Urology practice · 2026
UROLOGISTS PERFORMING UROGYNECOLOGY AND RECONSTRUCTIVE PELVIC SURGERY PROCEDURES: THE IMPACT OF FELLOWSHIP TRAINING.
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Jericevic Schwartz Dora, Gaddam Rishika, Koo John, Rosenblum Nirit, Ginsberg David, Clemens J Quentin, Brucker Benjamin M
Аннотация
INTRODUCTION: Urogynecology and Reconstructive Pelvic Surgery (URPS) became an accredited fellowship in 2013. Our objective was to assess the landscape of URPS procedures performed by URPS fellowship-trained (FT) and non-FT urologists (NFT) since accreditation.
MATERIALS AND METHODS: A retrospective cohort study of American Board of Urology case logs of urologists performing URPS procedures from January 2013 through August 2024 was conducted. The annual case volumes of FT and NFT urologists were compared. Multivariable mixed-effects Poisson regression models assessed the impact of covariates on annual case volume.
RESULTS: 5,816 urologists (393 FT, 5,423 NFT) performing URPS procedures were included, with 513 FT and 5,818 NFT case log submissions. Compared to NFT, FT urologists were predominantly female (48% vs 13%, p<0.01), practiced in metropolitan areas (52% vs 23%, p<0.01) and academic settings (41% vs 7%, p<0.01). FT performed 24% of annual URPS cases on average, rising to 34% when excluding benign prostate hypertrophy (BPH) procedures. Modelling demonstrated that FT performed URPS cases at 4.2 times the annual rate of NFT (RR 4.2, 95% CI 3.6-4.6) on average, rising to 7.6 times when BPH was excluded (RR 7.6, 95% CI 6.7-8.6), controlling for other covariates. Independent of FT status, women performed non-BPH URPS at a 62% higher rate than men, with higher rates also seen among urologists that are younger, recertifying and outside the Northeast.
CONCLUSIONS: Although NFT outnumber FT by 14 to one, FT performed eight times more non-BPH URPS cases annually on average and accounted for 34% of total non-BPH volume.
MATERIALS AND METHODS: A retrospective cohort study of American Board of Urology case logs of urologists performing URPS procedures from January 2013 through August 2024 was conducted. The annual case volumes of FT and NFT urologists were compared. Multivariable mixed-effects Poisson regression models assessed the impact of covariates on annual case volume.
RESULTS: 5,816 urologists (393 FT, 5,423 NFT) performing URPS procedures were included, with 513 FT and 5,818 NFT case log submissions. Compared to NFT, FT urologists were predominantly female (48% vs 13%, p<0.01), practiced in metropolitan areas (52% vs 23%, p<0.01) and academic settings (41% vs 7%, p<0.01). FT performed 24% of annual URPS cases on average, rising to 34% when excluding benign prostate hypertrophy (BPH) procedures. Modelling demonstrated that FT performed URPS cases at 4.2 times the annual rate of NFT (RR 4.2, 95% CI 3.6-4.6) on average, rising to 7.6 times when BPH was excluded (RR 7.6, 95% CI 6.7-8.6), controlling for other covariates. Independent of FT status, women performed non-BPH URPS at a 62% higher rate than men, with higher rates also seen among urologists that are younger, recertifying and outside the Northeast.
CONCLUSIONS: Although NFT outnumber FT by 14 to one, FT performed eight times more non-BPH URPS cases annually on average and accounted for 34% of total non-BPH volume.