Design, implementation and assessment of a novel, introductory curriculum into female, neurological and urodynamic urology: a 7-year experience of urology simulation bootcamp course.

PURPOSE: To present the seven-year experience of a multi-component and interactive module on female, neurological and urodynamic urology (FNUU) training at the UK National Urology Simulation Bootcamp Course (USBC) and demonstrate trainee satisfaction and competency progression. METHODS: During the week-long USBC, a four-hour module on FNUU was designed which consisted of short interactive presentations with an emphasis on practical stations in urodynamics, intravesical botulinum toxin injection, urethral bulking injection, female pelvic examination and, initially, mid-urethral tapes (subsequently replaced with percutaneous sacral nerve evaluation). The trainee's level of knowledge, operative experience and confidence were assessed pre- and post-course. The practical assessment consisted of preparation and intravesical administration of botulinum toxin, female pelvic examination, urodynamic trace interpretation or mid-urethral tape simulation. Trainee feedback was also collected. RESULTS: Two-hundred sixty-one newly appointed urology trainees participated in the USBC during this period. A high level of satisfaction was constantly reported. The highest rated session was urethral bulking with 72% being very satisfied, followed by Botox and urodynamics. The final assessment showed 70% had achieved level 4 competency in cystoscopy and Botox. Qualitative feedback was also obtained. CONCLUSION: To our knowledge, this is the first module of its kind, and it shows that it is feasible to develop, implement and evaluate an introductory curriculum into FNUU that is reproducible over a 7-year period with very positive feedback.

Urology study day: Leeds 2016.

Last year, urology nurses and continence nurse specialists took part in the second of two study days on urology. The events were delivered by the British Journal of Nursing with programme support in association with the British Association of Urology Nurses and Hollister Inc. Below are reports of some of the presentations.

Minimum standards for continence care in the UK.

AIM: This paper reports on the publication of a joint statement on minimum standards for continence care in the UK. METHODS: A multidisciplinary working party were tasked with creating standards for both training and education in continence care, as well as explicit standards for a framework of service delivery. This was done through a process of extensive consultation with relevant professional bodies. RESULTS: The standards suggest a modular structure to continence training, including basic, male, female, catheter care etc. Discussions on service provision cover primary care through to expert tertiary centres. CONCLUSIONS: This is the first attempt to standardise continence care and training for all health care professionals nationally. The document is available on the United Kingdom Continence Society website www.ukcs.uk.net.

Interventions for women in subsequent pregnancies following obstetric anal sphincter injury to reduce the risk of recurrent injury and associated harms.

BACKGROUND: Perineal damage occurs frequently during childbirth, with severe damage involving injury to the anal sphincter reported in up to 18% of vaginal births. Women who have sustained anal sphincter damage are more likely to suffer perineal pain, dyspareunia (painful sexual intercourse), defaecatory dysfunction, and urinary and faecal incontinence compared to those without damage. Interventions in a subsequent pregnancy may be beneficial in reducing the risk of further severe trauma and may reduce the risk of associated morbidities. OBJECTIVES: To examine the effects of Interventions for women in subsequent pregnancies following obstetric anal sphincter injury for improving health. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2014). SELECTION CRITERIA: Randomised controlled trials, cluster-randomised trials and multi-arm trials assessing the effects of any intervention in subsequent pregnancies following obstetric anal sphincter injury to improve health. Quasi-randomised controlled trials and cross-over trials were not eligible for inclusion. DATA COLLECTION AND ANALYSIS: No trials were included. In future updates of this review, at least two review authors will extract data and assess the risk of bias of included studies. MAIN RESULTS: No eligible completed trials were identified. One ongoing trial was identified. AUTHORS' CONCLUSIONS: No relevant trials were included. The effectiveness of interventions for women in subsequent pregnancies following obstetric anal sphincter injury for improving health is therefore unknown. Randomised trials to assess the relative effects of interventions are required before clear practice recommendations can be made.

Minimum standards for urodynamic practice in the UK.

AIM: This paper reports on the recent publication and wide distribution of a joint statement on minimum standards for urodynamic practice in the UK. METHODS: A multidisciplinary working party were tasked with creating standards for both training and certification in urodynamics, as well as explicit standards for a framework of service delivery. This was done through a process of extensive consultation with relevant professional bodies. RESULTS: The standards suggest a modular structure to urodynamics training, and make recommendations on minimum workload for individuals and departments, the need for multidisciplinary team working and for regular audit. CONCLUSIONS: This is the first attempt to standardise urodynamics practice nationally. The document is available on the United Kingdom Continence Society websitewww.ukcs.uk.net.

Assessing UK specialists' knowledge of the diagnostic criteria for painful bladder syndrome/interstitial cystitis.

The aim of this study was to assess UK clinicians' knowledge of the National Institute of Diabetes, Digestive and Kidney diseases (NIDDK) criteria for painful bladder syndrome (PBS)/interstitial cystitis (IC). A questionnaire survey was distributed nationally to 100 gynaecologists and urologists. The main outcome measure was to determine whether respondents knew the NIDDK diagnostic criteria for PBS/IC. All respondents cared for women with lower urinary tract dysfunction in their daily practice; 40% had a special interest in urogynaecology. Most (83%) knew that urgency, frequency and pain are required to diagnose PBS/IC; however, few were aware of exclusion/inclusion criteria. The minority perform double fill at cystoscopy, and only 56% were aware that glomerulations and/or Hunner's ulcers are required to diagnose IC. Urologists with a special interest in female urology answered nearly 75% of the questionnaire correctly in contrast to less than 40% of general gynaecologists. The findings suggest misdiagnosis of PBS/IC may be widespread in the UK. The NIDDK criteria are complex and appear to be of little relevance in clinical practice highlighting the need for more clearly defined diagnostic criteria.