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Paciotti M, Diana P, Gallioli A, De Groote R, Farinha R, Ficarra V, Gaston R, Gontero P, Hurle R, Martínez-Piñeiro L, Minervini A, Pansadoro V, Van Cleynenbreugel B, Wiklund P, Casale P, Lughezzani G, Uleri A, Mottrie A, Palou J, Gallagher AG, Breda A, Buffi N. International consensus panel for transurethral resection of bladder tumours metrics: assessment of face and content validity. BJU Int 2024. [PMID: 38830818 DOI: 10.1111/bju.16433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
OBJECTIVE To develop performance metrics that objectively define a reference approach to a transurethral resection of bladder tumours (TURBT) procedure, seek consensus on the performance metrics from a group of international experts. METHODS The characterisation of a reference approach to a TURBT procedure was performed by identifying phases and explicitly defined procedure events (i.e., steps, errors, and critical errors). An international panel of experienced urologists (i.e., Delphi panel) was then assembled to scrutinise the metrics using a modified Delphi process. Based on the panel's feedback, the proposed metrics could be edited, supplemented, or deleted. A voting process was conducted to establish the consensus level on the metrics. Consensus was defined as the panel majority (i.e., >80%) agreeing that the metric definitions were accurate and acceptable. The number of metric units before and after the Delphi meeting were presented. RESULTS A core metrics group (i.e., characterisation group) deconstructed the TURBT procedure. The reference case was identified as an elective TURBT on a male patient, diagnosed after full diagnostic evaluation with three or fewer bladder tumours of ≤3 cm. The characterisation group identified six procedure phases, 60 procedure steps, 43 errors, and 40 critical errors. The metrics were presented to the Delphi panel which included 15 experts from six countries. After the Delphi, six procedure phases, 63 procedure steps, 47 errors, and 41 critical errors were identified. The Delphi panel achieved a 100% consensus. CONCLUSION Performance metrics to characterise a reference approach to TURBT were developed and an international panel of experts reached 100% consensus on them. This consensus supports their face and content validity. The metrics can now be used for a proficiency-based progression training curriculum for TURBT.
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Affiliation(s)
- Marco Paciotti
- Department of Urology, IRCCS Humanitas Research Hospital Rozzano, Milan, Italy
| | - Pietro Diana
- Department of Urology, IRCCS Humanitas Research Hospital Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Urology, Fundació Puigvert, Barcelona, Spain
- Department of Surgery, Autonomous University of Barcelona, Barcelona, Spain
| | - Andrea Gallioli
- Department of Urology, Fundació Puigvert, Barcelona, Spain
- Department of Surgery, Autonomous University of Barcelona, Barcelona, Spain
| | - Ruben De Groote
- Department of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Rui Farinha
- Urology Department, Lusíadas Hospital, Lisbon, Portugal
| | - Vincenzo Ficarra
- Gaetano Barresi Department of Human and Paediatric Pathology, Section of Urology, University of Messina, Messina, Italy
| | - Richard Gaston
- Department of Urology, Clinique Saint Augustin, Bordeaux, France
| | - Paolo Gontero
- Department of Urology, University of Turin, Turin, Italy
| | - Rodolfo Hurle
- Department of Urology, IRCCS Humanitas Research Hospital Rozzano, Milan, Italy
| | - Luis Martínez-Piñeiro
- Department of Urology, La Paz University Hospital and La Paz Hospital Research Institute, Autonomous University of Madrid, Madrid, Spain
| | - Andrea Minervini
- Unit of Oncologic Minimally Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, Florence, Italy
| | - Vito Pansadoro
- Fondazione Vincenzo Pansadoro, Centro di Urologia Laparoscopica e Oncologia Medica, Rome, Italy
| | - Ben Van Cleynenbreugel
- Department of Urology, University Hospitals Leuven, Louvain, Belgium
- Department of Development and Regeneration, KU Leuven, Louvain, Belgium
| | - Peter Wiklund
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Urology, Karolinska University Hospital, Solna, Sweden
| | - Paolo Casale
- Department of Urology, IRCCS Humanitas Research Hospital Rozzano, Milan, Italy
| | - Giovanni Lughezzani
- Department of Urology, IRCCS Humanitas Research Hospital Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alessandro Uleri
- Department of Urology, IRCCS Humanitas Research Hospital Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alexandre Mottrie
- Department of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
- Orsi Academy, Melle, Belgium
| | - Joan Palou
- Department of Urology, Fundació Puigvert, Barcelona, Spain
- Department of Surgery, Autonomous University of Barcelona, Barcelona, Spain
| | - Anthony G Gallagher
- Department of Development and Regeneration, KU Leuven, Louvain, Belgium
- Orsi Academy, Melle, Belgium
| | - Alberto Breda
- Department of Urology, Fundació Puigvert, Barcelona, Spain
- Department of Surgery, Autonomous University of Barcelona, Barcelona, Spain
| | - Nicolò Buffi
- Department of Urology, IRCCS Humanitas Research Hospital Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Hori K, Abe T, Abe N, Abe J, Okada K, Takahashi K, Harada S, Furumido J, Murai S, Kon M, Hashimoto K, Masumori N, Kakizaki H, Shinohara N. Gap analysis between trainees' subjective competencies and the competencies expected by instructors in urology: A need assessment survey in Japan. Int J Urol 2024; 31:653-661. [PMID: 38366737 DOI: 10.1111/iju.15430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE According to the rapid progress in surgical techniques, a growing number of procedures should be learned during postgraduate training periods. This study aimed to clarify the current situation regarding urological surgical training and identify the perception gap between trainees' competency and the competency expected by instructors in Japan. METHODS Regarding the 40 urological surgical procedures selected via the Delphi method, we collected data on previous caseloads, current subjective autonomy, and confidence for future skill acquisition from trainees (<15 post-graduate years [PGY]), and the competencies when trainees became attending doctors expected by instructors (>15 PGY), according to a 5-point Likert scale. In total, 174 urologists in Hokkaido Prefecture, Japan were enrolled in this study. RESULTS The response rate was 96% (165/174). In a large proportion of the procedures, caseloads grew with accumulation of years of clinical practice. However, trainees had limited caseloads of robotic and reconstructive surgeries even after 15 PGY. Trainees showed low subjective competencies at present and low confidence for future skill acquisition in several procedures, such as open cystectomy, ureteroureterostomy, and ureterocystostomy, while instructors expected trainees to be able to perform these procedures independently when they became attending doctors. CONCLUSION Trainees showed low subjective competencies and low confidence for future skill acquisition in several open and reconstructive procedures, while instructors considered that these procedures should be independently performable by attending doctors. We believe that knowledge of these perception gaps is helpful to develop a practical training program.
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Affiliation(s)
- Kanta Hori
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takashige Abe
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Noriyuki Abe
- Department of Urology, Asahikawa Medical University, Asahikawa, Japan
| | - Junya Abe
- Department of Urology, Sapporo Medical University, Sapporo, Japan
| | - Kazufumi Okada
- Promotion Unit, Data Science Center, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan
| | - Keita Takahashi
- Promotion Unit, Data Science Center, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan
| | - Shigeru Harada
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Jun Furumido
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Sachiyo Murai
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Masafumi Kon
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kohei Hashimoto
- Department of Urology, Sapporo Medical University, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University, Sapporo, Japan
| | - Hidehiro Kakizaki
- Department of Urology, Asahikawa Medical University, Asahikawa, Japan
| | - Nobuo Shinohara
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Napolitano L, Maggi M, Sampogna G, Bianco M, Campetella M, Carilli M, Lucci Chiarissi M, Civitella A, DE Vita F, DI Maida F, DI Mauro M, Ercolino A, Fasulo V, Felici G, Gheza A, Guzzardo C, Loizzo D, Mazzone E, Parodi S, Piramide F, Rabito S, Rizzetto R, Romantini F, Scarcella S, Tedde M, Checcucci E, Esperto F, Claps F, Falagario U. A survey on preferences, attitudes, and perspectives of Italian urology trainees: implications of the novel national residency matching program. Minerva Urol Nephrol 2023; 75:718-728. [PMID: 37350584 DOI: 10.23736/s2724-6051.23.05257-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
BACKGROUND Since 2014, a new residency program selection process has been established with a national examination. The aim of this study was to assess characteristics, career goals, and practice preferences of current Italian urology residents. METHODS A web-based survey of 25 items performed from May 2021 to September 2021 was sent to 585 Italian urology residents. Descriptive analyses were conducted to describe the surveys' domains: demographics characteristics, studies, plans for fellowship training, interest in the urology field, and career expectations. RESULTS Four hundred and one residents completed the online survey (response rate 68.5%). Most residents were male (70.3%), with a median of 29 (IQR 28-31) years. Urology was the first chosen School in 325 (81.0%) cases, and 174 (43.4%) trainees have chosen to remain in the same University. Uro-oncology was the main field, and endourology the main subspeciality of interest, respectively. More than 40.0% of residents expressed a good level of satisfaction for the training urological course. 232 (57.2%) residents were strongly interested in seeking a hospital career, followed by private career (43.4%) and academic career (20%). CONCLUSIONS After the introduction of the novel national residency matching program the Italian Urology trainees showed a good satisfaction level. Further improvements of the Italian residency programs should be focused on the training network within and outside the main School of Urology.
