Podium Session 4: Pediatrics, Pelvic Pain, Sexual Dysfunction, Oncology
Notice bibliographique
Résumé
Introduction: Concerns have been raised regarding the effectiveness and durability of transverse ventral corporotomies to reliably correct chordee.Herein, we assessed the outcomes of this technique to correct ventral curvature (VC) in severe penoscrotal hypospadias.Methods: We selected 62 patients who underwent both stages of primary staged inner prepuce graft repair with a minimum six-month followup from a prospectively collected hypospadias database (2008-2021, n=881).Proximal TIP/Byars flaps cases and redos were excluded.VC was corrected by dividing the urethral plate in all cases and performing three transverse ventral corporotomies ± dorsal plication (80%).Residual VC was checked in all cases during the second stage.All procedures were performed by a single surgeon.Preoperative testosterone stimulation (PTS) was administered for glans width <14 mm (three intramuscular injections, three weeks apart).Age at each stage of repair, meatal location, degree of VC assessed before/ after degloving with an artificial erection measured by photograph with an electronic app, anesthetic block (caudal/dorsal penile block), and complications (urethrocutaneous fistula [UCF], glans dehiscence [GD], recurrent VC, and graft contraction) were collected.Outcomes of interest were postoperative recurrent VC and overall complication rate.Recurrent VC was assessed by reflex erection during examination and/or parents reporting.Results: Median patient age at first and second stage was 21 and 30 months, respectively; mean followup was 42 months.Eighty-four percent of patients had penoscrotal 45 (72%), scrotal 9 (15%), and perineal hypospadias 12 (13%).Overall, 35/62 (57%) patients had VC between 30-70° and 27 (43%) had >70° after degloving; 57/62(92%) boys received PHS (three shots).Grafts took well in most cases, with only four (6%) contractions.Of these, two needed re-grafting and two were stretched (vit.E).The median interval between stages was eight months.Overall, complications occurred in 15/62(24%) boys: nine UCFs, five GDs, and one recurrent VC due to skin tethering.All successful cases had the neomeatus located at the tip of the glans.Parents of three boys with GD decided for no further surgery, leaving the meatus at the corona.In total, the re-operation rate was 19% (12/62).Conclusions: An overall re-operation rate of 19% was observed in patients who underwent staged preputial graft repair with three transverse corporotomies to treat scrotal/perineal hypospadias.This rate is significantly lower than what has been previously reported using staged Byars flaps procedures or single-stage operations.After a mean followup of almost four years, recurrent VC was seen in only one child (1.6%) due to skin tethering.Despite being the longest followup described with this technique thus far, we recognize that recurrent VC may not present until adolescence, therefore, following these patients until adulthood is imperative.
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 | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,201 | 0,050 |
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 ».