Bibliographic record
Abstract
Introduction and Objective: One of the most frequent complications after radical prostatectomy (RP) is bladder neck contracture (BNC) that occurs in up to 32% of patients.Several treatment options for BNC have been proposed, but none reached a consensus and success rates are disappointing.Mitomycin, by inhibiting fibroblast proliferation, decreases scar formation.It was already used as an anti-scarring agent treating successfully glaucoma, tracheal and oesophageal strictures.In urology, 0,1 mg of Mitomycin had been used after laser incision to treat anterior urethral stricture.The objective of this study is to assess the safety and efficacy of Mitomycin in recurrent BNC.Methods: This study was approved by our Institutional Review Board committee.Recurrent BNC was defined as the inability to pass a 16 French cystoscope through the stricture after at least one previous treatment.The initial workup included history, physical examination, urodynamic studies, urinalysis and urine culture.After informed consent, 0.1 mg of Mitomycin diluted in 2 mL of normal saline was injected submucosally at 3, 6 and 9 o'clock positions and the BNC was then dilated with «S shape» dilatators up to 18-20 Fr under sedation.A 16 Fr urinary catheter was left in place for 3 days.Follow-ups at 2, 6 and 12 months were scheduled (urinalysis, urine culture and cystoscopy).If a recurrence occurred, patients were offered another treatment option.Results: From March to July 2009, ten patients had recurrent BNC after RP diagnosed in the workup of urinary incontinence.Nine patients had retropubic and 1 had laparoscopic RP.The mean age was 67 years old [59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75].The mean time between RP and diagnosis of BNC was 39 ± 7 months .Patients had an average of 2 treatments for their BNC before Mitomycine [1][2][3][4][5][6][7][8][9].All patients had dilatation, 2 had laser incision and 2 had cold knife incision.Eight patients showed no recurrence of BNC at 2 months followup cystoscopy.Of those recurrences, one had 9 and the other had 4 previous treatments.Five patients completed 6 months of follow-up and they were still stricture free.No adverse event was reported.Conclusions: Preliminary results of this case series showed an 80% success rate at 2 months post Mitomycin injection and dilatation for recurrent BNC after RP.It seems promising and there is no associated adverse event.However, longer follow-up and further studies are needed to access its use and long term efficacy in BNC following RP.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.644 | 0.340 |
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".