PD19-04 THE PROSTATIC URETHRAL LIFT (UROLIFT) VERSUS THE THERMAL WATER VAPOR ABLATION (REZūM) FOR MINIMALLY INVASIVE TREATMENT OF BPH: A COMPARISON OF IMPROVEMENTS AND DURABILITY IN 3-YEAR CLINICAL OUTCOMES
Bibliographic record
Abstract
You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation (PD19)1 Apr 2019PD19-04 THE PROSTATIC URETHRAL LIFT (UROLIFT) VERSUS THE THERMAL WATER VAPOR ABLATION (REZūM) FOR MINIMALLY INVASIVE TREATMENT OF BPH: A COMPARISON OF IMPROVEMENTS AND DURABILITY IN 3-YEAR CLINICAL OUTCOMES Shaun Shepherd, Hossein Saddat, Bilal Chughtai, and Dean Elterman* Shaun ShepherdShaun Shepherd More articles by this author , Hossein SaddatHossein Saddat More articles by this author , Bilal ChughtaiBilal Chughtai More articles by this author , and Dean Elterman*Dean Elterman* More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555724.50703.49AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: The minimally invasive radiofrequency thermal water vapour thermal therapy (Rezum) and the prostatic lift (Urolift) procedures offer minimally-invasive treatment for lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia. Rezum is a novel treatment modality that has demonstrated safety and efficacy in patients with LUTS. There have been no published head-to-head comparisons of the relative efficacy of the Rezum and Urolift systems. We report an indirect analysis of clinical symptoms and quality of life of two previously published studies of three year outcomes. METHODS: Clinical outcomes were obtained from published prospective data. International Prostate Symptom Score (IPSS) and IPSS - Quality of Life (QoL), Maximum flow rate (Q-max), post-void residual volume (PVR), Benign Prostate Hyperplasia Impact Index (BPHII) scores along with MSHQ-EjD function and bother domains were outcomes of interest. Outcomes were assessed at 3, 12, 24, and 36 months. The Indirect between-group analysis was followed by a within-group analysis of changes across time points. An adjusted indirect comparison was conducted at 3 years for all outcomes. RESULTS: All baseline features were similar between the two groups except for Q-max which was higher in the Rezum, and both BPHII and age which were higher in the Urolift group. Compared to the Urolift, the Rezūm resulted in an 18.48% and 19.73% greater reduction in IPSS score at 24-months and 36-months (p=0.04). The improvement in the MSHQ-EjD function domain was significantly higher with Urolift at 3,12, 24, and 36 months. Although Q-max improvement was favoured the Rezum group at 3 months (p<0.01) this was not durable. At 36 months the Q-max improvements were not statistically different between the Rezum and Urolift. Regarding MSHQ-EjD bother, the improvements were similar at 12 months and thereafter in both groups. CONCLUSIONS: This analysis Rezum demonstrated improved relief of LUTS attributed to BPH, with a significantly greater 3 year IPSS improvements compared to Urolift. Despite limitations of the published Urolift study in respect to the exclusion of participants who presented with an obstructive median lobes, considerable relief of LUTS with acceptable morbidity and functional outcomes warrants further of comparison of Rezum against other minimally-invasive surgical therapies for BPH. Source of Funding: None. Toronto, Canada; New York, NY; Toronto, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e373-e373 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shaun Shepherd More articles by this author Hossein Saddat More articles by this author Bilal Chughtai More articles by this author Dean Elterman* 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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.019 | 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".