Residency training in percutaneous renal access: Does it affect urological practice?

Purpose: We evaluated the impact of residency training in percutaneous renal access on subsequent urological practice. Materials and Methods: Surveys evaluating practice and training in percutaneous renal access were mailed to residents who graduated between 1981 and 2001. A statistical analysis was performed to determine the effect of percutaneous access training on current practice patterns in percutaneous renal procedures. A subgroup analysis was conducted for graduates with more than 10 years after residency. Results: Responses were received from 37 of 48 surveys mailed (77%) and 35 surveys were eligible for analysis. A total of 92% of urologists trained in percutaneous access currently perform percutaneous surgical procedures compared to only 33% of those untrained (p<0.001). Urologists trained in access perform a mean of 14.0 percutaneous renal procedures annually while those untrained perform 3.3 procedures(p=0.02). Only 27% of urologists trained in percutaneous access continue to perform percutaneous renal access compared to 11% of those untrained (p=0.33). A subset analysis of urologists trained more than 10 years ago shows similar results. The primary reasons stated for not performing their own access are that the radiologist has better equipment (61%) or skills (44%), or obtaining access requires extra time (50%). Conclusions: This study suggests a relationship between training in percutaneous renal access and subsequent use of percutaneous renal procedures in the urologist's practice. Emphasis should be placed on providing continuing education opportunities to maintain competency in this important technique.