Abstract
ABSTRACTPurpose:To develop and validate a new test of specific technical skills required for microsurgical varicocelectomy.Materials and Methods:An electronic questionnaire was sent to 558 members of the Brazilian Society of Urology for the validation of the task-specific checklist (TSC) for assessment of microsurgical varicocelectomy. Participants who had experience in this procedure were selected as judges. For construct validation, 12 participants including attending urologists and urological residents in training were recruited for voluntary participation. We formed a group of three experts and a group of nine novices, who had to perform the steps of microsurgical varicocelectomy on a simulation model using human placenta. Each participant was filmed and two blinded raters would then evaluate their performance using the TSC of microsurgical varicocelectomy.Results:14 judges were recruited. The assessment tool was reformulated, according to the judges suggestions and had the content validity achieved. The final version of the TSC was comprised of the task-specific score, a series of 4 items scored in a binary fashion designed for microscopic sub-inguinal varicocelectomy. The differences between the performance of participants with different levels of experience reflected the construct validity. The reliability between the raters was high. The mean time required to complete the training of microsurgical varicocelectomy in simulation model was significantly shorter for experts compared to novices (201 vs. 496 seconds, p=0.01).Conclusions:This preliminary study suggests that the task-specific checklist of microsurgical varicocelectomy is reliable and valid in assessing microsurgical skills.
Highlights
Since the classic work of Tulloch, varicoceles are known to be associated with male factor infertility [1]
Sub-inguinal microsurgical varicocelectomy is currently considered the gold standard treatment for varicocele, microsurgical manipulations are not parts of the skill set of many urologists making this procedure challenging [6]
Table-1 presents the final version of the task-specific checklist (TSC) was comprised of the task-specific score, a series of 4 items scored in a binary fashion designed for microscopic sub-inguinal varicocelectomy
Summary
Since the classic work of Tulloch, varicoceles are known to be associated with male factor infertility [1]. Surgical correction of varicoceles improves the rate of spontaneous pregnancy making this disease the most important surgically correctable cause of infertility in males [2]. Some other less common indications for varicocelectomy include testicular pain and testicular dysfunction [3]. Debenedictis & Praiss (1985) described the microdissection of the spermatic cord at the external inguinal ring for the management of varicoceles [4]. Sub-inguinal microsurgical varicocelectomy is currently considered the gold standard treatment for varicocele, microsurgical manipulations are not parts of the skill set of many urologists making this procedure challenging [6]
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