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Affiliation(s)
- Luigi Napolitano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Martina Maggi
- Department of Urology, Sapienza University, Rome, Italy -
| | - Gianluca Sampogna
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Bianco
- Department of Urology, University of Padua, Padua, Italy
| | | | - Marco Carilli
- Unit of Urology, Tor Vergata Polyclinic Foundation, Rome, Italy
| | | | - Angelo Civitella
- Department of Medicine and Surgery, Campus Bio-Medico University, Rome, Italy
| | | | - Fabrizio DI Maida
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | - Marina DI Mauro
- Section of Urology, Department of Surgery, University of Catania, Catania, Italy
| | | | - Vittorio Fasulo
- Department of Urology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Graziano Felici
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alberto Gheza
- Department of Urology, University of Brescia, Brescia, Italy
| | | | - Davide Loizzo
- Unit of Transplantation, Department of Urology, Andrology and Kidney, University of Bari, Bari, Italy
| | - Elio Mazzone
- Unit of Urology, Division of Oncology, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Stefano Parodi
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genoa, Genoa, Italy
| | - Federico Piramide
- Division of Urology, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Salvatore Rabito
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Rizzetto
- Department of Urology, AOUI Verona, University of Verona, Verona, Italy
| | - Federico Romantini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Matteo Tedde
- Department of Clinical and Experimental Medicine, Urologic Clinic, University of Sassari, Sassari, Italy
| | - Enrico Checcucci
- Division of Urology, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Francesco Esperto
- Department of Medicine and Surgery, Campus Bio-Medico University, Rome, Italy
| | - Francesco Claps
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Ugo Falagario
- Department of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, Foggia, Italy
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Enikeev D, Morozov A, Shpikina A, Fajkovic H, Baniel J, Herrmann TRW. A 10-year renaissance of en bloc resection of bladder tumors (ERBT): Are we approaching the peak or is it back to the trough? World J Urol 2023; 41:2607-2615. [PMID: 37244879 DOI: 10.1007/s00345-023-04439-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/02/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND The number of studies suggesting that en bloc resection of bladder tumor (ERBT) is superior to transurethral resection of bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC) management is growing. The aim of this review is to discuss the features of these procedures and to determine the prospects of en bloc in NMIBC management. MATERIALS AND METHODS We conducted a literature search using two databases (Medline and Scopus) and included any research which reported ERBT outcomes. RESULTS The lasers with minimal tissue penetration depth are becoming the main tool for ERBT. Unfortunately, most of the systematic reviews continue to be characterized by high heterogeneity. However, recent studies indicate that ERBT may have the edge when it comes to the detrusor muscle rate and the quality of the histological specimen. ERBT may favor in terms of in-field relapse, but its rate in the studies varies greatly. As for out-field relapse-free survival, the data are still lacking. The strongest evidence supports that ERBT is superior to TURBT in complications rate (bladder perforation). ERBT is feasible irrespective to tumor size and location. CONCLUSIONS ERBT has gained in momentum with the increasingly widespread use of this kind of laser surgery. The introduction of novel sources (TFL and Thulium:YAG pulsed laser) will definitely affect how the field develops and will result in further improvements in safety and precision. The latest trials make us more certain in our belief that ERBT will be beneficial in terms of histological specimen quality, relapse rate and complications rate.
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Affiliation(s)
- Dmitry Enikeev
- Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.
| | - Andrey Morozov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Anastasia Shpikina
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Harun Fajkovic
- Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
| | - Jack Baniel
- Division of Urology, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Thomas R W Herrmann
- Department of Urology, Spital Thurgau AG (STGAG), Frauenfeld, Switzerland
- Department of Urology, Stellenbosch University, Western Cape, South Africa
- Hannover Medical School, MHH Carl Neuberg Str. 1, 30625, Hannover, Germany
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Mantica G, Chierigo F, Gallo F, Cocci A, Esperto F, Patruno G, Diminutto A, Cerasuolo M, Campi R, Barale M, Ragonese M, Bettin L, Zanetti S, Bianchi L, Principi E, Puliatti S, Cancrini F, Parnanzini D, Bianchi G, Grande P, Primiceri G, Cavacece F, Schiralli P, Amparore D, Farullo G, Di Mauro M, Durante J, Baldesi R, Carobbio F, Russo GI, Luperto E, La Rocca R, Cacciamani GE. Patients' perceptions of quality of care delivery by urology residents: A nationwide study. BJU Int 2022; 130:832-838. [PMID: 35491978 PMCID: PMC9790253 DOI: 10.1111/bju.15768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To present the results of a nationwide survey among urological patients to evaluate their perception of the quality of care provided by residents. METHODS An anonymous survey was distributed to patients who were referred to 22 Italian academic institutions. The survey aimed to investigate the professional figure of the urology resident as perceived by the patient. RESULTS A total of 2587 patients were enrolled in this study. In all, 51.6% of patients were able to correctly identify a urology resident; however, almost 40% of respondents discriminated residents from fully trained urologists based exclusively on their young age. Overall, 98.2% patients rated the service provided by the resident as at least sufficient. Urology trainees were considered by more than 50% of the patients interviewed to have good communication skills, expertise and willingness. Overall, patients showed an excellent willingness to be managed by urology residents. The percentage of patients not available for this purpose showed an increasing trend that directly correlated with the difficulty of the procedure. Approximately 5-10% of patients were not willing to be managed by residents for simple procedures such as clinical visits, cystoscopy or sonography, and up to a third of patients were not prepared to undergo any surgical procedure performed by residents during steps in major surgery, even if the residents were adequately tutored. CONCLUSIONS Our data showed that patients have a good willingness to be managed by residents during their training, especially for medium- to low-difficulty procedures. Furthermore, the majority of patients interviewed rated the residents' care delivery as sufficient. Urology trainees were considered to have good communication skills, expertise and willingness.
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Affiliation(s)
- Guglielmo Mantica
- Department of Urology, Ospedale Policlinico San MartinoUniversity of GenoaGenoaItaly
| | - Francesco Chierigo
- Department of Urology, Ospedale Policlinico San MartinoUniversity of GenoaGenoaItaly
| | - Fabio Gallo
- Department of BiostatisticUniversity of GenoaGenoaItaly
| | - Andrea Cocci
- Department of Urology, Careggi HospitalUniversity of FlorenceFlorenceItaly
| | - Francesco Esperto
- Department of Urology, Campus Biomedico HospitalUniversity Campus BiomedicoRomeItaly
| | - Giulio Patruno
- Department of Urology, Hospital Policlinico Tor VergataUniversity of Roma Tor VergataRomeItaly
| | - Alberto Diminutto
- Department of Urology, Policlinico G.B. Rossi HospitalUniversity of VeronaVeronaItaly
| | - Mattia Cerasuolo
- Department of Urology, Ospedale Policlinico San MartinoUniversity of GenoaGenoaItaly
| | - Riccardo Campi
- Department of Urology, Careggi HospitalUniversity of FlorenceFlorenceItaly
| | - Maurizio Barale
- Department of Urology, Molinette hospitalUniversity of TorinoTorinoItaly
| | - Mauro Ragonese
- Department of Urology, Gemelli HospitalCattolica University of RomeRomeItaly
| | - Laura Bettin
- Department of UrologyUniversity of Padua¦PaduaItaly
| | - Stefano Zanetti
- Department of UrologyHospital Maggiore Policlinico Mangiagalli e Regina ElenaMilanItaly
| | - Lorenzo Bianchi
- Department of Urology, S. Orsola HospitalUniversity of BolognaBolognaItaly
| | - Emanuele Principi
- Department of Urology Ospedali riuniti di AnconaUniversity of MarcheAnconaItaly
| | - Stefano Puliatti
- Department of Urology, Policlinico di Modena HospitalUniversity of ModenaModenaItaly
| | - Fabiana Cancrini
- Department of Urology, Sant'Andrea HospitalUniversity La SapienzaRomeItaly
| | - Daniele Parnanzini
- Department of Urology, Santissima Trinità HospitalUniversity of CagliariCagliariItaly
| | - Grazia Bianchi
- Department of Urology, Cattinara HospitalUniversity of TriesteItaly
| | - Pietro Grande
- Department of Urology, Umberto I HospitalUniversity La Sapienza of RomeRomeItaly
| | - Giulia Primiceri
- Department of Urology, SS. Annunziata HospitalUniversity of ChietiChietiItaly
| | - Fernando Cavacece
- Department of Urology, SS. Annunziata HospitalUniversity of ChietiChietiItaly
| | - Pasquale Schiralli
- Department of Urology, Policlinico di Bari HospitalUniversity of BariBariItaly
| | - Daniele Amparore
- Department of Urology, San Luigi Gonzaga HospitalUniversity of TurinTurinItaly
| | - Giuseppe Farullo
- Department of Urology, Hospital Policlinico Tor VergataUniversity of Roma Tor VergataRomeItaly
| | - Marina Di Mauro
- Department of Surgery, Urology SectionUniversity of CataniaCataniaItaly
| | - Jacopo Durante
- Department of Urology, Cisanello HospitalUniversity of PisaPisaItaly
| | - Ramona Baldesi
- Department of Urology, Cisanello HospitalUniversity of PisaPisaItaly
| | - Francesca Carobbio
- Department of Urology, A.O. Spedali Civili di BresciaUniversity of BresciaBresciaItaly
| | - Giorgio I Russo
- Department of Surgery, Urology SectionUniversity of CataniaCataniaItaly
