Preserving essential skills: The future of vaginal hysterectomy training in urogynaecology
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Date
2025
Authors
Rotem, Reut
Carey, Michael O.
McCarthy, Claire M.
O'Reilly, Barry A.
Daykan, Yair
O'Sullivan, Orfhlaith E.
Journal Title
Journal ISSN
Volume Title
Publisher
John Wiley and Sons Inc
Published Version
Abstract
Objectives: This study aimed to evaluate the training and self-assessed proficiency of surgeons in the surgical management of pelvic organ prolapse (POP). We focused on the factors that influence decision-making, the surgical techniques employed, the training received, and the management of complications. Design: A cross-sectional survey. Setting: An electronic questionnaire. Population: European Urogynaecological Association (EUGA) and International Urogynecological Association (IUGA) members. Methods: A total of 33 questions evaluating surgeon preference regarding vaginal surgeries. Main Outcome Measures: Demographics, surgical selection, proficiency and technique, and training methods. Results: There were 471 respondents, of which 273 (58%) dedicated more than 50% of their week to urogynaecology. 250 (53%) had completed a fellowship, with 215 (86%) of those fellowships being in urogynaecology and pelvic floor reconstruction. A preference for hysterectomy in cases of uterine descent was noted by 297 (63%) respondents, influenced mainly by patient preference, age, and prolapse anatomical score. A total of 443 (94%) were proficient in vaginal hysterectomy, with two-thirds performing 30 or fewer procedures annually; 212 (45%) reporting a decrease in the number of procedures over the last decade. Additionally, 373 (79%) respondents believed that 10–30 cases were needed to achieve and maintain proficiency. Conclusion: Vaginal hysterectomy remains a key component in uterine prolapse repair. However, with the rise of uterine-sparing prolapse repairs, the decision-making process may be influenced by multiple factors, including surgical training. Emphasis should be placed on training and maintaining proficiency in both traditional and novel techniques. © 2024 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
Description
Keywords
Subspecialisation , Surgical training , Surgical volume , Training requirements , aginal hysterectomy
Citation
Rotem, R., Carey, M. O., McCarthy, C. M., O'Reilly, B. A., Daykan, Y. and O'Sullivan, O. E. (2025) 'Preserving essential skills: The future of vaginal hysterectomy training in urogynaecology', BJOG: An International Journal of Obstetrics & Gynaecology, 132(2), pp.205-211. https://doi.org/10.1111/1471-0528.17974