Grimstad Frances W, Boskey Elizabeth R, Staffa Steven J, Streed Carl G, Dalke Katharine B, Baratz Arlene, Chubak Barbara, Ferrando Cecile
Division of Gynecology, Department of Surgery, Boston Children's Hospital, 333 Longwood Avenue, Boston, MA, 02115, USA.
Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA, USA.
Int Urogynecol J. 2025 Mar;36(3):599-606. doi: 10.1007/s00192-024-06024-7. Epub 2025 Jan 9.
Patients with differences in sex development or intersex traits (DSD/I) struggle to find clinically competent care in adulthood. We sought to describe the surgical exposure of Urogynecology and Reconstructive Pelvic Surgery (URPS) fellows who had previously trained in ObGyn (URPS-Gyn) to patients with DSD/I and their interest in performing 18 relevant procedures. We hypothesized that most graduating fellows would not have had exposure to many of the surgeries.
We administered a cross-sectional online questionnaire of graduating URPS-Gyn fellows from April to June 2021. Questions assessed procedural knowledge, training, and clinical interest.
Of 56 eligible URPS-Gyn fellows graduating in 2021, a total of 14 completed the survey. Twelve (86%) had heard about most procedures (14 out of 18 surgeries listed); however, there was heterogeneity in exposure to specific surgeries and self-reported preparedness to perform them. Respondents were more interested in performing procedures that they were prepared to perform. Only 6 out of 11 who responded to questions about beliefs in training felt that it was important for residents to receive training regarding surgeries for patients with intersex traits, and only 8 felt it important for fellows to receive this surgical training. Three anticipated seeing patients with intersex traits.
Graduating URPS-Gyn fellows expressed interest in performing surgeries to meet the needs of patients with DSD/I. However, respondents had heterogeneous exposure and self-assessments of their proficiency. URPS-Gyn providers may be key collaborators in providing care for the growing number of adults with DSD/I seeking care.
性发育差异或双性特征（DSD/I）患者在成年后难以获得具备临床能力的医疗服务。我们试图描述曾接受过妇产科培训的泌尿妇科与盆底重建外科（URPS）住院医师（URPS-妇科方向）对DSD/I患者的手术接触情况，以及他们对开展18项相关手术的兴趣。我们假设大多数即将毕业的住院医师未曾接触过许多此类手术。
我们在2021年4月至6月对即将毕业的URPS-妇科方向住院医师进行了一项横断面在线问卷调查。问题涉及程序知识、培训情况和临床兴趣。
在2021年毕业的56名符合条件的URPS-妇科方向住院医师中，共有14人完成了调查。12人（86%）听说过大多数手术（列出的18项手术中的14项）；然而，在特定手术的接触情况以及自我报告的开展手术的准备程度方面存在异质性。受访者对他们准备开展的手术更感兴趣。在回答关于培训信念问题的11人中，只有6人认为住院医师接受关于双性特征患者手术的培训很重要，只有8人认为住院医师接受此类手术培训很重要。3人预计会接待双性特征患者。
即将毕业的URPS-妇科方向住院医师表示有兴趣开展手术以满足DSD/I患者的需求。然而，受访者在接触情况和对自身熟练程度的自我评估方面存在异质性。URPS-妇科医疗服务提供者可能是为越来越多寻求医疗服务的成年DSD/I患者提供护理的关键合作伙伴。
