RESUMEN
OBJECTIVE: Hematuria is the most common referral to Urology. Most initial evaluations are normal; however there are few medium- to long-term studies about these patients after they are discharged. METHODS: This study was a retrospective observational case-control study. Patients with normal initial investigations in our hematuria clinic (HC) over a 2-year period in 2012-2013 were included. We reviewed the electronic records of patients choosing January 1, 2021, as our reference date providing a median follow-up of 99 months. The primary aim of this study was to assess the missed urothelial malignancy (UM) rate in this cohort and also the UM rate in those re-referred to the HC. RESULTS: The study included 573 patients of whom 24.6% (141/573) were re-referred to urology during the study period. The overall missed UM cancer rate was 0.5% and 0.2% died as a result in this follow-up period. The UM cancer rate in those re-referred was 4.3% and of those re-referred with visible hematuria (VH) the UM cancer rate was 5.7%. No patients re-referred with non-visible VH (NVH) were diagnosed with UM. The only urological death during this time was due to UM. CONCLUSION: All urological malignancy and mortality remain very low even at mediumto long-term follow-up after an initial normal HC investigation. In this study, no patients with recurrent NVH developed UM; therefore, recurrent NVH is unlikely to need reinvestigation. The risk of UM in those re-referred with VH is low but more substantial and warrants reinvestigation, which should include computed tomography urogram imaging.
RESUMEN
BACKGROUND: The coronavirus pandemic has had an indisputable impact on surgical training. The qualitative effect on the perceived confidence and capability of trainees has been widely reported. In order to fully delineate the scope of the problem, quantitative data is also required. METHODS: This cross-sectional study collected compared data on the laparoscopic skills (pre- and post-pandemic) of first-year urology residents in the United Kingdom, who attended the annual Urology Simulation Boot Camp (USBC) in 2018 and 2019 (pre-pandemic), and 2021 (post-pandemic). RESULTS: Pre-pandemic group performance was significantly better in 2 out of 4 tasks (Task 3 p < 0.001) (Task 4 p = 0.003) during the practice session. During the assessment, pre-pandemic group performance was better (p = 0.017) for Task 2 and significantly faster (p = 003) for Task 4. CONCLUSIONS: Our results provide evidence to support the notion that the coronavirus pandemic has had a tangible and detrimental effect on the technical skills of surgical trainees.