ATOMS Prosthesis for Male Urinary Incontinence

Male urinary incontinence (MUI)is the involuntary loss of urine. It is not considered a disease in itself, but rather a symptom resulting from an issue within the urinary tract.

Urinary incontinence occurs when the pressure inside the bladder exceeds the pressure in the urethra. This condition can be caused by overactivity of the detrusor muscle. 

The main causes include:

• Stress incontinence may occur after prostate removal surgery. If nerves or the sphincter are damaged, the lower part of the bladder may lack sufficient support. As a result, maintaining urine in the bladder depends solely on the sphincter.
  
  
• Urge incontinence is caused by bladder muscles contracting so forcefully that the sphincter cannot hold back the urine. This leads to a sudden and intense need to urinate.
  
  
• Overflow incontinence may be caused by an obstruction in the urethra, which results in urine building up in the bladder. This is often due to an enlarged prostate or a narrowing of the urethra. It can also occur if the bladder muscles are weakened.

Treatment options for male urinary incontinence depend on the severity of the condition and how much it affects quality of life. In some cases, medication and simple pelvic floor exercises may be enough. However, in both mild and severe cases, surgery offers the most definitive solution.

On this page, we explain in detail the implantation of a sphincter prosthesis, the most successful treatment for stress urinary incontinence. 

In the sections below, you will find a step-by-step guide to the most advanced and safest procedure to treat stress incontinence in men, along with the benefits it offers.

One of the surgical solutions for urinary incontinence is the placement of a suburethral implant beneath the bulbocavernosus muscle.

The ATOMS implant (Adjustable Transobturator Male System) is considered the best option to treatstress urinary incontinence, which is one of the most common side effects after prostate surgery—whether oncological or benign (e.g., prostate reduction or radical prostatectomy).

The ATOMS implant is recommended in all cases of mild to moderate urinary incontinence, as well as in selected primary cases of severe incontinence.

The main reason for performing surgery with this hydraulic device is that it replaces the function of the sphincter, helping to restore urinary control. This significantly improves quality of life by eliminating the discomfort and limitations caused by incontinence—immediately and permanently.

In addition, this next-generation device stands out for its key advantage: adjustability. It can be regulated non-surgically on an outpatient basis, even years after implantation, to adapt to the progression of incontinence—without the need for reoperation.

Below, we explain the main features and functioning of the ATOMS hydraulic system, and why it is considered an innovative and highly effective solution.

Do you have incontinence issues?

Request now a free surgical consultation with our Urology specialist to evaluate your case for Male Urinary Incontinence Surgery.

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The treatment of male stress urinary incontinence remains a significant challenge, particularly after radical prostatectomy. 

The ATOMS System by A.M.I. offers aminimally invasive, low-risk solution, with the added benefit of easy adjustability at any time after implantation.

This device consists of three interconnected components that are implanted beneath the muscle in the perineal area. 

The components include:

• Suburethral cushion (sphincter substitute): Positioned at the center of the fixation mesh, this cushion is filled through a port-catheter connection after surgery.
  
  
• Catheter and scrotal port: The catheter exits laterally from the upper part of the suburethral cushion toward the scrotum. The small scrotal port, pre-connected to the cushion via the catheter, serves as the access point for filling or emptying the system with saline solution. Adjustments are made using a simple percutaneous puncture needle.
  
  
• Fixation mesh arms: These are folded toward the center of the implant to secure the system in place, eliminating the need for additional straps or screws. This ensures symmetrical fixation at four points.

The ATOMS hydraulic device increases pressure and supports the urethra, helping to control urination.

With this device, patients can urinate freely and spontaneously, without having to activate any mechanical component. This makes the ATOMS system by A.M.I. especially suitable for patients with certain limitations, such as:

• Patients with dementia, or those with expected progressive cognitive decline.
  
  
• Patients with joint pain, who benefit from not needing to manually manipulate the device.

Following treatment with the ATOMS mesh implant, there is a90% success rate in achieving complete continence—that is, total elimination of urinary incontinence.

The implant procedure is simple and quick, performed under regional or spinal anesthesia.

If you are interested in undergoing ATOMS prosthesis surgery (mesh implantation) to treat male stress urinary incontinence through Operarme, you can request a free consultation with no waiting time with one of our Urology Specialists. 

During this consultation, you will have the opportunity to meet the specialist, who will assess your condition and recommend the most appropriate treatment for you.

If you would like more information before booking your appointment, you can contact the Operarme team via the contact form, by calling at  +34 91 141 33 56, or by clicking the Request Appointment button below: 

Do you have incontinence issues?

Request now a free surgical consultation with our Urology specialist to evaluate your case for Male Urinary Incontinence Surgery.

Make an appointment

Once you have requested your consultation, one of our patient service advisors will contact you to answer any questions you may have and to confirm that the date and time of the consultation suit your availability.

On the day of your consultation with the specialist, please bring all medical and diagnostic tests related to your condition. The urologist will review your medical history, perform a physical examination (if necessary), and evaluate any test results provided (such as ultrasounds, blood tests, etc.). The goal is to determine the most suitable treatment option for you.

After the consultation, our Patient Service Team will follow up with you to see how everything went and whether you have decided to proceed with the surgery. 

