Oral Poster 20
Notice bibliographique
Résumé
OBJECTIVES: Evaluate the safety and efficacy of the ACT® device for the treatment of recurrent SUI. Secondary objectives included procedural technical difficulty and device adjustability. MATERIALS AND METHODS: Management of stress urinary incontinence (SUI) associated with intrinsic sphincter deficiency (ISD) can be challenging after prior failed therapies. The Uromedica ACT® system is a novel device under FDA investigation that provides bulk at the bladder neck with adjustable silicone balloons for urethral coaptation and bladder neck support. Each balloon is attached to a titanium port allowing for post-operative titration of the balloons for maximal efficacy. A small incision between the labia majora and minora at the level of the urethral allows for passage of a trocar under fluoroscopic guidance to the bladder neck. The device is delivered and the balloon filled with 1.5 cc dilute contrast. The injection port for balloon adjustment is placed into a subcutaneous pouch in the labia majora. Balloon adjustments begin 6 weeks post-operatively, as needed. The study population involves female patients with recurrent SUI with urethral hypermobility (UHM) and/or intrinsic sphincter deficiency (ISD). Testing was performed at baseline, then postop 6 wks, 3, 6, 9, 12 months, and annually thereafter, and included urinalysis, a 3-day diary, provocative pad weight test (PPWT), direct visual stress test (DVST), Stamey score, physical exam and validated questionnaires (UDI-6, IIQ-7, IQoL). RESULTS: : 162 patients were implanted to date, with 142, 84 and 57 patients completing at least 1, 2, and 3 years follow-up, respectively. Mean age is 67.4 yrs (range 31–94 yrs). 83% (N = 135) had at least one previous anti-incontinence procedure, with 42.6% experiencing 2 or more failed procedures. Difficulty of ACT® surgery was rated as mild, moderate, or severe in 62%, 29%, and 9% of procedures, respectively. Improvement in Stamey score was >1 in 75.4% (107/142), in 75.0% (63/84) and in 83.9% (47/56) at 1, 2 and 3 yrs, respectively. Mean PPWT decreased from 48.9, 44.3 and 44.5 grams at baseline to 11.8, 8.9 and 8.4 grams at 1, 2 and 3 yrs, respectively (P < 0.001). Dry rate was 50.8%, 63.0% and 71.4%, and >50% improved rate was 79.7%, 88.7% and 83.3% at 1, 2 and 3 yrs, respectively. Validated questionnaires noted significant improvements at 1, 2 and 3 yrs (P < 0.001). Mean number of balloon volume adjustments through the study period to achieve maximum continence was 2.9 (0–15). Device or procedure related complications (bladder perforation, port or balloon erosion, balloon migration, port or balloon related pain/discomfort, intermittent urinary retention) were reported in 25% (39/156) of subjects at the end of 12 months, 18.6% (21/113) through year 2, and 13.7% (10/73) through year 3. Of these, the majority (54%) were considered to be mild in severity. CONCLUSION: 3-year data suggest the Uromedica ACT® system can be an effective, simple, minimally-invasive and safe treatment for recurrent female SUI.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,011 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».