| | - Elia Luperto
- Department of Urology, Campus Biomedico HospitalUniversity Campus BiomedicoRomeItaly
| | - Roberto La Rocca
- Department of Urology, Policlinico Federico II HospitalUniversity Federico II of NaplesNaplesItaly
| | - Giovanni E. Cacciamani
- Department of Urology, Policlinico G.B. Rossi HospitalUniversity of VeronaVeronaItaly,Department of Urology, Keck School of MedicineUniversity of Southern CaliforniaCaliforniaLAUSA,Norris Cancer CenterUniversity of Southern CaliforniaCaliforniaLAUSA
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Assessing Trifecta Achievement after Percutaneous Cryoablation of Small Renal Masses: Results from a Multi-Institutional Collaboration. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081041. [PMID: 36013508 PMCID: PMC9412454 DOI: 10.3390/medicina58081041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: To assess efficacy and safety of Percutaneous Cryoablation (PCA) of small renal masses (SRMs) using Trifecta outcomes in a large cohort of patients who were not eligible for surgery. Materials and methods: All PCAs performed in four different centers between September 2009 and September 2019 were retrospectively evaluated. Patients were divided in two different groups depending on masses dimensional criteria: Group-A: diameter ≤ 25 mm and Group-B: diameter > 25 mm. Complications rates were reported and classified according to the Clavien−Dindo system. The estimate glomerular filtration rate (eGFR) was calculated before PCA and during follow-up schedule. Every patient received a Contrast Enhanced Ultrasound (CEUS) evaluation on the first postoperative day. Radiological follow-up was taken at 3, 6, and 12 months for the first year, then yearly. Radiological recurrence was defined as a contrast enhancement persistence and was reported in the study. Finally, Trifecta outcome, which included complications, RFS, and preservation of eGFR class, was calculated for every procedure at a median follow-up of 32 months. Results: The median age of the patients was 74 years. Group-A included 200 procedures while Group-B included 140. Seventy-eight patients were eligible for Trifecta evaluation. Trifecta was achieved in 69.6% of procedures in Group-A, 40.6% in Group-B (p = 0.02). We observed an increased rate of complication in Group-B (13.0% vs. 28.6; p < 0.001). However, 97.5% were <II Clavien−Dindo grade. No differences were found between the two groups regarding eGFR before and after treatment. Further, 24-months RFS rates were respectively 98.0% for Group-A and 92.1% in Group-B, while at 36 months were respectively 94.5% and 87.5% (p = 0.08). Conclusions: PCA seems to be a safe and effective treatment for SRM but in the need of more strict dimensional criteria to achieve a higher possible success rate.
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Kejela S, Tiruneh AG. Determinants of satisfaction and self-perceived proficiency of trainees in surgical residency programs at a single institution. BMC MEDICAL EDUCATION 2022; 22:473. [PMID: 35717190 PMCID: PMC9206365 DOI: 10.1186/s12909-022-03521-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND We aimed to identify factors contributing to training program satisfaction and self-perceived proficiency of residents in 5 integrated surgical residency programs within the same referral institution. METHODS We conducted a cross-sectional survey including all senior surgical residents in all integrated sub-specialty and general surgery residency programs at Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. Training programs were assessed on 6 educational components including operative case volume and diversity, intra-operative hands-on training, morning teaching sessions, seminars, ward rounds, and research opportunities. RESULTS Of 82 eligible residents, 69 (84.1%) responded to the survey. Overall resident satisfaction (rated from 0-10) varied between the 5 training programs, from a mean of 6.03 to 7.89 (overall p = 0.03). The percentage of residents who agreed they would be proficient by the end of their training ranged from 44.2%-88.9%. General surgery residents had the lowest overall satisfaction score, and lowest scores in all educational components except seminar teaching. In multivariable analysis, operative case volume and diversity (AOR 3.67; 95% CI, 1.24-10.83; P = 0.019), and hands-on training (AOR 4.15; 95% CI, 1.27-13.5; P = 0.018) were significantly associated with overall resident satisfaction. In ordinal logistic regression, hands-on training (OR 3.94, 95% CI, 1.69-9.2; P = 0.001), and seminar sessions (OR 2.43, 95% CI, 1.11-5.33; P = 0.028) were significantly associated with self-perceived proficiency. CONCLUSION Different surgical residency training programs within the same institution had divergent resident satisfaction scores and proficiency scores. Operative case volume and diversity, and intraoperative hands-on training are the most important predictors of resident satisfaction while hands-on training and seminar sessions independently predicted self-perceived proficiency. Attention to these key components of resident education is likely to have a strong effect on training outcomes.
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Affiliation(s)
- Segni Kejela
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
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Doğan Değer M, Alperen Yıldız H, Denizhan Demirkıran E, Madendere S. Current status of urological training and differences between institutions. Actas Urol Esp 2022; 46:285-292. [PMID: 35177364 DOI: 10.1016/j.acuroe.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/26/2021] [Accepted: 05/23/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Appropriate training of urology residents is important to secure not only high-quality patient care, but also the bright future of our specialty. We aimed to investigate residency training from the perspective of qualification and standardization and to evaluate surgical education, publication output, working conditions, future plans, and overall satisfaction, in a comprehensive way. METHODS We conducted a survey of urology chief residents/recent graduates in Turkey to identify differences between institutions and deficiencies in urology resident training. A total of 155 chief residents/recently graduated specialists were contacted by phone and a survey was completed. RESULTS The survey response rate was 96.1%. Respondents had high proficiency in endourology (97.3%), similar to Canada and European countries. However, they reported a lack of proficiency in laparoscopy (28.9%) and functional urology (26.2%). Also, no one had completed a robotic procedure as first surgeon. A total of 75.2% respondents had no first author publication, and 10.1% had no first author abstract presentation. There was no significant difference between institution types with or without certification. There was a satisfaction rate of 87.2% among participants. CONCLUSIONS It was observed that qualified and standardized training could has not been achieved and the positive effects of certification have not been seen yet. There is a lack of modernization in all aspects of education, and there is no standardized curriculum addressing academic research. Therefore, there is a risk that future urologists will have insufficient skills. We hope this study serves as a guide for modernization and standardization in urology training.
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Affiliation(s)
- M Doğan Değer
- Departamento de Urología, Hospital Edirne Sultan 1(er) Murat, Edirne, Turkey.
| | | | | | - S Madendere
- Departamento de Urología, Hospital Gümüşhane, Gümüşhane, Turkey
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Doğan Değer M, Alperen Yıldız H, Denizhan Demirkıran E, Madendere S. Estado actual de la formación urológica y diferencias entre instituciones. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Alkhamees MA, Almutairi SA, Aljuhayman AM, Alkanhal H, Alenezi SH, Almuhaideb M, Alkhateeb SS. Evaluation of the urology residency training program in Saudi Arabia: A cross-sectional study. Urol Ann 2021; 13:367-373. [PMID: 34759648 PMCID: PMC8525479 DOI: 10.4103/ua.ua_117_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 01/25/2021] [Indexed: 11/04/2022] Open
Abstract
PURPOSE This study evaluates the satisfaction of urology residents with the Saudi Board of Urology (SBU) Training Program and identifies areas of weakness and strength to improve the educational environment, surgical competency, and overall satisfaction of urology residents with the program. METHODS We administered an electronic self-made questionnaire that included two sections. One comprised demographic data (age, gender, weight, height, marital status, level of training, city of training, and center of training), while the other concerned SBU evaluation (satisfaction with different aspects of training, such as ways of assessment, mentors' feedback, surgical competency, research, and strengths and weaknesses of SBU). RESULTS The overall satisfaction of urology residency program was 28.8% while 44.2% of residents had a neutral response. The highest level of satisfaction with clinical and surgical practice was among graduates (56.9%) and Riyadh residents (45.1%). Furthermore, good work/life balance received the lowest level of satisfaction (5.2%) among senior residents, while good clinical experience received the highest level (62.7%) among the graduates. Residents reported a high exposure in endourology and pediatric urology, while transplant, reconstructive, and neurourology had the lowest exposure. Forty-two percent of respondents undertook research during their residency training, but most respondents (54%) did not publish any research papers during their training. Sixty-two percent of graduates felt that their training program did not prepare them adequately to perform well on the board examinations. CONCLUSION Our results confirmed that satisfaction of residents with the urology program process is variable according to the city of training. Having high satisfaction level in some cities reflects the improvement of urology training program after restructuring. We identified new areas in need of improvement, namely lack of mentorship, clear and formal assessment process, and variation of training process between central and peripheral programs.
