MP30-17 A COMPARATIVE ANALYSIS OF EMBOLIZATION VERSUS SURGICAL MANAGEMENT OF VARICOCELE IN THE PROVINCE OF ONTARIO: A POPULATION-BASED STUDY
Notice bibliographique
Résumé
You have accessJournal of UrologyCME1 Apr 2023MP30-17 A COMPARATIVE ANALYSIS OF EMBOLIZATION VERSUS SURGICAL MANAGEMENT OF VARICOCELE IN THE PROVINCE OF ONTARIO: A POPULATION-BASED STUDY Aidan Canil, Wenbin Li, Kingston Canada, Premal Patel, Winnipeg Canada, Ben Mussari, Timothy Hanna, D. Robert Siemens, and R. Christopher Doiron Aidan CanilAidan Canil More articles by this author , Wenbin LiWenbin Li More articles by this author , Kingston CanadaKingston Canada More articles by this author , Premal PatelPremal Patel More articles by this author , Winnipeg CanadaWinnipeg Canada More articles by this author , Ben MussariBen Mussari More articles by this author , Timothy HannaTimothy Hanna More articles by this author , D. Robert SiemensD. Robert Siemens More articles by this author , and R. Christopher DoironR. Christopher Doiron More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The optimal approach for management of varicocele is currently unknown. Existing evidence is of low quality with no randomized controlled studies comparing approaches. We provide the first population-based analysis of embolization vs surgical management of varicocele. METHODS: All patients in the province of Ontario who underwent treatment of their varicocele between April 1, 2002-March 31, 2012 were identified using ICES databases. The index intervention was considered the approach first used in the treatment-naïve patient – open surgery or embolization. The primary outcome was the rate of reintervention while secondary outcomes included complications and healthcare utilization. RESULTS: We identified 557,650 male patients with a varicocele diagnosis, of whom n=3,180 underwent an intervention and were included in the study – n=2,139(67%) underwent open varicocelectomy while n=1,041(33%) underwent embolization as their index intervention (Figure 1). Reintervention was more common amongst those who underwent embolization compared to those who underwent surgical management [n=97(9.3%) vs n=142(6.6%);p<0.01]. While controlling for demographics, regression analysis showed surgical varicocelectomy was still less likely to require reintervention [OR 0.68(0.52-0.90);p<0.01].Those who underwent surgical management had higher rates of complications requiring ED visits within 1 month of the procedure. This association was persistent on regression analysis, controlling for demographics [OR 1.69(1.27-2.25);p<0.01]. There was no difference in hospital admissions between the groups [OR 1.53(0.94-2.49);p=0.087].There was a weak association between socioeconomic status (SES) and type of index intervention with the least wealthy income quintile more likely to receive surgery [OR 1.27(1.01-1.60);p=0.04] while there was no difference based on rurality and age. CONCLUSIONS: This first population-based study to examine surgical management vs embolization for treatment of varicocele shows that surgery is less likely to require repeat intervention but with a modest increased risk of complications. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e397 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aidan Canil More articles by this author Wenbin Li More articles by this author Kingston Canada More articles by this author Premal Patel More articles by this author Winnipeg Canada More articles by this author Ben Mussari More articles by this author Timothy Hanna More articles by this author D. Robert Siemens More articles by this author R. Christopher Doiron 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 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,003 |
| Bibliométrie | 0,001 | 0,004 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
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 ».