Five-year experience with the adjustable transobturator male system for the treatment of male stress urinary incontinence: a single-center evaluation.
BACKGROUND
We report on our 5-year experience with the adjustable transobturator male system (ATOMS®, A.M.I., Feldkirch, Austria).


METHODS
Between 10-2009 and 10-2014, 54 patients received an ATOMS. The mean follow-up of this retrospective observational trial was 27.5 ± 18.4 (2.3-59) months. Within each follow-up, the following were evaluated: micturition protocol, 24-h pad count, uroflowmetry and residual volume. Statistical analysis was performed with SigmaPlot® 11.0, p < 0.05 considered as significant.


RESULTS
Stress urinary incontinence (SUI) I°, II° and III° was seen in 1 (1.9 %), 16 (29.6 %) and 37 patients (68.5 %), respectively. In summary, 48.1 % of the patients became "dry" (0-"safty pad"/day), while 29.6 % achieved at least an "improvement" of about more than 50 % (1-2 pads/day), which corresponds to an overall success rate of 77.7 %. The mean number of pads/day decreased from 7.7 to 1.6. Regarding the initial degree of SUI, patients with mild or moderate incontinence had a significantly better outcome (p = 0.002, 95 % CI 0.9066 to 2.760). Postoperative complications were scaled according to the Clavien classification, in which we have seen 4 grade I-, 1 grade IIIa- and 9 grade IIIb-complications (overall 25.9 %). The evaluation of quality of life by ICIQ-SF showed a significant improvement (p = 0.0001, 95 % CI -14.56 to -11.75).


CONCLUSION
The treatment of male SUI using the ATOMS incontinence system achieved the best results in patients with mild and moderate incontinence. For severe incontinent patients, the system represents an efficient alternative.
['Mühlstädt|Sandra|S|', 'Friedl|Alexander|A|', 'Mohammed|Nasreldin|N|', 'Schumann|André|A|', 'Weigand|Karl|K|', 'Kawan|Felix|F|', 'Göllert|Christian|C|', 'Kahlert|Christin|C|', 'Theil|Gerit|G|', 'Fischer|Kersten|K|', 'Fornara|Paolo|P|']
D000368:Aged D000369:Aged, 80 and over D005500:Follow-Up Studies D006801:Humans D008297:Male D008875:Middle Aged D011183:Postoperative Complications D019736:Prostheses and Implants D012189:Retrospective Studies D053825:Suburethral Slings D016896:Treatment Outcome D014550:Urinary Incontinence, Stress D013521:Urologic Surgical Procedures, Male
Adjustability Male stress urinary incontinence ATOMS Artificial implants Sphincter cushions