PA- versus urologist-performed flexible cystoscopy: A comparative study.

Area of Science:

• Urology
• Oncology
• Medical Practice

Background:

• Cystoscopy is a key diagnostic procedure for bladder cancer.
• Evaluating the performance of physician associates/assistants (PAs) compared to staff urologists (SUs) is crucial for healthcare delivery.
• Patient outcomes and diagnostic accuracy are important metrics for procedural comparison.

Purpose of the Study:

• To compare patient-reported pain and bladder cancer detection rates between cystoscopies performed by PAs and SUs.
• To assess the non-inferiority of PA-performed cystoscopies regarding patient comfort and diagnostic yield.
• To inform healthcare policy and clinical practice regarding the role of PAs in urological procedures.

Main Methods:

• Secondary analysis of a single-center, prospective, double-blind, randomized controlled trial.
• Included 98 male patients undergoing flexible cystoscopy by either a SU or a PA.
• Patient pain perception assessed via a post-procedure questionnaire.

Main Results:

• Mean pain scores were comparable: 2.67 for SU-performed and 2.62 for PA-performed cystoscopies (p = .92).
• Bladder cancer detection rates were similar: 6.25% for SU-performed and 10% for PA-performed cystoscopies.
• Positive or suspicious findings were observed in 23% of SU-performed and 24% of PA-performed procedures (p > .05).

Conclusions:

• PA-performed cystoscopies yield comparable patient pain scores to those performed by SUs.
• Malignancy detection rates are similar between PAs and SUs performing cystoscopies.
• PAs demonstrate equivalent efficacy to physicians in cystoscopy for bladder cancer diagnosis.