Adjustable Transobturator Male System (ATOMS) in Artificial Urinary Sphincter patients - a good Alternative?

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Authors

Publication Details

Journal
PubMed
Published
2026-09-05
DOI
https://doi.org/10.1159/uin/aewag023
Primary Topic
Prostate Cancer Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
0.00
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article

Adjustable Transobturator Male System (ATOMS) in Artificial Urinary Sphincter patients - a good Alternative?

Michael Chaloupka, Marc Kidess, Marina Hoffmann, Daniel Puhr‐Westerheide et al.
PubMed
Prostate Cancer Diagnosis and Treatment
article

Adjustable Transobturator Male System (ATOMS) in Artificial Urinary Sphincter patients - a good Alternative?

Michael Chaloupka, Marc Kidess, Marina Hoffmann, Daniel Puhr‐Westerheide, T. Georgieva, Ricarda M. Bauer, Elisa Lederer, Philipp Weinhold, Benedikt Ebner, Patrick Keller, Nikolaos Pyrgidis, Julian Hermans, Yannic Volz, Julian Marcon, Leo F Stadelmeier, Christian Stief
article en

Abstract

INTRODUCTION: Post-prostatectomy stress urinary incontinence (SUI) significantly impairs patients' quality of life. While the artificial urinary sphincter (AUS) is considered the gold standard for managing severe SUI, a subset of patients is not suitable for this intervention. This study aimed to evaluate the clinical outcomes of patients who received an adjustable transobturator male system (ATOMS) as an alternative to AUS for the treatment of SUI. METHODS: In this single-center retrospective study, we included 25 patients who received ATOMS implantation for post-prostatectomy SUI, despite being technically eligible for AUS based on incontinence severity and pelvic floor status. Primary outcomes included pad usage, continence rates, complications, and patient-reported satisfaction. A cross-sectional follow-up was conducted in using standardized questionnaires. RESULTS: Median age was 74.0 years; 60% of patients had undergone pelvic radiotherapy. Preoperative median pad usage was 6.0/day, reduced to 3.0/day postoperatively. Social continence (≤1 pad/day) was achieved in 16%, and ≥50% reduction in pad usage in 76% of patients. Complications were mostly minor. Cross-sectional follow-up data were available for 60% of patients at a median of 42 months. Patient satisfaction was high (73.3%), and 80% would recommend the procedure. According to the PGI score, 73.3% reported "very much" or "much improved" outcomes. CONCLUSION: ATOMS represents a feasible and safe treatment alternative for patients with severe SUI who are unable or unwilling to undergo AUS implantation. Despite suboptimal continence outcomes compared to AUS, high satisfaction and acceptable complication rates support its use in appropriately selected patients.

PubMed
Openalex Percentile: Top 11%
Prostate Cancer Diagnosis and Treatment
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