[Predictable access to the fellowship of urology in France till 2016: an update of the AFUF]. / Accessibilité prévisible au post-internat d'urologie en France jusqu'en 2016: une mise à jour de l'AFUF.

PURPOSE: To evaluate the predictable accessibility to the fellowship of urology for residents expecting to accomplish their residentship from November 2013 to November 2016. MATERIAL: Between September and November 2013, the representants of the residents ongoing for the residentship of urology in each region of France were reached to participate to the study. A questionnaire was given in aim at reporting all the local residents expecting to accomplish their residentship between November 2013 and 2016, and the number and the expected availability of fellow and specialist assistant posts in the region during the same period. RESULTS: In November 2013, our study listed 334 junior urologists (197 residents, 81 fellows, 56 assistants). Fifty-five residents were ending their internship by November 2013, whereas 67, 50, 77 residents were expecting to accomplish their residentship from November 2014 to 2016 respectively. The predictable accessibility to the fellowship of urology was 96.4%, 82.1%, 90.0%, 74.0% respectively for the residents accomplishing their residentship from November 2013 to November 2016. The predictable deficit of fellow and assistant posts were -2, -12, -5, -20 posts from November 2013 to November 2016 respectively. CONCLUSION: The predictable number of fellow and assistant post in Urology remains insufficiently available for the 2013-2016 period. By reason of the unstable number of residents accomplishing their residentship from 2014 to 2016, the fellowship accessibility was measured at 82.1%, 90.0%, 74.0% from 2014 to 2016 respectively.

[Research fellowship in the curriculum of French urologists-in-training: a study by the French Association of Urologists-in-training (AFUF)]. / Place du Master 2 recherche dans la formation des jeunes urologues français : une étude de l'AFUF.

OBJECTIVES: To assess motivations, the practical organization and the funding of a research fellowship in the training curriculum of French urologists-in-training. MATERIALS AND METHODS: An online questionnaire was sent to members of the AFUF and to participants of a research training seminar "Graines et Sol" organised by the AFU, between July and September 2013. Results are presented as the median (interquartile range). RESULTS: Sixty answers out of 115 research fellows (response rate 52%) were computed. Median age was 29 years (28-30) during the research year and male proportion 75%. The AFU grant was obtained by 57.4% of applicants, 56.4% for various grants and 47.6% for the research fellowship university grant. The annual gross amount was 29,870€ (22,710-30,195), without any significant difference between residency subdivisions. Financial supplements were obtained by being on-duty (26.2%), on-call (28.6%) and replacements (25%). The research fellowship year was done between 4th and 5th years of residency (53%), for a one-year length (96.7%) and in France (86.6%). Urologic cancerology was the thematic the most studied (60%). The research fellowship was done in view of an academic career (31.7%) or was done to wait for a post-residency position (20.8%). About a quarter was being proposed a chief-residency position before the beginning of the research year. During this year, 76.7% published. About 63% were interested in pursuing with a PhD. CONCLUSION: This study confirmed the interest for a research fellowship by French urologists-in-training. Financial support thanks to grants facilitated the conduct of a research fellowship in the aim of an academic career for most of them.

[The role of simulation in the curriculum of French urologists-in-training: a study by the French Association of Urologists-in-Training (AFUF)]. / Évaluation de l'utilisation de la simulation dans la formation des jeunes urologues français : une enquête de l'association française des urologues en formation (AFUF).

OBJECTIVES: To study the place of simulation in the training curriculum of French urologists-in-training. MATERIALS AND METHODS: An online questionnaire was sent to all residents and fellows members of the AFUF between February and May, 2013. Results are presented as the median (interquartile range). RESULTS: The answers of 125 urologists-in-training were computed (response rate 38%). They were residents in 90 cases (72%), and fellows in 35 cases (28%). Median age was 29 (27-30), male proportion 77%. All French academic urology departments were represented. Ninety of them (72%) had access to a pelvi-trainer and 66 (53%) to animal or cadaveric models, although they never used them or less than once a month in 83 and 97% of cases, respectively. Seventy-two (58%) had used a virtual-reality based simulator at least once and 38 (30%) had regular access to one, but without supervision in 64% of cases. Factors limiting simulation-based training were the lack of available simulators (70%), the lack of time (58%), the absence of incitement (34%) and supervision (20%). If these conditions were met, 86% of urologists-in-training would be ready to spend more than one hour a-week training on a simulator. CONCLUSION: This study revealed among the sample of respondents a limited use of simulation tools for skills aquisition. This was explained by a limited availability of these tools but also by an insufficient use of the tools when available.

[Current state of compensation of on-duty and on-call urologists in France: a study from AFUF]. / État des lieux des rémunérations des gardes et astreintes d'urologie en France: une étude de l'AFUF.

