Presented by: M. Reza Roshandel MD
Mayo Clinic, Department of Urology

Introduction

Exposure to diverse stone procedures is a cornerstone of endourology fellowships. The Endourological Society offers two potential tracks and two fellowship durations for fellows interested in stone disease, but differences in case volumes are not well understood. We aimed to characterize potential differences in stone procedural experience among endourology fellows.

Materials

The Endourological Society case logs for fellows graduating between 2020 and 2022 were queried for percutaneous (PCNL) and ureteroscopic (URS) stone procedures. Fellows who completed either a stone-focused track or a combined stone/robotics track in both 2-year and 1-year programs were included. Case volumes for 2-year fellowships were halved to facilitate comparisons of volumes per year of training.

Results

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A total of 107 endourology fellows from 54 programs worldwide were analyzed. The number of stone procedures performed by fellows varied widely based on program duration and track (Figure). For stone track fellows, median overall stone case volume was 206 cases (63 PCNL and 134 URS). 2-year stone track fellows performed significantly higher number of PCNL (86 vs 36, P<0.01) and had a significantly larger proportion of PCNL among total fellowship cases (39% vs 29%, P<0.01). URS volumes were similar regardless of fellowship duration (124 vs 153, P>0.05). For combined stone/robotics track fellows, median overall stone case volume was 109 cases (39 PCNL and 64 URS). There were no significant differences between 2-year vs 1-year combined track fellows for overall stone case volume (137 vs 90), PCNL cases (40 vs 37), URS cases (94 vs 59), or the proportion of PCNL among total fellowship cases (70% vs 68%) (all P>0.05).

Conclusion

Endourological Society fellows perform similar proportions of PCNL cases among the total volume of stone procedures, which is highest among

2-year stone track fellows. Training exposure to PCNL appears to be similar regardless of fellowship track or duration, which may help to strengthen the

endourological workforce.

Funding

Endourological Society fellows perform similar proportions of PCNL cases among the total volume of stone procedures, which is highest among

2-year stone track fellows. Training exposure to PCNL appears to be similar regardless of fellowship track or duration, which may help to strengthen the

endourological workforce.

Lead Authors

Garrett N. Ungerer, MD
Mayo Clinic, Department of Urology

Jamal M. Alamiri, MB, BCh
Mayo Clinic, Department of Urology

Aaron M. Potretzke, MD
Mayo Clinic, Department of Urology

Kevin Koo, MD, MPH
Mayo Clinic, Department of Urology