If so, we will explain the next steps, schedule the pre-operative and anesthesia appointments, and assist you with any questions or concerns you may have throughout the process.

Below is a detailed explanation of the ATOMS prosthesis procedure, including preoperative steps, the surgical process, and postoperative care through to full recovery.

Preoperative Assessment for the ATOMS Implant

Before the hydraulic sphincter prosthesis implantation, several tests will be conducted to evaluate your overall health:

• Electrocardiogram (ECG): to assess heart function.
• Chest X-ray: not always required—it will depend on your doctor's recommendation. This test helps identify any pulmonary conditions and ensures that the trachea is properly aligned.
• Complete blood work: includes a full blood count, basic coagulation profile, kidney function, and glucose levels. A urinalysis is also performed to rule out infections.
• Anesthesiologist consultation: inform the anesthesiologist if you have any allergies, are taking any medications (prescription or over-the-counter), or have had previous surgeries. This consultation will determine the appropriate anesthesia for the procedure.

Once the anesthesiologist clears you for surgery, the next step is to proceed with the operation at the hospital.

Step-by-step: ATOMS implant surgery for male stress urinary incontinence

On the day of surgery, after checking in at the hospital and submitting your documentation, the medical staff will prepare you for the procedure. 

You will then be taken to the operating room, where you’ll be greeted by the urologist, anesthesiologist, and nursing team who will assist with the surgery.

Here is a step-by-step breakdown of the procedure:

1. After the anesthesia takes effect, the urologist will insert a urethral catheter and make a small incision in the perianal area to access the sphincter region.
   
   
2. Using tunneling needles, the specialist will place the mesh fixation arms around the pelvic bones, specifically along the inferior pubic ramus, creating four fixation points to support the suburethral cushion.
   
   
3. The central component, a trapezoid-shaped cushion, is then positioned to gently compress the urethral walls, helping prevent involuntary urine leakage.
   
   
4. The scrotal port is then adjusted and connected to the cushion via a silicone catheter.
   
   
5. Pressure is regulated by injecting saline solution through the catheter, fine-tuning the system’s effect on the urethra.
   
   
6. Finally, the perianal incision is closed with surgical sutures, and the catheter is removed.

The surgery is performed under regional or spinal anesthesia and typically lasts 50 to 60 minutes.

After the operation, you will be transferred to the recovery room to recover from the anesthesia. Once stable, you’ll be moved to your room, where you’ll stay for 24 hours to ensure everything is progressing correctly.

Postoperative care and recovery

After 24 hours, you will be discharged from the hospital. The effects of the ATOMS implant are typically immediate, resulting in either a complete resolution or significant reduction of urinary incontinence. 

If the results aren’t optimal, the device can be adjusted non-surgically by modifying the fluid volume in the cushion to achieve the ideal urethral pressure.

In general, you will need a few days before resuming your normal activities, gradually starting with light tasks. Sexual activity is usually safe after 10 to 15 days, depending on your recovery.

For a successful recovery, it’s essential to follow your specialist’s instructions carefully. This includes maintaining proper hygiene of the surgical area, taking prescribed anti-inflammatory medications, and adhering to a wound care routine. After surgery, your urologist will explain all necessary post-op care in detail.

Surgery for male stress urinary incontinence using the ATOMS prosthesis offers a wide range of benefits, including:

• Sphincter function replacement: After surgery, many patients experience immediate dryness without requiring further adjustments. The system allows for normal, physiological urination without the need for any mechanical manipulation.
  
  
• Hydraulic system without mechanical components: The ATOMS device has no mechanical parts, which eliminates the risk of failure due to wear and tear over time, a common concern with mechanical implants.
  
  
• Lifetime adjustability: The system can be adjusted at any time—even years after implantation—allowing it to adapt to the patient’s changing condition. It also permits future endourological procedures without needing additional surgery.
  
  
• Minimally invasive surgery: The procedure is low-risk and minimally invasive, enabling a quick and smooth recovery.
  
  
• Fast recovery: Thanks to the precision in placement and careful surgical technique, postoperative pain is minimal and temporary, and patients typically return to daily life very quickly.
  
  
• Suitable for all levels of incontinence: The ATOMS prosthesis is effective for mild, moderate, and severe incontinence, and can also be used in patients who have undergone radiotherapy.

Besides the medical benefits of the ATOMS hydraulic prosthesis, there are exclusive advantages to having your procedure done through Operarme:

• Free surgical assessment: You can book a free consultation with a urology specialist to evaluate your case and discuss the best treatment option.
• All-inclusive fixed price: We guarantee a fixed, transparent price from the start, with everything included, so there are no unexpected costs.
• Personalized patient care: Our Patient Service Team will guide you through the entire process, answering your questions and making sure you feel supported and informed at every step.
• Medical complications insurance: All surgeries with hospital admission include complications insurance, which covers unexpected issues such as an extra night’s stay or a potential reoperation if necessary.

If you’re considering a safe and effective solution to male urinary incontinence with the support of expert urologists, you can request your free surgical consultation by filling out our contact form, calling us at  +34 91 141 33 56, or clicking the image below:

Do you have incontinence issues?

Request now a free surgical consultation with our Urology specialist to evaluate your case for Male Urinary Incontinence Surgery.

Make an appointment