{"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":1772519023794,"version":"3.50.1"},"reference-count":26,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,24]],"date-time":"2021-12-24T00:00:00Z","timestamp":1640304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: This study examined outcomes of second-line ATOMS implantation after failure of the fixed male sling (FMS) AdVance\/AdVance XP. (2) Methods: A retrospective multicenter cohort analysis was carried out in men implanted with an ATOMS between 2011 and 2020 after failure of an AdVance\/AdVance XP. Success was assessed on the basis of objective (dryness, 0\u20131 pad\/24 h or &gt;20 g\/24 h pad test) and subjective results (PGI-I). We performed the Wilcoxon rank sum test, Fisher\u2019s exact test, logistic regression, and multivariate analysis. (3) Results: The study included 88 patients from 9 centers with a mean age of 71.3 years. No Clavien\u2013Dindo &gt; II complications occurred within the first 3 months after ATOMS implantation. A total of 10 cases (9%) required revision in the ensuing clinical course. After a mean follow-up of 42.5 months, 76.1% achieved social continence, and 56.8% used no pads at all. Mean urine leakage\/24 h dropped from 422 g (3.9 pads) to 38 g (0.69 pads) and the mean ICIQ-SF decreased from 16.25 to 5.3 (p &lt; 0.0001). PROMs (patient-reported outcome measures) showed improvement in 98.9% of cases, and 63.6% gave a \u201cvery much better\u201d PGI-I rating. Multivariate analysis identified a lower probability of achieving maximum satisfaction for the following factors: the AdVance XP as first-line therapy (OR 0.35), a lower ICIQ-SF question 1 (OR 0.26), status post-irradiation (OR 0.14), and more severe pain prior to ATOMS implantation (OR 0.51). (4) Conclusions: Implantation of an ATOMS is an effective and safe second-line treatment option for recurrent urinary incontinence after implantation of an AdVance\/AdVance XP sling. High patient satisfaction was demonstrated in a long-term follow-up.<\/jats:p>","DOI":"10.3390\/jcm11010081","type":"journal-article","created":{"date-parts":[[2021,12,24]],"date-time":"2021-12-24T08:38:46Z","timestamp":1640335126000},"page":"81","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["ATOMS (Adjustable Transobturator Male System) Is an Effective and Safe Second-Line Treatment Option for Recurrent Urinary Incontinence after Implantation of an AdVance\/AdVance XP Fixed Male Sling? A Multicenter Cohort Analysis"],"prefix":"10.3390","volume":"11","author":[{"given":"Fabian","family":"Queissert","sequence":"first","affiliation":[{"name":"Department of Urology and Pediatric Urology, University of M\u00fcnster, Schlosspl. 2, 48149 M\u00fcnster, Germany"}]},{"given":"Keith","family":"Rourke","sequence":"additional","affiliation":[{"name":"Department of Urology, Alberta University, 116 St. & 85 Ave., Edmonton, AB T6G 2R3, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1530-263X","authenticated-orcid":false,"given":"Sandra","family":"Sch\u00f6nburg","sequence":"additional","affiliation":[{"name":"Department of Urology and Kidney Transplantation, Martin Luther University, Universit\u00e4tsplatz 10, 06108 Halle (Saale), Germany"}]},{"given":"Alessandro","family":"Giamm\u00f2","sequence":"additional","affiliation":[{"name":"Department of Neuro-Urology, CTO\/Spinal Cord Unit, AOU Citt\u00e0 della Salute e della Scienza di Torino, Via Gianfranco Zuretti, 29, 10126 Torino, Italy"}]},{"given":"Andreas","family":"Gonsior","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Urologie, University of Leipzig, Augustuspl. 10, 04109 Leipzig, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5881-6614","authenticated-orcid":false,"given":"Carmen","family":"Gonz\u00e1lez-Enguita","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz, Av. de los Reyes Cat\u00f3licos, 2, 28040 Madrid, Spain"}]},{"given":"Antonio","family":"Romero","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Universitario Morales Meseguer, Av. Marqu\u00e9s de los V\u00e9lez, s\/n, 30008 Murcia, Spain"}]},{"given":"Andres J.","family":"Schrader","sequence":"additional","affiliation":[{"name":"Department of Urology and Pediatric Urology, University of M\u00fcnster, Schlosspl. 2, 48149 M\u00fcnster, Germany"}]},{"given":"Francisco","family":"Cruz","sequence":"additional","affiliation":[{"name":"Centro Hospitalar S\u00e3o Jo\u00e3o, Faculty of Medicine of Porto and i3S Institute, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5718-6964","authenticated-orcid":false,"given":"Francisco E.","family":"Martins","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio de Lisboa Norte, Hospital Santa Mar\u00eda, Av. Prof. Egas Moniz MB, 1649-028 Lisboa, Portugal"}]},{"given":"Juan F.","family":"Dorado","sequence":"additional","affiliation":[{"name":"PeRTICA Statistical Solutions, Av. Leonardo Da Vinci, 8, OF217, Getafe, 28906 Madrid, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1735-8792","authenticated-orcid":false,"given":"Javier C.","family":"Angulo","sequence":"additional","affiliation":[{"name":"Clinical Department, Faculty of Biomedical Science, Universidad Europea de Madrid, Carretera de Toledo, Km 12.500, Getafe, 28905 Madrid, Spain"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1002\/nau.23845","article-title":"Surgical treatment of post-prostatectomy stress urinary incontinence in adult men: Report from the 6th international consultation on incontinence","volume":"38","author":"Averbeck","year":"2019","journal-title":"Neurourol. 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Urol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/1\/81\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:52:50Z","timestamp":1760169170000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/1\/81"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,24]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["jcm11010081"],"URL":"https:\/\/doi.org\/10.3390\/jcm11010081","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,24]]}}}