TY - JOUR
T1 - Preserving Essential Skills
T2 - The Future of Vaginal Hysterectomy Training in Urogynaecology
AU - Rotem, Reut
AU - Carey, Michael O.
AU - McCarthy, Claire M.
AU - O'Reilly, Barry A.
AU - Daykan, Yair
AU - O'Sullivan, Orfhlaith E.
N1 - Publisher Copyright:
© 2024 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
PY - 2025/1
Y1 - 2025/1
N2 - Objectives: This study aimed to evaluate the training and self-assessed proficiency of surgeons in the surgical management of pelvic organ prolapse (POP). We focused on the factors that influence decision-making, the surgical techniques employed, the training received, and the management of complications. Design: A cross-sectional survey. Setting: An electronic questionnaire. Population: European Urogynaecological Association (EUGA) and International Urogynecological Association (IUGA) members. Methods: A total of 33 questions evaluating surgeon preference regarding vaginal surgeries. Main Outcome Measures: Demographics, surgical selection, proficiency and technique, and training methods. Results: There were 471 respondents, of which 273 (58%) dedicated more than 50% of their week to urogynaecology. 250 (53%) had completed a fellowship, with 215 (86%) of those fellowships being in urogynaecology and pelvic floor reconstruction. A preference for hysterectomy in cases of uterine descent was noted by 297 (63%) respondents, influenced mainly by patient preference, age, and prolapse anatomical score. A total of 443 (94%) were proficient in vaginal hysterectomy, with two-thirds performing 30 or fewer procedures annually; 212 (45%) reporting a decrease in the number of procedures over the last decade. Additionally, 373 (79%) respondents believed that 10–30 cases were needed to achieve and maintain proficiency. Conclusion: Vaginal hysterectomy remains a key component in uterine prolapse repair. However, with the rise of uterine-sparing prolapse repairs, the decision-making process may be influenced by multiple factors, including surgical training. Emphasis should be placed on training and maintaining proficiency in both traditional and novel techniques.
AB - Objectives: This study aimed to evaluate the training and self-assessed proficiency of surgeons in the surgical management of pelvic organ prolapse (POP). We focused on the factors that influence decision-making, the surgical techniques employed, the training received, and the management of complications. Design: A cross-sectional survey. Setting: An electronic questionnaire. Population: European Urogynaecological Association (EUGA) and International Urogynecological Association (IUGA) members. Methods: A total of 33 questions evaluating surgeon preference regarding vaginal surgeries. Main Outcome Measures: Demographics, surgical selection, proficiency and technique, and training methods. Results: There were 471 respondents, of which 273 (58%) dedicated more than 50% of their week to urogynaecology. 250 (53%) had completed a fellowship, with 215 (86%) of those fellowships being in urogynaecology and pelvic floor reconstruction. A preference for hysterectomy in cases of uterine descent was noted by 297 (63%) respondents, influenced mainly by patient preference, age, and prolapse anatomical score. A total of 443 (94%) were proficient in vaginal hysterectomy, with two-thirds performing 30 or fewer procedures annually; 212 (45%) reporting a decrease in the number of procedures over the last decade. Additionally, 373 (79%) respondents believed that 10–30 cases were needed to achieve and maintain proficiency. Conclusion: Vaginal hysterectomy remains a key component in uterine prolapse repair. However, with the rise of uterine-sparing prolapse repairs, the decision-making process may be influenced by multiple factors, including surgical training. Emphasis should be placed on training and maintaining proficiency in both traditional and novel techniques.
KW - subspecialisation
KW - surgical training
KW - surgical volume
KW - training requirements
KW - vaginal hysterectomy
UR - http://www.scopus.com/inward/record.url?scp=85205560803&partnerID=8YFLogxK
U2 - 10.1111/1471-0528.17974
DO - 10.1111/1471-0528.17974
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C2 - 39358908
AN - SCOPUS:85205560803
SN - 1470-0328
VL - 132
SP - 205
EP - 211
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 2
ER -