Marc Kidess, Elisa Lederer, Nikolaos Pyrgidis, Troya Georgieva, Julian Hermans, Leo Stadelmeier, Marina Hoffmann, Benedikt Ebner, Patrick Keller, Michael Chaloupka, Julian Marcon, Philipp Weinhold, Ricarda Bauer, Christian G Stief, Yannic Volz
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This study evaluates the influence of prior radiotherapy-and its timing-on outcomes following ATOMS implantation.</p><p><strong>Materials and methods: </strong>This retrospective single-center study included 131 men treated with ATOMS for IPT between November 2018 and May 2024. Patients were stratified by history of having received radiotherapy and also by timing of radiotherapy ( ≤ 24 vs. > 24 months) before ATOMS implantation. Pre-, peri-, and postoperative variables were recorded. Cross-sectional follow-up was conducted in November 2024 using clinical questionnaires, 24-h-pad-tests, and validated instruments (PGI, ICIQ-UI). Statistical analysis included t-tests, Mann-Whitney U tests, Chi-square tests, Kaplan-Meier curves, and Cox regression.</p><p><strong>Results: </strong>Forty seven patients (35.9%) received radiotherapy before ATOMS implantation. These patients had higher tumor stages and Gleason scores. Postoperatively, radiated patients demonstrated lower complete continence rates (21% vs. 51%, p = 0.020) and higher median pad use (2.5 vs. 1, p < 0.01). Furthermore, they experienced higher rates of acute urinary retention (8.5% vs. 0%, p = 0.029) and explantation (21% vs. 6%, p = 0.018). No significant differences in satisfaction, long-term continence, or outcomes were found based on the timing of radiotherapy.</p><p><strong>Conclusion: </strong>ATOMS is an adequate treatment for IPT regardless of radiotherapy history or timing before its implantation. Although significant differences in immediate continence rates were observed (21% vs. 51%), long-term continence rates were comparable. Therefore, ATOMS seems to be a viable option in this patient population.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Adjustable TransObturator Male System (ATOMS) After Radiotherapy: Is Timing Everything? 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This study evaluates the influence of prior radiotherapy-and its timing-on outcomes following ATOMS implantation.</p><p><strong>Materials and methods: </strong>This retrospective single-center study included 131 men treated with ATOMS for IPT between November 2018 and May 2024. Patients were stratified by history of having received radiotherapy and also by timing of radiotherapy ( ≤ 24 vs. > 24 months) before ATOMS implantation. Pre-, peri-, and postoperative variables were recorded. Cross-sectional follow-up was conducted in November 2024 using clinical questionnaires, 24-h-pad-tests, and validated instruments (PGI, ICIQ-UI). Statistical analysis included t-tests, Mann-Whitney U tests, Chi-square tests, Kaplan-Meier curves, and Cox regression.</p><p><strong>Results: </strong>Forty seven patients (35.9%) received radiotherapy before ATOMS implantation. These patients had higher tumor stages and Gleason scores. Postoperatively, radiated patients demonstrated lower complete continence rates (21% vs. 51%, p = 0.020) and higher median pad use (2.5 vs. 1, p < 0.01). Furthermore, they experienced higher rates of acute urinary retention (8.5% vs. 0%, p = 0.029) and explantation (21% vs. 6%, p = 0.018). No significant differences in satisfaction, long-term continence, or outcomes were found based on the timing of radiotherapy.</p><p><strong>Conclusion: </strong>ATOMS is an adequate treatment for IPT regardless of radiotherapy history or timing before its implantation. Although significant differences in immediate continence rates were observed (21% vs. 51%), long-term continence rates were comparable. 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引用次数: 0
摘要
导读：前列腺癌根治性前列腺切除术和/或放疗后的前列腺治疗（IPT）后尿失禁显著影响生活质量。虽然可调节的男性透气器系统（ATOMS）是IPT的一种很有前途的手术选择，但先前放疗的患者接受ATOMS植入的结果数据有限。本研究评估既往放疗及其时间对原子植入后预后的影响。材料和方法：本回顾性单中心研究纳入了2018年11月至2024年5月期间接受ATOMS治疗IPT的131名男性。根据患者接受放射治疗的历史和放射治疗的时间（≤24个月vs. bb0 24个月）对患者进行分层。记录术前、术后和围手术期的变量。于2024年11月采用临床问卷、24小时垫试验和验证仪器（PGI, ICIQ-UI）进行横断面随访。统计分析包括t检验、Mann-Whitney U检验、卡方检验、Kaplan-Meier曲线和Cox回归。结果：47例患者（35.9%）在原子植入前接受放疗。这些患者的肿瘤分期和Gleason评分较高。术后，放疗患者表现出较低的完全失禁率（21% vs. 51%, p = 0.020）和较高的中位垫使用率（2.5 vs. 1, p）。结论：无论放射史或植入前的时间如何，ATOMS都是IPT的适当治疗方法。虽然观察到即时尿失禁率有显著差异（21%对51%），但长期尿失禁率是相当的。因此，在这类患者中，ATOMS似乎是一个可行的选择。
Adjustable TransObturator Male System (ATOMS) After Radiotherapy: Is Timing Everything? A Single-Center Experience.
Introduction: Incontinence after prostate treatment (IPT) following radical prostatectomy and/or radiotherapy for prostate cancer significantly impacts quality of life. While the Adjustable Transobturator Male System (ATOMS) is a promising surgical option for IPT, data on outcomes in patients undergoing ATOMS implantation with prior radiotherapy are limited. This study evaluates the influence of prior radiotherapy-and its timing-on outcomes following ATOMS implantation.
Materials and methods: This retrospective single-center study included 131 men treated with ATOMS for IPT between November 2018 and May 2024. Patients were stratified by history of having received radiotherapy and also by timing of radiotherapy ( ≤ 24 vs. > 24 months) before ATOMS implantation. Pre-, peri-, and postoperative variables were recorded. Cross-sectional follow-up was conducted in November 2024 using clinical questionnaires, 24-h-pad-tests, and validated instruments (PGI, ICIQ-UI). Statistical analysis included t-tests, Mann-Whitney U tests, Chi-square tests, Kaplan-Meier curves, and Cox regression.
Results: Forty seven patients (35.9%) received radiotherapy before ATOMS implantation. These patients had higher tumor stages and Gleason scores. Postoperatively, radiated patients demonstrated lower complete continence rates (21% vs. 51%, p = 0.020) and higher median pad use (2.5 vs. 1, p < 0.01). Furthermore, they experienced higher rates of acute urinary retention (8.5% vs. 0%, p = 0.029) and explantation (21% vs. 6%, p = 0.018). No significant differences in satisfaction, long-term continence, or outcomes were found based on the timing of radiotherapy.
Conclusion: ATOMS is an adequate treatment for IPT regardless of radiotherapy history or timing before its implantation. Although significant differences in immediate continence rates were observed (21% vs. 51%), long-term continence rates were comparable. Therefore, ATOMS seems to be a viable option in this patient population.
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