Better defining the optimal management of penile urethral strictures: A retrospective comparison of single-stage vs. two-stage urethroplasty
Bibliographic record
Abstract
INTRODUCTION: We aimed to compare single-stage and two-stage urethroplasty techniques for the treatment of penile urethral strictures. METHODS: We performed a retrospective review of all penile urethroplasties performed at a single centre between 2003 and 2017. The primary outcome was urethral patency, defined as the ability to easily pass a 16 Fr flexible cystoscope at six and 18 months of followup, and development of 90-day complications. RESULTS: Overall, 101 single-stage procedures (48 buccal mucosal graft [BMG] and 53 penile fasciocutaneous flap [PFF]) and 53 two-stage procedures were performed. There was no difference in median stricture length between groups (p=0.25). Cox regression analysis did not identify stricture etiology, length, age, obesity, prior reconstruction, or urethroplasty technique to be associated with failure. Log-rank testing did not demonstrate a difference in success rates between surgical techniques (91% [48/53] PFF vs. 83% [40/48] BMG vs. 87% two-stage [46/53]). Thirty-nine percent (60/154) of patients experienced a complication (51% [27/53] PFF vs. 29% [14/48] BMG vs. 36% [19/53] two-stage). Multivariate analysis found urethroplasty technique to be the only factor associated with development of complication (p=0.02); odds ratio relative to BMG was 3.1 (p=0.009) for PFF and 1.4 (p=0.43) for two-stage. CONCLUSIONS: There appears to be little difference in success between penile urethroplasty techniques. The shift in technique to a single-stage BMG, when appropriate, appears to be founded on the basis of fewer operations for the patient, relative to a two-stage repair, and a lower complication profile, relative to single-stage PFF, without compromising success rates.
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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) | 0.001 | 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) | 0.002 | 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 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".