Parallel Meeting on Thursday 4, September 2025, 14:50 - 15:25
14:50 - 14:53
S20-1 (OP)
Kelly HARRIS, Justin HEGEL, Kyle ROVE and Duncan WILCOX
Children's Hospital Colorado, Pediatric Urology, Aurora, USA
PURPOSE
The 2023 American Urological Association Census reported that the percentage of female urologists in the United States rose from 7.7% in 2014 to 11.8% in 2023. Notably, 25% of practicing urologists less than 45 years old are female, compared to only 1% of practicing urologists 65 years and older. The aim of this study was to evaluate the landscape of gender representation at European Society of Pediatric Urology (ESPU) and Society of Pediatric Urology (SPU) meetings over time.
MATERIAL AND METHODS
A review of all scientific sessions and panels from ESPU Annual Meetings and SPU Fall Congress Meetings from 2018-2024 was performed. The number of invited moderators and panelists by gender were recorded as well as the topic of discussion. Fisher exact tests were used to assess for differences in gender representation at ESPU and SPU meetings and to investigate temporal and topical trends.
RESULTS
Over the six-year period, there was not a change in gender representation at both meetings combined. Overall, SPU meetings had more equal gender representation than ESPU meetings (26.3% vs 47.8% female, p<0.001). Men trended towards more representation in topics related to basic science, artificial intelligence, and billing/coding. Women trended towards more representation in topics related to education, clinical research, and quality improvement.
CONCLUSIONS
Leadership and visibility at annual ESPU and SPU meetings have remained stable over time, with more equal representation within SPU. Further studies will investigate why this gap between meetings exists as well as how pediatric urology compares to other urologic subspecialties.
14:53 - 14:56
S20-2 (OP)
Victoria MAXON 1, Kathleen KIERAN 2, Catherine ROBEY 1 and Ming-Hsien WANG 1
1) Johns Hopkins University, Robert D. Jeffs Division of Pediatric Urology, Baltimore, USA - 2) Seattle Children's Hospital, Pediatric Urology, Seattle, USA
PURPOSE
Pediatric urologists manage a wide spectrum of genitourinary conditions, requiring a strong foundation in embryology, pathophysiology, and surgical management. Despite these demands, the current ACGME requirements for urology residency offer limited exposure to pediatric urology, leading to variable competence among trainees entering fellowship. Moreover, no standardized curriculum exists across the 27 ACGME-accredited pediatric urology fellowship programs, contributing to disparities in training. In this project we sought to develop, implement, and evaluate a standardized curriculum for pediatric urology fellowships that ensures comprehensive training in core clinical, surgical, and professional competencies while addressing variability in trainee preparedness and aligning with ACGME milestones.
MATERIAL AND METHODS
We conducted a targeted needs assessment using an anonymous survey of recent fellowship graduates to evaluate confidence in clinical, surgical, and interpersonal skills, as well as barriers to effective training.
RESULTS
Survey response was 35.3% (m=35/205) and revealed that over 80% of recent graduates felt confident in core clinical care but noted lower confidence in postoperative care (66.6%) and communication-based activities. Burnout was common, with institutional and partner-level mentorship cited as critical mitigating factors. The proposed curriculum includes clinical and surgical objectives, hands-on simulation, multidisciplinary conferences, and personalized feedback. Pilot implementation is planned at multiple institutions, with periodic evaluation using REDCap-based surveys and stakeholder feedback.
CONCLUSIONS
This standardized curriculum addresses critical gaps in training by defining core competencies, leveraging simulation, and fostering structured feedback. Collaboration among institutions will enable customization and scalability, ultimately improving trainee preparedness and patient outcomes. Future efforts will focus on assessing curriculum effectiveness and expanding adoption across programs.
15:05 - 15:08
S20-3 (OP)
Joseph BORER 1, Kate KRAFT 2, Thomas KOLON 3 and Caleb NELSON 1
1) BOSTON CHILDREN'S HOSPITAL, UROLOGY, Boston, USA - 2) University of Michigan, Urology, Ann Arbor, USA - 3) Children's Hospital of Philadelphia, Urology, Philadelphia, USA
PURPOSE
Anderson-Hynes dismembered pyeloplasty is the historic gold-standard surgical repair of ureteropelvic junction obstruction, typically via open approach - open pyeloplasty (OP). Advances in minimally invasive pyeloplasty (MIP) include technical skill and application in younger patients. We report trainee experience with OP and MIP over the last 10-years in the United States (US), and hypothesize that a paradigm shift in surgical approach will decrease trainee open surgery experience.
MATERIAL AND METHODS
The Accreditation Council for Graduate Medical Education (ACGME) defines and upholds standards in graduate medical training programs for US physicians. The ACGME annually reviews graduate case log data to assess the breadth and depth of a program’s procedural training. Deidentified ACGME case log data for pediatric urology fellows from 2014-2024 was divided into 3 periods (2014-2016, 2017-2021, 2022-2024), and total case counts for OP using Current Procedural Terminology (CPT) codes 50400 or 50405, and MIP CPT code 50544. Ureterocalicostomy (50750) and ureteropyelostomy (50740) were excluded. The proportions of OP vs. MIP cases performed were compared during each period using chi-square testing.
RESULTS
The proportion of MIP cases increased progressively during the time period, from 54.9% during the early time period to 58.2% during the middle time period to 75.5% during the latest time period (p<0.001). MIP accounted for 77.3% of pyeloplasty cases during the final year vs. 48.1% during the initial year.
