MP07-08 CONTEMPORARY MULTICENTER OUTCOMES OF AUGMENTATION CYSTOPLASTY IN THE ADULT POPULATION OVER A 10-YEAR PERIOD: A NEUROGENIC BLADDER RESEARCH GROUP (NBRG) STUDY
Bibliographic record
Abstract
You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (MP07)1 Apr 2019MP07-08 CONTEMPORARY MULTICENTER OUTCOMES OF AUGMENTATION CYSTOPLASTY IN THE ADULT POPULATION OVER A 10-YEAR PERIOD: A NEUROGENIC BLADDER RESEARCH GROUP (NBRG) STUDY Philip Cheng*, Sorena Keihani, Sanchita Bose, Rose Khavari, Sean Elliott, Joseph Pariser, Joshua Roth, Blayne Welk, Michael Kennelly, Cameron Futral, David Ginsberg, Christopher Elliott, Kyla Valaer, Sara Lenherr, Yahir Santiago-Lastra, John Stoffel, and Jeremy Myers Philip Cheng*Philip Cheng* More articles by this author , Sorena KeihaniSorena Keihani More articles by this author , Sanchita BoseSanchita Bose More articles by this author , Rose KhavariRose Khavari More articles by this author , Sean ElliottSean Elliott More articles by this author , Joseph PariserJoseph Pariser More articles by this author , Joshua RothJoshua Roth More articles by this author , Blayne WelkBlayne Welk More articles by this author , Michael KennellyMichael Kennelly More articles by this author , Cameron FutralCameron Futral More articles by this author , David GinsbergDavid Ginsberg More articles by this author , Christopher ElliottChristopher Elliott More articles by this author , Kyla ValaerKyla Valaer More articles by this author , Sara LenherrSara Lenherr More articles by this author , Yahir Santiago-LastraYahir Santiago-Lastra More articles by this author , John StoffelJohn Stoffel More articles by this author , and Jeremy MyersJeremy Myers More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555092.64436.7dAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: The objective of this study is to evaluate the outcomes of bladder augmentation in the adult population in a multicenter study. A secondary objective is to compare outcomes between patients who underwent a concomitant catheterizable channel placement vs. those who underwent a bladder augmentation alone. METHODS: We reviewed the charts of 193 patients from 7 sites from the Neurogenic Bladder Research Group who underwent bladder augmentation between July 2007 and September 2017. 23 patients were excluded due to age under 18 (2) or follow-up < 6 months (21). We evaluated patient demographics, modality and type of surgery, 90-day complications and readmissions, and follow-up surgeries. RESULTS: A total of 170 patients with a median age of 37 years were included in the study. 73 (43%) patients were male and the leading etiologies were spinal cord injury (81, 47%) and spina bifida (25, 15%). Prior to surgery, most patients' bladder management was clean intermittent catheterization (76, 45%), followed by indwelling urethral catheter or suprapubic tube (61, 36%). 137 (81%) patients underwent a bladder augmentation with a catheterizable channel, while 33 (19%) patients underwent a small bowel augmentation alone. The median length of hospital stay was 8 days (IQR 7-11) for channel patients and 7 days (IQR 6-10) for augment-only patients. The 90-day major complication rate was 13% (22 patients), which included 17 (12%) channel patients and 5 (15%) augment-only patients (p = 0.40). In the 90-day post-operative period, 33 (19%) patients were readmitted and there were 0 deaths; there were no statistically significant differences between the two groups. Beyond the 90-day period, 64 patients (38%) underwent a total of 90 surgeries related to their bladder augment. 6 of the 33 (18%) augment-only patients underwent 9 surgeries while 58 of the 137 (42%) channel patients underwent 81 surgeries (p = 0.01), 36 of which were for channel-specific complications (i.e. stenosis, leakage, and parastomal hernia). CONCLUSIONS: This is the first contemporary multicenter series evaluating bladder augmentation in the adult population. 90-day major complication rates were low, but many of these patients--primarily the ones with catheterizable channels--required follow-up surgeries. Source of Funding: None Salt Lake City, UT; Houston, TX; Minneapolis, MN; London, Canada; Chapel Hill, NC; Los Angeles, CA; San Jose, CA; Palo Alto, CA; Salt Lake City, UT; San Diego, CA; Ann Arbor, MI; Salt Lake City, UT© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e93-e93 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Philip Cheng* More articles by this author Sorena Keihani More articles by this author Sanchita Bose More articles by this author Rose Khavari More articles by this author Sean Elliott More articles by this author Joseph Pariser More articles by this author Joshua Roth More articles by this author Blayne Welk More articles by this author Michael Kennelly More articles by this author Cameron Futral More articles by this author David Ginsberg More articles by this author Christopher Elliott More articles by this author Kyla Valaer More articles by this author Sara Lenherr More articles by this author Yahir Santiago-Lastra More articles by this author John Stoffel More articles by this author Jeremy Myers More articles by this author Expand All Advertisement PDF downloadLoading ...
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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 | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".