Vol. 45 (1): 127-136, January – February, 2019
Alessandro Giammò 1, Enrico Ammirati 2, Annarita Tullio 3,Gianni Bodo 1, Alberto Manassero 1, Paolo Gontero 2, Roberto Carone 1
1 Department of Neuro-Urology, CTO – Spinal Unit, Città della Salute e della Scienza di Torino, Turin, Italy; 2 Department of Urology, Molinette Hospital, Città della Salute e della Scienza di Torino, Turin, Italy; 3 Hygiene and Clinical Epidemiology Unit, S. Maria della Misericordia University Hospital of Udine, Udine, Italy
Purpose: The aim of our study is to evaluate the efficacy and safety of ATOMS® system for the treatment of postoperative male stress urinary incontinence (SUI).
Materials and methods: We retrospectively evaluated all patients treated at our institution for postoperative male SUI with ATOMS® implant. We excluded patients with low bladder compliance (< 20 mL / cmH2O), uncontrolled detrusor overactivity, detrusor underactivity (BCI < 100), urethral or bladder neck stricture and low cystometric capacity (< 200 mL).
Results: From October 2014 to July 2017 we treated 52 patients, mean age 73.6 years. Most of them (92.3%) had undergone radical prostatectomy, 3.85% simple open pros¬tatectomy, 3.85% TURP; 28.8% of patients had undergone urethral surgery, 11.5% ad¬juvant radiotherapy; 57.7% had already undergone surgical treatment for urinary in¬continence. The average24 hours pad test was 411.6 g (180 – 1100). The mean follow-up was 20.1 months (8.1 – 41.5) 30.8% of patients were dry, 59.6% improved ≥ 50%, 7.7% improved < 50% and 1.9% unchanged. In total 73.1% reached social continence. There was a significant reduction of the 24 hours pad test and ICIQ – UI SF scores (p < 0.01).
In the postoperative follow-up we detected complications in 8 patients (19%): 5 cases of displacement of the scrotal port, in 2 cases catheterization difficulties, one case of epididimitis and concomitant superficial wound infection; no prosthesis infection, nor explants.
Radiotherapy, previous urethral surgery,previous incontinence surgery were not statistically related to social continence rates (p 0.65;p 0.11;p 0.11).
Conclusions: The ATOMS® system is an effective and safe surgical treatment of mild and moderate male postoperative SUI with durable results in the short term.
Keywords: Suburethral Slings; Urinary Incontinence; Surgical Procedures, Operative