CONCLUSIONS
Over the last 10-years, there is a significant dichotomy of trends favoring MIP versus OP in US pediatric urology fellowship training, particularly pronounced for the most recent 3-year period. Presuming proficiency with OP is important in practice, training paradigms that optimize experience should consider enhancing exposure of trainees to OP.
|
2014-2017 |
2018-2021 |
2022-2024 |
Total |
|
|
OP |
840 (45.1%) |
930 (41.8%) |
349 (24.5%) |
2119 (38.4%) |
|
MIP |
1023 (54.9%) |
1296 (58.2%) |
1078 (75.5%) |
3397 (61.6%) |
|
Total |
1863 |
2226 |
1427 |
5516 |
15:08 - 15:11
S20-4 (OP)
Enrico BRÖNNIMANN 1, Alessia ALLASIA 1, Harish CHANDRAN 2, Amulya SAXENA 3, Peter ZIMMERMANN 4 and Oliver SANCHEZ 1
1) University of Lausanne, University Hospital of Lausanne (CHUV), University Centre of Paediatric Surgery of Western Switzerland, Lausanne, Switzerland, Department of Paediatric Surgery, Lausanne, SWITZERLAND - 2) Birmingham Children's Hospital, Department of Paediatric Urology, Birmingham, UNITED KINGDOM - 3) Chelsea Children's Hospital, Department of Paediatric Surgery, Chelsea and Westminster, London, UNITED KINGDOM - 4) University of Leipzig, Department of Paediatric Surgery, Leipzig, GERMANY
PURPOSE
Addressing the lack of validated training models for paediatric retroperitoneoscopic pyeloplasty in literature, an innovative hybrid animal tissue model, the Combined Porcine-Avian, was designed and validated.
MATERIAL AND METHODS
A prospective observational study was conducted during two Minimally Access Surgery (MAS) courses in 2023 and 2024, using a model consisting of a chicken's crop and oesophagus connected to a piglet kidney. The model was placed on an inclined surface to simulate the alignment of the renal pelvis during retroperitoneoscopy. This setup allowed for simulating dismembered retroperitoneoscopic pyeloplasty on a standard pelvic trainer using tools and techniques consistent with clinical practice. Validation data were collected using a 5-point Likert scale questionnaire based on the Michigan Standard Simulation Experience Scale (MiSSES).
RESULTS
Twenty-nine participants (20 females, 9 males) were enrolled: 17 (59%) had performed <50 MAS cases, 4 (14%) 50-100 cases, and 8 (28%) >100 cases. Mean perceived realism was 4.4 ± 0.7, for simulated environment 4.3 ± 0.7, renal pelvis 4.4 ± 0.6, and ureter 4.4 ± 0.6. Knowledge improvement was rated 4.7 ± 0.5, confidence performing retroperitoneoscopic pyeloplasty 4.4 ± 0.6, and ability 4.4 ± 0.8. Educational value for retroperitoneoscopic surgery was rated 4.6 ± 0.6, and for suturing 4.8 ± 0.5. Overall satisfaction was 5 ± 0, with no significant differences across experience levels.
CONCLUSIONS
The novel combined porcine-avian model for retroperitoneoscopic pyeloplasty was successfully validated. Validation assessment highlights its high realism and effectiveness, enabling skill acquisition in retroperitoneoscopic pyeloplasty. It expands the range of established simulation models in paediatric urology.
15:11 - 15:14
S20-5 (OP)
Chaimae BENDRISS 1, Amane-Allah LACHKAR 1, Jean BREAUD 2, Liza ALI 1, Annabel PAYE-JAOUEN 1, Isabelle TALON 3, Delphine DEMEDE 4, Alaa EL GHONEIMI 1, Matthieu PEYCELON 1 and Valeska BIDAULT JOURDAINNE 5
1) Robert Debré University Hospital, Pediatric urology and visceral surgery Department, Paris, FRANCE - 2) Hôpital Universitaire Pédiatrique Lenval, Fondation Lenval Pour Enfants, Pediatric Visceral Surgery, Nice, FRANCE - 3) Hautepierre Hospital, Strasbourg University Hospitals, Pediatric Visceral Surgery, Strasbourg, FRANCE - 4) HFME, Civil Hospices of Lyon, Pediatric urovisceral, thoracic and transplantation surgery department, Bron Cedex, FRANCE - 5) HFME, Civils Hospices of Lyon, Pediatric urovisceral, thoracic and transplantation surgery department, Bron, FRANCE
PURPOSE
Auditory distractions such as phone calls can significantly impact a urologist’s focus during delicate procedures like minimal invasive surgeries. This study investigates the effect of such distractions on surgical performance during a laparoscopic training program.
MATERIAL AND METHODS
Trainees participating in a pediatric urology laparoscopic simulation program were tasked with performing an intracorporeal laparoscopic knot under two conditions: first in a quiet environment, and then with three auditory distractions introduced at 30-second intervals. Performance was assessed using an adapted Objective Structured Assessment of Technical Skill (OSATS[PM1] ) score (/40), time to complete the knot (in seconds), frequency inneedle drops, and procedure interruptions. Results are expressed as median [interquatile range (IQR)] and comparative statistics used paired or unpaired Student-t test.
RESULTS
A total of 21 right-handed pediatric urology residents , with a median number of 8 [6;9] semesters completed, demonstrated a significantly lower median OSATS score in the presence of auditory distractions (25 [21;32] vs 28 [24;31]), p=0.02). Additionally, they required significantly more time to complete the knot when exposed to phone call distractions (185s [97;356] versus 140s [95;253], p=0.02) compared to a quiet environment. Among the participants, 11 dropped the needle, 10 paused the procedure to answer questions, and 3 completely lost focus while responding.
CONCLUSIONS
This study underscores the detrimental impact of auditory distractions on laparoscopic performance, particularly among less experienced surgeons. Addressing this issue could enhance surgical training efficiency and help mitigate cognitive load, ultimately improving patient safety and procedural outcomes.