The impact of multiple prostate biopsies on radical prostatectomy outcomes: A population-based analysis.
Bibliographic record
Abstract
e16554 Background: The impact of multiple transrectal ultrasound-guided prostate biopsies (TRUS-Bx) on the complexity of radical prostatectomy (RP) remains unknown. Data analyzing the effect of multiple previous biopsies in surgical outcomes is sparse and no information about immediate postoperative outcomes is available. We evaluated the impact of repeated TRUS-Bx before RP on surgical outcomes. Methods: A population-based cohort study was designed to compare surgical outcomes between patients with one previous biopsy to patients with ≥ 2 biopsies before RP. All patients who had a RP performed in the province of Ontario from April 1, 2002 to March 31, 2013 were categorized according to the number of prior TRUS-Bx. The primary end point was a composite complication index encompassing the need of postoperative treatment of urinary or rectourethral fistula, intestinal diversion, upper urinary tract obstruction or ureteral injury. Secondary outcomes included functional and health care related. Follow-up time for all outcomes ranged from 12-24 months. Results: Among 27,637 patients, 4780 (17.3%) had ≥ 2 biopsies performed before RP. The proportion of cases who experienced the composite end point was similar between patients with one TRUS-Bx compared to those with ≥ 2 TRUS-Bx (1.1% vs 1.2%, p = 0.38). Patients with ≥ 2 biopsies were more likely to have a blood transfusion during RP hospitalization compared to patients with only one biopsy (15.5% vs 12.8%, OR 1.25 95% CI 1.15-1.37, p < 0.01), while readmission rate and 30-day mortality were similar (3.6% vs 3.3% p = 0.35, 0.2 vs 0.1% p = 0.43). Patients with multiple TRUS-Bx were more likely to require post RP urodynamic evaluation (OR 1.53, 95% CI 1.23-1.91, p < 0.01) but were not at increased risk of incontinence or erectile dysfunction invasive therapies. Conclusions: Perioperative outcomes after RP are similar between men with single or mutiple TRUS-Bx. Multiple TRUS-Bx before RP is associated with slightly increased risk of perioperative blood transfusion and postoperative urodynamic evaluation. This information can be used to counsel patients about similar postoperative outcomes after RP despite having multiple biopsies, including those under AS protocols.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".