Holmium laser enucleation of the prostate can be taught: the first learning experience
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
OBJECTIVE: To present the initial experience of a senior urology resident with holmium laser enucleation of the prostate (HoLEP) and to address the difficulties encountered while learning this technique, describing the detailed operative technique and pitfalls. PATIENTS AND METHODS: Between July and August 2001, 27 patients were treated using HoLEP administered by one senior urology resident (A.H.) under the supervision of an experienced urologist (M.M.E.). Patients were assessed before and 1 month after HoLEP by the International Prostate Symptom Score (IPSS), the associated quality-of-life (QoL) score, and measurements of maximum urinary flow rate (Qmax) and postvoid residual urine (PVR) volume. The prostate volume was measured before HoLEP using transrectal ultrasonography. The 27 patients were compared retrospectively with 118 who underwent HoLEP by the supervising urologist. Each of the 27 procedures was taped and reviewed. RESULTS: The mean (range) prostate size was 54.8 (21-122) mL (A.H.) and 61.7 (20.5-172) mL (M.M.E.). The mean operative duration was 98 (50-175) min and the mean enucleation time 68 (29-108) min. The improvements in IPSS, QoL score, Qmax and PVR were highly significant (P < 0.001), with mean values before and after HoLEP of 16.8 and 8.2, 3.1 and 1.4, 7.7 and 20.8 mL/s, and 232 and 41.3 mL, respectively. Of the 27 patients, 23 (85%) were catheter-free on the first day after HoLEP; the mean hospital stay was 1.8 days. All these results were comparable with the results of 118 patients treated by M.M.E. The two most difficult technical steps identified were the initial apical enucleation and the incision of the remaining antero-apical mucosal attachment of the lateral lobes. The operator became adept with the HoLEP technique after a mean of 20 patients. CONCLUSION: HoLEP can be learnt but requires longer training than standard transurethral resection. Extensive experience with transurethral surgery and the supervision of an experienced urologist are prerequisites for success.
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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 | 0.000 | 0.000 |
| 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 | 0.001 |
| 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 it