Minimal Approach to Water Vapor Thermal Therapy for Benign Prostatic Hyperplasia: Is Less More?
Bibliographic record
Abstract
OBJECTIVE: To evaluate postoperative outcomes after a minimal approach of water vapor thermal therapy (WVTT; Rezum, Boston Scientific, Marlborough, MA), defined as 1 treatment per prostate lobe, among men with benign prostatic hyperplasia. METHODS: We performed a multi-institutional retrospective review of patients who underwent WVTT from 2018 to 2022. Propensity score matching was utilized to generate patient cohorts based on number of treatments per lobe (1 per lobe, including median lobe if present [minimal group], vs ≥2 per lobe [nonminimal group]) matched for age, body mass index, and preoperative prostate volume. Primary outcome was postoperative complications and storage phase symptoms beyond 30days. We then conducted a non-propensity score matching independent t test to analyze differences in International Prostate Symptom Score (IPSS), uroflowmetry, and surgical retreatment rate postoperatively. RESULTS: 146 patients were included, with 73 in each arm. The nonminimal group had their median lobe treated more frequently (P=.021) and experienced higher postoperative de-novo retention (P=.009) and urinary tract infection (P=.003) rates. On multivariate analysis, increasing number of treatments (hazard ratio 1.3, P=.039) and median lobe treatment (hazard ratio 4.7, P=.008) were significant risk factors for postoperative storage phase symptoms. Mean IPSS and uroflowmetry parameters were similar at 1, 3, 6, and 12months postoperatively. Surgical retreatment rates were comparable at 2years (3% vs 1%; P=.444). CONCLUSION: Minimal approach to WVTT is associated with decreased postoperative complications with comparable IPSS, maximum flow rate, and surgical retreatment rate. Further studies are needed to investigate longer term outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".