Tauranga Hospital, Tauranga, New Zealand.
Statistics Department, University of Otago, Dunedin, New Zealand.
BJU Int. 2024 Feb;133 Suppl 3:33-38. doi: 10.1111/bju.16118. Epub 2023 Jul 18.
To evaluate the New Zealand clinical experience with the adjustable transobturator male system (ATOMS), a novel continence device in the management of all degrees of stress urinary incontinence (SUI), focusing on efficacy and safety outcomes.
A retrospective review of all ATOMS devices placed between May 2015 and November 2020 was conducted. Severity of SUI was assessed (pad usage) before and after surgery. SUI was defined as mild (1-<3 pads/day), moderate (≥3-5 pads/day) or severe (>5 pads/day). The primary outcome measures considered were the overall success rate (improvement in pad use) and the dry rate (with dry defined as either no or 1 safety pad/day). The number of outpatient adjustments and total filling volumes were also documented in each case. Additionally, we documented incidence and severity of device complications and an analysis of treatment failures.
A total of 140 patients were reviewed, with the most common indication for ATOMS placement being SUI after radical prostatectomy (82.8%). Of the patients included, 53 (37.9%) had previous radiotherapy, with 26 (18.6%) patients having had a previous continence procedure performed. No intraoperative complications were noted. The median preoperative pad usage was 4 pads/day. After a median follow-up of 11 months, median postoperative pad usage reduced to 1 pad/day. In our cohort, 116 patients (82.9%) reported an improvement in their pad usage and were considered successful with 107 (76.4%) patients reporting themselves to be dry. Complications within the first 90-days after surgery occurred in 20 (14.3%) of patients.
Treatment of SUI with the ATOMS is safe and effective. The option of long-term, minimally invasive adjustment to respond to patient needs is a significant advantage.
评估新型经闭孔男性控尿系统（ATOMS）在治疗各种程度压力性尿失禁（SUI）中的新西兰临床经验，重点关注疗效和安全性结果。
对 2015 年 5 月至 2020 年 11 月期间所有放置 ATOMS 装置的患者进行回顾性分析。术前和术后评估 SUI 的严重程度（使用尿垫量）。SUI 定义为轻度（1-<3 片/天）、中度（≥3-5 片/天）或重度（>5 片/天）。主要观察指标包括总体成功率（尿垫使用改善）和干燥率（定义为无或 1 片/天安全垫）。还记录了每个病例的门诊调整次数和总填充量。此外，我们记录了设备并发症的发生率和严重程度，并对治疗失败进行了分析。
共回顾了 140 例患者，ATOMS 放置的最常见指征是根治性前列腺切除术后的 SUI（82.8%）。纳入的患者中，53 例（37.9%）有放疗史，26 例（18.6%）有过先前的控尿手术史。术中无并发症。术前尿垫使用中位数为 4 片/天。中位随访 11 个月后，术后尿垫使用中位数减少至 1 片/天。在我们的队列中，116 例（82.9%）患者报告尿垫使用改善，认为治疗成功，107 例（76.4%）患者报告自己干燥。术后 90 天内发生并发症 20 例（14.3%）。
ATOMS 治疗 SUI 安全有效。长期、微创调整以满足患者需求的选择是一个显著优势。
