ATOMSATOMSDEVICE FOR MALE DEVICE FOR MALE

URINARY INCONTINENCE: URINARY INCONTINENCE: A READJUSTABLE AND A READJUSTABLE AND

REPRODUCIBLE SYSTEMREPRODUCIBLE SYSTEM

DR.EMILIO GUTIERREZ MINGUEZDR.EMILIO GUTIERREZ MINGUEZ

Department of UrologyDepartment of Urology

HOSPITAL UNIVERSITARIO DE BURGOSHOSPITAL UNIVERSITARIO DE BURGOS

ETIOLOGY OF INCONTINENCEETIOLOGY OF INCONTINENCE

• NEUROGENIC BLADDER.NEUROGENIC BLADDER.

• EVOLUTIONARY PROSTATICS.EVOLUTIONARY PROSTATICS.

• RADICAL PROSTATECTOMY.RADICAL PROSTATECTOMY.

• TURP / ADENOMECTOMY PROSTATE.TURP / ADENOMECTOMY PROSTATE.

• RADIOTHERAPY.RADIOTHERAPY.

FRECUENCYFRECUENCY

THE MOST COMMON CAUSE THE MOST COMMON CAUSE IS RADICAL PROSTATECTOMYIS RADICAL PROSTATECTOMY

(between 6 and 60 % with a (between 6 and 60 % with a mean of 14%)mean of 14%)

THERAPEUTIC DEVICESTHERAPEUTIC DEVICES

• REEMEXREEMEX

• ARGUSARGUS

• PRO-ACTPRO-ACT

• ARTIFICIAL SPHINCTER AMS 800ARTIFICIAL SPHINCTER AMS 800

• ARTIFICIAL SPHINCTER FLOWSECUREARTIFICIAL SPHINCTER FLOWSECURE

• ADVANCEADVANCE

• ATOMSATOMS

FFFFFFFFF

ATOMS SYSTEM: INDICATIONSATOMS SYSTEM: INDICATIONS

• RADICAL PROSTATECTOMY WITH OR RADICAL PROSTATECTOMY WITH OR WITHOUT RADIOTHERAPY.WITHOUT RADIOTHERAPY.

• RETROPUBIC ADENOMECTOMY.RETROPUBIC ADENOMECTOMY.

• TURP OR MIST PROSTATICTURP OR MIST PROSTATIC

ATOMS SYSTEM: ATOMS SYSTEM: PREOPERATIVEPREOPERATIVE

• SONOGRAPHY.SONOGRAPHY.

• CYSTOGRAPHY.CYSTOGRAPHY.

• FLOWMETER.FLOWMETER.

• URETHROCYSTOSCOPY.URETHROCYSTOSCOPY.

• ¿ URODYNAMIC STUDY ?¿ URODYNAMIC STUDY ?

ATOMS SYSTEM:ATOMS SYSTEM:CONTRAINDICATIONS.CONTRAINDICATIONS.

• RESIDUAL URINE.RESIDUAL URINE.

• RECURRENT URINARY TRACT RECURRENT URINARY TRACT INFECTIONS.INFECTIONS.

• URINARY FISTULA.URINARY FISTULA.

• IMMUNOSUPPRESSION.IMMUNOSUPPRESSION.

ATOMS SYSTEM:ATOMS SYSTEM:CASUISTRYCASUISTRY

OPERATE: 51 PATIENTS.OPERATE: 51 PATIENTS.

45 RADICAL PROSTATECTOMY (14 45 RADICAL PROSTATECTOMY (14 TREATMENT OF RADIOTHERAPY TREATMENT OF RADIOTHERAPY ADJUVANT ).ADJUVANT ).

2 RETROPUBIC ADENOMECTOMY2 RETROPUBIC ADENOMECTOMY

1 PROSTATE LASER1 PROSTATE LASER

3 TUR PROSTATE3 TUR PROSTATE

ATOMS SYSTEM:ATOMS SYSTEM:INCONTINENCE RANK.INCONTINENCE RANK.

• 33 SEVERE INCONTINENCE( + 3 pads 33 SEVERE INCONTINENCE( + 3 pads daily).daily).

• 16 MODERATE INCONTINENCE (1-3 16 MODERATE INCONTINENCE (1-3 pads daily).pads daily).

• 2 MILD INCONTINENCE.2 MILD INCONTINENCE.

ATOMS SYSTEMATOMS SYSTEM

• MEAN AGE:68 YEARS MEAN AGE:68 YEARS

• AVERAGE SURGICAL TIME: 55 MINUTESAVERAGE SURGICAL TIME: 55 MINUTES

• FOLLOW-UP: 24 MONTHSFOLLOW-UP: 24 MONTHS

• AVERAGE FILLING PORT:18cc (CAPACITY 27cc.)AVERAGE FILLING PORT:18cc (CAPACITY 27cc.)

• 17 % (9 PATIENTS) NO FILLING OUTPATIENT17 % (9 PATIENTS) NO FILLING OUTPATIENT

ATOMS SYSTEM:ATOMS SYSTEM:RESULTS.RESULTS.

• 85% TOTALLY DRY, NO ABSORBENT 85% TOTALLY DRY, NO ABSORBENT NEEDED (INCLUDING SEVERE NEEDED (INCLUDING SEVERE INCONTINENCE) INCONTINENCE)

• 11% GREAT IMPROVEMENT 11% GREAT IMPROVEMENT INCONTINENCE ( 1 PAD DAILY).INCONTINENCE ( 1 PAD DAILY).

• 4 % WITH MINOR IMPROVEMENT. 4 % WITH MINOR IMPROVEMENT.

PORT POSITIONPORT POSITION

•ABDOMINAL: 37 PATIENTS (73%)ABDOMINAL: 37 PATIENTS (73%)

•SCROTAL: 14 PATIENTS (27%)SCROTAL: 14 PATIENTS (27%)

ATOMS SYSTEM:ATOMS SYSTEM:COMPLICATIONS.COMPLICATIONS.

• 3 URINARY RETENTION (48 HOURS 3 URINARY RETENTION (48 HOURS CATHETER).CATHETER).

• 7 SURGICAL ABDOMINAL WOUND 7 SURGICAL ABDOMINAL WOUND INFECTION, REMOVAL TITANIUM INFECTION, REMOVAL TITANIUM PORT.PORT.

• 3 FULL SYSTEM INFECTIONS3 FULL SYSTEM INFECTIONS

• 1 TESTICULAR PAIN 2 MONTHS 1 TESTICULAR PAIN 2 MONTHS (EPIDIDYMITIS)(EPIDIDYMITIS)

ATOMS SYSTEM:ATOMS SYSTEM:ADVANTAGESADVANTAGES

• MINIMALLY INVASIVE SURGERYMINIMALLY INVASIVE SURGERY• REPRODUCIBLEREPRODUCIBLE• SUBURETHRAL CONSTANT PRESSURE SUBURETHRAL CONSTANT PRESSURE

DISTRIBUTION DISTRIBUTION • POSTOPERATIVELY READJUSTABLEPOSTOPERATIVELY READJUSTABLE• EFFECTIVE FOR ALL GRADES OF EFFECTIVE FOR ALL GRADES OF

INCONTINENCEINCONTINENCE• IDEAL FOR RADIATED PATIENTS IDEAL FOR RADIATED PATIENTS • PHYSIOLOGICAL URINATION WITHOUT PHYSIOLOGICAL URINATION WITHOUT

NEED FOR MECHANICAL HANDLINGNEED FOR MECHANICAL HANDLING