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Minerva Urologica e Nefrologica 2019 Nov 04

DOI: 10.23736/S0393-2249.19.03457-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

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 SC Neuro-Urologia, CTO/Unità Spinale Unipolare, AOU Città della Salute e della Scienza di Torino, Torino, Italy; 2 Dipartimento di Igiene ed Epidemiologia Clinica, Azienda Ospedaliero-Universitaria S. Maria della Misericordia di Udine, Udine, Italy; 3 Dipartimento di Urologia, Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele, Catania, Italy; 4 Asst Ovest Milanese, Ospedale Fornaroli di Magenta, Magenta, Italy; 5 Dipartimento di Urologia, Ente Ospedaliero Ospedali Galliera, Genova, Italy; 6 Dipartimento di Urologia, Ospedale Evangelico Internazionale, Genova, Italy; 7 Dipartimento di Urologia, ASL Alessandria, Ospedale San Giacomo di Novi Ligure, Novi Ligure, Alessandria, Italy


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BACKGROUND: The aim of this study is to evaluate efficacy and safety of the ATOMS system for the treatment of postoperative stress urinary incontinence (SUI).
METHODS: We included all consevutive male patients referring for postoperative SUI and treated with ATOMS system from June 2013 to July 2017. Patients received anamnesis, 24h 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 (24h pad test <200g), 49 moderate incontinence (200-400g), 10 severe incontinence (≥400g). 31 patients underwent previous incontinence surgery: 29 ProACT, 3 artificial urinary sphincter (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 24h 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: Male stress urinary incontinence; Surgical treatment; ATOMS

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