Management of recurrent post-prostatectomy incontinence after previous failed retrourethral male slings
Bibliographic record
Abstract
Objective: Our objective was to establish the feasibility of combining2 minimally invasive procedures in patients with failed primarytreatment (male sling) in post-prostatectomy incontinence(PPI) patients.Methods: From January 2007 to July 2008, 40 men with PPI wereimplanted with a suburethral tape (2 patients with Seratim, 3 withI-Stop and 35 with Advance). The median preoperative pad countwas 4 (range 2-10). Prior to sling placement, 6 patients had undergoneProACT implantation. Of these, 4 patients required explantationdue to balloon migration and 2 patients had their balloonskept in situ, with the balloons deflated.Results: Twenty-five patients were socially continent at this time.Fifteen patients (37.5%) did not improve or their improvementwas not significant. These patients had a preoperative pad countbetween 7 and 10. Two of these patients had prostate adjustablecontinence therapy (ProACT) systems still in place. By graduallyfilling the balloons to 3 mL, both of these patients achieved completecontinence, which was maintained at a mean follow-up of8.5 months. Three patients with prior pelvic irradiation receivedan artificial urinary sphincter and achieved continence at meanfollow-up of 8.3 months. The remaining 10 patients received aProACT system in addition to the already implanted sling. Afterappropriate healing and filling of the balloons (average balloonvolume 5 mL), all 10 patients reached complete continence; theywere pad-free at a mean follow-up of 6 months (range 3-9).Conclusions: The combination of ProACT and a suburethral tapewas demonstrated to be a possible treatment option in recurrentor persistent PPI.Objectif : Notre objectif était d’établir la faisabilité d’une associationde 2 interventions minimalement invasives chez des patients ayantsubi un échec thérapeutique primaire (bandelettes sous-urétrales)chez des patients atteints d’incontinence post- prostatectomie.Méthodologie : De janvier 2007 à juillet 2008, on a placé une bandelettesous-urétrale chez 40 hommes atteints d’incontinence postprostatectomie(2 patients ont reçu le dispositif de marque Seratim,3 patients, de marque I-Stop et 35, de marque Advance). Le nombremédian de protections absorbantes avant l’opération était de 4 (2 à10). Avant la mise en place de la bandelette, 6 patients avaient subiune implantation d’un système ProACT. De ce nombre, 4 patientsont dû se faire retirer les ballonnets en raison de leur déplacement;chez 2 patients, les ballonnets sont restés en place mais se sontdégonflés.Résultats : Vingt-cinq patients présentaient une continence socialeà ce moment. Quinze patients (37,5 %) n’ont présenté aucuneamélioration, ou une amélioration non significative. Ces patientsutilisaient de 7 à 10 protections absorbantes avant l’opération. Deuxde ces patients étaient toujours porteurs d’un système ProACT. Enremplissant graduellement les ballonnets de 3 mL, ces deux patientsont atteint une continence totale, maintenue après un suivi moyende 8,5 mois. Trois patients ayant reçu antérieurement un traitementpelvien par rayonnement ont reçu un sphincter urinaire artificielet ont atteint la continence après un suivi moyen de 8,3 mois.Chez les 10 derniers patients, on a implanté un système ProACTen plus de la bandelette déjà en place. Après un temps suffisant deguérison et le remplissage des ballonnets (volume moyen : 5 mL),les 10 patients ont atteint une continence complète. Ils n’avaientplus besoin de protection absorbante après un suivi moyen de6 mois (entre 3 et 9 mois).Conclusions : L’association d’un système ProACT et d’une bandelettesous-urétrale s’est révélée une option thérapeutique possibleen présence d’incontinence post-prostatectomie récurrenteou persistante.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| 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".