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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...

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Autores principales: Haider, Maahum, Jalloh, Mohamed, Yin, Jiaqi, Diallo, Amadou, Puttkammer, Nancy, Gueye, Serigne, Niang, Lamine, Wessells, Hunter, McCammon, Kurt
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2019
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.
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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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