Evaluating the effectiveness of the adjustable transobturator male system (ATOMS) to treat urinary incontinence

This study aimed to investigate the effectiveness of a surgical implant called the adjustable transobturator male system (ATOMS), in improving quality of life and side-effects of stress urinary incontinence after prostate cancer surgery. This study found that this implant led to significant improvements in quality of life in these patients.

Stress urinary incontinence (SUI) is the unintentional loss of urine due to a stress put on the bladder. This stress can result from sneezing or exercising. This is a common side-effect of surgery to remove the prostate gland in patients with prostate cancer. SUI can lead to a decreased quality of life. The adjustable transobturator male system (ATOMS) is a device that can be surgically implanted in the bladder that stops involuntary urine loss. It can be adjusted without further surgery. The long-term safety and effectiveness of this implant are still unclear. 

This study reviewed the data of 1393 patients from 20 other studies. Patients had an ATOMS device implanted and completed an average of 20.9 months of follow up. They were followed up using questionnaires examining their quality of life, urinary function or side-effects from the surgery.

Patients using the implant retained more urine in their bladder. Treatment with ATOMS resulted in an average of 67% dryness rate and 90% improvement of symptoms after fully adjusting the device. Patients also reported improvements in their quality of life. 87% of patients reported being satisfied with the procedure.

Side-effects occurred in 16.4% of patients. These include pain or bleeding after surgery. The device became dislodged in 5.75% of patients. 

This study found that the ATOMS implant led to significant improvements in quality of life in patients who have SUI after prostate removal surgery.

There has been no randomized study so far to compare ATOMS to other devices for treating male SUI.