Implant of ATOMS® system for the treatment of postoperative male stress urinary incontinence: results of a single centre

ABSTRACT Purpose: The aim of our study is to evaluate the efficacy and safety of ATOMS® system for the treatment of postoperative male stress urinary incontinence (SUI). Materials and methods: We retrospectively evaluated all patients treated at our institution for postoperative male SUI with ATOMS® implant. We excluded patients with low bladder compliance (< 20 mL / cmH2O), uncontrolled detrusor overactivity, detrusor underactivity (BCI < 100), urethral or bladder neck stricture and low cystometric capacity (< 200 mL). Results: From October 2014 to July 2017 we treated 52 patients, mean age 73.6 years. Most of them (92.3%) had undergone radical prostatectomy, 3.85% simple open prostatectomy, 3.85% TURP; 28.8% of patients had undergone urethral surgery, 11.5% adjuvant radiotherapy; 57.7% had already undergone surgical treatment for urinary incontinence. The average24 hours pad test was 411.6 g (180 - 1100). The mean follow-up was 20.1 months (8.1 - 41.5) 30.8% of patients were dry, 59.6% improved ≥ 50%, 7.7% improved < 50% and 1.9% unchanged. In total 73.1% reached social continence. There was a significant reduction of the 24 hours pad test and ICIQ - UI SF scores (p < 0.01). In the postoperative follow-up we detected complications in 8 patients (19%): 5 cases of displacement of the scrotal port, in 2 cases catheterization difficulties, one case of epididimitis and concomitant superficial wound infection; no prosthesis infection, nor explants. Radiotherapy, previous urethral surgery,previous incontinence surgery were not statistically related to social continence rates (p 0.65;p 0.11;p 0.11). Conclusions: The ATOMS® system is an effective and safe surgical treatment of mild and moderate male postoperative SUI with durable results in the short term.

Surgical pathology archive of urology in Iraq; where do we stand?

The international surgical centres recognised the progressive importance of archiving the written pathological data as well as the pathological materials such as paraffin blocks and slides using updated techniques to facilitate possible future retrieval of patients' pathological data and research plans. To highlight the difficulties and pitfalls of the current pathological archive of urology in Iraq and demonstrate the characteristics of urology archives in advanced urology centres represented by Torino University [Italy] and Johannes Gutenberg University - Mainz [Germany]. Recommendations are suggested to optimise our surgical pathology archive in general and urology archive in particular in the third millennium. Surgical pathology archive is an essential component of the daily surgical practice and research procedure. In Iraq clear legislation is needed to protect and regulate the surgical pathology archive including that of urology, as well as adequate economic funding to implement new international standards and techniques in this field