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Nestler T, Hircin E, Siech C, Moharam N, Mattigk A, Borgmann H, Kuru TH, Salem J. [Evaluation of the GeSRU-Steps educational video concept (German Society of Residents in Urology e. V.)]. Urologie 2024; 63:373-378. [PMID: 38153428 PMCID: PMC10991055 DOI: 10.1007/s00120-023-02248-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Surgical educational videos represent a contemporary, multimedia supplement to surgical education and training. The German Society of Residents in Urology e. V. (GeSRU) developed an educational video platform (steps.GeSRU.de) with free, quality-assured educational videos for urologists, especially for residents. OBJECTIVES The purpose of this study was to evaluate the GeSRU Steps teaching videos. MATERIALS AND METHODS Prospectively, 29 GeSRU Steps training videos were made available (03/2019-05/2023) via amboss.com, and an online questionnaire was inserted following the videos. This comprised 12 items on medical, technical, and didactic quality, usefulness for own knowledge acquisition, and sociodemographic data of respondents. Aspects of video quality were assessed with the Acceptability E‑scale and the Global Quality Score. RESULTS During the survey period, the GeSRU Steps videos implemented on the amboss.com website were viewed 49,698 times. A total of 474 questionnaires were answered (rate 0.25%). The collective of respondents consisted of 419 (88%) students, 47 (10%) physicians in training, and 5 (1%) specialists; 351 (74%) were female, 107 (23%) were male, and 4 (1%) were diverse. Each educational video was rated a median of 10 times (range 5-65). The six questions of the Acceptability E‑scale and the Global Quality Score were rated good and very good (81.6-95.8%), respectively. CONCLUSIONS GeSRU teaching videos achieved a very good rating with high user satisfaction. By specific promotion of these teaching videos, which are quality-assured through supervision, the portfolio of surgical videos available at a low threshold can be expanded and can serve as a contemporary education tool.
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Affiliation(s)
- Tim Nestler
- Klinik für Urologie, Bundeswehrzentralkrankenhaus Koblenz, Rübenacherstr. 170, 56072, Koblenz, Deutschland.
- Klinik für Urologie, Uniklinik Köln, Köln, Deutschland.
| | | | - Carolin Siech
- Universitätsklinik, Klinik für Urologie, Goethe Universität Frankfurt, Frankfurt, Deutschland
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Kanada
| | - Nadim Moharam
- Klinik für Urologie, Universitätsklinikum Mannheim, Mannheim, Deutschland
| | - Angelika Mattigk
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Hendrik Borgmann
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Brandenburg a.d. Havel, MHB Brandenburg Theodor Fontane, Neuruppin, Deutschland
| | - Timur H Kuru
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Brandenburg a.d. Havel, MHB Brandenburg Theodor Fontane, Neuruppin, Deutschland
- CUROS urologisches Zentrum, Klinik Links vom Rhein, Köln, Deutschland
| | - Johannes Salem
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Brandenburg a.d. Havel, MHB Brandenburg Theodor Fontane, Neuruppin, Deutschland
- CUROS urologisches Zentrum, Klinik Links vom Rhein, Köln, Deutschland
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Hoeh B, Garcia CC, Banek S, Klümper N, Cox A, Ellinger J, Schmucker P, Hahn O, Mattigk A, Zengerling F, Becker P, Erdmann K, Buerk BT, Flegar L, Huber J, Kalogirou C, Zeuschner P. Early CRP kinetics to predict long-term efficacy of first-line immune-checkpoint inhibition combination therapies in metastatic renal cell carcinoma: an updated multicentre real-world experience applying different CRP kinetics definitions. Clin Transl Immunology 2023; 12:e1471. [PMID: 37899949 PMCID: PMC10600333 DOI: 10.1002/cti2.1471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/31/2023] Open
Abstract
Objectives Although biomarkers predicting therapy response in first-line metastatic renal carcinoma (mRCC) therapy remain to be defined, C-reactive protein (CRP) kinetics have recently been associated with immunotherapy (IO) response. Here, we aimed to assess the predictive and prognostic power of two contemporary CRP kinetics definitions in a large, real-world first-line mRCC cohort. Methods Metastatic renal carcinoma patients treated with IO-based first-line therapy within 5 years were retrospectively included in this multicentre study. According to Fukuda et al., patients were defined as 'CRP flare-responder', 'CRP responder' and 'non-CRP responder'; according to Ishihara et al., patients were defined as 'normal', 'normalised' and 'non-normalised' based on their early CRP kinetics. Patient and tumor characteristics were compared, and treatment outcome was measured by overall (OS) and progression-free survival (PFS), including multivariable Cox regression analyses. Results Out of 316 mRCC patients, 227 (72%) were assigned to CRP groups according to Fukuda. Both CRP flare- (HR [Hazard ratio]: 0.59) and CRP responders (HR: 0.52) had a longer PFS, but not OS, than non-CRP responders. According to Ishihara, 276 (87%) patients were assigned to the respective groups, and both normal and normalised patients had a significantly longer PFS and OS, compared with non-normalised group. Conclusion Different early CRP kinetics may predict therapy response in first-line mRCC therapy in a large real-world cohort. However, further research regarding the optimal timing and frequency of measurement is needed.
