Preparing Urologists for Urethral Instrumentation in Patients With an Artificial Urinary Sphincter: Results From a...

Urethral instrumentation (UI) in patients with artificial urinary sphincters (AUS) requires specific technical considerations due to the risk of urethral erosion, which can lead to serious clinical and legal consequences. Many urologists report limited preparedness for performing UI in AUS patients, particularly in emergency scenarios. This study evaluated the impact of a brief training session (TS) on urologists' self-reported confidence in managing UI in this context.

Urologists and residents attending a national urology meeting in Brazil (November 2023) were invited to participate in a structured TS. The intervention included a theoretical overview of AUS components and mechanisms, device activation and deactivation, and safe catheterization techniques, followed by supervised hands-on practice using a simplified catheterization model. Confidence levels were assessed via pre- and post-training questionnaires.

A total of 135 participants (100 urologists and 35 residents) took part, with a median age of 35.0 ± 10.2 years; 76.3% were men. The mean duration of the TS, including evaluations, was 15 min. Before training, only 34.1% felt capable to independently perform UI in AUS patients during emergencies. Post-training, this proportion rose to 88.8% (p < 0.001). Significant improvements were observed across all assessed competencies, including AUS deactivation, catheter selection, duration of catheterization, and device reactivation.

A brief, focused training session significantly improved participants' confidence in performing UI in patients with AUS. These findings support the integration of targeted educational interventions into urologic training programs. Further studies are warranted to evaluate long-term retention and clinical outcomes.