Rotem Reut, Carey Michael O, McCarthy Claire M, O'Reilly Barry A, Daykan Yair, O'Sullivan Orfhlaith E
Department of Urogynaecology, Cork University Maternity Hospital, Cork, Ireland.
Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University School of Medicine, Jerusalem, Israel.
BJOG. 2025 Jan;132(2):205-211. doi: 10.1111/1471-0528.17974. Epub 2024 Oct 2.
This study aimed to evaluate the training and self-assessed proficiency of surgeons in the surgical management of pelvic organ prolapse (POP). We focused on the factors that influence decision-making, the surgical techniques employed, the training received, and the management of complications.
A cross-sectional survey.
An electronic questionnaire.
European Urogynaecological Association (EUGA) and International Urogynecological Association (IUGA) members.
A total of 33 questions evaluating surgeon preference regarding vaginal surgeries.
Demographics, surgical selection, proficiency and technique, and training methods.
There were 471 respondents, of which 273 (58%) dedicated more than 50% of their week to urogynaecology. 250 (53%) had completed a fellowship, with 215 (86%) of those fellowships being in urogynaecology and pelvic floor reconstruction. A preference for hysterectomy in cases of uterine descent was noted by 297 (63%) respondents, influenced mainly by patient preference, age, and prolapse anatomical score. A total of 443 (94%) were proficient in vaginal hysterectomy, with two-thirds performing 30 or fewer procedures annually; 212 (45%) reporting a decrease in the number of procedures over the last decade. Additionally, 373 (79%) respondents believed that 10-30 cases were needed to achieve and maintain proficiency.
Vaginal hysterectomy remains a key component in uterine prolapse repair. However, with the rise of uterine-sparing prolapse repairs, the decision-making process may be influenced by multiple factors, including surgical training. Emphasis should be placed on training and maintaining proficiency in both traditional and novel techniques.
本研究旨在评估外科医生在盆腔器官脱垂（POP）手术管理方面的培训情况和自我评估的熟练程度。我们重点关注影响决策的因素、所采用的手术技术、接受的培训以及并发症的管理。
横断面调查。
电子问卷。
欧洲泌尿妇科协会（EUGA）和国际泌尿妇科协会（IUGA）成员。
共有33个问题评估外科医生对阴道手术的偏好。
人口统计学特征、手术选择、熟练程度和技术以及培训方法。
共有471名受访者，其中273人（58%）每周将超过50%的时间用于泌尿妇科。250人（53%）完成了专科培训，其中215人（86%）的专科培训是在泌尿妇科和盆底重建方面。297名（63%）受访者指出，在子宫脱垂病例中倾向于进行子宫切除术，主要受患者偏好、年龄和脱垂解剖评分的影响。共有443人（94%）精通阴道子宫切除术，其中三分之二的人每年进行30例或更少的手术；212人（45%）报告称在过去十年中手术例数有所减少。此外，373名（79%）受访者认为需要10 - 30例手术才能达到并保持熟练程度。
阴道子宫切除术仍然是子宫脱垂修复的关键组成部分。然而，随着保留子宫的脱垂修复手术的兴起，决策过程可能受到多种因素的影响，包括手术培训。应重视传统技术和新技术的培训并保持熟练程度。