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Affiliation(s)
- Benedikt Hoeh
- Department of UrologyUniversity Hospital Frankfurt, Goethe University Frankfurt am MainFrankfurtGermany
| | - Cristina Cano Garcia
- Department of UrologyUniversity Hospital Frankfurt, Goethe University Frankfurt am MainFrankfurtGermany
- Cancer Prognostics and Health Outcomes Unit, Division of UrologyUniversity of Montréal Health CentreMontréalQCCanada
| | - Severine Banek
- Department of UrologyUniversity Hospital Frankfurt, Goethe University Frankfurt am MainFrankfurtGermany
| | - Niklas Klümper
- Department of UrologyUniversity Hospital Bonn (UKB)BonnGermany
- Institute of Experimental OncologyUniversity Hospital Bonn (UKB)BonnGermany
| | - Alexander Cox
- Department of UrologyUniversity Hospital Bonn (UKB)BonnGermany
| | - Jörg Ellinger
- Department of UrologyUniversity Hospital Bonn (UKB)BonnGermany
| | - Philipp Schmucker
- Department of Urology and Paediatric UrologyJulius Maximilians University Medical Centre of WürzburgWürzburgGermany
| | - Oliver Hahn
- Department of Urology and Paediatric UrologyJulius Maximilians University Medical Centre of WürzburgWürzburgGermany
| | - Angelika Mattigk
- Department of Urology and Paediatric UrologyUniversity Hospital UlmUlmGermany
| | | | - Philippe Becker
- Department of Urology and Paediatric UrologySaarland UniversityHomburg/SaarGermany
| | - Kati Erdmann
- Department of Urology, University Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany
| | - Bjoern Thorben Buerk
- Department of Urology, University Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany
| | - Luka Flegar
- Department of UrologyPhilipps‐University MarburgMarburgGermany
| | - Johannes Huber
- Department of UrologyPhilipps‐University MarburgMarburgGermany
| | - Charis Kalogirou
- Department of Urology and Paediatric UrologyJulius Maximilians University Medical Centre of WürzburgWürzburgGermany
| | - Philip Zeuschner
- Department of Urology and Paediatric UrologySaarland UniversityHomburg/SaarGermany
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Hoeh B, Schmucker P, Klümper N, Hahn O, Zeuschner P, Banek S, Karakiewicz PI, Ellinger J, Heinzelbecker J, Hölzel M, Strauß A, Zengerling F, Mattigk A, Kalogirou C. Comparison of First-Line Anti-PD-1-Based Combination Therapies in Metastatic Renal-Cell Carcinoma: Real-World Experiences from a Retrospective, Multi-Institutional Cohort. Urol Int 2022; 106:1150-1157. [DOI: 10.1159/000521661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/15/2021] [Indexed: 12/22/2022]
Abstract
<b><i>Introduction:</i></b> The aim of this study was to test for differences in overall (OS) and progression-free survival (PFS) rates and toxicity in first-line immune checkpoint inhibition (IO) combination therapy in metastatic renal-cell carcinoma (mRCC) patients. <b><i>Methods:</i></b> Between November 2017 and April 2021, 104 patients with histologically confirmed mRCC from 6 tertiary referral centers with either IO + IO (nivolumab + ipilimumab, <i>n</i> = 68) or IO + tyrosine kinase inhibitor (TKI) (pembrolizumab + axitinib, <i>n</i> = 36) were included. Kaplan-Meier and Cox regression analyses tested for OS and PFS differences. <b><i>Results:</i></b> Of 104 mRCC patients, 68 received IO + IO (65.4%) and 36 IO + TKI (34.6%) therapy, respectively. Median age was 67 years (interquartile range: 57–70.3). Patients receiving IO + TKI were less likely to be poor risk according to the International Metastatic Renal-Cell Carcinoma Database Consortium score (16.7 vs. 30.9%) and presented with lower T-stage, compared to IO + IO treated patients. Median PFS was 9.8 months (CI: 5.3–17.6) versus 12.3 months (CI: 7.7 – not reached) for IO + IO versus IO + TKI treatment, respectively (<i>p</i> = 0.22). Median OS was not reached, survival rates at 12 months being 73.9 versus 90.0% for IO + IO versus IO + TKI patients (<i>p</i> = 0.089). In subgroup analyses of elderly patients (≥70 years, <i>n</i> = 38), IO + TKI treatment resulted in better OS rates at 12 months compared to IO + IO (91.0 vs. 57.0%; <i>p</i> = 0.042). <b><i>Conclusion:</i></b> IO + IO and IO + TKI as first-line therapies in mRCC patients were both comparable as for the oncological outcome and toxicity.
