The Adjustable Transobturator Male System in Stress Urinary Incontinence after Transurethral Resection of the Prostate

Objective To investigate the efficacy and safety of the adjustable transobturator male system (ATOMS) in males with stress urinary incontinence (SUI) after transurethral resection of the prostate (TURP).

Materials and methods From a large international prospectively administrated ATOMS-register we identified 49 patients with an ATOMS device due to persistent SUI after TURP. For evaluation males were divided into standard TURP (sTURP) and palliative/post radiation TURP (pTURP). Baseline and follow-up measurements included continence parameters, urodynamics, quality of life surveys (PGI-I, ICIQ-SF) and pain ratings. Dry rate (DR; 0 to 1 security pad/<10ml urine loss), success rate (SR; overall improvement), removals, complications and treatment failures were recorded. A P value <0.05 was considered statistically significant. Results After a median of 34/22 months follow-up and 2-3 adjustments the sTURP/pTURP cohort had 58%/50% DR and 90%/87% SR. Hence, no improvement was seen in 10%/13%. Removal rate was higher in pTURP (50% vs. 10%; p=0.0171) and infection the most common side effect (50%) observed. Neither intra-operative nor Clavien Dindo 4 to 5 adverse events were recorded. In sTURP/pTURP median daily pad count and pad test improved significantly (all p<0.001) and quality of life parameters shifted to high satisfaction level (p<0.001 and p=0.001). Urodynamics remained unchanged and post-operative pain was not an issue. Conclusion The ATOMS device shows promising treatment outcome in patients after TURP and similar efficacy as in post-prostatectomy incontinence. There is no difference in continence outcome between sTURP and pTURP, however, higher removal was found after pTURP which may be important for patient counseling.

Urology. 2017 Jul 13 [Epub ahead of print]

Go “Beyond the Abstract” - Read an article commentary written by the author

Alexander Friedl, Jenifer Schneeweiss, Kathrin Stangl, Sandra Mühlstädt, Roman Zachoval, Stephan Hruby, Therese Gründler, Danijel Kivaranovic, Paolo Fornara, Lukas Lusuardi, Clemens Brössner

Department of Urology, Barmherzige Schwestern Krankenhaus, Vienna, Austria. Electronic address: ., Department of Urology, Barmherzige Schwestern Krankenhaus, Vienna, Austria., Klinik and Poliklinik of Urology and Kidney Transplantation, University Hospital, Martin-Luther-University, Halle-Wittenberg, Halle/Saale, Germany., Thomayer Hospital, Department of Urology and 1st and 3rd Medical Faculty, Charles University, Prague, Czech Republic., Department of Urology, Landeskrankenhaus Salzburg, Paracelsus Medical University, Salzburg, Austria., Department of Statistics and Operations Research, University of Vienna, Vienna, Austria.

email news signup
SUFU MyBladder app