Male adjustable transobturator system is associated with improved long-term outcomes in urinary incontinence

This study investigated the long-term durability and effectiveness of the adjustable transobturator male system (ATOMS) in patients with urinary incontinence. Researchers suggested that ATOMS is a good and safe option to treat these patients long-term.

Stress urinary incontinence is a common side effect after prostate cancer treatment. It affects around 10 to 20% of patients. It consists of the leakage of urine after a physical movement such as coughing or sneezing.

Efforts to treat urinary incontinence after cancer therapy could greatly improve the quality of life of these patients. ATOMS has been used in all degrees of incontinence with positive outcomes and fewer side effects. ATOMS is a device that allows the urethra (urinary tube) to be compressed only on one side. This holds the urethra in place improving the leakage of urine. However, the long-term effectiveness, safety, and durability of the device are unknown.

This study included information about 215 patients with urinary incontinence. All patients received the ATOMS. The average long-term follow-up was 60.6 months.

A total of 155 patients were dry at the last follow-up visit (72.1%). Of these, 99 (46%) used no pads and 56 (26%) used a security pad with urine loss of less than 10mL.

Of the dry patients, 96% remained dry 1 year later, 91.1% 3 years later, and 86.7% 8 years later. Complications during follow-up occurred in 20% of the participants. 25 (11.6%) devices were removed due to reduced effectiveness, 3 due to reduced effectiveness and pain, 10 due to port decline, and 1 due to wound infection. 11 patients received a second device, 6 an artificial urinary sphincter, and 5 repeated ATOMS.

Patients who had complications after ATOMS were 8.7 times more at risk of removing the device. This risk was 14.9 times higher for patients with more serious cases of incontinence and was 2.26 times higher for those who received radiation therapy. 3 patients received radiation after ATOMS without complications.

This study concluded that ATOMS is a good and safe option in the long-term for the treatment of urinary incontinence in men.