Dual implantation of penile prosthesis and ATOMS® system for post-prostatectomy erectile dysfunction and urinary incontinence: a feasibility study

Falcone, Marco; Preto, Mirko; Ammirati, Enrico; Blecher, Gideon; Carone, Roberto; Giammò, Alessandro

doi:10.1038/s41443-020-0320-y

Cited by 3 publications

(2 citation statements)

References 49 publications

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“…Taking these facts into account, SSP ATOMS remains a very interesting alternative to trans-corporeal AUSs for PPI in patients with a fragile urethra, i.e., patients with prior sling failure [ 15 ], former removal of an AUS [ 14 ] or previous urethroplasty [ 42 ]. Also, the dual implant of ATOMS and a penile prosthesis appears feasible and effective [ 43 ].…”

Section: Atoms Resultsmentioning

confidence: 99%

Update on Adjustable Trans-Obturator Male System (ATOMS) for Male Incontinence after Prostate Cancer Surgery

et al. 2023

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(1) Background: The adjustable trans-obturator male system (ATOMS) is a surgical device developed to treat post-prostatectomy incontinence (PPI) after prostate cancer treatment. We review the current literature on this anti-incontinence device with the intention of assessing the effectiveness, safety and duration of the silicone-covered scrotal port (SSP) ATOMS, the only generation of the device that is currently available. (2) Material and Methods: Non-systematic literature review is performed. Forty-eight full-text articles are assessed for eligibility. Case reports, expert opinions or commentaries without specific data reported (n = 6), studies with patients who underwent intervention before 2014 (IP or SP ATOMS; n = 10), and studies with incontinence after transurethral resection of the prostate (TUR-P; n = 2) are excluded for analysis. Thirty studies with SSP ATOMS are included in a qualitative synthesis that incorporates systematic reviews (n = 3), articles partially overlapping with other previously published studies (e.g., follow-up or series updates; n = 9), and studies focusing on specific populations (n = 8). Only articles revealing outcomes of SSP ATOMS were included in the quantitative synthesis of results (n = 10). (3) Results: the pooled data of 1515 patients from the 10 studies with SSP ATOMS confirmed very satisfactory results with this device after adjustment: dry rate: 63–82%, improved rate: 85–100%, complication rate: 7–33%, device infection rate: 2.7–6.2% and explant rate: 0–19%. The durability of the device is reassuring, with 89% of devices in place 5 years after implantation. (4) Conclusion: Despite the absence of randomized controlled studies, the literature findings confirm results of SSP ATOMS appear equivalent to those of artificial urinary sphincters (AUSs) in terms of continence, satisfaction and complications, but with a lower rate of revision in the long-term. A prospective study identified that patients with daily pad test results <900 mL and a Male Stress Incontinence Grading Scale (MSIGS) of not 4 (i.e., early and persistent stream or urine loss) are the best candidates. Future studies centered on the elder population at higher risk of impaired cognitive ability and in patients including radiation as prostate cancer treatment are needed.

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Section: Atoms Resultsmentioning

confidence: 99%

Update on Adjustable Trans-Obturator Male System (ATOMS) for Male Incontinence after Prostate Cancer Surgery

et al. 2023

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“…Dual implantation of penile prosthesis and ATOMS TM has been reported. To date, only data on simultaneous AUS placement at the time of surgical repair of refractory bladder neck contracture has been reported (23)(24)(25).…”

Section: Symptom Improvementmentioning

confidence: 99%

Current status of the adjustable transobturator male system (ATOMSTM) for male stress urinary incontinence

Juliebø-Jones,

Roth,

Tzelves

et al. 2024

Front. Surg.

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Male stress urinary incontinence is a debilitating condition, which can occur after prostate surgery. In persistent cases, surgery is indicated and a number of options are available. This includes one of the male slings, Adjustable transobturator male system (ATOMSTM, A.M.I, Austria). There are now an increasing number of studies published. This review provides an overview of the current status of this implant device including technical considerations, surgical outcomes and potential advantages and disadvantages compared to alternatives such as the artificial urinary sphincter.

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Practical Considerations in Inflatable Penile Implant Surgery

Chung

Mulhall

2021

The Journal of Sexual Medicine

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Background Penile prosthesis implantation remains an effective solution for men with medical-refractory erectile dysfunction (ED) following radical pelvic surgery. Despite the distortion of pelvic anatomy, a penile implant can be performed with excellent clinical outcomes provided strict patient selection, proper preoperative workup and safe surgical principles are adhered to. Aim To provide practical recommendations on inflatable penile prosthesis (IPP) implantation in patients with medical-refractory ED, with an emphasis on patient selection and counselling, preoperative workup as well as surgical considerations to minimize intraoperative complications. Methods A Medline search on relevant English-only articles on penile prostheses and pelvic surgery was undertaken and the following terms were included in the search for articles of interest: “bladder cancer”, “prostate cancer”, “rectal cancer”, “pelvic surgery” and “inflatable penile implant”. Outcomes Clinical key recommendations on patient selection, preoperative workup and surgical principles. RESULTS Patients should be made aware of the mechanics of IPP and the informed consent process should outline the benefits and disadvantages of IPP surgery, alternative treatment options, cost, potential prosthetic complications and patient’s expectations on clinical outcomes. Specialised diagnostic test for workup for ED is often not necessary although preoperative workup should include screening for active infection and optimising pre-existing medical comorbidities. Precautionary measures should be carried out to minimise infective complication. Corporal dilation and reservoir placement can be challenging in this group, and surgeons may require knowledge of advanced reconstructive surgical techniques when dealing with specific cases such as coexisting Peyronie’s disease and continence issue. Clinical translation Strict patient selection and counselling process coupled with safe surgical principles are important to achieve excellent linical outcomes and patient satisfaction rates. Strengths and limitations This masterclass paper provides an overview of the practical considerations for men who are undergoing IPP surgery following radical pelvic surgery. Limitations include the lack of highquality data and detailed surgical description on each surgical troubleshooting steps for various prosthetic-related complications. CONCLUSION The IPP implantation can be performed efficiently and safely in patients following radical pelvic surgery.

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Dual implantation of penile prosthesis and ATOMS® system for post-prostatectomy erectile dysfunction and urinary incontinence: a feasibility study

Cited by 3 publications

References 49 publications

Update on Adjustable Trans-Obturator Male System (ATOMS) for Male Incontinence after Prostate Cancer Surgery

Update on Adjustable Trans-Obturator Male System (ATOMS) for Male Incontinence after Prostate Cancer Surgery

Current status of the adjustable transobturator male system (ATOMSTM) for male stress urinary incontinence

Practical Considerations in Inflatable Penile Implant Surgery

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