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Affiliation(s)
| | - Sulaiman A. Almutairi
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Ahmed M. Aljuhayman
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Hammam Alkanhal
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Saad H. Alenezi
- Department of Ophthalmology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Mana Almuhaideb
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sultan S. Alkhateeb
- Department of Urology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Department of Surgery, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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11
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Urology residency training in Greece. Results from the first national resident survey. Actas Urol Esp 2021; 45:537-544. [PMID: 34531162 DOI: 10.1016/j.acuroe.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 11/29/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVES This is the first national survey assessing Greek Urology residency programs. The main objective of this study is to assess the level of confidence and perception of Greek Urology residents regarding their educational program and detect areas of improvement. MATERIAL AND METHODS A 51-question survey was developed via an electronic platform and answered by 91 out of 104 Greek residents from March 2019 until May 2019. Fisher's exact test, chi-squared test and Kruskal-Wallis test were used with statistical significance set at p = .05. RESULTS The median overall satisfaction regarding surgical training was 6/10 regardless of working schedule, working in a University Department, PGY or number of residents in clinic. Most residents have not performed any scrotal ultrasound or pressure-flow-studies; however, they are more familiar with KUB ultrasound. Double-J stent insertion and cystoscopy were common procedures for residents. Bureaucracy was reported as a major issue by 70.4% of residents. ESWL has not been performed by 80.2% of residents, 58.2% residents performed less than 10 ureteroscopies, and only the last year trainees performed more than 10 TURBT and TURP. Most residents mentioned to rarely perform basic steps in many open or laparoscopic urological procedures. Surprisingly, 59.3% of residents have not published any study in peer-reviewed journals. Regarding satisfaction, 44% rarely feel satisfied at work and 59.3% sometimes suffer from burnout. Response rate reached 87.5%. CONCLUSIONS Considering the results from this survey, regulatory authorities should join forces to establish a structured curriculum of clinical, surgical and research training in Urology across Europe.
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Tzelves L, Glykas I, Lazarou L, Zabaftis C, Fragkoulis C, Leventi A, Moulavasilis N, Tzavellas D, Tsirkas K, Ntoumas K, Mourmouris P, Dellis A, Varkarakis I, Skolarikos A, Liatsikos E, Gkialas I. Urology residency training in Greece. Results from the first national resident survey. Actas Urol Esp 2021; 45:S0210-4806(21)00092-9. [PMID: 34120774 DOI: 10.1016/j.acuro.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/22/2020] [Accepted: 11/29/2020] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES This is the first national survey assessing Greek Urology residency programs. The main objective of this study is to assess the level of confidence and perception of Greek Urology residents regarding their educational program and detect areas of improvement. MATERIAL AND METHODS A 51-question survey was developed via an electronic platform and answered by 91 out of 104 Greek residents from March 2019 until May 2019. Fisher's exact test, chi-squared test and Kruskal-Wallis test were used with statistical significance set at p=.05. RESULTS The median overall satisfaction regarding surgical training was 6/10 regardless of working schedule, working in a University Department, PGY or number of residents in clinic. Most residents have not performed any scrotal ultrasound or pressure-flow-studies; however, they are more familiar with KUB ultrasound. Double-J stent insertion and cystoscopy were common procedures for residents. Bureaucracy was reported as a major issue by 70.4% of residents. ESWL has not been performed by 80.2% of residents, 58.2% residents performed less than 10 ureteroscopies, and only the last year trainees performed more than 10 TURBT and TURP. Most residents mentioned to rarely perform basic steps in many open or laparoscopic urological procedures. Surprisingly, 59.3% of residents have not published any study in peer-reviewed journals. Regarding satisfaction, 44% rarely feel satisfied at work and 59.3% sometimes suffer from burnout. Response rate reached 87.5%. CONCLUSIONS Considering the results from this survey, regulatory authorities should join forces to establish a structured curriculum of clinical, surgical and research training in Urology across Europe.
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Affiliation(s)
- L Tzelves
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - I Glykas
- Department of Urology, General Hospital of Athens"G. Gennimatas", Atenas, Grecia.
| | - L Lazarou
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - C Zabaftis
- First Department of Urology, National and Kapodistrian University of Athens, Laiko Hospital, Atenas, Grecia
| | - C Fragkoulis
- Department of Urology, General Hospital of Athens"G. Gennimatas", Atenas, Grecia
| | - A Leventi
- Department of Urology, General Hospital of Athens"G. Gennimatas", Atenas, Grecia
| | - N Moulavasilis
- First Department of Urology, National and Kapodistrian University of Athens, Laiko Hospital, Atenas, Grecia
| | - D Tzavellas
- First Department of Urology, National and Kapodistrian University of Athens, Laiko Hospital, Atenas, Grecia
| | - K Tsirkas
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - K Ntoumas
- Department of Urology, General Hospital of Athens"G. Gennimatas", Atenas, Grecia
| | - P Mourmouris
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - A Dellis
- 2.(nd) Department of Surgery, National and Kapodistrian University of Athens, School of Medicine, Aretaieion Hospital, Atenas, Grecia, 1.(st) Department of Urology, National and Kapodistrian University of Athens, School of Medicine, Laiko Hospital, Atenas, Grecia
| | - I Varkarakis
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - A Skolarikos
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - E Liatsikos
- Department of Urology, University of Patras, School of Medicine, Patras, Grecia
| | - I Gkialas
- Department of Urology «Agios Savvas», Anti-Cancer Oncologic Hospital of Athens, Atenas, Grecia
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Busetto GM, Del Giudice F, Mari A, Sperduti I, Longo N, Antonelli A, Cerruto MA, Costantini E, Carini M, Minervini A, Rocco B, Artibani W, Porreca A, Porpiglia F, Damiano R, De Sio M, Arcaniolo D, Cimino S, Russo GI, Lucarelli G, Di Tonno P, Gontero P, Soria F, Trombetta C, Liguori G, Scarpa RM, Papalia R, Terrone C, Borghesi M, Verze P, Madonia M, De Lisa A, Bove P, Guazzoni G, Lughezzani G, Racioppi M, Di Gianfrancesco L, Brunocilla E, Schiavina R, Simeone C, Veccia A, Montorsi F, Briganti A, Dal Moro F, Pavone C, Serretta V, Di Stasi SM, Galosi AB, Schips L, Marchioni M, Montanari E, Carrieri G, Cormio L, Greco F, Musi G, Maggi M, Conti SL, Tubaro A, De Berardinis E, Sciarra A, Gallucci M, Mirone V, de Cobelli O, Ferro M. How Can the COVID-19 Pandemic Lead to Positive Changes in Urology Residency? Front Surg 2020; 7:563006. [PMID: 33330604 PMCID: PMC7732553 DOI: 10.3389/fsurg.2020.563006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 10/15/2020] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 outbreak, in a few weeks, overloaded Italian hospitals, and the majority of medical procedures were postponed. During the pandemic, with hospital reorganization, clinical and learning activities performed by residents suffered a forced remodulation. The objective of this study is to investigate how urology training in Italy has been affected during the COVID-19 era. In this multi-academic study, we compared residents' training during the highest outbreak level with their previous activity. Overall 387 (67.1%) of the 577 Italian Urology residents participated in a 72-h anonymous online survey with 36 items sent via email. The main outcomes were clinical/surgical activities, social distancing, distance learning, and telemedicine. Clinical and learning activity was significantly reduced for the overall group, and after categorizing residents as those working only in COVID hospitals, both "junior" and "senior" residents, and those working in any of three geographical areas created (Italian regions were clustered in three major zones according to the prevalence of COVID-19). A significant decrease in outpatient activity, invasive diagnostic procedures, and endoscopic and major surgeries was reported. Through multivariate analysis, the specific year of residency has been found to be an independent predictor for all response modification. Being in zone 3 and zone 2 and having "senior" resident status were independent predictors associated with a lower reduction of the clinical and learning activity. Working in a COVID hospital and having "senior" resident status were independent predictors associated with higher reduction of the outpatient activity. Working in zone 3 and having "senior" resident status were independent predictors of lower and higher outpatient surgical activity, respectively. Working in a COVID hospital was an independent predictor associated with robotic surgical activity. The majority of residents reported that distance teaching and multidisciplinary virtual meetings are still not used, and 44.8% reported that their relationships with colleagues decreased. The COVID-19 pandemic presents an unprecedented challenge, including changes in the training and education of urology residents. The COVID era can offer an opportunity to balance and implement innovative solutions that can bridge the educational gap and can be part of future urology training.
