MP40-18 5-YEAR EXPERIENCE ON THE ADJUSTABLE TRANSOBTURATOR MALE SYSTEM (ATOMS®) IN UK MEN WITH STRESS URINARY INCONTINENCE

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I (MP40)1 Apr 2020MP40-18 5-YEAR EXPERIENCE ON THE ADJUSTABLE TRANSOBTURATOR MALE SYSTEM (ATOMS®) IN UK MEN WITH STRESS URINARY INCONTINENCE Bob Yang*, Piotr Kowalski, Claire Jelley, and Steve Foley Bob Yang*Bob Yang* More articles by this author , Piotr KowalskiPiotr Kowalski More articles by this author , Claire JelleyClaire Jelley More articles by this author , and Steve FoleySteve Foley More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000889.018AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Male Stress Urinary Incontinence (SUI) is a debilitating condition, resulting often from radical prostatectomies. Commonly conventional slings cannot be easily adjusted post-op or over time and are ineffective in severe incontinence. Artificial sphincters involve major surgery. ATOMS (A.M.I.,Austria) is an adjustable sling consisting of a balloon mechanism inflated via a buried port-catheter allowing ongoing pressure adjustments in an outpatient setting, without needing anaesthetics. We present the first 5-year experience in the UK of using ATOMS in treating men with SUI. METHODS: 70 men (average age 70.3, range 50 - 81) with SUI post-surgery underwent insertion of ATOMS. 66 (94%) had radical prostatectomy. 11 had previously undergone a conventional sling and 14 had urethral bulking agents injected in the past.Follow-up was for up to 5 years. RESULTS: 51/70 (73%) post ATOMS are dry (defined as using up to a maximum of one pad for reassurance only). 30/51 (59%) achieved dryness within 6 months (range 1-24 months). Average pad usage was 3.3 pre-op and 0.8 post-op. Of the ″non-dry″ patients, 13/19 are currently undergoing ongoing adjustments. In the 6 patients where ATOMS have been ineffective, 4 had undergone radiotherapy previously. However, pad usage still reduced by 60% in these post-radiotherapy patients. Average pain levels 2-3 weeks post-op was 2.5/10. This decreased to 0.5/10 by 6-8 weeks. There were 8 (11%) complications: 4 cases of retention, 2 wound infections treated medically, 1 balloon mechanism erosion requiring re-implantation and 1 case of infected device requiring removal. CONCLUSIONS: ATOMS appears effective in treating men with SUI, including when other surgical therapies have failed. Its efficacy is hindered by radiotherapy, but still reduced overall pad usage. Further studies on ATOMS in larger numbers with longer follow-ups are required to confirm these positive outcomes. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e593-e593 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bob Yang* More articles by this author Piotr Kowalski More articles by this author Claire Jelley More articles by this author Steve Foley More articles by this author Expand All Advertisement PDF downloadLoading ...