First experience with ATOMS system implant in neurogenic stress urinary incontinence.
Adolescent
Adult
Cauda Equina Syndrome
/ complications
Female
Humans
Male
Meningomyelocele
/ complications
Postoperative Complications
/ surgery
Postoperative Period
Suburethral Slings
Surveys and Questionnaires
Treatment Outcome
Urinary Incontinence, Stress
/ etiology
Urinary Sphincter, Artificial
Urodynamics
Young Adult
ATOMS
neurogenic bladder
neurogenic stress urinary incontinence
stress urinary incontinence
Journal
Neurourology and urodynamics
ISSN: 1520-6777
Titre abrégé: Neurourol Urodyn
Pays: United States
ID NLM: 8303326
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
10
05
2020
revised:
01
06
2020
accepted:
03
06
2020
pubmed:
17
6
2020
medline:
2
4
2021
entrez:
17
6
2020
Statut:
ppublish
Résumé
To evaluate efficacy and safety of ATOMS implant in neurogenic patients with stress incontinence performing clean intermittent catheterization (CIC). We included all patients with neurogenic sacral/subsacral lesion and stress urinary incontinence, treated with ATOMS implant between January 2018 and March 2019. All patients received anamnesis, 24-hour pad test and pad count, physical examination, video urodynamic evaluation, Qualiveen questionnaire. All patients were followed up at 12 months after implantation. Patients were considered "continent" when dry or when wearing a security pad (social continence). We treated eight male patients with a median age of 25 years, four affected by myelomeningocele, and four by cauda equine syndrome. The median preoperative 24-hour pad test was 225 g (interquartile range [IQR]: 180-275). During the surgical procedure, we did not fill the cushion to prevent postoperative urethral injuries when performing CIC in the early postoperative time. At a 12-month follow-up, we had a significant reduction in postoperative 24-hour pad test (median value: 7.5 g; IQR: 0-16.25; P < .05). All patients reached continence. We had a significant reduction in the Qualiveen scores (P < .05). Patients demonstrated to be satisfied with the results of the intervention at the PGI-I questionnaire. The only complications were four cases of temporary scrotal edema (Clavien-Dindo 1) treated with conservative therapy. All patients resumed CIC without urethral traumatism nor catheter insertion difficulties. We had no cases of device infection nor device removal. Implantation of ATOMS device seems to be an effective and safe minimally invasive procedure also in neurological patients with a low rate of postoperative complications.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1837-1841Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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