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Abstract

Volume 23, Issue 6 (November 2021) 23, 616–620; 0.4103/aja.aja_21_21

Resident involvement in the prostatic urethral lift: implementing innovative technology in an academic setting

Ridwan Alam, Matthew J Rabinowitz, Taylor P Kohn, Vanessa N Peña, James L Liu, Yasin Bhanji, Amin S Herati

Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA

Correspondence: Dr. AS Herati (aherati1@jhmi.edu)

Date of Submission 11-Sep-2020 Date of Acceptance 20-Jan-2021 Date of Web Publication 20-Apr-2021

Abstract

Adoption of the prostatic urethral lift (PUL) as a treatment for benign prostatic hyperplasia highlights the importance of training residents with novel technology without compromising patient care. This study examines the effect of resident involvement during PUL on patient and procedural outcomes. Retrospective chart review was conducted on all consecutive PUL cases performed by a single academic urologist between October 2017 and November 2019. Trainees in post-graduate year (PGY) 1–3 are considered junior residents, while those in PGY 4–6 are senior residents. The International Prostate Symptom Score (IPSS) and quality of life (QOL) scores were used to measure outcomes. Simple and mixed-effects linear regression models were used to compare differences. There were 110 patients with a median age of 66.4 years. Residents were involved in 73 cases (66.4%), and senior residents were involved in 31 of those cases. Resident involvement was not associated with adverse perioperative outcomes with respect to the number of implants fired, the percentage of implants successfully placed, or the postoperative catheterization rate. After adjustment for confounding factors, junior residents were associated with significantly longer case length compared to the attending alone (+12.6 min, P = 0.003) but senior residents were not (+2.4 min, P = 0.59). IPSS and QOL scores were not significantly affected by resident involvement (P = 0.12 and P = 0.21, respectively). The presence of surgeons-in-training, particularly those in the early stages, prolongs PUL case length but does not appear to have an adverse impact on patient outcomes.

Keywords: internship and residency; operative time; prostatic hyperplasia; prostheses and implants; quality of life

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