MP55-16 COMPREHENSIVE PROSPECTIVE ASSESSMENT OF PATIENT REPORTED OUTCOMES AFTER URETHROPLASTY
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Résumé
You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) II (MP55)1 Apr 2019MP55-16 COMPREHENSIVE PROSPECTIVE ASSESSMENT OF PATIENT REPORTED OUTCOMES AFTER URETHROPLASTY Jordan Bekkema* and Keith Rourke Jordan Bekkema*Jordan Bekkema* More articles by this author and Keith RourkeKeith Rourke More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556659.46061.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: While urethroplasty is the most effective treatment for urethral stricture, the majority of outcomes are reported from a surgeon perspective and there is limited data describing patient reported outcomes after urethroplasty. Our objective is to comprehensively describe patient reported outcomes after urethroplasty. METHODS: 357 patients from 2011-2018 were enrolled in a prospective single-center study comprehensively assessing patient reported outcomes after urethroplasty including satisfaction, urinary function, quality of life, erectile function, ejaculatory function, penile appearance/curvature, genitourinary pain, and post-void dribbling. Patient satisfaction was determined using a 5-point Likert scale. Voiding function was assessed with the International Prostate Symptom Score (IPSS). Erectile function was assessment with the International Index of Erectile Function 5 (IIEF-5) and erectile dysfunction was defined as a ≥5-point change in IIEF-5. Ejaculatory function was scored using a hybrid of the ejaculatory component of the brief sexual function inventory. The remaining measures were assessed using literature derived 3 or 5 point Likert scales. Descriptive statistics were used to summarize findings while both parametric (paired t-test, Chi-square) and non-parametric (Wilcoxon) tests were used to compare pre- and post-operative findings. RESULTS: Of the 357 patients enrolled, mean age was 49.7 years with a mean stricture length of 4.4cm. Stricture location was most commonly bulbar (59.7%) followed by penile (19.9%) and posterior (13.7%). The most common stricture etiology was idiopathic (40.3%), iatrogenic (14.0%), trauma (13.2%) or lichen sclerosus (12.3%). Patients underwent a variety of urethroplasty techniques, including buccal mucosa graft onlay (42.6%), anastomotic (30.0%) or staged (11.2%) reconstruction. 92.0% of patients were stricture free on follow-up cystoscopy and 80.0% of patients reported being satisfied with the results of surgery while 7.3% of patients were unsatisfied. Voiding function was globally improved after urethroplasty including urinary quality of life (4.7 vs. 1.6; p<0.0001), IPSS (19.3 vs. 6.0; p<0.0001), post-void dribbling (2.7 vs. 2.5; p=0.04) and sitting to void (2.4 vs. 1.9; p<0.0001). Additionally, genitourinary pain scores improved postoperatively (2.2 vs. 1.6; p<0.0001). Overall, erectile function remained unchanged (17.7 vs. 17.2; p=0.46) but 12.0% of patients reported new onset erectile dysfunction. The incidence of ejaculatory function remained unchanged (p=0.13) but 7.1% of patients reported worsening of ejaculatory function postoperatively. The majority of patients reported minimal change in penile length or curvature but 6.7% and 3.1% of patients complained of bothersome loss of penile length or curvature respectively. CONCLUSIONS: Urethroplasty globally improves voiding function and genitourinary pain associated with urethral stricture. While sexual function is preserved for the majority of patients, a small proportion of patients describe new onset erectile dysfunction, penile shortening or curvature and should be counselled accordingly. Source of Funding: University of Alberta Department of Surgery Summer Studentship, Northern Alberta Urology Foundation Edmonton, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e800-e801 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jordan Bekkema* More articles by this author Keith Rourke More articles by this author Expand All 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 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,003 |
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 ».