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MP55-13 URETHRAL STRICTURE IS FREQUENTLY A MORBID CONDITION: IDENTIFYING PATIENTS AT INCREASED RISK FOR COMPLICATIONS DUE TO URETHRAL STRICTURE

2019· article· en· W2941066681 on OpenAlexaboutno aff
C. L. King, Keith Rourke

Bibliographic record

VenueThe Journal of Urology · 2019
Typearticle
Languageen
FieldMedicine
TopicUrological Disorders and Treatments
Canadian institutionsnot available
Fundersnot available
KeywordsUrethral strictureMedicineEtiologySurgeryEsophageal strictureUrethraInternal medicineDysphagia

Abstract

fetched live from OpenAlex

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) II (MP55)1 Apr 2019MP55-13 URETHRAL STRICTURE IS FREQUENTLY A MORBID CONDITION: IDENTIFYING PATIENTS AT INCREASED RISK FOR COMPLICATIONS DUE TO URETHRAL STRICTURE Christopher King* and Keith Rourke Christopher King*Christopher King* More articles by this author and Keith RourkeKeith Rourke More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556662.30814.8cAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: While urethral stricture can diminish patient-reported quality of life, a substantial proportion of patients will also experience complications directly related to urethral stricture. The objective of this study is to determine the frequency of complications related to urethral stricture and identify clinical factors associated with them. METHODS: 1851 patients with urethral stricture presenting to a single urologist from 2005 to 2016 were retrospectively reviewed. Clinical variables examined were complications directly related to urethral stricture at the time of stricture presentation, presenting signs/symptoms, type of complications, patient age, stricture length, location and etiology. Complications considered significant were acute urinary retention or difficult catheterization requiring emergent urologic intervention or renal failure, urosepsis, or urethral abscess directly related to urethral stricture. Patients without complete data were excluded from study. The occurrence of complications was compared in relation to patient age, symptoms, stricture length, location, and etiology using binary logistic regression. RESULTS: Of 1023 patients meeting study criteria, mean patient age was 48.0 years and mean stricture length was 5.0cm (1-18). Stricture etiology was idiopathic (46.3%), iatrogenic (15.0%), lichen sclerosus (14.9%), trauma (12.1%), hypospadias (6.9%), and radiation (4.8%). The most common stricture location was bulbar (65.6%) followed by penile (18.6%), multi-segment (10.6%) and posterior (5.4%). 40.6% (415) of patients had at least one complication directly related to urethral stricture including acute urinary retention (32.6%), difficult catheterization (16.0%), urethral abscess/urosepsis (5.0%), and renal failure (3.1%). 7.0% of patients experienced complications deemed to be life-threatening. On multivariate analysis stricture length (in cm) (O.R.1.1; 95%CI 1.1-1.2, p=0.01), lack of reported LUTS (O.R. 3.8, 95%CI 1.9-7.3, p<0.0001), posterior stenosis (O.R. 3.0, 95%CI 1.3-6.8, p=0.01), and traumatic strictures (O.R.1.6, 95% CI 1.1-2.4, p=0.02) were associated with complications related to urethral stricture. On multivariate analysis stricture etiology, particularly trauma (O.R.2.2, 95% CI 1.1-4.6, p=0.03) and hypospadias (O.R. 2.5, 95% CI 1.1-6.5, p=0.05) were associated with an increased risk of life-threatening complications. CONCLUSIONS: Urethral stricture is frequently a morbid condition. Patients with longer strictures, posterior stenoses, absence of preceding LUTS and traumatic strictures are at highest risk for complications related to urethral stricture. Patients with these high-risk characteristics should perhaps be strongly encouraged to pursue definitive treatment. Source of Funding: None Edmonton, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e799-e799 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher King* More articles by this author Keith Rourke More articles by this author Expand All Advertisement PDF downloadLoading ...

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.002
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.003
Threshold uncertainty score0.011

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0000.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0020.002
Science and technology studies0.0010.000
Scholarly communication0.0010.001
Open science0.0000.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0030.000

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.

Opus teacher head0.020
GPT teacher head0.293
Teacher spread0.273 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

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Citations0
Published2019
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