Laparoscopic pyeloplasty proficiency during a residency program after adoption of a standardized simulation training program is maintained during the COVID pandemic despite reduced surgery volume.

PURPOSE: To evaluate the effect of the standardized laparoscopic simulation training program in pyeloplasty, following its implementation and during the COVID-19 pandemic. MATERIAL AND METHODS: A retrospective chart review was performed at Hospital de Clínicas de Porto Alegre, a tertiary referral center in south Brazil, in which 151 patients underwent laparoscopic pyeloplasty performed by residents between 2006-2021. They were divided into three groups: before and after adoption of a standardized laparoscopic simulation training program and during the COVID-19 pandemic. The main outcome was a combined negative outcome of conversion to open surgery, major postoperative complications (Clavien-Dindo III or higher) or unsuccessful procedure, defined as need for redo pyeloplasty. RESULTS: There was a significant reduction in the combined negative outcome (21.1% vs 6.3%), surgical time (mean 200.0 min vs 177.4 min) and length of stay (median 5 days vs 3 days) after the adoption of simulation training program. These results were maintained during the COVID-19 pandemic (combined negative outcome of 6.3%, mean surgical time of 160.1 min and median length of stay of 3 days) despite a reduction in 55.4% of the surgical volume. CONCLUSION: A structured laparoscopic simulation program can improve outcomes of laparoscopic pyeloplasty during the learning curve.

Burnout syndrome in pediatric urology: A perspective during the COVID-19 pandemic - Ibero-American survey.

INTRODUCTION: Burnout syndrome is a major cause of decreased life quality, mental health, and productivity for physicians. It is strongly related to work overload and has been a scarcely studied topic in pediatric urology. During the COVID-19 pandemic, authorities' recommendations have led to big changes in pediatric urology practice worldwide. This study aimed to evaluate the level of burnout in Ibero-American pediatric urologists (IPUs) during this pandemic. MATERIAL AND METHODS: A cross-sectional study was conducted by applying an electronic survey during the COVID-19 pandemic peak to members of the two major associations of pediatric urology in Ibero-America (the Ibero-American Society of Pediatric Urology [SIUP] and the Brazilian School of Pediatric Urology [BSPU]) to evaluate demographic, pre-pandemic, and pandemic data. Burnout levels were assessed using the Copenhagen Burnout Inventory (CBI) questionnaire. RESULTS: A response rate of 40% was obtained (182 out of 455 IPU respondents). Participants were from 14 different countries in Ibero-America and 75.4% were male. Data showed that during the pandemic there was a significant decrease in weekly workload, that is: > 40 h per week (h/w) (91.4%-44.6%, p < 0.001); and >6 h/w (94.9%-45.1%%, p < 0.001) in operating room time (ORT). Personal (Pe-BO), work-related (W-BO), and patient-related (Pa-BO) burnout levels among IPUs were 26.3%, 22.3%, and 7.4%, respectively (Summary table). An important difference by gender was seen, with women suffering more from the syndrome (odds ratio of 2.67 [95% confidence interval, 1.285.58; p = 0.013] for Pe-BO and OR of 3.26 [95% CI, 1.52-7.01; p = 0.004] for W-BO). CONCLUSION: A significant decrease in workload for IPU during the pandemic was observed, as well as a low level of burnout syndrome during this time. However, the predominance of burnout in women found in this study is notable.