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Affiliation(s)
| | - Francesco Del Giudice
- Sapienza Rome University Policlinico Umberto I, Rome, Italy
- Stanford University, Palo Alto, CA, United States
| | | | - Isabella Sperduti
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Regina Elena National Cancer Institute, Rome, Italy
| | | | | | | | | | | | | | | | | | | | | | | | - Marco De Sio
- University of Campania “L. Vanvitelli”, Caserta, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Gennaro Musi
- Department of Urology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Martina Maggi
- Sapienza Rome University Policlinico Umberto I, Rome, Italy
| | | | - Andrea Tubaro
- Sapienza Rome University Sant'Andrea Hospital, Rome, Italy
| | | | | | | | | | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Haematology-Oncology, University of Milan, Milan, Italy
| | - Matteo Ferro
- Department of Urology, IEO European Institute of Oncology IRCCS, Milan, Italy
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Krishnappa P, Srini VS, Shah R, Lentz AC, Garaffa G, Martinez-Salamanca JI, Moncada I. Cadaveric Penile Prosthesis Workshop training improves surgical confidence levels of urologists: South Asian Society for Sexual Medicine course survey. Int J Urol 2020; 27:1032-1037. [PMID: 32776406 DOI: 10.1111/iju.14338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To analyze the impact of South Asia's first cadaveric hands-on workshop on urologists' training in inflatable penile prosthesis surgery. METHODS A total of 72 urologists/andrologists participated in the 2019 South Asian Society for Sexual Medicine Pre-congress Penile Prosthesis hands-on workshop. The workshop included 4 h of lectures and 2 h of hands-on cadaveric laboratory experience using three-piece inflatable penile prosthesis. The Shapiro-Wilk test was used on self-rated procedural confidence levels, which proved the normality. A non-parametric McNemar test was used to examine the change in the number of correct answers. RESULTS Of those who attended the cadaver laboratory, just 45 who answered the survey both before and after the workshop were included for analysis. Significant objective improvements were noted in procedural knowledge test scores (44.30 ± 0.027 vs 72.44 ± 0.024, P < 0.05) and median surgical confidence levels (4 vs 3 and 2, P < 0.001) of the urologists after the completion of the workshop. CONCLUSIONS Cadaveric hands-on workshop training improves urologists' procedural knowledge and surgical confidence levels in carrying out three-piece inflatable penile prosthesis surgery. The feasibility of such workshops should be considered in increasing the surgical expertise of general urologists in prosthetic urology.
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Affiliation(s)
- Pramod Krishnappa
- Andrology Division, Department of Urology, NU Hospitals, Bangalore, India
| | - Vasan S Srini
- Department of Andrology, Ankur Healthcare, Bangalore, India
| | - Rupin Shah
- Department of Andrology, Lilavati Hospital, Mumbai, India
| | - Aaron C Lentz
- Department of Urologic Surgery, Duke University, Raleigh, NC, USA
| | - Giulio Garaffa
- Department of Urology, University College of London Hospital, London, UK
| | - Juan Ignacio Martinez-Salamanca
- Department of Urology, Puerta de Hierro Majadahonda University Hospital, Lyx Institute of Urology, Francisco de Vitoria University, Madrid, Spain
| | - Ignacio Moncada
- Department of Urology and Robotic Surgery, University Hospital La Zarzuela, Madrid, Spain
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Esperto F, Papalia R, Autrán-Gómez AM, Scarpa RM. COVID-19's Impact on Italian Urology. Int Braz J Urol 2020; 46:26-33. [PMID: 32568494 PMCID: PMC7719978 DOI: 10.1590/s1677-5538.ibju.2020.s103] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/10/2020] [Indexed: 01/16/2023] Open
Abstract
The COVID-19 pandemic has impacted our lives, our habits and our healthcare system. Italy is one of the countries affected first and more aggressively from the outbreak. Our rapidity has been guide for other healthcare systems from around the World. We describe the impact of COVID-19 on Urology, how the Urological scientific community responded to the emergency and our experience in a high-volume Roman University hospital. The aim of our work is to share our experience providing suggestions for other global hospitals on how to manage the COVID-19 emergency.
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Affiliation(s)
- Francesco Esperto
- University of RomeCampus Bio-medicoDepartment of UrologyRomeItalyDepartment of Urology, Campus Bio-medico, University of Rome, Rome, Italy
| | - Rocco Papalia
- University of RomeCampus Bio-medicoDepartment of UrologyRomeItalyDepartment of Urology, Campus Bio-medico, University of Rome, Rome, Italy
| | - Ana María Autrán-Gómez
- University Hospital Fundación Jiménez DíazDepartment of UrologyMadridSpainDepartment of Urology University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Roberto M. Scarpa
- University of RomeCampus Bio-medicoDepartment of UrologyRomeItalyDepartment of Urology, Campus Bio-medico, University of Rome, Rome, Italy
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Poletajew S, Krajewski W, Kaczmarek K, Kopczyński B, Stamirowski R, Tukiendorf A, Zdrojowy R, Słojewski M, Radziszewski P. The Learning Curve for Transurethral Resection of Bladder Tumour: How Many is Enough to be Independent, Safe and Effective Surgeon? JOURNAL OF SURGICAL EDUCATION 2020; 77:978-985. [PMID: 32147466 DOI: 10.1016/j.jsurg.2020.02.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 02/03/2020] [Accepted: 02/15/2020] [Indexed: 05/20/2023]
Abstract
OBJECTIVE Transurethral resection of the bladder tumour (TURBT) is one the most common urological procedures. It is also one the fundamental surgeries performed by residents. The learning curve (LC) for TUR has never been analysed. The aim of the study was to analyse the learning curve of TURBT in a residency setting. DESIGN, SETTING AND PARTICIPANTS This retrospective multicentre analysis of prospectively maintained databases enrolled 993 consecutive TURBTs performed by 10 urology residents in 3 academic institutions. Study end-points were as follows: the absence of muscularis propria in a specimen, any intra- or postoperative surgical complication and 3-month recurrence-free survival. RESULTS With increasing experience, residents operated more complex cases defined by higher rate of large, multifocal or high-risk tumours. In the same time, surgery time, postoperative catheterization time and hospital stay became shorter. An improvement has been noticed regarding the muscularis propria sampling and 3-month recurrence-free survival, but not regarding the risk of surgical complications. Evident improvement in study end-points was noticed after 101 operations; surgeons achieved the best clinical outcomes after performing 170 procedures, whereas the poorest results for the first 45 operations. CONCLUSIONS TURBT has a flat LC with 100 cases being the absolute minimum for a resident in training to achieve acceptable oncological and surgical outcomes.
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Affiliation(s)
- Sławomir Poletajew
- Second Department of Urology, Medical Centre of Postgraduate Education, Warsaw, Poland
| | - Wojciech Krajewski
- Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland.
| | - Krystian Kaczmarek
- Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Bartłomiej Kopczyński
- Department of General, Oncological and Functional Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Remigiusz Stamirowski
- Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland
| | | | - Romuald Zdrojowy
- Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland
| | - Marcin Słojewski
- Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Piotr Radziszewski
- Department of General, Oncological and Functional Oncology, Medical University of Warsaw, Warsaw, Poland
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Socarrás MER, Esperto F, Bapstistussi MD, Barufaldi F, Vital MS, Papalia R, Salerno A, Cataldo R, Autrán-Gómez AM, Scarpa RM. Endourology (Lithiasis). Management, surgical considerations and follow-up of patients in the COVID-19 era. Int Braz J Urol 2020; 46:39-49. [PMID: 32568495 PMCID: PMC7719981 DOI: 10.1590/s1677-5538.ibju.2020.s105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/10/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To provide recommendations on the endourological management of lithiasis in the scenario of the COVID-19 pandemic. MATERIALS AND METHODS A non-systematic review in PubMed and the grey literature, as well as recommendations by a panel of stakeholders was made, regarding management, surgical considerations and follow-up of patients affected by lithiasis in the COVID-19 era. RESULTS Under the current outbreak and COVID-19 pandemic scenario, patients affected by lithiasis should be prioritized into low, intermediate and high risk categories, to decide their delay and save resources, healthcare personnel, beds and ventilators. However, patients with potentially serious septic complications need emergency interventions. The possibility of performing or restarting elective activity depends on local conditions, the availability of beds and ventilators, and the implementation of screening protocols in the context of the COVID-19 pandemic. Delaying lithiasis surgery and increasing waiting lists will have consequences and will require considerable additional effort. Teleconsultation may be useful in guiding these patients, reducing visits and unnecessary exposure. CONCLUSIONS categorization and prioritization of patients affected by lithiasis is crucial for management, surgical selection and follow-up. Protocols, measures and additional efforts should be carried out in the current situation of the COVID-19 pandemic.
