ArticleCanadian Urological Association journal = Journal de l'Association des urologues du Canada2025
Analyzing outcomes of the adjustable transobturator male system for post-prostatectomy incontinence and its relationship with detrusor overactivity and radiotherapy with the help of urodynamics.
Article in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe adjustable transobturator male system (ATOMS) has recently garnered attention for its surgical simplicity and suitability for mild post-prostatectomy incontinence (PPI). This retrospective study investigated the outcomes of patients who received ATOMS, including subgroup analyses of individuals with overactive bladder (OAB) or previous radiotherapy.
methodsA retrospective cohort study was conducted on 104 patients who received ATOMS. To classify mild, moderate, and severe incontinence, preoperative severity was defined as <2 pads per day (PPD), 2-4 PPD, and >4 PPD, based on the 24-hour pad count and/or <200 g, 200-400 g, and >400 g, based on the 24-hour pad-test (24h-PT). Postoperative "dry" status referred to ≤1 pad/day, while "improved" or "very much improved" indicated a pad reduction of ≥50% or ≥75%, respectively. Patients who reported "much better" or "very much better" on the Patient Global Impression of Improvement-Incontinence (PGI-I) questionnaire were considered "satisfied."
resultsThirteen patients were excluded for insufficient followup, leaving 91 patients (mean age 70 years, mean followup 42 months). Most were classified as moderately (44%) or severely (55%) incontinent, with a median of four pads/day and a mean 24-hour pad test of 351 g preoperatively. At final followup, the median pad count was 0.5; 89% improved overall, 58% became dry, and 91% were satisfied. Complications occurred in 27% (five grade III). Patients with prior radiotherapy (n=29) exhibited lower dryness (55% vs. 79%) and improvement (83% vs. 92%), alongside more adjustments and higher total instilled volume. There were no other significant subgroup differences.
conclusionsATOMS appears to be a safe and effective device for PPI, including for moderate to severe incontinence, although radiotherapy may affect efficacy.
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