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Patient satisfaction with adjustable transobturator male system in the Iberian multicenter study

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Abstract

Backgrounds

Patient-reported outcome measurements are important for urinary incontinence. We analyze self-assessed patient satisfaction and define the clinical profile of patient with highest satisfaction with the adjustable transobturator male system (ATOMS).

Methods

Patient perception of results was evaluated in a series of 181 patients after ATOMS adjustment. Baseline incontinence severity was defined in pads-per-day (PPD) as mild (2), moderate (3–5) or severe (≥ 6), and dryness as use of none or one security PPD. Post-operative pain at discharge was evaluated by 0–10 visual analogue scale and complications by Clavien–Dindo classification. Multivariate analysis was performed to anticipate “very much better” than baseline perception on patient global impression of improvement and a predictive nomogram was developed.

Results

Dryness was achieved in 80.7% (94.9% mild, 80.8% moderate and 65.8% severe groups). Mean pad-test and pad-count decrease with respect to baseline was 458 ± 330 ml and 3.2 ± 1.9 PPD, respectively (both p < .0001). Complications presented in 25 (13.8%). The proportion of patients that self-declared satisfied with the procedure was 87.1%; 90.6% perceived their situation “better” and 48.1% “very much better” than before. Multivariate analysis revealed best perception is defined by dryness after adjustment (p < .0001), baseline severity of incontinence (p = .007), low post-operative pain at discharge (p = .0018) and lack of complications (p = .007).

Conclusions

Self-assessed satisfaction with ATOMS is very high. Factors that predict best perception of improvement include dryness, baseline SUI severity, presence of complications and pain level during admission. Radiotherapy and device generation were not independent predictors. A nomogram to predict patients that are completely satisfied with ATOMS after adjustment is proposed.

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Acknowledgements

The authors acknowledge Mr. Juan Dorado (PerTICA S.L.) for statistical analysis.

Author information

Authors and Affiliations

  1. Departamento Clínico, Hospital Universitario de Getafe, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Carretera de Toledo Km 12.5, Getafe, 28905, Madrid, Spain

    Javier C. Angulo & Ignacio Arance

  2. Hospital Alvaro Cunqueiro, Vigo, Spain

    Antonio Ojea & Manuel Carballo

  3. Hospital Arquitecto Marcide, Ferrol, Spain

    Andrés Rodríguez & Javier Pereira

  4. Hospital Son Llatzer, Palma de Mallorca, Spain

    Miguel Rebassa & Antoine Teyrouz

  5. Hospital Universitario Gregorio Marañón, Madrid, Spain

    Gregorio Escribano

  6. Hospital Universitario de la Princesa, Madrid, Spain

    Fernando Teba

  7. Hospital Universitario Puerta del Mar, Cádiz, Spain

    Blanca Madurga

  8. Hospital de Santa María, Lisbon, Portugal

    Francisco E. Martins

  9. Centro Hospitalar São João, Oporto, Portugal

    Francisco Cruz

Authors
  1. Javier C. Angulo
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  2. Ignacio Arance
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  3. Antonio Ojea
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  4. Manuel Carballo
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  5. Andrés Rodríguez
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  6. Javier Pereira
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  7. Miguel Rebassa
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  8. Antoine Teyrouz
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  9. Gregorio Escribano
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  10. Fernando Teba
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  11. Blanca Madurga
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  12. Francisco E. Martins
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  13. Francisco Cruz
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Contributions

The contribution to each author is as follows: protocol/project development: JCA. Data collection or management: JCA, IA, AO, MC, AR, JP, MR, AT, GE, FT, BM, FEM, FC. Data analysis: JCA, IA, AO, MC, AR, JP, MR, AT, GE, FT, BM, FEM, FC. Manuscript writing/editing: JCA, FC.

Corresponding author

Correspondence to Javier C. Angulo.

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Conflict of interest

The authors have no conflict of interest or specific disclosure regarding the publication of this article.

Ethical standards

The protocol was approved by local ethics committee in Hospital Universitario de Getafe (A08/17). All subject received informed consent to undergo surgery and all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Angulo, J.C., Arance, I., Ojea, A. et al. Patient satisfaction with adjustable transobturator male system in the Iberian multicenter study. World J Urol 37, 2189–2197 (2019). https://doi.org/10.1007/s00345-019-02639-4

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  • DOI: https://doi.org/10.1007/s00345-019-02639-4

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