HYPOSPADIA REPAIR SURGERY LEARNING CURVE IN PEDIATRIC UROLOGY FELLOWSHIP PROGRAM
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Abstract
Introduction: The paediatric urology fellowship program was designed to accelerate the learning curve of junior urologist in various paediatric urology procedures, including hypospadias repair. Objective: This study aimed to provide insight in the learning curve of hypospadia repair during the paediatric urology fellowship program. Material & Methods: Three paediatric urology fellows performed 176 hypospadias repairs at four Jakarta, Indonesia, centers throughout their six-month fellowship training program between January 2022 and January 2023. Secondary repair or the initial stage of staged repair were excluded from the analysis. Complications such as urethrocutaneous fistula formation and wound dehiscence requiring secondary repair were documented. The learning curve of each fellow in hypospadias repair was documented. Results: Each fellow performed a median of 58 procedures (range: 56–62) during their training period. A total of 34 (19.3%) experienced complications, including 19 cases of fistula formation and 15 cases of wound dehiscence, over a mean follow-up period of 24.1±17.1 weeks. There were no significant differences in demographics, distribution of hypospadias, or complication rates observed among the fellows. Notably, there was a significant improvement in the learning curve for each fellow after performing 30 consecutive cases, achieving a success rate of over 84%. The average success rate showed a significant increase from 74.4% to 87.2% after 30 cases (p=0.032). Conclusion: Significant improvement of hypospadia repair success rate was observed among paediatric urology fellows after performing 30 consecutive hypospadia repair during their training. This improvement suggests that the fellowship program likely played a pivotal role in accelerating their learning curve. Keywords: Fellowship, hypospadias, learning curve, urethrocutaneous.
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Fellowship, hypospadias, learning curve, urethrocutaneous.
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