Why a large cushion?
Atrophy reduction and erosion prophylaxis.
The effect of the implant is simple: The urologist determines the fill volume of the cushion. A compression of the bulbospongiosus muscle, indirectly of the urethra, increases the urethral resistance. The contraction of the bladder will make a physiological urination possible, but an involuntary loss of urine is reduced or ideally avoided. The size of the cushion determines the pressure on the bulbospongiosus muscle, and the smaller the cushion, the more punctate the pressure is. The soft compression of the large ATOMS cushion allows a low pressure, and a low tissue pressure leads to low atrophy. Limited tissue atrophy means lower risk of erosion. A very limited number of urethral erosions is known to A.M.I. after 15 years of experience with ATOMS, and those few cases were usually associated with a difficult patient situation (e.g. following previous cuff erosion of an artificial urinary sphincter).1