MP52-01 ANALYZING OUTCOMES OF THE <i>ADJUSTABLE TRANSOBTURATOR MALE SYSTEM (ATOMS)</i> FOR POST-PROSTATECTOMY INCONTINENCE: RESULTS OF A SINGLE-CENTER STUDY
Bibliographic record
Abstract
You have accessJournal of UrologyCME1 May 2022MP52-01 ANALYZING OUTCOMES OF THE ADJUSTABLE TRANSOBTURATOR MALE SYSTEM (ATOMS) FOR POST-PROSTATECTOMY INCONTINENCE: RESULTS OF A SINGLE-CENTER STUDY Samuel Farag, Joanie Pelletier, Salima Ismail, and Le Mai Tu Samuel FaragSamuel Farag More articles by this author , Joanie PelletierJoanie Pelletier More articles by this author , Salima IsmailSalima Ismail More articles by this author , and Le Mai TuLe Mai Tu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002627.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The ATOMS has recently gained popularity in the post-prostatectomy incontinence (PPI) scene, touting advantages such as surgical simplicity and post-operative adjustability. The present study explores the device as a potential treatment option for PPI. Primary outcome was dryness rate, 24-hour pad-count change compared to baseline and results from the patient global impression of improvement (PGI-I) questionnaire. Secondary outcome was the frequency of postoperative adverse events. METHODS: A retrospective medical record study was conducted on 91 patients who underwent ATOMS implantation between February 2016 and September 2020 at our institution. Preoperative incontinence severity was defined as <2 pads per day (PPD), 2-4 PPD, and >4 PPD with regards to 24-h pad-count or/and <200g, 200-400g and >400g regarding 24-h pad-test (24h-PT) to classify mild, moderate, and severe incontinence, respectively. Dryness was defined as requiring 0 or 1 PPD postoperatively. Patients considered “improved” or “very much improved” were defined as having a diminution of PPD of ≥ 50% or ≥ 75%, respectively. Positive patient satisfaction was defined by “Much better”, and “Very much better” PGI-I results. RESULTS: Out of the 91 patients identified, 65 were included in the study (26 were excluded due to a follow-up <12 months). Mean patient age was 71 years, with a mean follow-up of 29.9 months (SE 1.8; range 12-67). Median preoperative PPD and 24h-PT were 4 (IQR 6-3; range 1-10) and 358 g (IQR 607-256; range 34-1592) respectively, classifying most patients as moderate (n=24; 36.9%) or severe (n=40; 61.5%) incontinence. Median PPD at final follow-up was 1.0 (IQR 2-0; range 0-5; p < 0.001). 59 (90.7%) patients required adjustment postoperatively, with a mean of 2.4 adjustments (SE 0.25; range 1-8) and a mean total instilled volume of 14.8mL (SE 0.76; range 6-31). Overall improvement was noted in 56 (86.2%) patients, with 43 (76.7%) being “very much improved” and 42 (75.0%) being dry. Patient satisfaction rate was 87.7% (n=57). 8 (12.3%) patients experienced complications of any Clavien-Dindo grade, of which 4 were a grade III due to 1 device migration (1.5%), and 3 explantations due to leakage (4.6%). CONCLUSIONS: The present study vouches ATOMS as a safe and effective device in the treatment of PPI. More robust studies may allow integration of the ATOMS device among treatments options in North American urological practices. Source of Funding: Funding was acquired from the research budget of the Urology Department at Université de Sherbrooke © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e886 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Samuel Farag More articles by this author Joanie Pelletier More articles by this author Salima Ismail More articles by this author Le Mai Tu 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 | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.010 | 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".