Attendings versus supervised residents: Educational results and future perspective in transurethral resection of bladder tumors.

Introduction and objectives: Urology residents training programs across Europe are uneven and often unsatisfactory. The significance of resident mentoring should not be overstated and trainees should be mentored by training-trained attending urologist even in case of common procedures such transurethral resection of bladder tumor (TURBT). The goal of this study is to demonstrate the comparability in TURBT performance between supervised urology residents and attendings.

Materials and methods: This study is a subanalysis of a prospective, randomized trial enrolling patients diagnosed with BC and undergoing endoscopic intervention. The trial (NCT04712201) was approved by the Institutional Review Board (2017/09c). Surgeons were either urology attendings or supervised residents of the 3rd-5th year. Primary outcome was to compare surgical and post-operative outcomes in both groups.

Results: From 04/2018 to 06/2021, 300 patients met inclusion criteria and 248 (83%) of these underwent the assigned intervention. 200 (80.6%) patients were males and median (SD) age was 72.2 (11.2). No statistical differences were found in terms of intra and post-operative outcomes (all P > .05). Linear and logistic regression analysis resulted comparable for all variables (all P > .05).

Conclusion: Supervised urology residents do not put the patient at an increased risk of complications neither perform a suboptimal procedure. Resident mentoring is fundamental in order to reach comparable results in surgical outcomes and pathological diagnosis. A structured standardized program with trained trainers and proficiency evaluations are warranted to gain and maintain these outcomes across Europe.