Non-Oral Poster 35
Bibliographic record
Abstract
OBJECTIVES: Age is often considered a risk factor for successful treatment of stress urinary incontinence (SUI). We assessed whether age remains a risk factor when treating patients with the Adjustable Continence Therapy (ACT®) device for recurrent SUI with respect to efficacy and safety. MATERIALS AND METHODS: The Uromedica ACT® system is a novel device under FDA investigation that provides bulk at the bladder neck with adjustable silicone balloons for urethral coaptation and bladder neck support. Each balloon is attached to a titanium port buried in the labia majora allowing for post-operative size titration of the balloons for continued maximal efficacy. A small incision between the labia majora and minora at the level of the urethra allows for passage of a trocar under fluoroscopic guidance to the bladder neck. The device is delivered and the balloons filled with 1.5 cc contrast. The injection port for balloon adjustment is placed into a subcutaneous pouch in the labia majora. Device adjustments begin 6 weeks post-operatively, as needed. 162 patients were implanted, ranging in age from 31 to 94 (mean 67.4 ± 11.6), with recurrent SUI diagnosed as urethral hypermobility (UHM) and/or intrinsic sphincter deficiency (ISD). 140 (86%) and 68 (42%) completed 1 and 2 years follow-up, respectively. Patients were divided in three age groups: 54 (38.6%) patients <65yrs; 55 (39.3%) patients 65–74 yrs; and 31 (22.1%) patients >75yrs old. Age was associated with more HTN (P < 0.001), CAD (P = 0.012) as well as prior failed incontinence surgeries (P = 0.021). Younger patients had more non-surgical treatments for SUI (P = 0.024). Older patients had greater severity of SUI as indicated by direct visual stress test (DVST) and provocative pad weight testing (PPWT) (P = 0.025). Older patients were less likely to be sexually active (P < 0.001). RESULTS: At 1 year all three age groups demonstrated significant (P ≤ 0.005) improvement on all efficacy endpoints compared to baseline including the Stamey score, DVST severity, PPWT, number of incontinence episodes/day, number of pads/day, UDI-6, IIQ-7 and IQoL scores. At 2 years all three age groups continued to show significant improvement (P ≤ 0.021) on most tests conducted. There were no significant differences between the three age groups on any of the efficacy endpoints or complication rates. CONCLUSION: The 1- and 2-year results demonstrate that the ACT® system can be effectively used for recurrent SUI in adult women, regardless of age. Age does not appear to be a risk factor for this therapy.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
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".