Bibliographic record
Abstract
Introduction:The impact of urethral transection on urethroplasty outcomes remains limited and at times conflicting.The purpose of this study was to compare outcomes of transecting and non-transecting bulbar urethroplasty techniques using a matched case-control analysis.Methods: This was a matched, case-control analysis comparing patients undergoing non-transecting bulbar urethroplasty to a transecting cohort.Patients were matched with respect to age, stricture length, and urethroplasty technique.Followup consisted of clinical assessment three weeks postoperatively with cystoscopy at 3-4 months and clinical assessment annually.Outcome measures were stricture recurrence (failure to easily pass a 16 Fr flexible cystoscope on followup), 90-day complications (Clavien ≥2), patient satisfaction, patient-perceived de novo erectile dysfunction, and chordee.Comparison between transecting and non-transecting cohorts were made using the Mantel-Cox test or Chi-squared when indicated.Results: A total of 406 patients that underwent non-transecting bulbar urethroplasty (group 1) were successfully matched to 406 with urethral transection (group 2) from a cohort of 1331 bulbar urethroplasty performed from August 2003 to April 2024.The entire cohort (n=812) had a median patient age of 47 years (IQR 26), stricture length of 2 cm (IQR 2.5), and the stricture etiology most commonly idiopathic in 63.7% (517), traumatic in (16.1%), or iatrogenic in 9.6% (78).Patients underwent reconstruction with either buccal mucosa onlay in 58.9% (487), anastomotic urethroplasty in 39.9% (324), or combined tissue transfer in 1.2% (10).Groups did not differ with respect to age (p=0.90),stricture length (p=0.96),technique (p=1.0),failed endoscopic treatment (p=0.84),comorbidities (p=0.44),obesity (p=0.10),diabetes (p=0.21),smoking (p=0.55), or preoperative catheter status (p=0.82).On log-rank testing with a median followup of 143 months (IQR 96.75), there was no difference in urethroplasty success between groups (p=0.99).Stricture-free status at one year was 96.1% and 96.0% for non-transecting and transecting groups, respectively.Corresponding five-year stricture-free estimates were 95.0% and 94.4%, while estimated 10-year stricture-free results were 93.0% and 93.0%, respectively.There was no difference between groups with respect to 90-day complications (9.1% vs. 8.1%, p=0.71) or satisfaction (94.1% vs. 94.6%,p=0.88); however, patients undergoing non-transecting techniques had a lower incidence of erectile dysfunction (3.9% vs. 7.4%, p=0.03) and patient-perceived chordee (0.5% vs. 2.6%, p=0.02).Conclusions: Non-transecting bulbar urethroplasty techniques provide similar stricture-free success compared to case-matched transecting techniques but reduce the incidence of patient-reported erectile dysfunction and chordee.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.351 | 0.098 |
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".