Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Can J Urol. 2022 Apr;29(2):11101-11110.
Utilizing a physician-reported survey, we assessed general surgeons (GS) comfort level in the management of bladder trauma, from a GS and urologist's perspective.
Online questionnaires were distributed electronically to physicians of the American College of Surgeons and American Urological Association. This survey queried demographic data, clinical factors that may influence urology consultations, and bladder injury scenarios of varying severities. Two questions were presented for each scenario, the first querying GS comfort level in bladder trauma management, the second assessing the likelihood of obtaining urology consultations in such scenarios. Responses were graded on a Likert scale.
Overall, 108 (51%) GS and 104 (49%) urologists responded. When compared to managing Grade I injuries, the comfort level of GS decreased as the severity of bladder trauma increased, while the likelihood of obtaining a urology consultation increased. While the perceived comfort of GS by urologists decreased from 84% to 5% for Grade I to Grade V injuries, GS reported a significantly higher comfort level (Grade I: 92%, p = 0.09; Grade V: 31%, p < 0.001). Majority of GS indicated that preoperative diagnosis on imaging (56%), intraoperative diagnosis (62%), and timing of patient presentation (76%), did not affect their decision to consult urology for assistance in bladder trauma (p < 0.001).
GS-reported comfort levels for bladder trauma management remains higher than urology-perceived comfort levels. Contrary to urologists' perception, most peri-injury factors did not affect GS decision to consult urology for bladder trauma. We hope this study can foster discussion and improve interdisciplinary collaboration in bladder trauma management.
本研究通过医生报告调查，从普通外科医生和泌尿科医生的角度评估了普通外科医生处理膀胱创伤的舒适程度。
通过电子邮件向美国外科医师学院和美国泌尿科协会的医生分发在线问卷。该调查询问了人口统计学数据、可能影响泌尿科咨询的临床因素以及不同严重程度的膀胱损伤情况。每个场景提出了两个问题，第一个问题询问普通外科医生处理膀胱创伤管理的舒适程度，第二个问题评估在这种情况下获得泌尿科咨询的可能性。回答是在李克特量表上进行评分的。
共有 108 名（51%）普通外科医生和 104 名（49%）泌尿科医生做出了回应。与处理 I 级损伤相比，普通外科医生处理膀胱创伤的舒适程度随着损伤严重程度的增加而降低，而获得泌尿科咨询的可能性则增加。虽然泌尿科医生对 I 级至 V 级损伤的普通外科医生的舒适度感知从 84%降至 5%，但普通外科医生报告的舒适度水平显著更高（I 级：92%，p=0.09；V 级：31%，p<0.001）。大多数普通外科医生表示，术前影像学诊断（56%）、术中诊断（62%）和患者就诊时间（76%）不会影响他们决定咨询泌尿科医生协助处理膀胱创伤（p<0.001）。
普通外科医生报告的处理膀胱创伤的舒适程度仍然高于泌尿科医生的感知舒适度。与泌尿科医生的看法相反，大多数创伤前因素并未影响普通外科医生咨询泌尿科医生处理膀胱创伤的决定。我们希望这项研究能够促进讨论并改善膀胱创伤管理中的跨学科合作。
