Analyzing outcomes of the adjustable transobturator male system (ATOMS) for post-prostatectomy incontinence and its relationship with detrusor overactivity and radiotherapy with the help of urodynamics
Bibliographic record
Abstract
INTRODUCTION: The adjustable transobturator male system (ATOMS) has recently garnered attention for its surgical simplicity and suitability for mild post-prostatectomy incontinence (PPI). This retrospective study investigated the outcomes of patients who received ATOMS, including subgroup analyses of individuals with overactive bladder (OAB) or previous radiotherapy. METHODS: A retrospective cohort study was conducted on 104 patients who received ATOMS. To classify mild, moderate, and severe incontinence, preoperative severity was defined as <2 pads per day (PPD), 2-4 PPD, and >4 PPD, based on the 24-hour pad count and/or <200 g, 200-400 g, and >400 g, based on the 24-hour pad-test (24h-PT). Postoperative "dry" status referred to ≤1 pad/day, while "improved" or "very much improved" indicated a pad reduction of ≥50% or ≥75%, respectively. Patients who reported "much better" or "very much better" on the Patient Global Impression of Improvement-Incontinence (PGI-I) questionnaire were considered "satisfied." RESULTS: Thirteen patients were excluded for insufficient followup, leaving 91 patients (mean age 70 years, mean followup 42 months). Most were classified as moderately (44%) or severely (55%) incontinent, with a median of four pads/day and a mean 24-hour pad test of 351 g preoperatively. At final followup, the median pad count was 0.5; 89% improved overall, 58% became dry, and 91% were satisfied. Complications occurred in 27% (five grade III). Patients with prior radiotherapy (n=29) exhibited lower dryness (55% vs. 79%) and improvement (83% vs. 92%), alongside more adjustments and higher total instilled volume. There were no other significant subgroup differences. CONCLUSIONS: ATOMS appears to be a safe and effective device for PPI, including for moderate to severe incontinence, although radiotherapy may affect efficacy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".