Division of Urology, Federal University of Bahia State, Salvador, Brazil.
Division of Urology, Santa Casa de São Paulo School of Medical Science, São Paulo, Brazil.
Neurourol Urodyn. 2022 Nov;41(8):1890-1897. doi: 10.1002/nau.25041. Epub 2022 Sep 6.
Urology has rapidly evolved during the last decades, incorporating new technologies faster than most specialties. The challenge to maintain a competent workforce that is prepared to deliver proper contemporary treatment has become increasingly difficult and newly graduated urologists throughout the world typically lack the skills to practice many urological subspecialties. We performed a survey to evaluate the practice patterns and educational aspirations in functional urology (FU) among Brazilian urologists.
A web-based survey was sent to board-certified Brazilian urologists to collect data on clinical practice and training aspirations in four subareas of FU: female urology, urodynamics, postprostatectomy incontinence (PPI), and neurourology. We evaluated urologists' clinical and surgical workload in each subarea and investigated educational training aspirations to identify areas and training formats of interest.
A total of 366 urologists (mean age 47.7 + 10.7 years) completed the survey. Mean time since completion of residency was 17.9 + 11.9 years. Of the respondents, 176 (53%) perform urodynamics, 285 (83.1%) SUI surgeries, 159 (47.6%) PPI surgeries, 194 (58.1%) third line OAB procedures, 168 (48.9%) pelvic organ prolapse (POP), and 88 (26.3%) bladder augmentation. Mid-urethral sling is the most performed SUI surgery and transobturator is the preferred route (64.0%). For those performing POP surgery, 40.5% use mesh in at least 50% of their cases, and the vaginal route is used in most cases (75.4%) for apical prolapse. For PPI, 64.6% use artificial sphincter in most surgeries and only 8.1% perform at least 5 surgeries/year. Being fellowship-trained and working in an academic hospital are associated with a higher chance of being active in FU. Most urologists are interested in receiving training in PPI, female SUI, and POP and a hands-on course is the preferred educational method (81%).
Most urologists in Brazil are involved in the evaluation and treatment of FU patients, but few have a large volume of patient visits and surgical procedures. Completing a fellowship program and working in an academic practice are associated with a higher chance of being a FU practitioner. There is a high interest in training for PPI, female SUI, and POP.
在过去几十年中，泌尿外科迅速发展，吸收新技术的速度超过了大多数专业。维持一支有能力提供现代治疗的劳动力的挑战变得越来越困难，世界各地的新毕业泌尿科医生通常缺乏实践许多泌尿科亚专业的技能。我们进行了一项调查，以评估巴西泌尿科医生在功能泌尿外科（FU）中的实践模式和教育愿望。
我们向经过董事会认证的巴西泌尿科医生发送了一份基于网络的调查，以收集四个 FU 亚领域的临床实践和培训愿望的数据：女性泌尿外科、尿动力学、前列腺切除术后尿失禁（PPI）和神经泌尿外科。我们评估了泌尿科医生在每个亚领域的临床和手术工作量，并调查了教育培训愿望，以确定感兴趣的领域和培训形式。
共有 366 名泌尿科医生（平均年龄 47.7±10.7 岁）完成了调查。从住院医师培训结束到现在的平均时间为 17.9±11.9 年。在回答者中，176 人（53%）进行尿动力学检查，285 人（83.1%）进行 SUI 手术，159 人（47.6%）进行 PPI 手术，194 人（58.1%）进行三线 OAB 手术，168 人（48.9%）进行盆腔器官脱垂（POP）手术，88 人（26.3%）进行膀胱扩大术。中尿道吊带术是最常进行的 SUI 手术，经闭孔途径是首选（64.0%）。对于进行 POP 手术的医生，40.5%在至少 50%的病例中使用网片，阴道途径在大多数病例（75.4%）中用于 apical prolapse。对于 PPI，64.6%在大多数手术中使用人工括约肌，只有 8.1%每年至少进行 5 次手术。接受专科培训和在学术医院工作与积极参与 FU 的机会更高相关。大多数泌尿科医生对接受 PPI、女性 SUI 和 POP 的培训感兴趣，并且实践课程是首选的教育方法（81%）。
巴西大多数泌尿科医生都参与了 FU 患者的评估和治疗，但很少有大量的患者就诊和手术。完成专科培训计划和在学术实践中工作与成为 FU 从业者的机会更高相关。对 PPI、女性 SUI 和 POP 的培训有很高的兴趣。