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Affiliation(s)
| | - Francesco Esperto
- University of RomeCampus BiomedicoDepartment of UrologyRomeItalyDepartment of Urology, Campus Biomedico, University of Rome, Rome, Italy
- European Society of Residents in UrologyArnhemThe NetherlandsEuropean Society of Residents in Urology (ESRU), Arnhem, The Netherlands
| | - Marcelo Denilson Bapstistussi
- Beneficência Portuguesa HospitalDepartment of UrologySão PauloSPBrasilDepartment of Urology, Beneficência Portuguesa Hospital, São Paulo, SP, Brasil
- American Confederation of UrologyDepartment of LithiasisBuenos AiresArgentinaDepartment of Lithiasis of American Confederation of Urology (CAU), Buenos Aires, Argentina
| | - Felipe Barufaldi
- Beneficência Portuguesa HospitalDepartment of UrologySão PauloSPBrasilDepartment of Urology, Beneficência Portuguesa Hospital, São Paulo, SP, Brasil
| | - Matheus Soares Vital
- Beneficência Portuguesa HospitalDepartment of UrologySão PauloSPBrasilDepartment of Urology, Beneficência Portuguesa Hospital, São Paulo, SP, Brasil
| | - Rocco Papalia
- University of RomeCampus BiomedicoDepartment of UrologyRomeItalyDepartment of Urology, Campus Biomedico, University of Rome, Rome, Italy
| | - Annamaria Salerno
- University of RomeCampus BiomedicoDepartment of UrologyRomeItalyDepartment of Urology, Campus Biomedico, University of Rome, Rome, Italy
| | - Rita Cataldo
- University of RomeUnit of Anesthesia, Intensive care and pain managementDepartment of MedicineRomeItalyDepartment of Medicine, Unit of Anesthesia, Intensive care and pain management, Campus Biomédico, University of Rome, Rome, Italy
| | - Ana María Autrán-Gómez
- University Hospital Fundación Jiménez DíazDepartment of UrologyMadridSpainDepartment of Urology, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Roberto Mario Scarpa
- University of RomeCampus BiomedicoDepartment of UrologyRomeItalyDepartment of Urology, Campus Biomedico, University of Rome, Rome, Italy
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Papalia R, Cataldo R, Alloni R, Pang KH, Alcini A, Flammia G, Salerno A, Notarangelo MG, Angeletti S, Venditti A, Sommella L, Scarpa RM, Esperto F. Urologic surgery in a safe hospital during the COVID-19 pandemic scenario. Minerva Urol Nephrol 2020; 73:384-391. [PMID: 32573174 DOI: 10.23736/s2724-6051.20.03923-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The COVID-19 pandemic induced a global emergency that overwhelmed most hospitals around the world. Access to hospitals has been restricted to selective oncological and urgent patients to minimize surgeries requiring Intensive Care Unit care. All other kind of non-urgent and benign surgeries have been rescheduled. The burden of oncological and urgent cases on the healthcare system has increased. METHODS We have been asked to become the referral center for major oncological and urgent urological surgeries, increasing our surgical volume. Through meticulous hospital protocols on PPE, use of nasopharyngeal swabs, controlled hospital access and the prompt management of suspected/positive cases, we were able to perform 31% more urological surgical procedures during the COVID-19 pandemic compared to the same period in 2019. RESULTS We observed a 72% increase in oncological surgical procedures and 150% in urgent procedures. CONCLUSIONS Our experience shows how the management of oncological and urgent cases can be maintained during unexpected, global emergencies, such as COVID-19.
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Affiliation(s)
- Rocco Papalia
- Department of Urology, Campus Bio-Medico University, Rome, Italy
| | - Rita Cataldo
- Unit of Anesthesiology, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | - Rossana Alloni
- Clinical Direction, Campus Bio-Medico University, Rome, Italy
| | - Karl H Pang
- Unit of Academic Urology, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Antonio Alcini
- Department of Urology, Campus Bio-Medico University, Rome, Italy
| | - Gerardo Flammia
- Department of Urology, Campus Bio-Medico University, Rome, Italy
| | | | | | - Silvia Angeletti
- Unit of Clinical Laboratory Science, Campus Bio-Medico University, Rome, Italy
| | | | | | - Roberto M Scarpa
- Department of Urology, Campus Bio-Medico University, Rome, Italy
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Carrion DM, Rodríguez-Socarrás ME, Mantica G, Pang KH, Esperto F, Mattigk A, Duijvesz D, Vásquez JL, Díez Sebastián J, Scarpa RM, Papalia R, Palou J, Gómez Rivas J. Interest and involvement of European urology residents in academic and research activities. An ESRU-ESU-ESUT collaborative study. MINERVA UROL NEFROL 2020; 72:384-387. [DOI: 10.23736/s0393-2249.20.03734-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Porpiglia F, Checcucci E, Amparore D, Verri P, Campi R, Claps F, Esperto F, Fiori C, Carrieri G, Ficarra V, Mario Scarpa R, Dasgupta P. Slowdown of urology residents' learning curve during the COVID-19 emergency. BJU Int 2020; 125:E15-E17. [PMID: 32274879 PMCID: PMC7262049 DOI: 10.1111/bju.15076] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Francesco Porpiglia
- Division of Urology, Department of Oncology, "San Luigi Gonzaga" Hospital, University of Turin , Orbassano (Turin), Italy
| | - Enrico Checcucci
- Division of Urology, Department of Oncology, "San Luigi Gonzaga" Hospital, University of Turin , Orbassano (Turin), Italy.,Uro-technology and SoMe Working Group of the Young Academic Urologists (YAU) Working Party of the European Association of Urology (EAU), Arnhem, The Netherlands.,European Society of Residents in Urology (ESRU), Arnhem, the Netherlands
| | - Daniele Amparore
- Division of Urology, Department of Oncology, "San Luigi Gonzaga" Hospital, University of Turin , Orbassano (Turin), Italy
| | - Paolo Verri
- Division of Urology, Department of Oncology, "San Luigi Gonzaga" Hospital, University of Turin , Orbassano (Turin), Italy
| | - Riccardo Campi
- European Society of Residents in Urology (ESRU), Arnhem, the Netherlands.,Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesco Claps
- Urological Clinic Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Franceso Esperto
- European Society of Residents in Urology (ESRU), Arnhem, the Netherlands.,Department of Urology, University of Rome, Rome, Italy
| | - Cristian Fiori
- Division of Urology, Department of Oncology, "San Luigi Gonzaga" Hospital, University of Turin , Orbassano (Turin), Italy
| | - Giuseppe Carrieri
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Vincenzo Ficarra
- Department of Human and Pediatric Pathology "Gaetano Barresi", Urology Section, University of Messina, Messina, Italy
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21
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Pandey S, Goel A. Residents Feedback on Faculty and Working Environment: the Urology Training Program in India. Indian J Surg 2020. [DOI: 10.1007/s12262-019-01907-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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22
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Marchioni M, Berardinelli F, Zhang C, Simone G, Uzzo RG, Capitanio U, Minervini A, Lau C, Kaouk J, Langenstroer P, Amparore D, de Luyk N, Porter J, Gallucci M, Kutikov A, Larcher A, Mari A, Kilday P, Rha KH, Quarto G, Perdonà S, White W, Eun DD, Derweesh I, Mottrie A, Anele UA, Jacobsohn K, Porpiglia F, Challacombe B, Sundaram CP, Autorino R, Yang B, Schips L. Effect of Obesity and Overweight Status on Complications and Survival After Minimally Invasive Kidney Surgery in Patients with Clinical T2-4 Renal Masses. J Endourol 2020; 34:289-297. [DOI: 10.1089/end.2019.0604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, Urology Unit, SS Annunziata Hospital, “G.D'Annunzio” University of Chieti, Chieti, Italy
| | | | - Chao Zhang
- Department of Urology, Changhai Hospital, Shanghai, China
| | - Giuseppe Simone
- Department of Urology, Regina Elena National Cancer Institute, Rome, Italy
| | - Robert G. Uzzo
- Division of Urology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Umberto Capitanio
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Minervini
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Clayton Lau
- Division of Urology, City of Hope Medical Center, Duarte, California
| | - Jihad Kaouk
- Glickman Urology and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Peter Langenstroer
- Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Daniele Amparore
- Department of Urology, University of Turin-San Luigi Gonzaga Hospital, Turin, Italy
| | | | | | - Michele Gallucci
- Department of Urology, Regina Elena National Cancer Institute, Rome, Italy
| | - Alexander Kutikov
- Division of Urology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Alessandro Larcher
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Mari
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Patrick Kilday
- Division of Urology, City of Hope Medical Center, Duarte, California
| | - Koon Ho Rha
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Giuseppe Quarto
- Uro-Gynecological Department, Fondazione “G. Pascale” IRCCS, Naples, Italy
| | - Sisto Perdonà
- Uro-Gynecological Department, Fondazione “G. Pascale” IRCCS, Naples, Italy
| | - Wesley White
- Department of Urology, University of Tennessee Medical Center, Knoxville, Tennessee
| | - Daniel D. Eun
- Department of Urology, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Ithaar Derweesh
- Department of Urology, UC San Diego Health System, La Jolla, California
| | - Alexandre Mottrie
- ORSI Academy, Melle, Belgium
- Department of Urology, OLV Hospital, Aalst, Belgium
| | | | - Ken Jacobsohn
- Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Francesco Porpiglia
- Department of Urology, University of Turin-San Luigi Gonzaga Hospital, Turin, Italy
| | | | - Chandru P. Sundaram
- Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Bo Yang
- Department of Urology, Changhai Hospital, Shanghai, China
| | - Luigi Schips
- Department of Medical, Oral and Biotechnological Sciences, Urology Unit, SS Annunziata Hospital, “G.D'Annunzio” University of Chieti, Chieti, Italy
- Department of Urology, ASL 02 Lanciano Vasto Chieti, Chieti, Italy
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Busato WFS, Girardi F, Almeida GL. Training of Brazilian Urology residents in laparoscopy: results of a national survey. Int Braz J Urol 2020; 46:203-213. [PMID: 32022508 PMCID: PMC7025843 DOI: 10.1590/s1677-5538.ibju.2018.0668] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 08/04/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives To evaluate the familiarity of Brazilian urology residents with laparoscopy, methods of training and perspectives. Material and methods a questionnaire with 23 questions was sent by e-mail to all urological residents of 86 Urology Residence Programs certified by the Brazilian Society of Urology (BSU). Results 225 valid answers (85% of all residents) responded. Most residences belong to academic hospitals mainly in the Southeast region of Brazil. Women account for 5% of residents and 82% of programs perform less than 100 procedures per year. Residents have access to LESS, RAL and 98% to surgical laparoscopy and 87% of these participate actively at the surgery, but 84.9% do not have access to RAL. The most common laparoscopic procedure is radical nephrectomy (73.2%), but only 28.8% of residents acted as surgeons, and third year residents (R3) are those that mainly performed this procedure (statistical significance, p <0.05). 61% of residents do not participate in hands-on courses or fellowship in laparoscopy, among those who attended these fellowships, 23.47% were sponsored by BSU in equal regions of the country. Although there are several opportunities of training in laparoscopy, 42% of residents do not have access to any kind of preparation and 52% have no structured specific program. R3 perception of laparoscopy experience is significantly higher than R2 and R1 residents. Almost 30% of them affirms that they are prepared for professional life regarding urologic laparoscopy. Conclusion Brazilian urologic residents have access to laparoscopy and actively participate in the learning process. Robotic surgery is expanding in the country, although still very far from residents. Brazilian resident, at the end of medical residency, is motivated to perform laparoscopic procedures.
