotomy, 7 bladder neck incision, 14 adjuvant radiotherapy. Thirty-nine patients suffered of mild incontinence (24 h Pad Test <200 g), 49 moderate incontinence (200-400 g), 10 severe incontinence (≥400 g). Thirty-one patients underwent previous incontinence surgery: 29 ProACT, 3 artificial urinary sphincters (in 2 cases both devices), 1 bulking agents and subsequent male sling. Median follow-up was 21.5 months. We had a significant reduction of mean 24 h Pads Test, pad count and ICIQ-UI SF questionnaire (P<0.01). At last follow-up 47.96% of patients were dry and 79.59% reached social continence. A high incontinence grade, adjuvant radiotherapy, previous urethral surgery and incontinence surgery have been associated with lower continence results. We had complications in 33 patients (33.7%). The device was removed in 4 cases due to scrotal port erosion and in one case due to persistent pain. CONCLUSIONS: The ATOMS system seems to be an effective and safe surgical treatment for postoperative male SUI.
BACKGROUND: The aim of this study was to evaluate efficacy and safety of the ATOMS system for the treatment of postoperative stress urinary incontinence (SUI). METHODS: We included all consecutive male patients referring for postoperative SUI and treated with ATOMS system from June 2013 to July 2017. Patients received anamnesis, 24 h Pad Test, Pad count, physical examination, urodynamic evaluation, ICIQ-UI SF questionnaire. We excluded patients with low bladder capacity and compliance, uncontrolled detrusor overactivity. RESULTS: We treated 98 patients with median age of 70.21±10.02 years. The most common cause of SUI was open radical prostatectomy in 79 patients. Ten patients had undergone urethrotomy, 7 bladder neck incision, 14 adjuvant radiotherapy. Thirty-nine patients suffered of mild incontinence (24 h Pad Test <200 g), 49 moderate incontinence (200-400 g), 10 severe incontinence (≥400 g). Thirty-one patients underwent previous incontinence surgery: 29 ProACT, 3 artificial urinary sphincters (in 2 cases both devices), 1 bulking agents and subsequent male sling. Median follow-up was 21.5 months. We had a significant reduction of mean 24 h Pads Test, pad count and ICIQ-UI SF questionnaire (P<0.01). At last follow-up 47.96% of patients were dry and 79.59% reached social continence. A high incontinence grade, adjuvant radiotherapy, previous urethral surgery and incontinence surgery have been associated with lower continence results. We had complications in 33 patients (33.7%). The device was removed in 4 cases due to scrotal port erosion and in one case due to persistent pain. CONCLUSIONS: The ATOMS system seems to be an effective and safe surgical treatment for postoperative male SUI.
Authors: Javier C Angulo; Sonia Ruiz; Martín Lozano; Ignacio Arance; Miguel Virseda; David Lora Journal: World J Urol Date: 2020-06-11 Impact factor: 4.226
Authors: Emily M Yura; Christopher J Staniorski; Jason E Cohen; Liqi Chen; Ashima Singal; Francisco E Martins; Matthias D Hofer Journal: J Clin Med Date: 2021-12-13 Impact factor: 4.241