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Mattigk A, Miernik A. [Digitalization-benefits for urology]. Urologe A 2022; 61:115-116. [PMID: 35142882 DOI: 10.1007/s00120-021-01752-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 11/25/2022]
Affiliation(s)
- A Mattigk
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.
| | - A Miernik
- Klinik für Urologie, Medizinische Fakultät, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland.
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Siech C, Arnold H, Mattigk A, Bellut L, König J, Kluth L. Gender differences in Urologic training – results of the second GeSRU (Germany Society of Residents in Urology) training survey. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00187-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pereira-Lourenço M, Ucar T, Nikles S, Pang KH, Almeida J, Carrion DM, Esperto F, Freire MJ, Karsza D, Mantica G, Mattigk A, Rodríguez Socarrás M, Rivas JG. Annual educational expenses of European urology residents and the role of sponsorship in urology training: a survey-based analysis. Cent European J Urol 2022; 75:418-428. [PMID: 36794035 PMCID: PMC9903171 DOI: 10.5173/ceju.2022.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/02/2022] [Accepted: 11/13/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction The aim of this article was to evaluate the personal monetary costs associated with the urology residency. Material and methods The European Society of Residents in Urology (ESRU) designed a 35-item survey and distributed it via email and social media to urology residents in Europe.Monthly net salary and educational expenses (general expenses, literature, congresses and courses) and opinions regarding sponsorship and expenditure were evaluated. Comparisons between different countries and salary cut-offs were made. Results A total of 211 European urology residents completed the survey from 21 European countries. The median interquartile range (IQR) age was 30 (18-42) years and 83.0% were male. A total of 69.6% receive less than €1500 net per month and 34.6% spent ≥€3000 on education in the previous 12 months. Sponsorships came mainly from the pharmaceutical industry (57.8%), but 56.4% of trainees thought that the ideal sponsor should be the hospital/urology department. Only 14.7% of respondents stated that their salary is sufficient to cover training expenses, and 69.2% agreed that training costs have an influence on family dynamics. Conclusions Personal expenses during training are high, are not sufficiently covered by the salary and impact family dynamics for a majority of residents in Europe. The majority thought that hospitals/national urology associations should contribute to the educational costs. For homogeneous opportunities across Europe, institutions should strive to increase sponsorship.
