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

Abstract

Backgrounds Patient-reported outcome measurements are important for urinary incontinence. We analyze self-assessed patient satisfaction and defne the clinical profle 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 defned 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 classifcation. 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 padcount 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 satisfed 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 defned 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 satisfed with ATOMS after adjustment is proposed.