Bilateral Ureteral Reimplantation at Primary Bladder Exstrophy Closure
Bibliographic record
Abstract
PURPOSE: We present the outcomes of children who underwent concurrent complete primary repair of bladder exstrophy and bilateral ureteral reimplantation vs those undergoing bladder exstrophy repair alone, focusing on the rate of postoperative febrile urinary tract infections. MATERIALS AND METHODS: We performed complete primary repair of bladder exstrophy with bilateral ureteral reimplantation using a cephalotrigonal technique in 15 patients (group 1) and without bilateral ureteral reimplantation in 23 patients (group 2). Postoperative assessment included ultrasound and voiding cystourethrogram in all patients. Outcome measurements included postoperative febrile urinary tract infections, hydronephrosis and presence of vesicoureteral reflux. RESULTS: Mean followup was 34 months (range 6 to 54) for group 1 and 70 months (23 to 117) for group 2. Median age at surgery was 3 days for both groups (range 1 to 140). There were 10 boys and 5 girls in group 1, and 11 boys and 12 girls in group 2. Two of 15 patients (13%) in group 1 had hydronephrosis postoperatively compared to 10 of 23 (43%) in group 2 (p = 0.05). One patient in group 1 (7%) had a febrile urinary tract infection vs 11 (48%) in group 2 (p = 0.01). No patients in group 1 had postoperative vesicoureteral reflux compared to 17 (74%) in group 2 (p = 0.04). There were no complications related to ureteral reimplantation. CONCLUSIONS: Bilateral ureteral reimplantation can be safely and effectively performed during primary closure of bladder exstrophy in newborns, potentially reducing postoperative febrile urinary tract infections and hydronephrosis by early correction of vesicoureteral reflux.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".