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Affiliation(s)
| | - Taha Ucar
- Istanbul Medeniyet University, Department of Urology, Istanbul, Turkey
| | - Sven Nikles
- Sestre Milosrdnice University Hospital Center, Department of Urology, Zagreb, Croatia
| | - Karl H. Pang
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - João Almeida
- North Lisbon Hospital Center, Department Urology, Lisbon, Portugal
| | - Diego M Carrion
- Torrejon University Hospital, Department of Urology, Madrid, Spain,Universidad Francisco de Vitoria, Madrid, Spain,Institute of Advanced Urologic Surgery (ICUA), Clinica CEMTRO, Madrid, Spain
| | - Francesco Esperto
- Campus Biomedico Foundation, University of Rome, Department of Urology, Rome, Italy
| | - Maria José Freire
- Trás-os-Montes and Alto Douro Hospital Center, Department of Urology, Vila Real, Portugal
| | - David Karsza
- Hungarian Defence Force Medical Center, Department of Urology and Andrology, Budapest, Hungary
| | - Guglielmo Mantica
- Policlinico San Martino Hospital, University of Genova, Department of Urology, Genoa, Italy
| | | | | | - Juan Gomez Rivas
- Institute of Advanced Urologic Surgery (ICUA), Clinica CEMTRO, Madrid, Spain,Hospital Clínico San Carlos, Deptartment of Urology, Madrid, Spain
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Klümper N, Schmucker P, Hahn O, Höh B, Mattigk A, Banek S, Ellinger J, Heinzelbecker J, Sikic D, Eckstein M, Strauß A, Zengerling F, Hölzel M, Zeuschner P, Kalogirou C. C‐reactive protein flare‐response predicts long‐term efficacy to first‐line anti‐PD‐1‐based combination therapy in metastatic renal cell carcinoma. Clin Transl Immunology 2021; 10:e1358. [PMID: 34925829 PMCID: PMC8648498 DOI: 10.1002/cti2.1358] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/01/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives Immune checkpoint blockade (IO) has revolutionised the treatment of metastatic renal cell carcinoma (mRCC). Early C‐reactive protein (CRP) kinetics, especially the recently introduced CRP flare‐response phenomenon, has shown promising results to predict IO efficacy in mRCC, but has only been studied in second line or later. Here, we aimed to validate the predictive value of early CRP kinetics for 1st‐line treatment of mRCC with αPD‐1 plus either αCTLA‐4 (IO+IO) or tyrosine kinase inhibitor (IO+TKI). Methods In this multicentre retrospective study, we investigated the predictive potential of early CRP kinetics during 1st‐line IO therapy. Ninety‐five patients with mRCC from six tertiary referral centres with either IO+IO (N = 59) or IO+TKI (N = 36) were included. Patients were classified as CRP flare‐responders, CRP responders or non‐CRP responders as previously described, and their oncological outcome was compared. Results Our data validate the predictive potential of early CRP kinetics in 1st‐line immunotherapy in mRCC. CRP responders, especially CRP flare‐responders, had significantly prolonged progression‐free survival (PFS) compared with non‐CRP responders (median PFS: CRP flare‐responder: 19.2 months vs. responders: 16.2 vs. non‐CRP responders: 5.6, P < 0.001). In both the IO+IO and IO+TKI subgroups, early CRP kinetics remained significantly associated with improved PFS. CRP flare‐response was also associated with long‐term response ≥ 12 months. Conclusions Early CRP kinetics appears to be a low‐cost and easy‐to‐implement on‐treatment biomarker to predict response to 1st‐line IO combination therapy. It has potential to optimise therapy monitoring and might represent a new standard of care biomarker for immunotherapy in mRCC.
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Affiliation(s)
- Niklas Klümper
- Department of Urology and Paediatric Urology University Hospital Bonn (UKB) Bonn Germany
- Institute of Experimental Oncology University Hospital Bonn (UKB) Bonn Germany
| | - Philipp Schmucker
- Department of Urology and Paediatric Urology Julius Maximilians University Medical Center of Würzburg Würzburg Germany
| | - Oliver Hahn
- Department of Urology University Medical Center Göttingen Göttingen Germany
