MP27-17 EFFECTIVENESS OF REZŪM FOR CATHETER-DEPENDENT URINARY RETENTION: 12 MONTHS OUTCOMES OF A REAL-WORLD DATABASE
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Résumé
You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II (MP27)1 May 2024MP27-17 EFFECTIVENESS OF REZŪM FOR CATHETER-DEPENDENT URINARY RETENTION: 12 MONTHS OUTCOMES OF A REAL-WORLD DATABASE Roseanne Ferreira, Naeem Bhojani, Bilal Chughtai, Kevin C. Zorn, and Dean Elterman Roseanne FerreiraRoseanne Ferreira , Naeem BhojaniNaeem Bhojani , Bilal ChughtaiBilal Chughtai , Kevin C. ZornKevin C. Zorn , and Dean EltermanDean Elterman View All Author Informationhttps://doi.org/10.1097/01.JU.0001009400.86696.a2.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Managing catheter-dependent urinary retention typically involves medical therapies and when these are ineffective, transurethral surgery. Rezūm, a minimally invasive procedure utilizing convective water vapor to ablate benign prostatic tissue, presents an alternative treatment paradigm. This study aims to evaluate the clinical outcomes of treating catheter-dependent urinary retention using Rezūm therapy. METHODS: We analyzed data from the Canadian Rezūm registry database, which prospectively collated information from two high-volume centers between April 2019 and June 2023. Eligible patients were those with catheter-dependent urinary retention at the time of treatment. Variables such as patient demographics, operative characteristics, and functional outcomes were assessed at baseline, as well as 3, 6, and 12 months post-procedure. Descriptive statistics and logistic regression analyses were employed for data interpretation. RESULTS: Out of 95 patients with a history of urinary retention, 44 were catheter-dependent at the time of undergoing Rezūm therapy. The mean age of the patients was 69.6±10.3 years, and 70.5% presented with at least one comorbidity. Average prostate volume was 87.3 ml (range 29-195 ml), with 11% of prostates exceeding 150 ml. 82% of patients had a median lobe. 4.5% (2/44) had received prior surgical intervention. All patients had recently failed at least one trial without catheter (TWOC), and 52.3% were under oral BPH medical therapy at the time of the procedure. Median vapor injections numbered 14.5 (range 7-21), and mean procedure duration was 5.0±1.7 minutes. Median scores for visibility and bleeding during the procedure were both 1 out of 5 (range 1-3). Anesthesia comprised IV propofol sedation in 57%, spinal block in 36%, and self-administered methoxyflurane in 7% of patients. The trial of void (TOV) was attempted at a median of 30 days (range 7-30), with 38% (15/44) failing their initial TOV. No significant associations were found between failed initial TOV and variables such as prostate volume, number of treatments, comorbidities, or presence of a median lobe. Urinary tract infections were noted in 6 of 10 cases, and hematuria in 2 of 3 cases among those who failed their initial TOV. The rates of spontaneous voiding and catheter independence were 43/44, 39/40, 30/31, and 24/25 at 1, 3, 6, and 12 months, respectively. By the 12-month mark, reoperation was required in 4% (1/25), while 96% (24/25) remained catheter-independent. CONCLUSIONS: Rezūm water vapor therapy offers a promising and effective treatment alternative for catheter-dependent urinary retention patients who have failed initial TWOC, high rate of spontaneous voiding at 12 months post-procedure. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e430 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Roseanne Ferreira More articles by this author Naeem Bhojani More articles by this author Bilal Chughtai More articles by this author Kevin C. Zorn More articles by this author Dean Elterman 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 | 0,002 | 0,011 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,003 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 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 ».