An Ileal Neobladder Urinary Leak Mimicking Rapidly Progressive Glomerulonephritis
Bibliographic record
Abstract
Urinary leak is a known postoperative complication, occurring usually within the first months after surgical creation of an ileal neobladder following cystectomy. We describe the case of a 54-year old man who, ten years after creation of a continent and fully functioning ileal neobladder, presented with abdominal pain and dysuria. This was associated with nephrotic range proteinuria, microscopic hematuria and a rapid rise in serum creatinine, mimicking a rapidly progressive glomerulonephritis. Following an extensive nephrological workup, including a kidney biopsy that yielded normal results, urological evaluation including a pouchogram was performed revealing an ileal neobladder urinary leak. It was postulated that a urinary tract infection must have caused the clinical symptoms, the proteinuria and hematuria and the urinary leak caused acute renal failure with reabsorption of retention solutes via the peritoneal cavity. The case is discussed and the available literature, with special focus on late ileal neobladder urinary leaks, is critically reviewed. We can conclude that there is little information on characteristic urinalysis findings, particularly proteinuria, from patients with an ileal neobladder in healthy and disease states such as urinary tract infection.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".