Female neo-urethral reconstruction with a modified neurovascular pudendal thigh flap (Singapore flap): initial experience.
Bibliographic record
Abstract
PURPOSE: Complete urethral reconstruction in women is an extreme challenge for urologists. We report a new approach to this challenging procedure, using a modified neurovascular pudendal thigh flap (Singapore flap) for neo-urethral reconstruction in two patients at our institution. MATERIALS AND METHODS: A Singapore flap was raised and transposed to the vagina in two patients with destroyed urethras following several previous uro-gynecologic procedures. In one case, the flap was tubularized distally and anastomosed proximally to the bladder neck. In the second case, the flap served to cover a urethroplasty inlay. RESULTS: We are presently reporting mainly on the surgical technique. At 24 and 27 months respectively, the two flaps are viable and appear to fulfill their designated roles. The first case developed bladder neck stricture 2 months after surgery, and urethral dilation was performed successfully. Urinary incontinence still remains an issue in one of these two patients, and further continence procedures have been used. CONCLUSIONS: It has been found that the neurovascular pudendal thigh flap, initially described for vaginal reconstruction, is an attractive technique to aid in complete female neo-urethral reconstruction. Further follow-up of patients is necessary to address the issue of continence.
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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 | 0.000 | 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 | 0.000 |
| 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".