A technique using a resectoscope sheath under direct vision and nasogastric tube for difficult catheterization following TURP
Bibliographic record
Abstract
We read with great interest the recent CUA guidelines on prostate biopsy methodology. 1 We note that the recommendation regarding high-grade prostatic intra-epithelial neoplasia (HGPIN) states that "in the current era of extended biopsy schemes, HGPIN is no longer considered a strict indication for repeat biopsy and patients should be followed clinically." 1 Our Canadian research group, set out to specifically address the issue of HGPIN on prostatic needle biopsy (PNB) after 2 large review articles authored by high profile urological pathologists, rendered differing conclusions regarding the significance of HGPIN on PNB. 2,3 We used a large Canadian database containing over 12 000 patients undergoing initial PNB and concluded that HGPIN, when multifocal, is a significant risk factor for prostate cancer (PCa) carrying an odds ratio (OR) of 1.38. 4 In fact, the risk generally increases with the extent of HGPIN such that increasing cores involved correlates with increasing risk of PCa on follow-up PNB. 4 Our initial study, although well-controlled with a benign group and statistically sound, did contain a mixture of prostate sampling protocols, so we recently repeated the study, specifically limiting the analysis to include only extended biopsy protocols yielding 10 or more cores. 5On the repeat study, we again found the same results.Patients with multifocal HGPIN carry a significantly increased risk of detecting PCa on follow-up PNB compared to patients with benign findings on initial PNB. 5 Again, there is a general elevation in risk with increasing volume of HGPIN in the initial sample with 1 core showing no increased risk of PCa (OR 0.68) but 2 cores and >2 cores involved by HGPIN showing ORs of 2.57 and 3.61, respectively. 5Our studies show that HGPIN, when multifocal, is still a significant independent risk factor for PCa, even in the current era of extended PNB protocols.While it is a sound recommendation that patients with unifocal HGPIN be followed clinically with PSA and DRE, it is our recommendation and practice that patients with multifocal HGPIN should undergo a repeat biopsy within 1 year even in the absence of PSA or DRE changes.We also suggest that pathologists with expertise in urological pathology be involved in the CUA guideline development and review process, especially when recommendations are being rendered for entities diagnosed solely on the basis of morphological findings.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".