[Current state of compensation of on-duty and on-call urologists in France: a study from AFUF]

INTRODUCTION

The French Association of Urologists-in-training (AFUF) aimed to assess the current state of remunerations of on-call and on-duty residents, assistants and lecturers in urology in France.

MATERIAL AND METHODS

Data were collected from February to May 2013 through a questionnaire sent to all members of the AFUF (327 members). Remunerations were given in gross values.

RESULTS

Forty-three residents took part in the study, 16 assistants and 16 lecturers, representing 62 % of the whole centers (54 hospitals out of the 92 centers practicing urology in France). Most of responders were on security or operational on-call. Twenty hospitals were practicing multi-organ removal. Median remunerations of residents were about 59.51€ per on-call when moving at hospital for work and about 119.02€ per onsite duty. Assistants and lecturers were paid a flat fee rate for 37.5 % of them (140€ for assistants [with variability from 40 to 195€] and 130€ for lecturers [42.5-180]) or an hourly rate depending on the hours spent at hospital for the others (62.5 %): first, second move or move<3h were paid 100€ for assistants and 65€ for lecturers, 233.5€ and 236€ respectively for the third one or above 3h, 365€ and 473€ respectively above 8h. Multi-organ removals were paid a flat fee rate (60 %) or an hourly rate (40 %) as well. Beyond a threshold of 2-3hours, the hourly rate was more interesting than the flat fee rate.

CONCLUSION

There were disparities in remuneration of on-call and on-duty urologists. Greater variability affected on-call flat fee rate remuneration beyond a certain threshold of hours and remuneration of multi-organ removal. These disparities should be considered in order to get a national harmonization.

[Analysis of postoperative urgenturies after prostate photovaporization by the laser Greenlight ®]

Urgencies are classically described after prostate photovaporization (PVP). The objective of this study was to analyze the incidence of urgency in patients who underwent PVP using the International Prostate Symptom Score (IPSS) to defined urgencies.

METHOD

This is a single-center prospective cohort study assessing patients who underwent surgery between May 2005 and January 2011. The questions 2 and 4 of the IPSS and open questions were selected to evaluate urgency during the follow-up.

RESULTS

Two-hundred and four patients were operated during this period and 93 complete records were analyzed. Twenty-one percent of these patients had a clinical urgency after 1 month and 1,9% at 12 months (significant improvement, P<0.001) corresponding to scores greater than 4 for questions 2 and 4 of the IPSS. Answer scores to questions 2 and 4 improved significantly over 12 months (P<0.001). The clinical urgencies decreased significantly as well as answers to questions 2 and 4 of the IPSS.

CONCLUSION

Urgencies decreased significantly between 3 and 12 months of postoperative follow. Questions 2 and 4 of the IPSS score appeared to be a standardized definition of these urgencies.

[Perioperative and early postoperative results of photoselective vaporization of the prostate using fiber 4090 (providing 120 watts) versus fiber MOXY (providing 180 watts)]

INTRODUCTION

Photoselective vaporisation of the prostate (PVP) is a surgical alternative to transurethral resection of the prostate (TURP). The goal of this study was to compare the new AMS MOXY fiber which provide 180 watts power to the 4090 fiber 120 watts power source currently used in benign prostatic hyperplasia. The assessment criteria were peroperative and early postoperative data.

METHOD

This study was a monocentric prospective trial comparing two parallel groups of treatment: prostatic vaporisation with MOXY fiber (180 watts) against 4090 fiber (120 watts) in patients operated by an experienced surgeon. The urinary catheter was removed the day after the intervention and the patient was allowed to quit after a clinical examination. All the patients had a routine consultation at 1 month: clinical examination, max flow rate, biological results and results of autoquestionnaires.

RESULTS

This study included 50 patients. The two groups were similar at the inclusion: age, urinary catheter, and prostate volume. The operative data show a decrease of vaporization duration (29 minutes versus 36 minutes, P=0.009) with an energy delivered increased (281 kJoules versus 223 kJoules, P=0.036) and with similar postoperative data: duration of urinary catheterization (3.8 days versus 3.6 days, P=0.908), length of stay (1.6 days versus 1.8 days, P=0.371). The 1-month results were similar between the two groups.

CONCLUSION

The new fiber AMS 180 watts ROXY offer similar postoperative data to the 4090 fiber with improved operative duration and energy delivered.