| | - Benedikt Höh
- Department of Urology University Hospital Frankfurt Goethe University Frankfurt am Main Frankfurt Germany
| | - Angelika Mattigk
- Department of Urology and Paediatric Urology University Hospital Ulm Ulm Germany
| | - Severine Banek
- Department of Urology University Hospital Frankfurt Goethe University Frankfurt am Main Frankfurt Germany
| | - Jörg Ellinger
- Department of Urology and Paediatric Urology University Hospital Bonn (UKB) Bonn Germany
| | - Julia Heinzelbecker
- Department of Urology and Paediatric Urology Saarland University Homburg/Saar Germany
| | - Danijel Sikic
- Department of Urology and Pediatric Urology University Hospital Erlangen Friedrich‐Alexander‐University Erlangen‐Nuremberg Erlangen Germany
- Comprehensive Cancer Center Erlangen‐EMN (CCC ER‐EMN) Erlangen Germany
| | - Markus Eckstein
- Comprehensive Cancer Center Erlangen‐EMN (CCC ER‐EMN) Erlangen Germany
- Institute of Pathology University Hospital Erlangen Friedrich‐Alexander‐University Erlangen‐Nuremberg Erlangen Germany
| | - Arne Strauß
- Department of Urology University Medical Center Göttingen Göttingen Germany
| | | | - Michael Hölzel
- Institute of Experimental Oncology University Hospital Bonn (UKB) Bonn Germany
| | - Philip Zeuschner
- Department of Urology and Paediatric Urology Saarland University Homburg/Saar Germany
| | - Charis Kalogirou
- Department of Urology and Paediatric Urology Julius Maximilians University Medical Center of Würzburg Würzburg Germany
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Struck JP, Hennig MJP, Hupe MC, Moharam N, Paffenholz P, Nestler T, Frank T, Worst TS, Grabbert M, Pohlmann PF, Dogan S, Hofbauer SL, Kalogirou C, Mattigk A, Brandt MP, Krabbe LM, Reis H, Dressler FF, Kramer MW, Salem J. Discrepancy between German S3 Guideline Recommendations and Daily Urologic Practice in the Management of Nonmuscle Invasive Bladder Cancer: Results of a Binational Survey. Urol Int 2021; 107:35-45. [PMID: 34515257 DOI: 10.1159/000518166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/22/2021] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Guideline recommendations are meant to help minimize morbidity and to improve the care of nonmuscle invasive bladder cancer (NMIBC) patients but studies have suggested an underuse of guideline-recommended care. The aim of this study was to evaluate the level of adherence of German and Austrian urologists to German guideline recommendations. METHODS A survey of 27 items evaluating diagnostic and therapeutic recommendations (15 cases of strong consensus and 6 cases of consensus) for NMIBC was administered among 14 urologic training courses. Survey construction and realization followed the checklist for reporting results of internet e-surveys and was approved by an internal review board. RESULTS Between January 2018 and June 2019, a total of 307 urologists responded to the questionnaire, with a mean response rate of 71%. The data showed a weak role of urine cytology (54%) for initial diagnostics although it is strongly recommended by the guideline. The most frequently used supporting diagnostic tool during transurethral resection of the bladder was hexaminolevulinate (95%). Contrary to the guideline recommendation, 38% of the participants performed a second resection in the case of pTa low-grade NMIBC. Correct monitoring of Bacille Calmette-Guérin (BCG) response with cystoscopy and cytology was performed by only 34% of the urologists. CONCLUSIONS We found a discrepancy between certain guideline recommendations and daily routine practice concerning the use of urine cytology for initial diagnostics, instillation therapy with a low monitoring rate of BCG response, and follow-up care with unnecessary second resection after pTa low-grade NMIBC in particular. Our survey showed a moderate overall adherence rate of 73%. These results demonstrate the need for sharpening awareness of German guideline recommendations by promoting more intense education of urologists to optimize NMIBC care thus decreasing morbidity and mortality rates.
