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Five-year experience with the adjustable transobturator male system for the treatment of male stress urinary incontinence: a single-center evaluation

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Abstract

Background

We report on our 5-year experience with the adjustable transobturator male system (ATOMS®, A.M.I., Feldkirch, Austria).

Methods

Between 10-2009 and 10-2014, 54 patients received an ATOMS. The mean follow-up of this retrospective observational trial was 27.5 ± 18.4 (2.3–59) months. Within each follow-up, the following were evaluated: micturition protocol, 24-h pad count, uroflowmetry and residual volume. Statistical analysis was performed with SigmaPlot® 11.0, p < 0.05 considered as significant.

Results

Stress urinary incontinence (SUI) I°, II° and III° was seen in 1 (1.9 %), 16 (29.6 %) and 37 patients (68.5 %), respectively. In summary, 48.1 % of the patients became “dry” (0-“safty pad”/day), while 29.6 % achieved at least an “improvement” of about more than 50 % (1–2 pads/day), which corresponds to an overall success rate of 77.7 %. The mean number of pads/day decreased from 7.7 to 1.6. Regarding the initial degree of SUI, patients with mild or moderate incontinence had a significantly better outcome (p = 0.002, 95 % CI 0.9066 to 2.760). Postoperative complications were scaled according to the Clavien classification, in which we have seen 4 grade I-, 1 grade IIIa- and 9 grade IIIb-complications (overall 25.9 %). The evaluation of quality of life by ICIQ-SF showed a significant improvement (p = 0.0001, 95 % CI −14.56 to −11.75).

Conclusion

The treatment of male SUI using the ATOMS incontinence system achieved the best results in patients with mild and moderate incontinence. For severe incontinent patients, the system represents an efficient alternative.

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Author contributions

S. Mühlstädt involved in protocol development, data collection and analysis, and manuscript writing; A. Friedl involved in manuscript writing; N. Mohammed involved in data collection and manuscript editing; A. Schumann involved in data collection and manuscript editing; K. Weigand involved in manuscript editing; F. Kawan involved in manuscript editing; C. Göllert involved in manuscript editing; C. Kahlert involved in data collection and manuscript editing; G. Theil involved in data analysis and manuscript editing; K. Fischer involved in data analysis and manuscript editing; P. Fornara involved in protocol development, data collection and manuscript editing.

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Authors and Affiliations

  1. Department of Urology and Kidney Transplantation, Martin Luther University, Halle (Saale), Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany

    Sandra Mühlstädt, Nasreldin Mohammed, André Schumann, Karl Weigand, Felix Kawan, Christian Göllert, Christin Kahlert, Gerit Theil, Kersten Fischer & Paolo Fornara

  2. Department of Urology, Hospital Göttlicher Heiland, Vienna, Austria

    Alexander Friedl

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  1. Sandra Mühlstädt
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Correspondence to Sandra Mühlstädt.

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Mühlstädt, S., Friedl, A., Mohammed, N. et al. Five-year experience with the adjustable transobturator male system for the treatment of male stress urinary incontinence: a single-center evaluation. World J Urol 35, 145–151 (2017). https://doi.org/10.1007/s00345-016-1839-x

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  • DOI: https://doi.org/10.1007/s00345-016-1839-x

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