PD24-05 THE IMPACT OF COVID-19 ON UROLOGY RESIDENT SURGICAL EXPERIENCE: AN ANALYSIS OF NATIONAL CASE LOGS

Abstract

INTRODUCTION AND OBJECTIVE: To analyze the impact of elective surgical closures across Canadian Urology residency programs using a national case log surgical registry. METHODS: Urology resident case log data in T-Res was analyzed for 11 different residency programs for the time period of Sept 15, 2019 - Sept 14, 2020 for 20 common urological procedures. The 6- month time period (Sept 15, 2019-March 14, 2020) prior to COVID-19 was compared to the 6-month time period after COVID-19 (March 20, 2020-Sept 14, 2020). Total number of cases per program for the 20 most common surgeries as well as specific surgery volumes were analyzed. A paired sample t-test was used for comparison of mean cases pre- and post-COVID-19 with an alpha of 0.05 defined as significant. RESULTS: A total of 12,831 procedures were recorded in TRes over the 12-month period among 122 resident users in 11 training programs. In the 6-months prior to COVID-19, 7211 procedures were logged while 5620 procedures were logged in the 6-months after. 9/ 11 (81.8%) programs reported a reduction in surgical volumes. Mean total case numbers were significantly reduced in the 6-months after COVID-19 when compared to 6-months prior (510.9 procedures per program vs. 655.5;p=0.05). Mean program volumes after COVID-19 for TURBT (62.1 vs. 75.4;p=0.26), PCNL (33.5 vs. 48.5;p=0.27), hypospadias repair (1.5 vs. 3.5;p=0.08), ureteroscopy (69.5 vs. 76.1;p=0.66), stent insertion (63.7 vs. 76.5;p=0.24), radical prostatectomy (17.4 vs. 21.5;p=0.37), radical nephrectomy (14.2 vs. 20.9;p=0.20), and partial nephrectomy (9.9 vs. 10.6;p=0.67) were not significantly reduced. However, mean surgical volumes after COVID-19 for TURP (33.5 vs. 48.5;p=0.02), circumcision (12.7 vs. 26.6;p=0.02), hydrocelectomy (7.0 vs. 13.2;p=0.01), orchidopexy (10.7 vs. 20.3;p=0.03), radical cystectomy (5.7 vs. 13.1;p=0.006), and cystolithopaxy (7.9 vs. 13.7;p=0.04) were reduced in the 6- months following COVID-19. CONCLUSIONS: Based on this national case log sample there appears to be an overall decline in urology resident surgical experience in the 6 months after COVID-19. This decline appears most pronounced in TURP, circumcision, hydrocelectomy, orchidopexy, radical cystectomy and cystolithopaxy.