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Affiliation(s)
- Julian P Struck
- Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Martin J P Hennig
- Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Marie C Hupe
- Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Nadim Moharam
- Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Pia Paffenholz
- Department of Urology, Uro-Oncology, Robot Assisted and Reconstructive Urologic Surgery, University Hospital Cologne, Cologne, Germany
| | - Tim Nestler
- Department of Urology, Uro-Oncology, Robot Assisted and Reconstructive Urologic Surgery, University Hospital Cologne, Cologne, Germany
| | - Tanja Frank
- Department of Urology and Pediatric Urology, RoMed Hospital Rosenheim, Rosenheim, Germany
| | - Thomas S Worst
- Department of Urology, University Medical Centre Mannheim, Mannheim, Germany
| | - Markus Grabbert
- Department of Urology, Medical Centre, University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Serkan Dogan
- Department of Urology, Heilig Geist Hospital Cologne, Cologne, Germany
| | | | - Charis Kalogirou
- Department of Urology and Pediatric Urology, Julius-Maximilians-University of Würzburg, Würzburg, Germany
| | - Angelika Mattigk
- Department of Urology and Pediatric Urology, University Hospital Ulm, Ulm, Germany
| | | | - Laura-Maria Krabbe
- Department of Urology, The University of Münster Medical Center, Münster, Germany
| | - Henning Reis
- Institute of Pathology, University Hospital Essen, Essen, Germany
| | - Franz F Dressler
- Institute of Pathology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Mario W Kramer
- Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Johannes Salem
- Department of Urology, Clinic LINKS VOM RHEIN, Cologne, Germany
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Arnold H, Fassbach M, Mattigk A, Zehe V, Beck A, Wundrack F, Bellut L, König J, Siech C. [Training and work conditions of residents in urology in Germany : Results of the second German Society of Residents in Urology e. V. (GeSRU) residency survey from 2020]. Urologe A 2021; 60:1025-1034. [PMID: 34259878 PMCID: PMC8278189 DOI: 10.1007/s00120-021-01608-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Residency is the fundation for high-quality medical care and also for career development of young urologists. In 2015 the GeSRU (German Society of Residents in Urology) carried out the first nationwide survey among young physicians in urology and described the status quo of their residency. This revised follow-up examination draws an updated picture of the training and working conditions of residents in urology and assesses the development. METHODS In 2020 the GeSRU conducted an online-based survey of all residents in urology; therefore, the 2015 questionnaire was expanded. The model of the professional gratification crisis was used again. RESULTS A total of 332 questionnaires were analyzed. Major findings have not changed since 2015. The daily working routine is characterized by high pace and workload and economic considerations. Family- and research-friendly working conditions are largely lacking. 35% of the respondents draw professional consequences. The psychosocial strain remains very high and conveys a risk for physicians' health and patients' quality of care. CONCLUSION These results demonstrate that there are still systemically immanent burdens for residents in urology, which require adjustments to the working and training conditions. A structured, transparent curriculum for urological residency, remuneration and time for training and models which enable work-life balance should be established.
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Affiliation(s)
- H Arnold
- Facharztpraxis, Urologie Dr. Hannah Arnold, Gesundheitszentrum Senden, Hauptstraße 11 c, 89250, Senden, Deutschland.
| | - M Fassbach
- Klinik für Urologie, urologische Onkologie und Kinderurologie, Helios Klinikum Duisburg, Duisburg, Deutschland
| | - A Mattigk
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - V Zehe
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - A Beck
- Klinik für Urologie, Katholisches Marienkrankenhaus Hamburg, Hamburg, Deutschland
| | - F Wundrack
- Klinik für Urologie, Helios Klinikum Berlin-Buch, Berlin-Buch, Deutschland
| | - L Bellut
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - J König
- Klinik für Urologie, Asklepios Stadtklinik Bad Tölz, Bad Tölz, Deutschland
| | - C Siech
- Klinik für Urologie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
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Mantica G, Pang KH, Nikles S, Ucar T, Mattigk A, Karsza D, Rivas JG, Carrion DM, Esperto F. Struggle, current situation and future perspective for European urology trainees. A vision from The European Society of Residents in Urology. BJU Int 2021; 128:262-263. [PMID: 34318985 DOI: 10.1111/bju.15536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Guglielmo Mantica
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy.,European Society of Residents in Urology (ESRU), Arnhem, The Netherlands
| | - Karl H Pang
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Unit of Academic Urology, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Sven Nikles
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Sestre Milosrdnice University Hospital, Zagreb, Croatia
| | - Taha Ucar
- Urology department, Nigde Omer Halis Demir University Research and Training Hospital, Nigde, Turkey
| | - Angelika Mattigk
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, University Hospital Ulm, Ulm, Germany
| | - David Karsza
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, MH EK Honvédkórház, Budapest, Hungary
| | - Juan Gomez Rivas
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Diego M Carrion
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, La Paz University Hospital, Autonomous University of Madrid, Madrid, Spain
| | - Francesco Esperto
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Campus Bio-Medico University, Rome, Italy
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11
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Arnold H, Beck A, Mattigk A, Himmler M, Harke NN, von Ostau N, Necknig UH. [Working pregnant in urology! : Assessments by chief physicians and presentation of liability risks]. Urologe A 2021; 60:746-752. [PMID: 33783583 PMCID: PMC8008331 DOI: 10.1007/s00120-021-01504-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES In Germany, approximately 1500 female physicians become pregnant each year. This also applies to urologys. The announcement of a pregnancy is often met with ignorance and unanswered questions by chief physicians and colleagues. The aim of this study is to clarify how urological chief physicians assess the current situation and to present liability risks versus health risks. MATERIALS AND METHODS From July to October 2019, an anonymous online questionnaire was sent to 340 chief physicians by the Working Group Young Urologists of the German Society of Urology (DGU). The questionnaire asked about the risk assessment of the workplace, the timing of a pregnancy announcement, and the employment possibilities of pregnant employees in urology. In addition, a law firm was commissioned to prepare a brief legal opinion on the topic of medical work and surgery during pregnancy with specific reference to the field of urology, including any liability risks. RESULTS In all, 62 chief physicians participated in the survey (18.2%): 93.5% of the respondents considered an anticipatory risk assessment of the workplace for pregnant women to be useful; 82.3% would appreciate an overlapping recruitment by the employer. Respondents (62.9%) were skeptical of pregnant employees operating. Taking into account the regulations of the Maternity Protection Act, the liability risk does not exceed that which the employer generally has to bear. CONCLUSION The amendment of the Maternity Protection Act has not fundamentally changed the reality for female urologists. However, the individual risk assessment provides an opportunity to develop concrete protective measures-also for the operating room-with the employer. The aim must be to provide pregnant women with greater support in asserting their rights in the future.
