Presented by: Zubin Shetty MD
University of Iowa Health Care

Introduction

Point-of-care ultrasound (POCUS) is a valuable tool for clinicians with multiple benefits, including lack of ionizing radiation, portability, and real time results. Yet, implementation into urology practices has been slow, at best. While there is plentiful evidence supporting the merits of POCUS, there are no studies assessing contemporary practice patterns or perceived optimal POCUS utilization. We now aim to assess this amongst North American urologists.

Materials

An IRB-approved survey was developed and disseminated to 6 of 8 AUA sub-section by email. Data including demographics, prior training, current ultrasound utilization, and perceived optimal POCUS utilization was collected. Perceived optimal use was defined as a positive response to questions regarding when “POCUS is the most useful” (Figure 1). Data was collected via the University of Iowa RedCap system (NIH CTSA UL1TR002537). Descriptive statistics and Chi squared analyses were performed (p<0.05).

Results

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There were 199 respondents, of which 51% worked in an academic practice and 68% had >10 years practice experience. Most respondents (77%) used some form of POCUS in practice but only 37% had prior formal training. When considering organ-specific POCUS, significant disparities between perceived optimal use and current use were noted for renal (optimal 88% vs current 58%), testes (74% vs 37%), and penile (37% vs 19%) studies (Table 1). These changes did not appear to be driven by those who are not current POCUS users. Similar differences were also seen in both diagnostic (81 vs 52%, p<0.01) and therapeutic (24 vs 9%, p<0.01) based utilization. Finally, the emergency room was the only setting in which perceived optimal use differed from current use (39% vs 16%, p<0.01).

Conclusion

POCUS appears to be underutilized in various aspects of urologic practice. Exploring means for increased POCUS training, particularly in diagnostic ultrasound focused on the kidneys, testes and penis, is warranted.

Funding

University of Iowa Health Care 2021 Graduate Medical Education Innovation Grant

Co-Authors

Charles Schlaepfer, MD
University of Iowa Health Care

Chad Tracy, MD
University of Iowa Health Care

Vignesh Packiam, MD
University of Iowa Health Care

Elizabeth Takacs, MD
University of Iowa Health Care

Ryan Steinberg, MD
University of Iowa Health Care