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The Learning Curve of Urodynamics for the Evaluation of Lower Urinary Tract Symptoms

Background and Objectives: Urodynamics is considered the gold standard for lower urinary tract functional assessment. However, it requires very specific skills and training, which are currently difficult to master due to its reduced use. Moreover, no studies or data are available to define the workl...

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Autores principales: Frigerio, Matteo, Barba, Marta, Cola, Alice, Volontè, Silvia, Marino, Giuseppe, Regusci, Luca, Sorice, Paola, Ruggeri, Giovanni, Castronovo, Fabiana, Serati, Maurizio, Torella, Marco, Braga, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8955767/
https://www.ncbi.nlm.nih.gov/pubmed/35334517
http://dx.doi.org/10.3390/medicina58030341
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author Frigerio, Matteo
Barba, Marta
Cola, Alice
Volontè, Silvia
Marino, Giuseppe
Regusci, Luca
Sorice, Paola
Ruggeri, Giovanni
Castronovo, Fabiana
Serati, Maurizio
Torella, Marco
Braga, Andrea
author_facet Frigerio, Matteo
Barba, Marta
Cola, Alice
Volontè, Silvia
Marino, Giuseppe
Regusci, Luca
Sorice, Paola
Ruggeri, Giovanni
Castronovo, Fabiana
Serati, Maurizio
Torella, Marco
Braga, Andrea
author_sort Frigerio, Matteo
collection PubMed
description Background and Objectives: Urodynamics is considered the gold standard for lower urinary tract functional assessment. However, it requires very specific skills and training, which are currently difficult to master due to its reduced use. Moreover, no studies or data are available to define the workload and the learning curve of this diagnostic tool. As a consequence, we aimed to evaluate the learning curve of residents with no previous experience to correctly perform and interpret urodynamics, and properly address and manage patients with pelvic floor disorders based on urodynamics findings. Materials and Methods: This prospective study analyzed a series of proficiency parameters in residents performing urodynamics under consultant supervision, including the following: duration of procedure, perceived difficulty, need for consultant intervention, accuracy of interpretation, and therapeutic proposal. The number of procedures performed was then divided into groups of five to evaluate the progressive grade of autonomy (technical and full management autonomy) reached by each resident. Results: In total, 69 patients underwent urodynamics performed by three residents, with every resident performing at least 20 exams. Duration of procedure, perceived difficulty, need for consultant intervention, accuracy of interpretation, and the appropriateness of the hypothetical proposal of management/treatment based on their interpretation of clinical data and urodynamic findings was shown to be directly related to the number of exams performed. Technical autonomy in the execution of uroflowmetry was reached in the group performing 6–10 procedures, while technical autonomy in the execution of cystomanometry with pressure/flow study was obtained in the group of 16–20 procedures. The latter corresponded also to the gain of full autonomy which also included an optimal therapeutic proposal. Conclusion: We found that there is a tangible learning curve for urodynamics in terms of several proficiency parameters. A workload of 5 uroflowmetries and 15 cystomanometries with pressure/flow studies may be adequate to complete the learning curve.
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spelling pubmed-89557672022-03-26 The Learning Curve of Urodynamics for the Evaluation of Lower Urinary Tract Symptoms Frigerio, Matteo Barba, Marta Cola, Alice Volontè, Silvia Marino, Giuseppe Regusci, Luca Sorice, Paola Ruggeri, Giovanni Castronovo, Fabiana Serati, Maurizio Torella, Marco Braga, Andrea Medicina (Kaunas) Article Background and Objectives: Urodynamics is considered the gold standard for lower urinary tract functional assessment. However, it requires very specific skills and training, which are currently difficult to master due to its reduced use. Moreover, no studies or data are available to define the workload and the learning curve of this diagnostic tool. As a consequence, we aimed to evaluate the learning curve of residents with no previous experience to correctly perform and interpret urodynamics, and properly address and manage patients with pelvic floor disorders based on urodynamics findings. Materials and Methods: This prospective study analyzed a series of proficiency parameters in residents performing urodynamics under consultant supervision, including the following: duration of procedure, perceived difficulty, need for consultant intervention, accuracy of interpretation, and therapeutic proposal. The number of procedures performed was then divided into groups of five to evaluate the progressive grade of autonomy (technical and full management autonomy) reached by each resident. Results: In total, 69 patients underwent urodynamics performed by three residents, with every resident performing at least 20 exams. Duration of procedure, perceived difficulty, need for consultant intervention, accuracy of interpretation, and the appropriateness of the hypothetical proposal of management/treatment based on their interpretation of clinical data and urodynamic findings was shown to be directly related to the number of exams performed. Technical autonomy in the execution of uroflowmetry was reached in the group performing 6–10 procedures, while technical autonomy in the execution of cystomanometry with pressure/flow study was obtained in the group of 16–20 procedures. The latter corresponded also to the gain of full autonomy which also included an optimal therapeutic proposal. Conclusion: We found that there is a tangible learning curve for urodynamics in terms of several proficiency parameters. A workload of 5 uroflowmetries and 15 cystomanometries with pressure/flow studies may be adequate to complete the learning curve. MDPI 2022-02-23 /pmc/articles/PMC8955767/ /pubmed/35334517 http://dx.doi.org/10.3390/medicina58030341 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Frigerio, Matteo
Barba, Marta
Cola, Alice
Volontè, Silvia
Marino, Giuseppe
Regusci, Luca
Sorice, Paola
Ruggeri, Giovanni
Castronovo, Fabiana
Serati, Maurizio
Torella, Marco
Braga, Andrea
The Learning Curve of Urodynamics for the Evaluation of Lower Urinary Tract Symptoms
title The Learning Curve of Urodynamics for the Evaluation of Lower Urinary Tract Symptoms
title_full The Learning Curve of Urodynamics for the Evaluation of Lower Urinary Tract Symptoms
title_fullStr The Learning Curve of Urodynamics for the Evaluation of Lower Urinary Tract Symptoms
title_full_unstemmed The Learning Curve of Urodynamics for the Evaluation of Lower Urinary Tract Symptoms
title_short The Learning Curve of Urodynamics for the Evaluation of Lower Urinary Tract Symptoms
title_sort learning curve of urodynamics for the evaluation of lower urinary tract symptoms
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8955767/
https://www.ncbi.nlm.nih.gov/pubmed/35334517
http://dx.doi.org/10.3390/medicina58030341
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