Impact of urologic resident training on patient pain and morbidity associated with office-based cystoscopy

Abstract

OBJECTIVES: To determine whether pain and morbidity experienced by patients undergoing cystoscopy were affected by whether a staff urologist or resident was the primary surgeon.

METHODS: Patients scheduled to undergo cystoscopy were assigned to either the staff urologist or a resident as the primary surgeon. After cystoscopy, patients were given a visual analogue scale (VAS, 0 to 100 mm) to assess pain. A two-part model was fit to investigate the effect that staff or resident had on pain scores. Confounding factors, such as age, gender, viewing of the procedure on video, and resident training year, were accounted for with multivariable regression techniques.

RESULTS: There was no statistically significant difference between the VAS scores for patients undergoing cystoscopy regardless of whether staff or resident performed the procedure. Further comparisons indicated no statistically significant differences in the effect that resident training year had on pain scores.

CONCLUSIONS: Office-based cystoscopy can be performed by residents under staff supervision, with pain and morbidity comparable to when a staff urologist performs the procedure. The impact of urologic resident training on patient care is an area that is relatively unexplored in the literature.