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Affiliation(s)
- H Arnold
- Urologie Arnold, Urologische Facharztpraxis, Senden, Deutschland
| | - A Beck
- Klinik für Urologie, Katholisches Marienkrankenhaus, Hamburg, Deutschland
| | - A Mattigk
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - M Himmler
- Klinik für Urologie und Urochirurgie, Universitätsklinikum Mannheim, Mannheim, Deutschland
| | - N N Harke
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - N von Ostau
- Klinik und Poliklinik für Urologie, Kinderurologie und Uroonkologie, Universitätsklinikum Essen, Essen, Deutschland
| | - U H Necknig
- Abteilung für Urologie und Kinderurologie, Klinikum Garmisch-Partenkirchen GmbH, Auenstr. 6, 82467, Garmisch-Partenkirchen, Deutschland.
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12
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Borgmann H, Struck JP, Mattigk A, Wenzel M, Pilatz A, Kranz J, Weiten R, von Landenberg N, Spachmann PJ, Aksoy C, Haferkamp A, Boehm K. Increased Severe Adverse Outcomes and Decreased Emergency Room Visits for Pyelonephritis: First Report of Collateral Damage during COVID-19 Pandemic in Urology. Urol Int 2021; 105:199-205. [PMID: 33406523 PMCID: PMC7900463 DOI: 10.1159/000513458] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 11/19/2020] [Indexed: 11/19/2022]
Abstract
Purpose The coronavirus disease 2019 (COVID-19) pandemic is disrupting urology health-care worldwide. Reduced emergency room visits resulting in adverse outcomes have most recently been reported in pediatrics and cardiology. We aimed to compare patients with emergency room visits for pyelonephritis in 2019 (pre-COVID-19 era) and within the first wave of pandemic in 2020 (COVID-19 era) with regard to the number of visits and severe adverse disease outcomes. Methods We performed a retrospective multicentre study comparing characteristics and outcomes of patients with pyelonephritis, excluding patients with hydronephrosis due to stone disease, in 10 urology departments in Germany during a 1-month time frame in March and April in each 2019 and 2020. Results The number of emergency room visits for pyelonephritis in the COVID-19 era was lower (44 patients, 37.0%) than in the pre-COVID-19 era (76 patients, 63.0%), reduction rate: 42.1% (p = 0.003). Severe adverse disease outcome was more frequent in the COVID-19 era (9/44 patients, 20.5%) than in the pre-COVID-19 era (5/76 patients, 6.6%, p = 0.046). In detail, 7 versus 3 patients needed monitoring (15.9 vs. 3.9%), 2 versus no patients needed intensive-care treatment (4.5 vs. 0%), 2 versus no patients needed drain placement (4.5 vs. 0%), 2 versus no patients had a nephrectomy (4.5 vs. 0%), and 2 versus 1 patient died (4.5 vs. 1.3%). Conclusion This report of collateral damage during COVID-19 showed that emergency room visits were decreased, and severe adverse disease outcomes were increased for patients with pyelonephritis in the COVID-19 era. Health authorities should set up information campaign programs actively encouraging patients to utilize emergency room services in case of severe symptoms specifically during the actual second wave of pandemic.
