RÉSUMÉ
OBJECTIVE: To describe experiences and outcomes of the Society of Genitourinary Reconstructive Surgeons (GURS) fellowship match. In 2012, GURS developed a centralized fellowship match which has grown from 13 to 30 programs. METHODS: GURS match statistics and case logs were reviewed from 2013-2024. Additionally, a 37-question survey evaluating satisfaction, procedural competency, fellowship experience, and employment opportunities were sent to graduates. Linear regression was performed to examine trends over time. RESULTS: Over the study period, program match success remained stable (94.7%; P = .50) while applicant success (63.3%) increased over time (P = .04). North American and female applicants experienced higher match success (72.8% and 73.6%) compared to their international (35.5%; P <.0001) and male counterparts (60.0%; P = .02). On case log analysis, mean surgical volumes per year increased in urethral reconstruction (mean=88.1; P = .02), male sexual health (n = 32.7; P = .03), genital reconstruction (mean=16.4; P <.01) and abdominal reconstruction (mean=24.5; P = .03). Male incontinence surgeries remained stable (mean=30.5; P = .21) while female reconstruction declined (mean=23.2; P = .01). With a survey response rate of 54.5% (97/178), training satisfaction was 95.9% which did not differ by gender (P = .54) or year of training (P = .22). Around 97.9% felt competent to enter unsupervised reconstructive practice, 94.8% reported an understanding of the relevant literature and 96.9% were satisfied with their job as a reconstructive urologist. Around 49.5% identified a different case mix in practice compared to fellowship, most commonly related to abdominal (44.9%) or genital reconstruction (16.3%). CONCLUSION: GURS fellowships have grown organically over the last decade and mirror the growth and evolution of the discipline with sustained high levels of graduate satisfaction, surgical experience, competence, scholarly inquiry and employment.
RÉSUMÉ
OBJECTIVE: To provide a comprehensive overview of genital anomalies encountered among adolescents, including late effects of problems addressed earlier in childhood. MATERIALS AND METHODS: The major congenital genital anomalies encountered in pediatric urology were identified. They include hypospadias, exstrophy-epispadias, cloacal malformations, disorders of sexual development, undescended testes, and some acquired penile anomalies seen in adolescence (priapism, adolescent varicocele). Recommendations of the International Consultation on Urological Diseases are provided on various aspects of these conditions, such as postpubertal cosmesis and function, fertility implications, and long-term nephrological considerations (when relevant). RESULTS: Specific recommendations for care, including strength of clinical recommendation, are provided in this paper. Whereas the basis of this paper is to discuss specific management recommendations as they relate to several heterogeneous conditions, general recommendations include patient-centered discussions regarding operative treatment be deferred until the patient is able to articulate goals and participate in shared decision-making and utilization of multidisciplinary teams for conditions where multiple organ systems may be involved. CONCLUSION: Congenital abnormalities of the genitalia are common and widely heterogeneous. Late effects and concerns often emerge after puberty, and patients should be followed throughout their adult lives to address such concerns.