MP80-07 TRANSRECTAL ULTRASOUND GUIDED PROSTATE BIOPSY PERFORMED BY SUPERVISED JUNIOR AND SENIOR RESIDENTS IS SAFE AND DOES NOT RESULT IN INFERIOR OUTCOMES

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety III1 Apr 2018MP80-07 TRANSRECTAL ULTRASOUND GUIDED PROSTATE BIOPSY PERFORMED BY SUPERVISED JUNIOR AND SENIOR RESIDENTS IS SAFE AND DOES NOT RESULT IN INFERIOR OUTCOMES Margaret Knoedler, Kimberly Maciolek, Natasza Posielski, Vania Lopez, Wade Bushman, Sara Best, Dan Gralnek, and Kyle Richards Margaret KnoedlerMargaret Knoedler More articles by this author , Kimberly MaciolekKimberly Maciolek More articles by this author , Natasza PosielskiNatasza Posielski More articles by this author , Vania LopezVania Lopez More articles by this author , Wade BushmanWade Bushman More articles by this author , Sara BestSara Best More articles by this author , Dan GralnekDan Gralnek More articles by this author , and Kyle RichardsKyle Richards More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2695AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is growing public concern over the safety of trainee involvement in patient care at academic medical centers. To assess for safety in the performance of transrectal ultrasound (TRUS) guided prostate biopsy, we measured rates of detection of prostate cancer and complication rates following TRUS biopsy by trainees compared to faculty urologists. METHODS All prostate biopsies performed at our Veterans Affairs Hospital from June 2014 to February 2017 were retrospectively reviewed. A total of 623 prostate biopsies were performed: 244 by junior residents (PGY-2), 212 by senior residents (PGY-4), and 167 by faculty urologists. All biopsies were performed in a standardized fashion and residents had appropriate supervision during the procedures. We evaluated patient demographics, PSA levels, digital rectal exam (DRE) findings, detection of prostate cancer, and complications between different trainee levels. Multivariable logistic regression modeling was used to identify independent predictors of prostate cancer detection and complications. RESULTS There was no statistical difference in patient populations between the three groups when stratified by age, BMI, Charleston co-morbidity index, aspirin use, PSA level and palpable nodule on DRE. Prostate cancer was detected in 43.6% of the biopsies and there was no difference in detection rates, Gleason score, or number of positive cores between the trainees and the faculty urologists. 30-day hospitalization and complication rates were low at 2.4% and 12.5% respectively. There was no difference in hospitalization (p=0.863) or complication rates (p=0.671) between the trainee levels. Interestingly, biopsy in the second half of the academic year (OR 1.48, 95% CI 1.06-2.07; p=0.02) was associated with increased odds of prostate cancer detection, but level of trainee was not. Level of trainee was also not an independent predictor of 30-day complications. CONCLUSIONS Prostate biopsy performed by trainees has similar prostate cancer detection rates compared to faculty urologists without increased complications. There is no difference in outcomes between junior and senior residents suggesting that with adequate faculty supervision, it is safe for trainees at all levels to perform prostate biopsies. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1091 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Margaret Knoedler More articles by this author Kimberly Maciolek More articles by this author Natasza Posielski More articles by this author Vania Lopez More articles by this author Wade Bushman More articles by this author Sara Best More articles by this author Dan Gralnek More articles by this author Kyle Richards More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...