Modified early apical release vs. non-early apical release in holmium laser prostatic enucleation
Bibliographic record
Abstract
INTRODUCTION: We aimed to compare the incidence of de novo stress urinary incontinence (SUI) of two apical release techniques for holmium laser prostatic enucleation (HoLEP): modified early apical release (EAR) and non-early apical release (non-EAR). METHODS: We conducted a retrospective database review analyzing the records of patients who underwent HoLEP with the modified EAR and non-EAR techniques for symptomatic benign prostatic hyperplasia. The study period spanned from January 2012 to December 2021 in a single center. Patient demographics, perioperative data, and functional and technical outcomes were compared between the techniques. RESULTS: The study included a total of 786 patients; 556 patients underwent the non-EAR technique (group 1), and 230 underwent the modified EAR technique (group 2). The mean enucleated prostate weight in group 1 was 68.2±45.6 g compared to 93.3±51.9 g in group 2 (p<0.001). De novo SUI within a month of surgery was reported in 34 cases (6.1%) in group 1 compared to eight cases (3.5%) in group 2. The percentage of patients with persistent SUI at one year postoperatively dropped to 2.7% and 0.9% in the non-EAR and modified EAR groups, respectively. Moreover, persistent SUI after one year from surgery was reported in 1.4 % of the non-EAR group compared to 0.44% in the modified EAR group. Multivariate regression analysis demonstrated that age >70 years (p=0.06), operative time >90 minutes (p=0.011), and the non-EAR technique (p=0.004) were significantly associated with the onset of postoperative de novo SUI. CONCLUSIONS: Our research indicates that both modified EAR and non-EAR techniques employed during HoLEP yield comparable efficacy and safety outcomes. Nonetheless, the modified EAR technique is associated with reduced postoperative de novo SUI.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 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) | 0.001 | 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".