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Treatment of male stress urinary incontinence with the adjustable transobturator male system: Outcomes of a multi‐center Iberian study

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dc.contributor.author Angulo Cuesta, Javier
dc.contributor.author Cruz, Francisco
dc.contributor.author Esquinas, Cristina
dc.contributor.author Arance Gil, José Ignacio
dc.contributor.author Manso, Margarida
dc.contributor.author Rodríguez, Andrés
dc.contributor.author Pereira, Javier
dc.contributor.author Ojea, Antonio
dc.contributor.author Carballo, Manuel
dc.contributor.author Martins, Francisco
dc.contributor.author Et al.
dc.date.accessioned 2018-08-13T11:29:54Z
dc.date.available 2018-08-13T11:29:54Z
dc.date.issued 2018
dc.identifier.citation Angulo, J. C., Cruz, F., Esquinas, C., Arance, I., Manso, M., Rodríguez, A., ... & Teyrouz, A. (2018). Treatment of male stress urinary incontinence with the adjustable transobturator male system: Outcomes of a multi‐center Iberian study. Neurourology and urodynamics, 37(4), 1458-1466. DOI: 10.1002/nau.23474 spa
dc.identifier.issn 0733-2467
dc.identifier.issn 1520-6777
dc.identifier.uri http://hdl.handle.net/11268/7365
dc.description.abstract Aim: To evaluate effectiveness and safety of the adjustable transobturator male system (ATOMS) for male stress urinary incontinence (SUI). Material and Methods: A retrospective multicenter study was conducted in nine Iberian institutions using a board‐approved database for 215 patients intervened between 2012 and 2017, with no case excluded. Continence status, patient satisfaction, number, and grade of complications (Clavien‐Dindo) and factors affecting dry rate at adjustment were evaluated. Multivariate analysis defined the population at best success rate. Incontinence recurrence due to device failure and/or explant was evaluated and Kaplan‐Meier curve for durability performed. Results: Adjustment was achieved at a mean 1.4 ± 1.9 fillings. Dry‐rate after adjustment was 80.5% (96.2% mild and 75.3% moderate‐severe), 121 (56.3%) used no pads, and 52 (24.2%) a security pad with urine loss under 10 mL. Mean basal daily pad‐test and pad‐count decreased from 484 ± 372.3 mL and 3.9 ± 2 pads to 63.5 ± 201.2 mL and 0.9 ± 1.5pads (both P < 0.0001). Satisfaction rate was 85.1% (94.3% mild and 82.1% moderate‐severe). Factors associated to dryness were: lesser severity of SUI (P < .0001), absence of radiotherapy (P = 0.0002) and device generation (P = 0.05). Multivariate analysis revealed absence of radiation (OR = 3.12; 1.36‐7.19), mild (OR = 19.61; 3.95‐100), and moderate (OR = 2.48; 1.1‐5.59) SUI were independent predictors. Complications presented in 33(15.35%); 66.7% grade 1, 9.1% grade 2, and 24.2% grade 3. At 24.3 ± 15 mo mean follow‐up device was explanted in seven (3.25%) and SUI worsened after adjustment in nine (4.2%). Dry‐rate at follow‐up was 73% and durability of device in dry patients at adjustment was 89.8% (82.9‐94) at 2‐years. Conclusions: This study confirms ATOMS device is safe and achieves high treatment efficacy and patient satisfaction in a multicenter setting. Significantly better results are achieved in less severe and non‐irradiated cases. Durability of the device is reassuring in the short‐term. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.title Treatment of male stress urinary incontinence with the adjustable transobturator male system: Outcomes of a multi‐center Iberian study spa
dc.type article spa
dc.description.impact 3.360 JCR (2018) Q2, 32/80 Urology & Nephrology spa
dc.identifier.doi 10.1002/nau.23474
dc.rights.accessRights closedAccess spa
dc.subject.uem Incontinencia urinaria spa
dc.subject.uem Hombres spa
dc.subject.unesco Hombre spa
dc.subject.unesco Tratamiento médico spa
dc.description.filiation UEM spa
dc.peerreviewed Si spa


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