Department of Urology and Andrology, St John of God Hospital, Teaching Hospital of the Medical University of Vienna, Vienna, Austria.
J Urol. 2012 Mar;187(3):956-61. doi: 10.1016/j.juro.2011.10.138. Epub 2012 Jan 20.
We report on our initial experience in terms of efficacy and safety with a new, self-anchoring adjustable transobturator male system (A.M.I.® ATOMS System) for the treatment of male stress urinary incontinence after prostate surgery.
In this prospective, nonrandomized single center study conducted between March and December 2009, patients with stress urinary incontinence secondary to prostatic surgery were treated with the ATOMS device. Urethroscopy, filling and voiding cystometry were performed preoperatively for all patients. In addition, incontinence symptoms were assessed, and a physical examination, 24-hour pad test and 24-hour pad count were performed before and after surgery.
A total of 38 patients were included in the study (36 after radical prostatectomy, 2 after benign prostatic hyperplasia surgery). No intraoperative complications occurred. Mean number of adjustments during followup was 3.97 (range 0 to 9). At a mean followup of 16.9 months (range 13 to 21) the overall success rate was 84.2%. Of the successful cases 60.5% were considered dry (0 to 1 pad and less than 15 ml/24-hour pad test) and 23.7% improved (more than 1 pad per 24 hours but more than 50% decrease in pad use and less than 100 ml per 24-hour pad test). In 15.8% of the patients the treatment was considered to have failed (more than 2 pads daily and greater than 100 ml on 24-hour pad test).
The treatment of male stress urinary incontinence with the ATOMS is safe and effective. It is an excellent first or second line treatment for mild to moderate male stress urinary incontinence, even after external irradiation. The option of long-term, minimally invasive adjustment to respond to patient needs is a significant advantage of this new implant.
我们报告一种新的、自锚定可调经闭孔男性系统（A.M.I.®ATOMS 系统）治疗前列腺手术后男性压力性尿失禁的初步疗效和安全性。
在 2009 年 3 月至 12 月期间进行的这项前瞻性、非随机单中心研究中，对继发于前列腺手术的压力性尿失禁患者采用 ATOMS 装置进行治疗。所有患者均行术前尿道镜检查、充盈和排空膀胱测压。此外，在手术前后对尿失禁症状进行评估，并进行体格检查、24 小时垫试验和 24 小时垫计数。
共有 38 例患者纳入研究（根治性前列腺切除术 36 例，良性前列腺增生症手术 2 例）。术中无并发症发生。随访期间平均调整次数为 3.97 次（范围 0 至 9 次）。平均随访 16.9 个月（范围 13 至 21 个月）后，总成功率为 84.2%。在成功的病例中，60.5%的患者被认为是干燥的（0 至 1 片，24 小时垫试验少于 15 毫升），23.7%的患者得到改善（每天超过 1 片，但垫用量减少超过 50%，24 小时垫试验少于 100 毫升）。在 15.8%的患者中，治疗被认为失败（每天超过 2 片，24 小时垫试验超过 100 毫升）。
ATOMS 治疗男性压力性尿失禁安全有效。对于轻度至中度男性压力性尿失禁，即使在外部照射后，它也是一种极好的一线或二线治疗选择。这种新植入物的一个显著优势是可以长期进行微创调整以满足患者的需求。
