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The role of international partnerships in improving urethral reconstruction in low- and middle-income countries
PURPOSE: To explore the impact of education and training in international surgical partnerships on outcomes of urethral stricture disease in low- and middle-income countries. To encourage data collection and outcomes assessments to promote evidence-based and safe surgical care. METHODS: Qualitative...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716901/ https://www.ncbi.nlm.nih.gov/pubmed/31177304 http://dx.doi.org/10.1007/s00345-019-02819-2 |
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author | Haider, Maahum Jalloh, Mohamed Yin, Jiaqi Diallo, Amadou Puttkammer, Nancy Gueye, Serigne Niang, Lamine Wessells, Hunter McCammon, Kurt |
author_facet | Haider, Maahum Jalloh, Mohamed Yin, Jiaqi Diallo, Amadou Puttkammer, Nancy Gueye, Serigne Niang, Lamine Wessells, Hunter McCammon, Kurt |
author_sort | Haider, Maahum |
collection | PubMed |
description | PURPOSE: To explore the impact of education and training in international surgical partnerships on outcomes of urethral stricture disease in low- and middle-income countries. To encourage data collection and outcomes assessments to promote evidence-based and safe surgical care. METHODS: Qualitative data were collected through observation of a reconstructive surgical workshop held by IVUmed at a host site in Dakar, Senegal. Quantitative data were collected through a retrospective review of 11 years of hospital data to assess surgical outcomes of urethral stricture disease before and after IVUmed started reconstructive workshops at the site. RESULTS: In the 11-year study period, 569 patients underwent 774 surgical procedures for urethral strictures. The numbers and types of urethroplasty techniques increased after IVUmed started its workshops. The average number of urethroplasties increased from 10 to 18.75/year. There was a statistically significant improvement in the mean success rate of urethroplasties from 12.7% before to 29% after the workshops. Anastomotic urethroplasty success rates doubled from 16.7 to 35.1%, but this was not statistically significant (p = 0.07). The improved success rate was sustained in cases performed without an IVUmed provider. CONCLUSIONS: Urethral stricture disease treatment in low- and middle-income countries is fraught with challenges due to complex presentations and limited subspecialty training. Improper preoperative management, lack of specialty instruments, and suboptimal wound care all contribute to poor outcomes. International surgical groups like IVUmed who employ the “teach-the-teacher” model enhance local practitioner expertise and independence leading to long-term improvements in patient outcomes. Tailoring practice guidelines to the local resource framework and encouraging data collection and outcomes assessment are vital components of providing responsible care and should be encouraged. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00345-019-02819-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7716901 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-77169012020-12-04 The role of international partnerships in improving urethral reconstruction in low- and middle-income countries Haider, Maahum Jalloh, Mohamed Yin, Jiaqi Diallo, Amadou Puttkammer, Nancy Gueye, Serigne Niang, Lamine Wessells, Hunter McCammon, Kurt World J Urol Topic Paper PURPOSE: To explore the impact of education and training in international surgical partnerships on outcomes of urethral stricture disease in low- and middle-income countries. To encourage data collection and outcomes assessments to promote evidence-based and safe surgical care. METHODS: Qualitative data were collected through observation of a reconstructive surgical workshop held by IVUmed at a host site in Dakar, Senegal. Quantitative data were collected through a retrospective review of 11 years of hospital data to assess surgical outcomes of urethral stricture disease before and after IVUmed started reconstructive workshops at the site. RESULTS: In the 11-year study period, 569 patients underwent 774 surgical procedures for urethral strictures. The numbers and types of urethroplasty techniques increased after IVUmed started its workshops. The average number of urethroplasties increased from 10 to 18.75/year. There was a statistically significant improvement in the mean success rate of urethroplasties from 12.7% before to 29% after the workshops. Anastomotic urethroplasty success rates doubled from 16.7 to 35.1%, but this was not statistically significant (p = 0.07). The improved success rate was sustained in cases performed without an IVUmed provider. CONCLUSIONS: Urethral stricture disease treatment in low- and middle-income countries is fraught with challenges due to complex presentations and limited subspecialty training. Improper preoperative management, lack of specialty instruments, and suboptimal wound care all contribute to poor outcomes. International surgical groups like IVUmed who employ the “teach-the-teacher” model enhance local practitioner expertise and independence leading to long-term improvements in patient outcomes. Tailoring practice guidelines to the local resource framework and encouraging data collection and outcomes assessment are vital components of providing responsible care and should be encouraged. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00345-019-02819-2) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2019-06-08 2020 /pmc/articles/PMC7716901/ /pubmed/31177304 http://dx.doi.org/10.1007/s00345-019-02819-2 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Topic Paper Haider, Maahum Jalloh, Mohamed Yin, Jiaqi Diallo, Amadou Puttkammer, Nancy Gueye, Serigne Niang, Lamine Wessells, Hunter McCammon, Kurt The role of international partnerships in improving urethral reconstruction in low- and middle-income countries |
title | The role of international partnerships in improving urethral reconstruction in low- and middle-income countries |
title_full | The role of international partnerships in improving urethral reconstruction in low- and middle-income countries |
title_fullStr | The role of international partnerships in improving urethral reconstruction in low- and middle-income countries |
title_full_unstemmed | The role of international partnerships in improving urethral reconstruction in low- and middle-income countries |
title_short | The role of international partnerships in improving urethral reconstruction in low- and middle-income countries |
title_sort | role of international partnerships in improving urethral reconstruction in low- and middle-income countries |
topic | Topic Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716901/ https://www.ncbi.nlm.nih.gov/pubmed/31177304 http://dx.doi.org/10.1007/s00345-019-02819-2 |
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