MP35-09 LOWER URINARY TRACT SYMPTOM NON-RESPONSE (″LUTS FAILURE″) AFTER URETHROPLASTY
Notice bibliographique
Résumé
INTRODUCTION AND OBJECTIVE: Urethroplasty is a highly effective treatment for urethral stricture. However, some patients fail to experience significant improvement in lower urinary tract symptoms (LUTS) despite being stricture-free. We aim to identify the incidence of ″LUTS failure″ after urethroplasty and examine associated factors. METHODS: Patients undergoing urethroplasty over a 6-year period (January 2012 – December 2018) were offered enrollment in a study examining urinary function after urethroplasty. Urinary function and urinary quality of life (UQOL) were assessed pre-operatively and at 6 months postoperatively using the international prostate symptoms score (IPSS). ″LUTS failure″ was defined as less than 3-point improvement in IPSS. Stricture recurrence was defined as the inability to pass a 16Fr flexible cystoscope. Patients not completing pre- and post-operative IPSS questionnaires and patients with stricture recurrence were excluded from analysis. Descriptive statistics were used to summarize findings while multivariate binary logistic regression was used to determine the association between clinical factors and LUTS failure. RESULTS: Of the 828 patients undergoing urethroplasty over this period, 387 patients completed IPSS scores pre- and post-operatively and of these 372 (96.1%) were stricture free on cystoscopy at 6 months. Mean patient age was 49.5 years, mean stricture length was 4.3cm and 84.4% of patients failed prior endoscopic treatment. Stricture location, etiology and urethroplasty technique were typical of that found in most industrialized nations. As expected, mean IPSS (19.0 vs. 5.4; p<0.0001) and median UQOL (5 vs. 1; p<0.0001) were improved post-urethroplasty. Despite being stricture free on cystoscopy, 13.7% of patients did not experience improvement in IPSS (″LUTS failure″) and 10.2% did not report improvement in UQOL. On multivariate binary logistic regression, increasing patient age (OR 1.04, 95% CI 1.01-1.06, p=0.006), lichen sclerosus (OR 7.6, 95% CI 1.1-51.0, p=0.04) and hypospadias strictures (OR 8.3, 95% CI 1.3-54.0, p=0.03) were associated with "LUTS failure" while stricture location (p=0.46), length (p=0.07), previous urethroplasty (p=0.86), prior endoscopic treatment (p=0.50), type of urethroplasty (p=0.17) and other etiologies were not. Increasing patient age was the sole factor associated with a lack of improvement in UQOL (OR 1.03, 95% CI 1.01-1.06, p=0.02). CONCLUSIONS: While the majority of patients experience improvement in lower urinary tract function after urethroplasty, 13.7% experience ″LUTS failure″ despite being stricture-free on cystoscopy and 10.2% report no improvement in UQOL. Both occurrences are independently associated with increasing patient age and may be related to concurrent benign prostatic hyperplasia or alternately detrusor dysfunction related to longstanding bladder outlet obstruction. Source of Funding: Northern Alberta Urology Foundation
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 | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 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 ».