Patient satisfaction with adjustable transobturator male system in the Iberian multicenter study.
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.
['Angulo|Javier C|JC|http://orcid.org/0000-0002-1735-8792', 'Arance|Ignacio|I|', 'Ojea|Antonio|A|', 'Carballo|Manuel|M|', 'Rodríguez|Andrés|A|', 'Pereira|Javier|J|', 'Rebassa|Miguel|M|', 'Teyrouz|Antoine|A|', 'Escribano|Gregorio|G|', 'Teba|Fernando|F|', 'Madurga|Blanca|B|', 'Martins|Francisco E|FE|', 'Cruz|Francisco|F|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D006801:Humans D008297:Male D008875:Middle Aged D000071066:Patient Reported Outcome Measures D017060:Patient Satisfaction D011474:Prosthesis Design D012189:Retrospective Studies D053825:Suburethral Slings D014549:Urinary Incontinence D013521:Urologic Surgical Procedures, Male
Satisfaction Adjustable transobturator male system Patient-reported outcome measurement Male stress urinary incontinence