{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T06:23:43Z","timestamp":1772519023805,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,2,11]],"date-time":"2024-02-11T00:00:00Z","timestamp":1707609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010859","name":"Texas A and M University-Kingsville","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010859","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to compare the effectiveness and safety of the adjustable trans\u2010obturator male system (ATOMS\u00ae) to treat post\u2010prostatectomy incontinence (PPI) in radiated patients compared with non\u2010radiated patients, using propensity score\u2010matching analysis to enhance the validity of the comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Consecutive men with PPI treated with silicone\u2010covered scrotal port ATOMS (A.M.I., Feldkirch, Austria) in nine different institutions between 2016 and 2022 were included. Preoperative assessment evaluated 24\u2010h pad usage, urethroscopy and urodynamics, if indicated. Propensity score\u2010matching analysis was based on age, length of follow\u2010up, previous PPI treatment, previous bladder neck stricture, androgen deprivation and pad usage. The primary endpoint was dry rate, defined as no pads post\u2010operatively with a security pad allowed. The secondary endpoints were complications, device removal and self\u2010perceived satisfaction with the Patient Global Impression of Improvement (PGI\u2010I) scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 710 included patients, 342 were matched, and the study groups were balanced for the baseline matched variables. The mean baseline 24\u2010h pad was 4.8 in both groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.48). The mean follow\u2010up was 27.5\u2009\u00b1\u200918.6\u2009months, which was also equivalent between groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.36). The primary outcome was achieved in 73 (42.7%) radiated patients and in 115 (67.3%) non\u2010radiated patients (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The mean pad count at the last follow\u2010up was 1.5 and 0.8, respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). There was no significant difference in complications (<jats:italic>p<\/jats:italic>\u2009=\u20090.94), but surgical revision and device explant rates were higher (<jats:italic>p<\/jats:italic>\u2009=\u20090.03 and <jats:italic>p<\/jats:italic>\u2009=\u20090.01, respectively), and the proportion of patients highly satisfied (PGI\u2010I\u2009=\u20091) was lower in the radiated group (<jats:italic>p<\/jats:italic>\u2009=\u20090.01). At sensitivity analysis, the study was found to be reasonably robust to hidden bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ATOMS implantation significantly outperformed in patients without adjuvant radiation over radiated patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bco2.329","type":"journal-article","created":{"date-parts":[[2024,2,11]],"date-time":"2024-02-11T18:38:15Z","timestamp":1707676695000},"page":"506-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The effectiveness of adjustable trans\u2010obturator male system (ATOMS) in radiated patients is reduced: A propensity score\u2010matched analysis"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1735-8792","authenticated-orcid":false,"given":"Javier C.","family":"Angulo","sequence":"first","affiliation":[{"name":"Clinical Department, Faculty of Biomedical Science Universidad Europea  Madrid Spain"},{"name":"Department of Urology Hospital Universitario de Getafe  Madrid Spain"}]},{"given":"Alessandro","family":"Giamm\u00f2","sequence":"additional","affiliation":[{"name":"Department of Neuro\u2010Urology, CTO\/Spinal Cord Unit AOU Citt\u00e0 della Salute e della Scienza di Torino  Turin Italy"}]},{"given":"Fabian","family":"Queissert","sequence":"additional","affiliation":[{"name":"Department of Urology and Pediatric Urology University Hospital Muenster  M\u00fcnster Germany"}]},{"given":"Sandra","family":"Sch\u00f6nburg","sequence":"additional","affiliation":[{"name":"Department of Urology and Kidney Transplantation Martin Luther University  Halle (Saale) Germany"}]},{"given":"Carmen","family":"Gonz\u00e1lez\u2010Enguita","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Fundaci\u00f3n Jim\u00e9nez D\u00edaz  Madrid Spain"}]},{"given":"Andreas","family":"Gonsior","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Urologie University of Leipzig  Leipzig Germany"}]},{"given":"Antonio","family":"Romero","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Morales Meseguer  Murcia Spain"}]},{"given":"Francisco E.","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Urology Centro Hospitalar Universit\u00e1rio de Lisboa Norte, Hospital Santa Mar\u00eda  Lisbon Portugal"}]},{"given":"Tiago","family":"Antunes\u2010Lopes","sequence":"additional","affiliation":[{"name":"Department of Urology Centro Hospitalar S\u00e3o Jo\u00e3o  Porto Portugal"},{"name":"Faculty of Medicine of Porto I3S Institute  Porto Portugal"}]},{"given":"Raquel","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Fundaci\u00f3n Jim\u00e9nez D\u00edaz  Madrid Spain"}]},{"given":"Juliusz","family":"Szczesniewski","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital 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