Patient-reported quality-of-life outcomes after ATOMS surgery for post-prostatectomy stress urinary incontinence managed with an on-demand follow-up strategy.
Ingunn Roth, Karin Margrethe Hjelle, Christian Beisland, Christian Arvei Moen, Patrick Juliebø-Jones
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引用次数: 0
Abstract
Background: Stress urinary incontinence (SUI) following radical prostatectomy (RP) can impair quality of life (QoL). While surgical treatments have shown promising short-term results, data on long-term patient-reported outcomes remain limited.
Objectives: To evaluate symptom burden, perceived improvement, and health-related quality of life (HRQoL) at extended follow-up after adjustable male obturator system (ATOMS) surgery.
Methods: Men with post-RP SUI who underwent ATOMS implantation between 2012 and 2023 at a single tertiary centre were retrospectively identified (n = 111). Postoperative follow-up beyond the early postoperative period was conducted on an on-demand basis. Survivors (n = 99) were contacted and, following informed consent, completed the EPIC-26, RAND-12, and Patient Global Impression of Change questionnaires. Follow-up duration was defined as the time from ATOMS surgery to questionnaire completion.
Results: Eighty-three patients participated (median age: 75 years; median follow-up: 87 months). At follow-up, 66% reported perceived improvement. Perceived improvement correlated with higher RAND-12 physical and mental scores. Pad use negatively correlated with both physical and mental HRQoL (r = -0.4, p < 0.001). Prior radiotherapy and higher BMI were associated with poorer EPIC-26 incontinence scores. RAND-12 scores were comparable to age-matched general population data. Device removal did not significantly impact HRQoL scores. At final follow-up, only 11% used were completely pad-free.
Conclusion: ATOMS surgery was associated with symptom improvement and favourable quality-of-life outcomes for most patients. In the context of an on-demand postoperative follow-up strategy without routine scheduled refilling, continence outcomes likely reflect the management model employed, and structured reassessment and refilling may therefore serve to optimise long-term results.
期刊介绍：
Therapeutic Advances in Urology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of urology.
The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in urology, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest across all areas of urology, including treatment of urological disorders, with a focus on emerging pharmacological therapies.
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