Competencias quirúrgicas en urología: concordancia entre la percepción de residentes y profesionales en ejercicio en un país latinoamericano

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2025-09-01 DOI:10.1016/j.acuro.2025.501794

J. Scherñuk, M.G. Dorsemaine, J.K. Toapanta Ortega, D. Zimmermann, I.P. Tobia, D. Santillán

{"title":"Competencias quirúrgicas en urología: concordancia entre la percepción de residentes y profesionales en ejercicio en un país latinoamericano","authors":"J. Scherñuk, M.G. Dorsemaine, J.K. Toapanta Ortega, D. Zimmermann, I.P. Tobia, D. Santillán","doi":"10.1016/j.acuro.2025.501794","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Consensus remains lacking on which surgeries should be deemed essential for general urologists and which should be reserved for subspecialists. This study aims to compare the perceptions of urology trainees (Trainees) and practicing urologists (PractUrol) regarding the relevance of surgeries for independent practice and subspecialist training.</div></div><div><h3>Methods</h3><div>Cross-sectional comparative study on Trainees and PractUrol from a Latin-American country. Participants completed a Google Forms® questionnaire on 56 urological surgeries in September-October 2023, categorizing each as Essential Index (E-index), Supervised Index (Sup-index), or Subspecialty (Subspec). Statistical comparisons were performed using Chi-square or Fisher's exact tests with Bonferroni correction.</div></div><div><h3>Results</h3><div>Among 138 participants (109 PractUrol, 29 Trainees), 78.6% (44/56) of surgeries showed agreement between groups, with 13 surgeries achieving over 75% concordance. Disagreements were noted for 21.4% (12/56) of surgeries: (1) Microvaricocelectomy, penectomy, DVIU, ureteral reimplantation, and vesicovaginal fístula repair were more often classified as Subspec by Trainees but as E-index by PractUrol. (2) Radical cystectomy with orthotopic diversion and Boari Flap were classified as Subspec by Trainees but as Sup-index by PractUrol. (3) Partial cystectomy, pelvic, and inguinal lymphadenectomy were more frequently deemed Subspec by Trainees. (4) Flexible ureteroscopy was considered E-index by Trainees but Sup-index by PractUrol. (5) Artificial urinary sphincter placement was more often classified as Sup-index by PractUrol.</div></div><div><h3>Conclusion</h3><div>There is substantial agreement on the relevance of urological surgeries between PractUrol and Trainees, including 13 surgeries deemed essential by over 75% of participants. However, differing opinions on 12 surgeries highlight areas for further discussion.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501794"},"PeriodicalIF":1.2000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Actas urologicas espanolas","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0210480625001123","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Consensus remains lacking on which surgeries should be deemed essential for general urologists and which should be reserved for subspecialists. This study aims to compare the perceptions of urology trainees (Trainees) and practicing urologists (PractUrol) regarding the relevance of surgeries for independent practice and subspecialist training.

Methods

Cross-sectional comparative study on Trainees and PractUrol from a Latin-American country. Participants completed a Google Forms® questionnaire on 56 urological surgeries in September-October 2023, categorizing each as Essential Index (E-index), Supervised Index (Sup-index), or Subspecialty (Subspec). Statistical comparisons were performed using Chi-square or Fisher's exact tests with Bonferroni correction.

Results

Among 138 participants (109 PractUrol, 29 Trainees), 78.6% (44/56) of surgeries showed agreement between groups, with 13 surgeries achieving over 75% concordance. Disagreements were noted for 21.4% (12/56) of surgeries: (1) Microvaricocelectomy, penectomy, DVIU, ureteral reimplantation, and vesicovaginal fístula repair were more often classified as Subspec by Trainees but as E-index by PractUrol. (2) Radical cystectomy with orthotopic diversion and Boari Flap were classified as Subspec by Trainees but as Sup-index by PractUrol. (3) Partial cystectomy, pelvic, and inguinal lymphadenectomy were more frequently deemed Subspec by Trainees. (4) Flexible ureteroscopy was considered E-index by Trainees but Sup-index by PractUrol. (5) Artificial urinary sphincter placement was more often classified as Sup-index by PractUrol.

Conclusion

There is substantial agreement on the relevance of urological surgeries between PractUrol and Trainees, including 13 surgeries deemed essential by over 75% of participants. However, differing opinions on 12 surgeries highlight areas for further discussion.

Abstract Image

查看原文本刊更多论文

泌尿科的外科手术技能：拉丁美洲国家居民与执业专业人员之间的一致性

对于哪些手术对于普通泌尿科医生来说是必要的，哪些手术应该留给专科医生，共识仍然缺乏。本研究旨在比较泌尿外科培训生（受训者）和执业泌尿科医生（PractUrol）对独立执业和专科培训手术相关性的看法。方法对来自拉美某国的研修生和实业生进行横断面比较研究。参与者于2023年9月至10月完成了56例泌尿外科手术的谷歌Forms®问卷调查，并将其分类为基本指数（E-index）、监督指数（Sup-index）或亚专科（Subspec）。统计学比较采用卡方检验或Fisher精确检验，并进行Bonferroni校正。结果138例患者（PractUrol 109例，实习生29例）中，78.6%（44/56）例手术组间吻合，其中13例手术组间吻合率达75%以上。21.4%（12/56）的手术存在分歧：(1)微精索静脉曲张切除术、阴茎切除术、DVIU、输尿管再植和膀胱阴道fístula修复被练习者更多地归类为Subspec，而PractUrol则将其归类为e指数。(2)根治性膀胱切除术伴原位转流和Boari皮瓣被学员归为Subspec， PractUrol归为Sup-index。(3)部分膀胱切除术、盆腔和腹股沟淋巴结切除术更常被学员视为亚规范。(4)柔性输尿管镜被学员认为是E-index，而PractUrol认为是Sup-index。(5) PractUrol多将人工尿道括约肌置入术分类为supi -index。结论PractUrol和受训者对泌尿外科手术的相关性有实质性的共识，包括75%以上的参与者认为必要的13种手术。然而，对12种手术的不同意见突出了进一步讨论的领域。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.