INTRODUCTION: The French Association of Urologists-in-training (AFUF) aimed to assess the current state of remunerations of on-call and on-duty residents, assistants and lecturers in urology in France. MATERIAL AND METHODS: Data were collected from February to May 2013 through a questionnaire sent to all members of the AFUF (327 members). Remunerations were given in gross values. RESULTS: Forty-three residents took part in the study, 16 assistants and 16 lecturers, representing 62 % of the whole centers (54 hospitals out of the 92 centers practicing urology in France). Most of responders were on security or operational on-call. Twenty hospitals were practicing multi-organ removal. Median remunerations of residents were about 59.51€ per on-call when moving at hospital for work and about 119.02€ per onsite duty. Assistants and lecturers were paid a flat fee rate for 37.5 % of them (140€ for assistants [with variability from 40 to 195€] and 130€ for lecturers [42.5-180]) or an hourly rate depending on the hours spent at hospital for the others (62.5 %): first, second move or move<3h were paid 100€ for assistants and 65€ for lecturers, 233.5€ and 236€ respectively for the third one or above 3h, 365€ and 473€ respectively above 8h. Multi-organ removals were paid a flat fee rate (60 %) or an hourly rate (40 %) as well. Beyond a threshold of 2-3hours, the hourly rate was more interesting than the flat fee rate. CONCLUSION: There were disparities in remuneration of on-call and on-duty urologists. Greater variability affected on-call flat fee rate remuneration beyond a certain threshold of hours and remuneration of multi-organ removal. These disparities should be considered in order to get a national harmonization.

[Analysis of postoperative urgenturies after prostate photovaporization by the laser Greenlight ®]. / Étude des urgenturies postopératoires après photovaporisation prostatique par laser Greenlight ®.

UNLABELLED: Urgencies are classically described after prostate photovaporization (PVP). The objective of this study was to analyze the incidence of urgency in patients who underwent PVP using the International Prostate Symptom Score (IPSS) to defined urgencies. METHOD: This is a single-center prospective cohort study assessing patients who underwent surgery between May 2005 and January 2011. The questions 2 and 4 of the IPSS and open questions were selected to evaluate urgency during the follow-up. RESULTS: Two-hundred and four patients were operated during this period and 93 complete records were analyzed. Twenty-one percent of these patients had a clinical urgency after 1 month and 1,9% at 12 months (significant improvement, P<0.001) corresponding to scores greater than 4 for questions 2 and 4 of the IPSS. Answer scores to questions 2 and 4 improved significantly over 12 months (P<0.001). The clinical urgencies decreased significantly as well as answers to questions 2 and 4 of the IPSS. CONCLUSION: Urgencies decreased significantly between 3 and 12 months of postoperative follow. Questions 2 and 4 of the IPSS score appeared to be a standardized definition of these urgencies.

[Perioperative and early postoperative results of photoselective vaporization of the prostate using fiber 4090 (providing 120 watts) versus fiber MOXY (providing 180 watts)]. / Résultats périopératoires et postopératoires précoces de la photovaporisation prostatique au laser Greenlight XPS selon l'utilisation d'une fibre 4090 délivrant 120 watts ou d'une fibre MOXY délivrant 180 watts.

INTRODUCTION: Photoselective vaporisation of the prostate (PVP) is a surgical alternative to transurethral resection of the prostate (TURP). The goal of this study was to compare the new AMS MOXY fiber which provide 180 watts power to the 4090 fiber 120 watts power source currently used in benign prostatic hyperplasia. The assessment criteria were peroperative and early postoperative data. METHOD: This study was a monocentric prospective trial comparing two parallel groups of treatment: prostatic vaporisation with MOXY fiber (180 watts) against 4090 fiber (120 watts) in patients operated by an experienced surgeon. The urinary catheter was removed the day after the intervention and the patient was allowed to quit after a clinical examination. All the patients had a routine consultation at 1 month: clinical examination, max flow rate, biological results and results of autoquestionnaires. RESULTS: This study included 50 patients. The two groups were similar at the inclusion: age, urinary catheter, and prostate volume. The operative data show a decrease of vaporization duration (29 minutes versus 36 minutes, P=0.009) with an energy delivered increased (281 kJoules versus 223 kJoules, P=0.036) and with similar postoperative data: duration of urinary catheterization (3.8 days versus 3.6 days, P=0.908), length of stay (1.6 days versus 1.8 days, P=0.371). The 1-month results were similar between the two groups. CONCLUSION: The new fiber AMS 180 watts ROXY offer similar postoperative data to the 4090 fiber with improved operative duration and energy delivered.