Excessive fibrosis and non-function after ATOMS (adjustable transobturator male system): A case of capsular contracture?

Abstract

The adjustable transobturator male system (ATOMS) treats post-prostatectomy urinary incontinence by compression of the proximal bulbous urethra. It reminds of the Kaufman prosthesis described in 1978. We describe a case where an excessive fibrotic reaction occurred around the cushion. Furthermore, the bulbous urethra underneath, developed severe atrophy devoid of any visible blood supply. We suspect ongoing shear forces around the cushion while sitting resulting in a chain reaction of acute through chronic inflammation and progressive fibrosis and encapsulation. Does the encapsulation lead to capsular contracture resulting in non-function?

Keywords

• ATOMS
• Capsular contracture
• Radical prostatectomy and urinary incontinence
• Fibrosis and complications