MP13-10 SURGICAL MANAGEMENT OF BENIGN PROSTATIC OBSTRUCTION: 20-YEAR POPULATION-LEVEL TRENDS
Notice bibliographique
Résumé
You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation1 Apr 2017MP13-10 SURGICAL MANAGEMENT OF BENIGN PROSTATIC OBSTRUCTION: 20-YEAR POPULATION-LEVEL TRENDS Christopher Wallis, Lesley Carr, Sender Herschorn, Refik Saskin, Sidney Radomski, Armando Lorenzo, and Robert Nam Christopher WallisChristopher Wallis More articles by this author , Lesley CarrLesley Carr More articles by this author , Sender HerschornSender Herschorn More articles by this author , Refik SaskinRefik Saskin More articles by this author , Sidney RadomskiSidney Radomski More articles by this author , Armando LorenzoArmando Lorenzo More articles by this author , and Robert NamRobert Nam More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.453AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Benign prostatic obstruction (BPO) due to histologic benign prostatic hyperplasia is highly prevalent among older men. Despite widespread use of medical therapy, surgical treatment remains a mainstay in the management of BPO. We sought to characterise trends in the surgical management of BPO in a single-payer healthcare system in Ontario, Canada over a 20 year period. METHODS We performed an interrupted time-series analysis using segmented regression among men aged 18 years and older undergoing surgical treatment for BPO between January 1, 1994 and December 31, 2014 in Ontario, Canada. The passage of time was considered the primary exposure. The primary outcome was the proportion of all BPO surgeries performed using each of the following modalities: transurethral resection of the prostate (TURP), endoscopic laser prostatectomy, open/laparoscopic prostatectomy, and others. Secondary outcomes included trends in the age and comorbidity of patients undergoing BPO surgery. RESULTS We identified 136,459 men who underwent BPO surgery between 1994 and 2014. Across the study interval, the annual age-adjusted rate of BPO surgery declined significantly (24 per 10,000 population in 1995 to 10 per 10,000 population in 2014). We identified two distinct epochs with respect to treatment modality. From 1994 to 2001, there were no significant changes in the distribution of BPO surgical modalities with TURP the most common throughout (97.2% in 1994 and 97.0% in 2001). In the period 2002 to 2014, there was a significant decline in the use of TURP (92.1% to 76.9%; p=0.027) with a corresponding increase in the use of endoscopic laser prostatectomy (3.5% to 21.9%; p=0.0008). We identified small but statistically significant increases in the age (p=0.0004) and comorbidity (p<0.0001) of patients undergoing BPO surgery over time. CONCLUSIONS This large, population-based study demonstrates a shift in the management of BPO with increasing use of endoscopic laser prostatectomy, beginning in 2002. However, TURP remains the most common treatment modality. We also identified shifting demographics of patients undergoing BPO surgery with a trend for patients to be older and have greater comorbid disease at the time of surgery in more recent years. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e157 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Christopher Wallis More articles by this author Lesley Carr More articles by this author Sender Herschorn More articles by this author Refik Saskin More articles by this author Sidney Radomski More articles by this author Armando Lorenzo More articles by this author Robert Nam More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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 machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,005 | 0,011 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 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 source (Gemma direct ou Codex distillé), 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 ».