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Affiliation(s)
- Wilson Francisco Schreiner Busato
- Disciplina de Urologia Universidade do Vale do Itajai - UNIVALI, Itajaí, SC, Brasil.,Departamento de Uro-oncologia da Sociedade Brasileira de Urologia, Brasil
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24
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Jaboulay's technique contrasted with a novel hydrocelectomy technique using a vessel sealer in the treatment of adult hydrocele: a prospective randomized study. Int Urol Nephrol 2019; 52:447-453. [PMID: 31776880 DOI: 10.1007/s11255-019-02342-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 11/21/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The study aims to compare the clinical efficacy, complications, and patient satisfaction rates of two open hydrocelectomy techniques, Jaboulay's technique, and sac excision hydrocelectomy using a LigaSure™ device, in a prospective and randomized fashion. METHODS Eighty-two (82) patients were randomized, one-to-one into two groups. All surgeries were carried out by a single surgeon. Jaboulay's technique and hydrocelectomy with excision of the sac were carried out in the first and the second groups, respectively. The patients' data were collected prospectively on the first day, the first week, the first month, and the sixth month after surgery. Patient demographics, length of hospital stay, postoperative complications, and sixth-month cosmetic satisfaction rates were compared between the groups. RESULTS We observed better patient satisfaction [73.2% confer (cf.) 92.9%], shorter hospital stay (1.66 cf. 1.29 days), and less incidence of postoperative edemas (31.7% cf. 6%) in the sac excision hydrocelectomy group (p = 0.017, p = 0.011, and p = 0.029, respectively). CONCLUSION We can report that hydrocelectomy with an excision of the sac using a vessel-sealing device, namely LigaSure™, provides less incidences of postoperative edemas and better patient satisfaction rates respective to the Jaboulay's technique in the treatment of adult hydrocele. The statistical difference between hospital stay times is mostly affected by social factors in our study. Clinically, all patients were amenable to discharge in the first day.
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25
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Veneziano D, Tafuri A, Rivas JG, Dourado A, Okhunov Z, Somani BK, Marino N, Fuchs G, Cacciamani G. Is remote live urologic surgery a reality? Evidences from a systematic review of the literature. World J Urol 2019; 38:2367-2376. [PMID: 31701210 DOI: 10.1007/s00345-019-02996-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/20/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES The possibility of performing remote-surgery has been the goal to achieve, since the early development of the first surgical robotic platforms. This systematic review aims to analyse the state of the art in the field and to provide an overview of the possible growth of this technology. METHODS All English language publications on Telementoring and Telesurgery for minimally invasive urologic procedures were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement to evaluate PubMed®, Scopus®, and Web of Science™ databases (up to June 2019). RESULTS Our electronic search identified a total of 124 papers in PubMed, Scopus, and Web of Science. Of these, 81 publications were identified for detailed review, which yielded 22 included in the present systematic review. Our results showed that remote surgery has been under-utilised until today, mostly due to the lack of appropriate telecommunication technologies. CONCLUSION Remote live surgery is a growing technology that is catalyzing incremental interest. Despite not being yet reliable today on a regular basis in its most advanced applications, thanks to the advent of novel data-transmission technologies, telepresence might become a critical educational methodology, highly impacting the global healthcare system.
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Affiliation(s)
- Domenico Veneziano
- Department of Urology and Kidney Transplant, Grande Ospedale Metropolitano, Reggio Calabria, Italy. .,Department of Urology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
| | - A Tafuri
- USC Institute of Urology and Catherine and Joseph, University of Southern California, Los Angeles, CA, USA.,Department of Urology, University of Verona, Verona, Italy
| | - J Gomez Rivas
- Department of Urology, Hospital Universitario La Paz, Madrid, Spain
| | - A Dourado
- Department of Urology, Camargo Cancer Center, Sao Paulo, Brasil
| | - Z Okhunov
- Department of Urology, University of California, Irvine, CA, USA
| | - B K Somani
- University Hospital Southampton NHS Trust, Southampton, UK
| | - N Marino
- University of Foggia, Foggia, Italy
| | - G Fuchs
- USC Institute of Urology and Catherine and Joseph, University of Southern California, Los Angeles, CA, USA
| | - G Cacciamani
- USC Institute of Urology and Catherine and Joseph, University of Southern California, Los Angeles, CA, USA
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Mantica G, Fransvea P, Virdis F, Hardcastle TC, Ackermann H, Terrone C, Costa G, Van der Merwe A, Balducci G, Steyn E. Surgical Training in South Africa: An Overview and Attempt to Assess the Training System from the Perspective of Foreign Trainees. World J Surg 2019; 43:2137-2142. [PMID: 31111230 DOI: 10.1007/s00268-019-05034-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Currently, there are no objective reports evaluating the quality of the South African surgical training. The aim of this study is to evaluate the current state of surgical training in South Africa from an external impartial point of view and to rate the experience of short-term supernumerary registrars and fellows (STSRF) within the South African training system. METHODS A 29-item survey was distributed via e-mail and social media to non-South African trainees who worked in South Africa as STSRF for a period of at least 1 month during the past 5 years. The survey evaluated the surgical, clinical and academic training received during their elective period in a South African department. RESULTS Sixty-four STSRF replied to the survey. Sixty-two percent of STSRF attended a trauma unit during their experience. For the majority of respondents, open and emergency surgical exposure, as well as experience as first surgeon, is significantly higher in the South African system, while minimally invasive and endoscopic surgery exposure is significantly less. Research project involvement is significantly less, for the STSRF, as opposed to lectures and teaching that constitute a higher percentage. No significant difference was found regarding exposure to hands-on activities. CONCLUSIONS The South African system still provides excellent surgical and clinical exposure as well as teaching. However, minimally invasive surgery training and research are generally lacking for the STSRF. Exchange programs between South African and developed country institutes should be improved and encouraged in order to gain mutual benefits.
