Improvement in Storage Related Lower Urinary Tract Symptoms following Urethroplasty: A Prospective Cohort Study
Bibliographic record
Abstract
PURPOSE: In patients with lower urinary tract symptoms, storage related symptoms induce the greatest degree of bother. When associated with urethral stricture, it is unclear how these specific symptoms respond to urethroplasty. This study aims to evaluate the prevalence and effect of urethroplasty on patient reported storage lower urinary tract symptoms. MATERIALS AND METHODS: This prospective cohort study evaluated patients undergoing urethroplasty for urethral stricture from 2012-2019. Patients were administered the International Prostate Symptom Score preoperatively and 6 months posturethroplasty. The primary outcomes were change in urinary frequency, urgency, nocturia and composite storage symptom measure according to International Prostate Symptom Score. Symptoms were considered clinically significant if they were graded 3 or greater for the individual domains, and greater than 6 for the combined score. Wilcoxon signed-rank test was used to compare results. RESULTS: A total of 387 patients completed the International Prostate Symptom Score preoperatively and postoperatively. Median age was 50 years and median stricture length was 4.5 cm. Cystoscopic success at 6 months was 96.1%. Preoperatively, urinary frequency, urgency and nocturia were common symptoms (52.5%, 48.8% and 41.6%, respectively). Postoperatively, these rates decreased to 11.6%, 11.4% and 11.1%, respectively, reductions that were significant (p <0.0001) across all domains. Overall storage symptom scores improved significantly (median 8 preoperatively vs 2 postoperatively, p <0.0001). On binary logistic regression, no factor was associated with a lack of response, including stricture recurrence (p=0.44), age (p=0.45), stricture length (p=0.63), location (p=0.13), etiology (p=0.17), number of failed endoscopic treatments (p=0.53) and prior urethroplasty (p=0.06). CONCLUSIONS: Urethroplasty yields clinically and statistically significant improvements in storage related lower urinary tract symptoms in men with urethral stricture.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 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".