ORIGINAL ARTICLE   Free access

Minerva Urologica e Nefrologica 2020 December;72(6):770-7

DOI: 10.23736/S0393-2249.19.03457-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Implant of ATOMS® system for the treatment of postoperative male stress urinary incontinence: an Italian multicentric study

Alessandro GIAMMÒ ¹, Enrico AMMIRATI ¹ ✉, Annarita TULLIO ², Giuseppe MORGIA ³, Sandro SANDRI ⁴, Carlo INTROINI ⁵, Giorgio CANEPA ⁵, Luca TIMOSSI ⁶, Cristina ROSSI ⁷, Cristina MOZZI ⁷, Roberto CARONE ¹

¹ CTO/Unipolar Spinal Cord Unit, Department of Neuro-Urology, Città della Salute e della Scienza, Turin, Italy; ² Department of Clinical Hygiene And Epidemiology, S. Maria della Misericordia University Hospital, Udine, Italy; ³ Department of Urology, Vittorio Emanuele University Hospital, Catania, Italy; ⁴ ASST Ovest Milanese, Fornaroli Hospital, Magenta, Milan, Italy; ⁵ Department of Urology, Galliera Hospitals, Genoa, Italy; ⁶ Department of Urology, International Evangelical Hospital of Genoa, Genoa, Italy; ⁷ Department of Urology, ASL Alessandria, San Giacomo Hospital, Novi Ligure, Alessandria, Italy

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.

KEY WORDS: Urinary Incontinence, stress; Urologic surgical procedures, male; Urology