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01-01-2017 | Original Article

Five-year experience with the adjustable transobturator male system for the treatment of male stress urinary incontinence: a single-center evaluation

Authors: Sandra Mühlstädt, Alexander Friedl, Nasreldin Mohammed, André Schumann, Karl Weigand, Felix Kawan, Christian Göllert, Christin Kahlert, Gerit Theil, Kersten Fischer, Paolo Fornara

Published in: World Journal of Urology | Issue 1/2017

Abstract

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.

Tikkinen KAO, Agarwal A, Griebling TL (2013) Epidemiology of male urinary incontinence. Curr Opin Urol 23:502–508CrossRefPubMed

Rehder P, Haab F, Cornu JN, Gozzi C, Bauer RM (2012) Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow up. Eur Urol 62:140–145CrossRefPubMed

Serra A, Folkersma L, Domínguez-Escrig JL, Gómez-Ferrer A, Rubio-Briones J, Solsona Narbón E (2013) AdVance/AdVance XP transobturator male slings: preoperative degree of incontinence as predictor of surgical outcome. Urology 81:1034–1039CrossRef

Hübner WA, Gallistl H, Rutkowski M, Huber ER (2010) Adjustable bulbourethral male sling: experience after 101 cases of moderate-to-severe male stress urinary incontinence. BJU Int 107:777–782CrossRefPubMed

Romano SV, Huebner W, Rocha FT, Vaz FP, Muller V, Nakamura F (2015) A transobturator adjustable system for male incontinence: 30-month follow-up of a multicenter study. Int Braz J Urol 40:781–789CrossRef

Seweryn J, Bauer W, Ponholzer A, Schramek P (2012) Initial experience and results with a new adjustable transobturator male system for the treatment of stress urinary incontinence. J Urol 187:956–961CrossRefPubMed

Hoda MR, Primus G, Fischereder K et al (2013) Early results of a european multicentre experience with a new self-anchoring adjustable transobturator system for treatment of stress urinary incontinence in men. BJU Int 111:296–303CrossRefPubMed

González SP, Cansino JR, Portilla MA, Rodriguez SC, Hidalgo L, De la Peña J (2014) First experience with the ATOMS(^®) implant, a new treatment option for male urinary incontinence. Cent Eur J Urol 67:387–391

Trigo RF, Mendes GC, Ibrahim MA, Arap S, Srougi M (2008) A prospective study evaluating the efficacy of the artificial sphincter AMS 800 for the treatment of postradical prostatectomy urinary incontinence and the correlation between preoperative urodynamic and surgical outcome. Urology 71:85–89CrossRef

10.

Van der Aa F, Drake MJ, Kasyan GR, Petrolekas A, Cornu JN (2013) The artificial sphincter after a quarter of century: a critical systemic review of its use in male non-neurogenic incontinence. Eur Urol 63:681–689CrossRefPubMed

11.

Ficarra V, Novara G, Rosen RC et al (2012) Systemic review and meta-analysis studies reporting urinary continence recovery after robotic-assisted radical prostatectomy. Eur Urol 62:405–417CrossRefPubMed

12.

Tannenbaum C, Corcos J (2008) Outcomes in urinary incontinence: reconciling clinical relevance with scientific rigour. Eur Urol 53:1151–1161CrossRefPubMed

13.

Utomo E, Korfage IJ, Wildhagen MF, Steensma AB, Bangma CH, Blok BFM (2015) Validation of the urogenital distress inventory (UDI-6) and incontinence impact questionnaire (IIQ-7) in a Dutch population. Neurourol Urodyn 34:24–31CrossRefPubMed

14.

Gould D, Kelly D, Goldstone L, Gammon J (2001) Examining the validity of pressure ulcer risk assessment scales: developing and using illustrated patient simulations to collect the data. J Clin Nurs 10:697–706CrossRefPubMed

15.

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications. Ann Surg 244:931–937

16.

Cornel EB, Elzevier HW, Putter H (2010) Can advance transobturator sling suspension cure male urinary postoperative stress incontinence? J Urol 183:1459–1463CrossRefPubMed

17.

Leon P, Chartier-Kastler E, Roupret M, Ambrogi V, Mozer P, Phe V (2015) Long-term functional outcomes after artificial urinary sphincter implantation in men with stress urinary incontinence. BJU Int 115:951–957CrossRefPubMed

18.

Linder BJ, Rivera ME, Ziegelmann MJ, Elliott DS (2015) Long-term outcomes following artificial urinary sphincter placement: an analysis of 1082 cases at mayo clinic. Urology 86:602–607CrossRefPubMed

19.

Bauer RM, Soljanik I, Fullhase C, Buchner A, May F, Stief CG et al (2011) Results of the AdVance transobturator male sling after radical prostatectomy and adjuvant radiotherapy. Urology 77:474–479CrossRefPubMed

20.

Bauer RM, Mayer ME, May F, Gratzke C, Buchner A, Soljanik I et al (2010) Complications of the AdVance transobturator male sling in the treatment of male stress urinary incontinence. Urology 75:1494–1498CrossRefPubMed

21.

Bauer RM, Rutkowski M, Kretschmer A, Casuscelli J, Stief CG, Huebner W (2015) Efficacy and complications of the adjustable sling system ArgusT for male incontinence: results of a prospective 2-center Study. Urology 85:316–320CrossRefPubMed

22.

Shakya S, Wang Y, Mack JA, Maytin EV (2015) Hyperglycemia-induced changes in hyaluronan contribute to impaired skin wound healing in diabetes: review and perspective. Int J Cell Biol 2015:2016CrossRef

Title: Five-year experience with the adjustable transobturator male system for the treatment of male stress urinary incontinence: a single-center evaluation
Authors: Sandra Mühlstädt
Alexander Friedl
Nasreldin Mohammed
André Schumann
Karl Weigand
Felix Kawan
Christian Göllert
Christin Kahlert
Gerit Theil
Kersten Fischer
Paolo Fornara
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 1/2017
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-016-1839-x

At a glance: The STEP trials

Springer Medicine

Five-year experience with the adjustable transobturator male system for the treatment of male stress urinary incontinence: a single-center evaluation

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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