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Complications of the urinary incontinence system ATOMS: Description of risk factors and how to prevent these pitfalls

World Journal of Urology Sep 27, 2019

Mühlstädt S, et al. - A total of 187 individuals with constant postoperative stress urinary incontinence received an ATOMS device in Madrid (n = 101) or Halle (n = 86) to report on the multicentre assessment of the occurrence and management of complications with the ATOMS device (AMI, Austria). In total, 18.2%, 21.9%, 14.1% and 22.9% of the patients had diabetes mellitus, were irradiated, and underwent former surgery for urinary incontinence and urethral stricture, respectively. Of the device, the overall success rate was 80.2%. With 18 grade I, 1 grade II, 3-grade IIIa (1.6%) and 29-grade IIIb complications, a total of 51 postoperative complications were noted. Primary wound infection and long-term cutaneous erosion with subsequent infection were the most severe postoperative complications. For complications, the chief risk factors were former radiotherapy and surgery for urethral stricture. In bivariate analysis, no other parameters were important. Therefore, the most critical complications of ATOMS implantation were primary wound infection and cutaneous erosion, particularly in the presence of the former radiotherapy. Moreover, special focus on delivering hygienic and accurate implantation techniques is suggested.
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