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Affiliation(s)
- Hendrik Borgmann
- Department of Urology, University Medical Center, Johannes Gutenberg University, Mainz, Germany,
| | - Julian P Struck
- Department of Urology, University Hospital Luebeck, Luebeck, Germany
| | | | - Mike Wenzel
- Department of Urology, University Hospital Frankfurt, Frankfurt, Germany
| | - Adrian Pilatz
- Department of Urology, Pediatric Urology and Andrology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Jennifer Kranz
- Department of Urology, St.-Antonius Hospital Eschweiler, Eschweiler, Germany.,Department of Urology and Kidney Transplantation, Martin Luther University, Halle (Saale), Germany
| | - Richard Weiten
- Department of Urology, University Hospital Bonn, Bonn, Germany
| | | | | | - Cem Aksoy
- Department of Urology, University Hospital Dresden, Dresden, Germany
| | - Axel Haferkamp
- Department of Urology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Katharina Boehm
- Department of Urology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
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13
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Ghayda RA, Carrion DM, Gomez Rivas J, Esperto F, Mantica G, Rodriguez-Socarras ME, Mattigk A, Kathrins M, O'Leary M, Niederberger C. Knowledge gap across continents: the andrology and male infertility exposure among urology residents in the United States and Europe. Int J Impot Res 2020; 33:603-610. [PMID: 32826968 DOI: 10.1038/s41443-020-00342-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 06/19/2020] [Accepted: 08/06/2020] [Indexed: 11/09/2022]
Abstract
It is well established that resident's exposure and training are of primary importance and positively correlated with patient and health quality outcomes. We aimed to compare and contrast urology residents' self-reported perspectives and attitudes toward exposure and education of andrology and male infertility during residency in both the United States and Europe. We performed a cross-sectional design study using a survey that was distributed to a representative sample of American and European urology residents. The survey included questions regarding demographics, and the residents' perception and description of their training in this specific subspecialty. Response data were analyzed using Chi-square tests. Sixty-five percent of European and thirty-five percent American urology residents reported feeling uncomfortable in a new consultation evaluating an infertile patient and interpreting semen analyses. Surprisingly, more than half of responders replied that they would not go to their own training institutions seeking for male fertility care (78% US and 58% Europeans). In the comparative analysis, although no differences were observed in the very low number (18%) of hospitals that offer formal microsurgical training for urology residents between the US and Europe, more US institutions were reported to have an operating microscope for urology (68% vs. 41%), and more US residents replied reported participating in at least one urologic surgery using the microscope (65% vs. 34%). In conclusion, both American and European residents shared the same frustration regarding their education and exposure to andrology and male infertility during residency training. Collaborative efforts between stakeholders are needed to establish a clear and focused curriculum and training objectives to eliminate this educational gap.
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Affiliation(s)
- Ramy Abou Ghayda
- Division of Urology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Diego M Carrion
- Department of Urology, La Paz University Hospital, Madrid, Spain.,European Society of Residents in Urology (ESRU), Arnhem, The Netherlands
| | - Juan Gomez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain.,European Society of Residents in Urology (ESRU), Arnhem, The Netherlands
| | - Francesco Esperto
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Campus Biomedico, University of Rome, Rome, Italy
| | - Guglielmo Mantica
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Moises E Rodriguez-Socarras
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Instituto de Cirugia Urologica Avanzada (ICUA), Madrid, Spain
| | - Angelika Mattigk
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Ulm University Medical Center, Ulm, Germany
| | - Martin Kathrins
- Division of Urology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Michael O'Leary
- Division of Urology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Craig Niederberger
- Department of Urology, University of Illinois at Chicago, Chicago, USA. .,Department of Bioengineering, College of Engineering, University of Illinois at Chicago, Chicago, USA. .,University of Illinois at Chicago Innovation Center, Chicago, USA.
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14
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Pereira-Lourenço M, Ucar T, Freire M, Pang K, Carrion D, Rodríguez-Socarrás M, Nikles S, Mantica G, Karsza D, Mattigk A, Esperto F, Gomez Rivas J. Annual educational expenses of European urology residents and the role of sponsorship in urology training. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33941-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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15
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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