MP30-08 IS STRESS INCONTINENCE AND PELVIC ORGAN PROLAPSE SURGERY ASSOCIATED WITH THE DEVELOPMENT OF AUTOIMMUNE RHEUMATIC DISEASE? THE RESULTS OF A POPULATION-BASED COHORT STUDY
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Résumé
You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy I (MP30)1 Apr 2020MP30-08 IS STRESS INCONTINENCE AND PELVIC ORGAN PROLAPSE SURGERY ASSOCIATED WITH THE DEVELOPMENT OF AUTOIMMUNE RHEUMATIC DISEASE? THE RESULTS OF A POPULATION-BASED COHORT STUDY Humberto Vigil*, Rano Matta, Arielle Mendel, Lesley Carr, and Sender Herschorn Humberto Vigil*Humberto Vigil* More articles by this author , Rano MattaRano Matta More articles by this author , Arielle MendelArielle Mendel More articles by this author , Lesley CarrLesley Carr More articles by this author , and Sender HerschornSender Herschorn More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000869.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Regulatory warnings for mesh-based stress urinary incontinence (SUI) and pelvic organ prolapse (POP) procedures have led to an unsupported claim that mesh directly stimulates the immune system and predisposes to autoimmune rheumatic disease (ARD). We sought to evaluate the association between SUI and POP on the development of ARD in Ontario, Canada. METHODS: Adult women who underwent surgery for SUI or POP between January 1, 2002 and December 31, 2015 were identified from an administrative database. Surgical codes were used to identify women undergoing mesh and non-mesh procedures. The remaining population of women during this period were divided into two control groups according to diagnostic codes: SUI or POP with no surgery and the general population. The primary outcome was a composite of any ARD diagnosis (rheumatoid arthritis, connective tissue disorders, seronegative spondyloarthropathies and vasculitis) developing at least 3-months following SUI or POP surgery or diagnosis. Secondary outcomes included the development of the individual ARDs. A 4-level categorical Cox-proportional hazards model was used to estimate the risk of primary and secondary outcomes with the general population as the reference group, adjusting for patient-level baseline covariates. RESULTS: 281,122 women were diagnosed with SUI or POP and did not undergo surgery. Of the 139,904 women who underwent surgery, 79,222 and 60,682 underwent repair with and without mesh, respectively. Median age was 43 (IQR 29-57). Overall, 84,992 (1.45%) women were diagnosed with an ARD. Compared to the general population, women with SUI or POP had an increased risk of ARD independent of treatment modality (mesh HR 1.17 [95%CI 1.13-1.21]; non-mesh HR 1.16 [95%CI 1.12-1.20]; no surgery HR 1.11 [95%CI 1.09-1.13]). In terms of ARDs, women with SUI or POP had the greatest risk of developing rheumatoid arthritis (mesh HR 1.28 [95%CI 1.21-1.34]; non-mesh HR 1.32 [95%CI 1.24-1.39]; no surgery HR 1.14 [95%CI 1.11-1.17]) and seronegative spondyloarthropathies (mesh HR 1.36 [95%CI 1.24-1.48]; non-mesh HR 1.23 [95%CI 1.11-1.36]; no surgery HR 1.19 [95%CI 1.12-1.25]). CONCLUSIONS: SUI and POP are associated with an increased risk of ARD irrespective of management approach. Risk factors for SUI and POP may account for the increased risk of ARD; however, further work is required to clarify this novel finding. Source of Funding: N/A © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e441-e441 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Humberto Vigil* More articles by this author Rano Matta More articles by this author Arielle Mendel More articles by this author Lesley Carr More articles by this author Sender Herschorn 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 | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 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 ».