4.6 Article

Findings from an international survey of urology trainee experience with prostate biopsy

Journal

BJU INTERNATIONAL
Volume 131, Issue 6, Pages 705-711

Publisher

WILEY
DOI: 10.1111/bju.15935

Keywords

prostatic neoplasms; biopsy; education; surveys and questionnaires; residency

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The study assesses the exposure of urology trainees to transperineal prostate biopsy (TP-Bx) and their intention to use TP-Bx in practice. Less than half of the surveyed trainees reported exposure to TP-Bx, with significant differences among countries. The study suggests that greater experience with TP-Bx during training is associated with a higher intention to perform TP-Bx in practice. The authors recommend setting a minimum requirement for TP-Bx cases during urological training to increase trainees' familiarity and adoption of this approach.
ObjectiveTo assess urology trainees' exposure to transperineal prostate biopsy (TP-Bx) and intent to use TP-Bx in practice. Subjects and MethodsA 34-question survey about prostate biopsy was distributed to urology trainees in the United States and Europe. Primary outcomes were exposure to TP-Bx in training and intent to use TP-Bx post training. Exposure to transrectal prostate biopsy (TR-Bx) and magnetic resonance imaging-targeted biopsy (MRI-Bx) was also assessed. Survey answers were compared between groups as categorical variables using Fisher's exact test. Multivariable logistic regression was used to identify factors associated with intent of performing TP-Bx post training. ResultsA total of 658 trainees from 19 countries completed the survey. Of these, 313 trainees (48%) reported exposure to TP-Bx, 370 (56%) reported exposure to MRI-Bx, and 572 (87%) reported exposure to TR-Bx. There was significant heterogeneity in TP-Bx exposure among countries (P < 0.001), with the highest prevalence in Italy (72%) and the lowest prevalence in Greece (4%). Intent to perform TP-Bx post training was higher in those exposed to TP-Bx during training (89% vs 58%; P < 0.001) and did not differ between trainees in postgraduate year (PGY) 1-3 vs those in PGY >= 4 (73% vs 72%; P = 0.7). On multivariable regression, exposure to TP-Bx in training was independently associated with increased intent to perform TP-Bx post training (odds ratio 5.09, 95% confidence interval 3.29-8.03; P < 0.001). ConclusionsFewer than half of 658 surveyed urology trainees reported exposure to TP-Bx, with significant heterogeneity among countries. Greater experience with TP-Bx in training was associated with greater intent to perform TP-Bx post training. A minimum requirement of TP-Bx cases during urological training may increase resident familiarity and adoption of this guideline-endorsed prostate biopsy approach.

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