MP62-05 BPH SURGICAL TRIFECTA OUTCOMES—CRITICAL EVALUATION OF KEY OPTIMAL OUTCOMES WITH COMPARISON OF AQUABLATION VS TURP
Bibliographic record
Abstract
You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV (MP62)1 May 2024MP62-05 BPH SURGICAL TRIFECTA OUTCOMES—CRITICAL EVALUATION OF KEY OPTIMAL OUTCOMES WITH COMPARISON OF AQUABLATION VS TURP Kevin C. Zorn, Andrew P. Steinberg, Bilal Chughtai, Brian Helfand, Rahul Mehan, and Dean Elterman Kevin C. ZornKevin C. Zorn , Andrew P. SteinbergAndrew P. Steinberg , Bilal ChughtaiBilal Chughtai , Brian HelfandBrian Helfand , Rahul MehanRahul Mehan , and Dean EltermanDean Elterman View All Author Informationhttps://doi.org/10.1097/01.JU.0001008904.63948.3b.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The concept of "success" in surgical procedures is crucial, in any field, and needs standardization to (1) assess the effectively patients' postoperative benefits, (2) evaluate the surgical quality within centers and operators, and (3) perform reliable comparisons among techniques. The present study sought to describe and analyze the patient level trifecta success of Aquablation and TURP for the treatment of benign prostatic obstruction. Clinical and surgical predictors of failure to achieve trifecta were investigated. METHODS: A retrospective analysis of prospectively conducted clinical trials WATER (NCT02505919), WATER II (NCT03123250), and OPEN WATER (NCT02974751) included patients from the United States, Canada, Germany, Australia, New Zealand, Lebanon, and United Kingdom between 2017-2021. Trifecta was defined as the contemporary efficiency and safety presence of: (1): freedom from procedure-related sexual dysfunction (either erectile or ejaculatory dysfunction) (2) no pad-use urinary incontinence and (3) no interventional retreatment due to LUTS. The trifecta success rates were assessed at 3, 6 and 12 months post-operatively. Subanslysis in the Aquablation cohort was also conducted for prostate voulmes <80 cc and >80 cc. Multivariate logistic regression analysis was performed to assess predictors of Trifecta failure. RESULTS: The cohort included 395 Aquablation patients that treated prostates up to 150cc and 65 TURP patients that treated prostates up to 80 cc. Mean prostate volumes and age for the Aquablation patients and TURP patients were 70 cc and 52 cc, and 67 and 66 years old, respectively. The achievement of trifecta success at one year was 88.6% for Aquablation and 73.8% for TURP (p=.0014). Trifecta success at 3 and 6 months for the Aquablation cohort comparing to the TURP cohort were. 91.4% vs 75.4% and 89.9% vs 73.8%, respectively. Subanalysis within the Aquablation cohort <80 cc and >80 cc demonstrated Trifecta rates at 12M of 90.3% and 85.5%, respectively. Patient age, preoperative PVR≥250 mL and larger prostate volume were independent predictors of trifecta failure. CONCLUSIONS: Aquablation has demonstrated better trifecta success compared to TURP while treating a much broader range of prostate sizes, particularly with the preservation of antegrade ejaculation. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1022 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kevin C. Zorn More articles by this author Andrew P. Steinberg More articles by this author Bilal Chughtai More articles by this author Brian Helfand More articles by this author Rahul Mehan More articles by this author Dean Elterman 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 | 0.034 | 0.110 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.021 | 0.003 |
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".