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2008 Annual Meeting Abstracts
Expert Training with Standardized Operative Technique Helps Establish a Successful Penile Prosthetics Program for Urologic Resident Education
Corey M Johnson1, Ann Miller Wilson*1, Christopher P Cost1, Baruch M Grob1, Steven K Wilson*2, Adam P Klausner1
1Virginia Commonwealth University, Richmond, VA;2University of Arkansas, Little Rock, AR
Introduction:
The purpose of this study was to evaluate the impact of yearly training sessions from a recognized expert in the establishment of a successful penile prosthetics program for urologic residency education.
Methods:
For the last four years, a recognized expert conducted annual operative training sessions to teach standardized technique for penile prosthetics to resident urologic surgeons. Each session consisted of 3 to 4 operative cases supervised directly by the expert. We retrospectively reviewed all penile prosthetic operations before (1/2000 to 7/2004: N=48) and after (8/2004 to 10/2008: N=59) implementation of these sessions. Outcomes reviewed included patient characteristics, operative time, estimated blood loss, proportion of inflatable vs. malleable implants, operations per year, and explantation/revision rates. Data were analyzed using Student's T or Fisher's exact tests.
Results: Patient age and race did not differ pre- vs. post-training. Operative time decreased from 113.3 ± 5.4 (pre-training) to 99.3 ± 4.8 minutes (post-training) (P=0.05). Estimated blood loss decreased from 95 ± 21.7mL to 58 ± 9.3mL, but did not reach significance (P=0.09). Inflatable implants increased from 27/48 (56.3%- pre-training) to 48/59 (81.4%, post-training) (p<0.0001). Operations per year increased from 10.9 (pre-training) to 18.6 (post-training) (p<0.05). Revision/explantation occured in 8/48 patients (16.7%, pre-training) vs. 2/59 (3.4%, post-training) (P<.05).
Conclusions:
These data demonstrate that yearly sessions with a recognized expert can improve surgical outcomes, type and volume of implants, and can reduce explanation/revision rates. This respresents an excellent model for improved training of urologic residents in penile prosthetics surgery.
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