Influence of ATOMS implant on the voiding phase of patients with post-prostatectomy urinary incontinence.

adjustable transobturator male system bladder outlet obstruction detrusor contractility postprostatectomy incontinence urodynamics

Journal

Neurourology and urodynamics
ISSN: 1520-6777
Titre abrégé: Neurourol Urodyn
Pays: United States
ID NLM: 8303326

Informations de publication

Date de publication:
02 2022
Historique:
revised: 12 09 2021
received: 24 05 2021
accepted: 29 11 2021
pubmed: 31 12 2021
medline: 25 3 2022
entrez: 30 12 2021
Statut: ppublish

Résumé

To assess changes in voiding phase, especially urethral resistance after post-prostatectomy urinary incontinence (PPI) treatment with the Adjustable TransObturator Male System (ATOMS). A longitudinal prospective study was performed on 45 men treated with ATOMS for PPI, with the intention to evaluate the changes produced by the implant on the voiding phase. Patients with preoperative urodynamic study were offered postoperative urodynamic evaluation, and both studies were compared. The following urodynamic date were evaluated: maximum voiding detrusor pressure, detrusor pressure at maximum flow rate, maximum flow rate (Qmax), voiding volume, post-void residue, bladder outlet obstruction index (BOOI), urethral resistance factor (URA), and bladder contractility index (BCI). The statistical analysis used were the mean comparison test for dependent groups (Student's t test) for parametric variables and the Wilcoxon test for non-parametric variables. The signification level was set at 95% bilateral. A total of 37 patients (82.2%) used zero pads/day at the time of urodynamic postoperative evaluation and pad-test evolved from 592 ± 289 ml baseline to 25 ± 40 ml (p = 0.0001). Significant differences were observed in Qmax (15 ± 8.3 before and 11 ± 8.3 after surgery; p = 0.008), voiding volume (282 ± 130.7 before and 184 ± 99.92 after surgery). BOOI (-12 ± 23.9 before and -2 ± 21.4 after surgery; p = 0.025) and BCI (93 ± 46.4 before and 76 ± 46.0 after surgery; p = 0.044). In no case did we observe postoperative bladder outlet obstruction, according to URA parameter below 29 cm H The ATOMS implant induces a decrease of Qmax, voided volume, and bladder contractility and an increase of BOOI. However, our findings suggest that ATOMS device does not cause bladder outlet obstruction.

Identifiants

pubmed: 34969148
doi: 10.1002/nau.24856
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

609-615

Informations de copyright

© 2021 Wiley Periodicals LLC.

Références

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Auteurs

Sonia Ruiz (S)

Departamento Clinico, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, Spain.
Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain.

Miguel Virseda-Chamorro (M)

Servicio de Urología, Centro Nacional de Parapléjicos, Toledo, Spain.

Jesús Salinas (J)

Servicio de Urología, Hospital Clínico San Carlos, Madrid, Spain.

Fabian Queissert (F)

Department of Urology and Pediatric Urology, University Hospital Muenster, Muenster, Germany.

Ignacio Arance (I)

Departamento Clinico, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, Spain.
Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain.

Javier C Angulo (JC)

Departamento Clinico, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, Spain.
Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain.

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