Patient reported outcomes of intermittent self‐dilatation after direct vision internal urethrotomy
Bibliographic record
Abstract
Abstract Purpose Long‐term results on quality of life (QoL) as well as clinical outcomes of intermittent self‐dilatation (ISD) of the urethra after direct visual internal urethrotomy (DVIU) are scarce. The aim of this study was to prospectively evaluate patient reported outcomes (PROs) on voiding symptoms and QoL in a large cohort of urethral stricture patients performing ISD. Methods We identified a total of 121 patients who performed ISD following DVIU between 2008 and 2013. Baseline assessment was conducted for each patient before ISD was started. Follow‐up visits were scheduled in 6‐month intervals. Each assessment included the following questionnaires: International prostate symptom score (IPSS), IPSS quality of life index (IPSS‐QoL), patient global impression of severity (PGI‐S), and patient global impression of improvement (PGI‐I). Additional parameters were maximum urinary flow rate (Qmax), postvoid residual urine, rate of complications, and stricture recurrence. Linear mixed models were used to examine the change over the course of the follow‐up visits to the baseline. Results The median age of the patients was 58 years (interquartile range [IQR]: 43−70). The median follow‐up was 17 months (IQR: 7−30). Mean change from baseline IPSS was −6.1, −5.9, −4.2, and −4.8 points at 6, 24, 36, and 48 months. Mean change from baseline IPSS‐QoL was −1.3, −1.4, −1.6, and −1.8 points, respectively. Mean PGI‐I was 1.7 points at 6, 1.9 points at 24, 1.9 points at 36, and 2.2 points at 48 months after ISD initiation. Mean change of Qmax ranged from 1.7 at 6 to 2.2 mL/s at 48 months. The median complication rate was 3.3% per 6‐month ISD interval. Overall, 11 patients developed stricture recurrence (9%). Conclusion ISD after DVIU had no negative impact on patients' QoL (IPSS‐QoL, PGI‐I, PGI‐S). Urodynamic parameters remained stable for up to 48 months with low complications and an acceptable stricture recurrence rate.
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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 | 0.002 | 0.009 |
| 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 | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".