PD06-05 STRESS INCONTINENCE SURGERY IS NOT ASSOCIATED WITH PELVIC MALIGNANCY: THE RESULTS OF A LARGE POPULATION-BASED STUDY
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Résumé
You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy II (PD06)1 Apr 2019PD06-05 STRESS INCONTINENCE SURGERY IS NOT ASSOCIATED WITH PELVIC MALIGNANCY: THE RESULTS OF A LARGE POPULATION-BASED STUDY Humberto R Vigil*, Christopher Wallis, Joseph LaBossiere, Sender Herschorn, and Lesley Carr Humberto R Vigil*Humberto R Vigil* More articles by this author , Christopher WallisChristopher Wallis More articles by this author , Joseph LaBossiereJoseph LaBossiere More articles by this author , Sender HerschornSender Herschorn More articles by this author , and Lesley CarrLesley Carr More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555189.18045.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Stress incontinence surgery is common and was revolutionized by the midurethral sling. In the wake of regulatory warnings, unsubstantiated claims regarding mesh have permeated public discourse. Despite no supporting evidence, concerns continue to exist regarding a link between mesh and malignancy. We sought to evaluate the association between stress incontinence surgery, including transvaginal mesh, and carcinogenesis in a large population-based cohort. METHODS: A retrospective cohort of adult women who underwent stress incontinence surgery from 1994-2016 in Ontario was captured from the Institute for Clinical Evaluation Sciences database. Women were identified using physician billing codes in Ontario for the different stress incontinence procedures. The primary outcome of interest was the diagnosis of pelvic cancers. These were defined using ICD-9 and ICD-10 billing codes. Pelvic cancers included urological and gynaecological malignancies. The standardized incidence rate (SIR) was calculated as the ratio of the observed number of pelvic cancer cases divided by the age-stratified expected number of pelvic cancer cases based on the Ontario population. Subgroup analyses were performed for individual malignancies and midurethral sling patients. Multivariable logistic regression modeling examined for risk factors of pelvic malignancy. RESULTS: A total of 120,999 women underwent a procedure for stress incontinence in the form of urethropexy, combined abdominal/vaginal sling, bulking agent or midurethral sling in Ontario during the study period. Midurethral sling accounted for 63% of procedures performed. Median follow up was 9.3 years (IQR 5.4-14.4). Expected cancer cases over a total exposure time of 1,221,668 person-years was 1,146. 935 pelvic cancers were observed with a frequency of 0.77%. The SIR for any cancer diagnosis compared to the general population of Ontario was 0.816, 95% CI 0.764-0.870. In patients who underwent a midurethral sling only, the expected number of cancer cases over an exposure time of 562,457 person-years was 576. 479 pelvic cancers were observed with an SIR of 0.831, 95% CI 0.758-0.909. On multivariable analysis, midurethral sling was not associated with an increased risk of pelvic cancer when compared to the other stress incontinence procedures. CONCLUSIONS: Stress incontinence surgery including the transvaginal implantation of mesh was not associated with an increased risk of pelvic malignancy in a large population-based cohort. Source of Funding: None Toronto, Canada; Edmonton, Canada; Toronto, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e138-e138 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Humberto R Vigil* More articles by this author Christopher Wallis More articles by this author Joseph LaBossiere More articles by this author Sender Herschorn More articles by this author Lesley Carr 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 | 0,003 | 0,011 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 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 ».