Division of Urologic Surgery, School of Medicine, Washington University in St Louis, St Louis, MO.
Division of Urologic Surgery, School of Medicine, Washington University in St Louis, St Louis, MO.
Urology. 2014 Jun;83(6):1239-42. doi: 10.1016/j.urology.2014.02.027. Epub 2014 Apr 24.
To assess the ability of urology and radiology residents to interpret retrograde urethrograms (RUGs) and voiding cystourethrograms (VCUGs).
A standardized examination of 10 combination RUGs and VCUGs of the male urethra was administered to urology and radiology residents from all levels of training at Washington University, Stanford University, and Northwestern University. Residents were asked to evaluate stricture location(s) and length, if present.
Sixty residents participated, consisting of 26 from Washington University, 15 from Stanford University, and 19 from Northwestern University. Average years of training for urology and radiology were 3.6 and 2.8 years, respectively (P=.01). Normal RUGs and VCUGs were recognized by 18 of 31 radiologists (58%) and 19 of 29 urologists (65.5%; P=.5). Anterior strictures were correctly identified in 145 of 403 (36%) and 165 of 377 (43.8%) responses by radiologists and urologists, respectively (P=.03). Posterior strictures were correctly identified in 20 of 62 (32.3%) and 10 of 58 (17.2%) responses by radiologists and urologists, respectively (P=.09). When both groups of residents were combined, anterior strictures were identified correctly more often than posterior strictures (39.7% vs 25%; P<.01). Overall accuracy was 24.2% (75 of 310) for the radiology group and 27.9% (81 of 290) for the urology group (P=.30). In the presence of multiple strictures, accuracy declined to 7.26% (9 of 124) for the radiology group and 9.48% (11 of 116) for the urology group (P=.5), with a combined accuracy of 8.33% (20 of 240).
Radiology and urology residents in the United States have poor skills at interpreting urethrography, especially when multiple strictures or posterior strictures are present. A formal educational program for RUG and VCUG interpretation should be designed and implemented into the radiology and urology resident curriculum.
评估泌尿科和放射科住院医师解读逆行尿道造影（RUG）和排尿性膀胱尿道造影（VCUG）的能力。
华盛顿大学、斯坦福大学和西北大学的各级泌尿科和放射科住院医师接受了 10 例男性尿道组合 RUG 和 VCUG 的标准化检查。要求住院医师评估是否存在狭窄部位和长度。
共有 60 名住院医师参加，其中华盛顿大学 26 名，斯坦福大学 15 名，西北大学 19 名。泌尿科和放射科住院医师的平均培训年限分别为 3.6 年和 2.8 年（P=.01）。31 名放射科医生中有 18 名（58%）和 29 名泌尿科医生中有 19 名（65.5%）正确识别正常 RUG 和 VCUG（P=.5）。放射科医生和泌尿科医生分别正确识别 403 个中的 145 个（36%）和 377 个中的 165 个（43.8%）前尿道狭窄（P=.03）。放射科医生和泌尿科医生分别正确识别 62 个中的 20 个（32.3%）和 58 个中的 10 个（17.2%）后尿道狭窄（P=.09）。当将两组住院医师结合起来时，前尿道狭窄的识别率高于后尿道狭窄（39.7%比 25%；P<.01）。放射科组的总体准确率为 24.2%（75/310），泌尿科组为 27.9%（81/290）（P=.30）。在存在多个狭窄的情况下，放射科组的准确率下降至 7.26%（9/124），泌尿科组下降至 9.48%（11/116）（P=.5），两组的准确率为 8.33%（20/240）。
美国的放射科和泌尿科住院医师在解读尿道造影术方面技能较差，尤其是在存在多个狭窄或后尿道狭窄时。应设计并将 RUG 和 VCUG 解读的正规教育计划纳入放射科和泌尿科住院医师课程。
