ADJUSTABLE TRANSOBTURATOR MALE SYSTEM (ATOMS (R)) - A NOVEL TREATMENT OPTION IN MEN WITH STRESS URINARY INCONTINENCE: THE FIRST EXPERIENCE IN THE UNITED KINGDOM

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy II (PD37)1 Apr 2019PD37-03 ADJUSTABLE TRANSOBTURATOR MALE SYSTEM (ATOMS®) – A NOVEL TREATMENT OPTION IN MEN WITH STRESS URINARY INCONTINENCE: THE FIRST EXPERIENCE IN THE UNITED KINGDOM Bob Yang*, Clare Jelley, and Steve Foley Bob Yang*Bob Yang* More articles by this author , Clare JelleyClare Jelley More articles by this author , and Steve FoleySteve Foley More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556359.39114.aaAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Male Stress Urinary Incontinence (SUI) is a debilitating condition, resulting often from radical prostatectomies. Current treatments include bulking agents, urethral slings and artificial sphincters. However efficacy is inconsistent, especially in severe incontinence where bulking agents and conventional slings fail. Furthermore artificial sphincters involve major surgery. ATOMS (A.M.I., Austria) is a new 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 experience in the United Kingdom of using ATOMS in treating men who developed SUI post prostate surgery, including patients who have failed previous conventional SUI surgical treatment. METHODS: Since 2015, 40 men (average age 70.4, range 50 - 81) with SUI post-surgery underwent insertion of ATOMS under general anaesthetic. 37 (93%) developed stress incontinence following radical prostatectomy. Follow-up was for up to 3 years (average - 17 months) via a specialist clinic. RESULTS: 34/40 (85%) post ATOMS were dry (defined as using up to a maximum of one pad for reassurance only). 22/40 (55%) achieved dryness within 6 months (range 1 - 24 months). 15 (44%) of these newly dry patients had previously failed other surgical incontinence treatments (Urethral Bulking agents, Trans-obturator Tapes). Average pad use (per day) decreased from 3.2 to 0.6. 18/34 (53%) of patients achieved dryness without needing any top-ups. 5 required 1 top up. 5 required 2 top ups. 6 required 4 top ups. 5/6 (83%) of the “non-dry” patients had previously received radiotherapy. However ATOMS still reduced pad usage by 72% in these post-radiotherapy patients. Average pain levels 2-3 weeks post-op was 2.5 out of 10. This decreased to 0.5 out of 10 by 6-8 weeks. Complications were as follows: 2 patients developed superficial infections requiring antibiotics alone. 1 had erosion of inflator mechanism requiring reinsertion under general anaesthetics. 1 developed perineal pain requiring balloon deflation. CONCLUSIONS: ATOMS is a novel safe and effective treatment for men with SUI post surgery, including radical prostatectomy, and also in patients where other surgical therapies have failed. Its efficacy is hindered by previous radiotherapy, but is still successful at reducing overall pad usage. Further studies on ATOMS in larger groups of patients with longer follow-ups are required to confirm these positive outcomes. Source of Funding: None Reading, United Kingdom© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e662-e662 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bob Yang* More articles by this author Clare Jelley More articles by this author Steve Foley More articles by this author Expand All Advertisement PDF downloadLoading ...