Findings from an international survey of urology trainee experience with prostate biopsy

Aaron Brant; Riccardo Campi; Diego M Carrion; Francesco Esperto; Christina Sze; Jeffrey P Johnson; Jim C Hu; Leonardo D Borregales; ICE‐OUT (International Collaboration on Experiences and Opinions of Urology Trainees) Collaborators

doi:10.1111/bju.15935

Findings from an international survey of urology trainee experience with prostate biopsy

BJU Int. 2022 Nov 24:10.1111/bju.15935. doi: 10.1111/bju.15935. Online ahead of print.

Authors

Aaron Brant¹, Riccardo Campi², Diego M Carrion^{3

4}, Francesco Esperto⁵, Christina Sze¹, Jeffrey P Johnson¹, Jim C Hu¹, Leonardo D Borregales¹; ICE‐OUT (International Collaboration on Experiences and Opinions of Urology Trainees) Collaborators

Collaborators

ICE‐OUT (International Collaboration on Experiences and Opinions of Urology Trainees) Collaborators:
Luca Afferi, Enrico Checcucci, Emin Gürtan, Nino Karazanashvili, Adrien Khelif, Guglielmo Mantica, Görkem Özenç, Lazaros Tzelves, Vasco Quaresma

Affiliations

¹ Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA.
² Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy.
³ Department of Urology, Torrejon University Hospital, Madrid, Spain.
⁴ Department of Urology, Universidad Francisco de Vitoria, Madrid, Spain.
⁵ Department of Urology, Campus Biomedico, University of Rome, Rome, Italy.

PMID: 36424894
PMCID: PMC10205912 (available on 2024-05-24)
DOI: 10.1111/bju.15935

Abstract

Objective: To assess urology trainees' exposure to transperineal prostate biopsy (TP-Bx) and intent to use TP-Bx in practice.

Subjects and methods: A 34-question survey about prostate biopsy was distributed to urology trainees in the United States and Europe. Primary outcomes were exposure to TP-Bx in training and intent to use TP-Bx post training. Exposure to transrectal prostate biopsy (TR-Bx) and magnetic resonance imaging-targeted biopsy (MRI-Bx) was also assessed. Survey answers were compared between groups as categorical variables using Fisher's exact test. Multivariable logistic regression was used to identify factors associated with intent of performing TP-Bx post training.

Results: A total of 658 trainees from 19 countries completed the survey. Of these, 313 trainees (48%) reported exposure to TP-Bx, 370 (56%) reported exposure to MRI-Bx, and 572 (87%) reported exposure to TR-Bx. There was significant heterogeneity in TP-Bx exposure among countries (P < 0.001), with the highest prevalence in Italy (72%) and the lowest prevalence in Greece (4%). Intent to perform TP-Bx post training was higher in those exposed to TP-Bx during training (89% vs 58%; P < 0.001) and did not differ between trainees in postgraduate year (PGY) 1-3 vs those in PGY ≥4 (73% vs 72%; P = 0.7). On multivariable regression, exposure to TP-Bx in training was independently associated with increased intent to perform TP-Bx post training (odds ratio 5.09, 95% confidence interval 3.29-8.03; P < 0.001).

Conclusions: Fewer than half of 658 surveyed urology trainees reported exposure to TP-Bx, with significant heterogeneity among countries. Greater experience with TP-Bx in training was associated with greater intent to perform TP-Bx post training. A minimum requirement of TP-Bx cases during urological training may increase resident familiarity and adoption of this guideline-endorsed prostate biopsy approach.

Keywords: biopsy; education; prostatic neoplasms; residency; surveys and questionnaires.

Abstract

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