Bibliographic record
Abstract
Introduction and Objectives: Holmium laser technology allows for enucleation of very large prostate glands with outcomes equivalent to or superior to those of open simple prostatectomy.Here we describe our experience with HoLEP for glands ≥200 grams.Methods: Between January 1999 and February 2011, 58 patients with glands ≥200 grams underwent HoLEP at our institution.All procedures were performed by one surgeon (JEL).Residents and/or fellows assisted in all cases.Results: Mean patient age was 72.6 years.Mean preoperative patient characteristics include transrectal ultrasound (TRUS) volume of 218 grams, AUA symptom score (AUASS) of 18.9, Qmax of 7.5 ml/sec, post-void residual (PVR) of 237.6 cc and PSA of 19.9 ng/mL.Mean enucleation and morcellation times were 86.7 min (range 30-211 min) and 49.3 min (range 23-133 min) respectively.Mean weight of tissue resected was 213.4 grams (range 111.1 -532.2 grams).Two patients (3.4%) required perineal urethrostomy.Eight patients (13.8%) had concomitant procedures [bladder neck incision (2), cystolithopaxy (5), bladder biopsy (1)].One patient (1.7%) required cystotomy for tissue retrieval.One patient required same-day take back for clot evacuation and one patient required take back 48 hours postoperatively to complete morcellation.Mean pre-and postoperative hemoglobin were 14.1 g/dL and 11.5 g/dL, respectively.Two patients (3.4%) required transfusion (mean 4 units).Mean catheterization time was 19.9 hours (range 8-96 hours) and all patients voided spontaneously after catheter removal.Mean AUASS at 12 months was 3.86 and mean PVR at 12 months was 34.9 cc.Mean PSA at 6 months was 0.85 ng/ml (mean reduction 87.4%).To date, one patient (1.7%) has developed a urethral stricture and 0 patients have required secondary procedures.Conclusions: HoLEP can be safely performed in patients with glands ≥200 grams.In experienced hands, results equivalent to or superior to open simple prostatectomy can be expected.
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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 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.518 | 0.242 |
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".