Challenges of Training General Surgery Residents to Do Urology in the Developing World

AbstractPurpose of ReviewThe purpose this manuscript is to describe the work of one program in Kenya, East Africa, to train general surgery residents in urology to make available the much needed service to the underserved rural population.Recent FindingsPeople in developing countries continue to face the challenge of accessing surgical care with a ratio of 1 surgeon to 20,000 people. This is due, in part, to the inadequate number of trained surgeons. The availability of specialized surgical care such as urology is even more unlikely due to fewer numbers of specialists in urology. Such disciplines take many years of training before a person qualifies as a specialist. This requires highly motivated and suitable candidates who are willing to spend time in training and acquiring skills as well as proper infrastructure for training. There is an effort to train general surgical residents in enhanced skills to make available urology services to the wider population. This involves equipping them with skills in general urology, basic skills in handling endoscopic equipment, and basic endo-urology procedures such as diagnostic cystoscopy with or without biopsy and direct vision urethrotomy (DVU). The residents are also exposed to visiting faculty through international collaborations, surgical camps, and workshops to enhance their skills and knowledge.SummaryEquipping general surgical residents with urology skills will greatly reduce the shortage of these services to the people of devel...
Source: Current Bladder Dysfunction Reports - Category: Urology & Nephrology Source Type: research

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Conclusions: Use of ADM represents a new option for the surgical management of AUS repair and reconstruction, with positive clinical effects. In addition, it has the advantages of convenient for operation procedures and access, with no need for additional sampling surgery.Urol Int
Source: Urologia Internationalis - Category: Urology & Nephrology Source Type: research
In this study, we examined the necessity of routine RBB after BCG therapy.MethodsWe retrospectively identified 102 patients who were initially diagnosed with CIS with or without papillary tumor and received subsequent 6 –8-week BCG therapy. Thereafter, all patients underwent voiding cytology analysis, cystoscopy, and RBB to evaluate the effects of BCG therapy. We evaluated the association between clinical parameters (voiding cytology and cystoscopy findings) and the final pathological results by RBB specimens.ResultsAccording to the pathological results of RBB, 30 (29%) patients had BCG-unresponsive disease (remainin...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
Conclusions: In neonates with bilateral UPJO, the worse affected kidney is operated first, as it still has the potential to recover. The contralateral milder UPJO unit is known to recover spontaneously following unilateral pyeloplasty. In those with bilateral Grade 4 UPJO and mass, bilateral pyeloplasty is feasible. Alternatively, unilateral pyeloplasty + contralateral cystoscopic retrograde stenting may prevent rupture or functional deterioration in the opposite kidney.
Source: Indian Journal of Urology - Category: Urology & Nephrology Authors: Source Type: research
Conclusions: At a median of 5 years and 5 months of follow up, CCG (including the IM-type) did not show any increase in the risk of malignancy.
Source: Indian Journal of Urology - Category: Urology & Nephrology Authors: Source Type: research
Abstract Postpolio syndrome (PPS) is a disabling process characterized by progressive muscle weakness and atrophy that typically emerges decades after an initial poliomyelitis infection. Although the exact incidence of PPS is unknown, it is estimated that 25% to 40% of all poliomyelitis survivors are affected. Patients with PPS may have increased sensitivity to numerous anesthetic agents including neuromuscular blocking drugs. A case report of a patient with PPS undergoing general anesthesia for a cystoscopy procedure is presented. Because of a previous general anesthetic using traditional muscle relaxant reversal...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research
Conclusions: In neonates with bilateral UPJO, the worse affected kidney is operated first, as it still has the potential to recover. The contralateral milder UPJO unit is known to recover spontaneously following unilateral pyeloplasty. In those with bilateral Grade 4 UPJO and mass, bilateral pyeloplasty is feasible. Alternatively, unilateral pyeloplasty + contralateral cystoscopic retrograde stenting may prevent rupture or functional deterioration in the opposite kidney.
Source: Indian Journal of Urology - Category: Urology & Nephrology Authors: Source Type: research
Conclusions: At a median of 5 years and 5 months of follow up, CCG (including the IM-type) did not show any increase in the risk of malignancy.
Source: Indian Journal of Urology - Category: Urology & Nephrology Authors: Source Type: research
Authors: Kim JK, Choi C, Kim US, Kwon H, Lee SH, Lee YG, Han JH Abstract BACKGROUND: Demographic change and advances in technology affect transurethral surgery and outpatient procedures in the urologic field. There are few population-based studies that accurately assess the trend of transurethral surgery and outpatient procedures including diagnostic tests. We investigated the recent epidemiologic trends in transurethral surgeries and urological outpatient procedures from 2009 to 2016 in Korea using the entire population-based cohort. METHODS: We analyzed medical service claim data of transurethral surgery, uro...
Source: Journal of Korean Medical Science - Category: Biomedical Science Tags: J Korean Med Sci Source Type: research
CONCLUSION: We consider that the removal of a stent placed in pediatric intravesical UNC operations without anesthesia and cystoscopy is less invasive and affords safety and long-term results comparable to the standard method. PMID: 33000454 [PubMed - as supplied by publisher]
Source: Urology Journal - Category: Urology & Nephrology Authors: Tags: Urol J Source Type: research
Abstract There is an underutilization of potentially curative treatments for patients with muscle-invasive bladder cancer. Contemporary trimodality bladder-preservation therapy - which includes a maximally safe transurethral resection of the bladder tumor followed by concurrent chemoradiation and close cystoscopic surveillance with salvage cystectomy reserved for invasive tumor recurrence - can help fulfill this unmet need. Over the past few decades, cumulative published data from prospective clinical trials and large institutional series have established trimodality therapy (TMT) for select patients as a safe and...
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
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