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Affiliation(s)
- Guglielmo Mantica
- Department of Urology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.,Department of Urology, Ospedale Policlinico San Martino, University of Genova, Genoa, Italy
| | - Pietro Fransvea
- Trauma Unit, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa. .,Surgical and Medical Department of Translational Medicine, Sant' Andrea Teaching Hospital, Sapienza University of Rome, Rome, Italy.
| | - Francesco Virdis
- General Surgery and Colorectal Unit Hillingdon Hospital NHS Trust London, London, UK
| | - Timothy C Hardcastle
- Department Surgery, Nelson R Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Hilgard Ackermann
- Department of Urology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Carlo Terrone
- Department of Urology, Ospedale Policlinico San Martino, University of Genova, Genoa, Italy
| | - Gianluca Costa
- Surgical and Medical Department of Translational Medicine, Sant' Andrea Teaching Hospital, Sapienza University of Rome, Rome, Italy
| | - André Van der Merwe
- Department of Urology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Genoveffa Balducci
- Surgical and Medical Department of Translational Medicine, Sant' Andrea Teaching Hospital, Sapienza University of Rome, Rome, Italy
| | - Elmin Steyn
- Trauma Unit, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
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Rodríguez Socarrás M, Ciappara M, García Sanz M, Pesquera L, Carrión DM, Tortolero L, Palou Redorta J, Cózar-Olmo JM, Esteban Fuertes M, Gómez Rivas J. Current status of young urologists and residents' activity and academic training in Spain. National survey results. Actas Urol Esp 2019; 43:169-175. [PMID: 30846289 DOI: 10.1016/j.acuro.2018.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 11/03/2018] [Accepted: 11/11/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study the current status of the activity and academic training of residents and young urologists in Spain. MATERIAL AND METHODS From the working group of residents and young urologists of the Spanish Association of Urology (AEU), an anonymous survey of 32 questions was designed. Its aim was to evaluate the academic activity of residents, defined by: number of communications to congresses, publications in national and international journals, clinical rotations within Spain and abroad, master's degree, Doctorate (PhD), applications to the European Board of Urology exam and language competences. The survey was sent via email and disseminated through social networks. RESULTS Ninety-one respondents were obtained; 66% affirmed not having publications in scientific journals, 67% did not perform rotations abroad. Only 21% claimed to have taken the EBU exam. Only 2% of the respondents had completed a Fellowship. Although most of them (82%) had not done so, they would be interested. However, 67% of respondents believed that the relevance of academic/research activity is from high to very high. CONCLUSIONS Our results indicate that academic activity, scientific production and publication of articles of the residents and young urologists in Spain is low. Moreover, participation in the EBU exam, the completion of a master's degree, PhD, rotations and fellowship is low. In contrast, the assessment of scientific activity is considered to be very relevant.
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Affiliation(s)
- M Rodríguez Socarrás
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Fellowship Servicio de Urología, Ospedale San Raffaele Turro, Milán, Italia; European Training Center in Endourology (ETCE); Young Academic Urologist Urotechnology group (YAU-ESUT).
| | - M Ciappara
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, Hospital Clínico San Carlos, Madrid, España
| | - M García Sanz
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, Complejo Universitario Hospitalario de León, León, España
| | - L Pesquera
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - D M Carrión
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, Hospital Universitario La Paz, Madrid, España
| | - L Tortolero
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, IMED Hospitales, Levante, España
| | | | - J M Cózar-Olmo
- Servicio de Urología, Complejo Hospitalario Universitario de Granada, Granada, España
| | - M Esteban Fuertes
- Servicio de Urología, Hospital de Parapléjicos de Toledo, Toledo, España
| | - J Gómez Rivas
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, Hospital Universitario La Paz, Madrid, España; Young Academic Urologist Urotechnology group (YAU-ESUT)
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Current status of urology surgical training in Europe: an ESRU–ESU–ESUT collaborative study. World J Urol 2019; 38:239-246. [DOI: 10.1007/s00345-019-02763-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/04/2019] [Indexed: 11/30/2022] Open
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Taggar AS, Martell K, Husain S, Peacock M, Sia M, Gotto G. Exposure to radiation and medical oncology training: A survey of Canadian urology residents and fellows. Can Urol Assoc J 2018; 12:321-325. [PMID: 29989919 DOI: 10.5489/cuaj.5147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Residency experiences and teaching in oncology among urology residents are variable across Canada. We sought to identify how radiation and medical oncology concepts, as they pertain to genitourinary malignancies, are taught to urology residents. METHODS A total of 190 trainees enrolled in Canadian urology residency training programs were invited to participate in the study from January 2016 to June 2016. Participants completed an online questionnaire addressing the training they received. RESULTS The overall response rate was 32%. Twenty-three percent of respondents were in their fellowship year; 17%, 20%, 10%, 17%, and 12% were first-, second-, third-, fourth-, and fifth-year residents, respectively, with a median of four (range 1-9) respondents from each training program. Ninety-five percent of respondents had academic half-day (AHD) as part of their training that included radiotherapy (61%) and chemotherapy (51%) teaching. Most respondents indicated their main exposure to chemotherapy and radiation came from informal teaching in urology clinics. Twenty-nine percent and 41%, of participants had mandatory rotations in radiation and medical oncology, respectively. Only 6% of respondents used their voluntary elective time in these disciplines and most voluntary electives were of 1-2-week duration. Despite this, 90% of respondents preferred some mandatory radiation and medical oncology training. CONCLUSIONS Most of the limited exposure that urology residents have to medical and radiation oncology is through AHD or informal urology clinics, despite a desire among current urology trainees to have clinical exposure in these areas. Moving forward, urology residency programs should consider integrating medical and radiation oncology rotations into the residency program curriculum.
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Affiliation(s)
- Amandeep S Taggar
- Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Kevin Martell
- Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Siraj Husain
- Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Michael Peacock
- Department of Radiation Oncology, BC Cancer Agency, Vancouver, BC, Canada
| | - Michael Sia
- Department of Radiation Oncology, BC Cancer Agency, Vancouver, BC, Canada
| | - Geoffrey Gotto
- Department of Surgery, Division of Urology, University of Calgary, Calgary, AB, Canada
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30
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Borgmann H, Arnold HK, Meyer CP, Bründl J, König J, Nestler T, Ruf C, Struck J, Salem J. Training, Research, and Working Conditions for Urology Residents in Germany: A Contemporary Survey. Eur Urol Focus 2018; 4:455-460. [DOI: 10.1016/j.euf.2016.12.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 11/17/2016] [Accepted: 12/02/2016] [Indexed: 11/27/2022]
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31
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Rodríguez-Socarrás M, Gómez Rivas J, García-Sanz M, Pesquera L, Tortolero-Blanco L, Ciappara M, Melnick A, Colombo J, Patruno G, Serrano-Pascual Á, Bachiller-Burgos J, Cozar-Olmo J. Medical-surgical activity and the current state of training of urology residents in Spain: Results of a national survey. Actas Urol Esp 2017; 41:391-399. [PMID: 28336202 DOI: 10.1016/j.acuro.2016.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To determine the actual state of medical-surgical activity and training for urology residents in Spain. MATERIAL AND METHOD We designed 2 anonymous surveys, which were uploaded with the Google Docs© tool so that the respondents could answer the surveys online. The online collection period was September 2015 to January 2016. The collected data were processing using the statistical programme IBM SPSS for Windows, Version 21.0 and the programme R version 3.2.3. RESULTS The total number of responders was 163. In reference to the number of physically present on-call residents, the majority conducted between 4 and 6 shifts a month. Eighty-four of those surveyed indicated that they were in the operating room less than 20hours a week, and 43 of these even less than 10hours. Thirty percent of those surveyed had not performed any transurethral resection. The majority had performed at least one prostatic adenomectomy, but had not performed any major oncologic procedure, either laparoscopically or openly. In the questions concerning training and training courses, we found that most of the residents trained in laparoscopy at the hospital or at home. The overall satisfaction for the residence was assessed at 2.6. Based on this score, the overall satisfaction could be considered moderate. CONCLUSIONS Efforts should be directed towards standardising the acquisition of surgical and nonsurgical skills, ensuring access to training courses, establishing a minimum of required operations per year and achieving an objective assessment of the specialty.
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[Prerequisites, skills and productivity of young academic urologists in Germany]. Urologe A 2016; 56:1603-1610. [PMID: 27924352 DOI: 10.1007/s00120-016-0287-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND To safeguard scientific and clinical progress, German urology requires properly trained junior scientists. Before initiating or continuing actions aiming at quality improvement an analysis of the status quo is necessary. OBJECTIVE To assess the conditions to pursue research, research skills and research output of junior scientists in urology in Germany. MATERIAL UND METHODS A 16-item online questionnaire was sent to 95 junior scientists in urology within the research network GeSRU Academics. Primary outcomes were the conditions to pursue research in terms of research time, research skills and sources of learning and research output as measured by peer-reviewed publications. Subpopulations were compared with respect to the number of peer-reviewed publications. RESULTS Out of 78 junior scientists (82% response rate) 45% pursued research exclusively in their leisure time. Self-assessment of research skills varied from good (systematic literature search) to sufficient (grant acquisition). The main source of learning for research skills was self-study, followed by mentor, own department, courses and networks. Of the junior scientists 81% had peer-reviewed publications (median 4). The groups of junior scientists who pursued research (partially) during working hours, who had good skills and whose research skills were supported by a mentor/network had significantly more peer-reviewed publications than their counterparts. CONCLUSION Junior scientists in urology in Germany lack protected time to pursue research and have varying research skills, which are predominantly acquired by self-study and demonstrate their first research output as peer-reviewed publications.
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