Bibliographic record
Abstract
Introduction and Objective:The incidence of abnormal meatal position is in constant augmentation and the surgical techniques to correct them are continuously evolving.The tubularized incised plate urethroplasty (Snodgrass) has gained in popularity in the last decade and has now a widespread acceptance for all degrees of hypospadias.We present the outcomes of this technique. Materials and Methods:We reviewed all cases (213) of primary hypospadias repairs performed by a single pediatric urologist using TIP urethroplasty between July 2002 and January 2009.Cases without a minimum follow-up of two months were excluded.Therefore, we collected clinical data for 161 patients with consideration of their age, meatal position, presence of chordee, the use and duration of a uretral stent and blood loss.We looked for association between complication rate and each of the previously mentioned characteristics of our population.Results: Over a 6-year period, 161 patients aged between 5 month and 49 years old (median 1.2 years old) underwent primary hypospadias repair by TIP urethroplasty.The median follow-up was 14.6 month.Distal hypospadias was the most common presentation (78.3%).Midshaft hypospadias (7.5%) and proximal hypospadias (14.3%) were also encountered.Fifty-seven patients (36%) had a cutaneous chordee and 10 patients (6%) had an intrinsic chordee that required a dorsal plication.A urethral stent was used for a mean of 11 days in 141 patients (87.5%).Mean estimated blood loss was 15 ml.Fifty-one patients (31.6%) presented 67 complications during follow-up : 12 infections (7.5%), 16 meatal stenosis (9.9%), 15 urethrocutaneous fistulas (9.3%), 13 coronal meatal migrations (8.1%), 1 peno-scrotal complete wound dehiscence (0.6%), 4 esthetical imperfections (2.5%) and 6 others complications (3.7%).Of those patients, 32 required surgical revision (19.8 %).No patient in our cohort experienced a recurrence of chordee after primary repair.Although data collection is still ongoing, we noticed a trend for an association between the occurrence of complications and a more proximal initial meatal position, presence of an intrinsic chordee and patient age at surgery.Conclusion: The TIP urethroplasty is a frequently used technique which has proved to be safe and effective.Among the factors influencing the results, initial meatal position, presence of an intrinsic chordee and age at surgery seem to have an impact on the occurrence of complications.A significant proportion of patients (23%) in our series had insufficient follow-up.Since long-term follow-up will help for definitive outcome evaluation, we should put effort to correct this issue in the future.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.521 | 0.235 |
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".