Redefining urology residency applicant preferences in the new era of the match

Introduction

Introduction: Augmented ureteroplasty with buccal mucosal graft for ureteral strictures has become an increasingly common reconstructive approach. This study describes our outcomes at a single institution of using a non-transecting buccal mucosa graft ureteroplasty for the management of both primary and recurrent ureteral strictures causing obstruction.

The primary outcome was need for reintervention for recurrent obstruction.

Secondary data included time to re-intervention, presence of hydronephrosis on postoperative imaging, complications, and pre-and postoperative creatinine.

Research Question

The primary aim was to assess applicant perspectives regarding residency interview format and how this affected their assessment of “fit” with programs.

Methodology

Results: Overall, nine patients were included in our analysis; 33% of patients had a previous reconstruction. After using the model, participants completed a survey that included five-point Likert scales to measure the realism of the simulated vasectomy.

Study Design

Participants also provided feedback on the effectiveness of the model as a teaching tool.

Overall, participants agreed that the experience improved their skills in manipulating the robot (median 5; IQR 1) and that they would benefit from robotic surgery education in their preclinical years (median 5; IQR 1).

Results & Findings

Methods: We performed a retrospective review of a single institution in patients who underwent buccal mucosa graft ureteroplasty between January 2020 and June 2024 for management of ureteral strictures. None of the patients had a stent at the time of surgery; 22% had a nephrostomy tube present.

• Methods: We performed a retrospective review of a single institution in patients who underwent buccal mucosa graft ureteroplasty between January 2020 and June 2024 for management.
• None of the patients had a stent at the time of surgery; 22% had a nephrostomy tube present.
• There was no significant difference in pre-vs postoperative creatine.
• We developed a hydrogel-based vasectomy simulation model and evaluated the model’s realism and educational effectiveness with urology residents’ feedback.
• Methods: The hydrogel model consists of a scrotum, dartos muscle, cremaster muscles, testes, vas deferens, and the pampiniform plexus, created using injection molding of polyvinyl alcohol.

Practical Applications

Given the uncertainty surrounding these decisions going forward, qualitative data summarizing applicant preferences and perspectives may be particularly valuable as programs decide the future direction of the AUA match.

Figures Explained

The paper’s visual material highlights the workflow and the main system components.

• Figure 1: Benedikt M. Winzer 1 , Trevor C. Hunt 2 , George K. Siodis1, Jean-Pierre (Trey) Kanumuambidi 3 , Scott O. Quarrier 2 , Hani H. Rashid 2 1 School of Medicine and Dentistry, University of Rochester, Rochester, NY; 2 Department of Urology, University of Rochester Medical Center, Rochester, NY; 3 The Brody School of Medicine at East Carolina University, Greenville, NC Introduction:.
• Figure 2: Session 3: Education, Laparoscopy, Robotics, and Surgical Innovation Abstract #37 Utilizing hands-on workshops to promote interest in urology and robotic surgery among first-year medical students Alyssa Konopaski 1 , Murali Kovvur 1 , Samuel Ding 1 , Christopher Shannon 1 , Nahom Zewde 1 , Tatum Tarin 1,2 1 University of Pittsburgh School of Medicine, Pittsburgh, PA; 2 Department of Urology, UPMC, Pittsburgh, PA Introduction: The field of urology has experienced significant advancements with the integration of robotic-assisted surgery, offering improved precision, reduced recovery times, and enhanced surgical outcomes. Despite these innovations, medical student interest in urology remains limited, often due to misconceptions about the field and a lack of early exposure. This survey study explores how incorporating robotic surgical technology into medical education can enhance engagement, provide hands-on learning opportunities, and ultimately increase student interest in pursuing urology as a career. Methods: The University of Pittsburgh School of Medicine Urology Interest Group hosted two robotic surgery workshops for preclinical students to promote familiarity with the da Vinci ® console through games and simulations. Attendance was open to all first-year students, with sessions offered in October 2024 and January 2025, the latter of which incorporated using the da Vinci ® in an operating room. All attendees completed at least one simulation with guidance from a urologic oncologist. After obtaining IRB approval, a voluntary survey using Likert scale and open-ended questions was administered via email in March 2025. Responses were analyzed by descriptive statistics performed on R version 4.4.0 and thematic analysis.
• Age: Kristin Bremer 2 , Yuzhi Wang 1 , Brian Inouye 1 , Tejinder Singh 2 1 Department of Urology, Albany Medical Center; 2 Department of Surgery, Albany Medical Center Introduction: Parastomal hernia (PSH) is a common complication following ileal conduit urinary diversion. Repair of PSH is traditionally performed using the intraperitoneal space and is associated with high recurrence rates. This study reports on the technique and outcomes of a modified retrorectus keyhole technique for repair of ileal conduit PSHs at our institution. Methods: This study is a retrospective case series of patients with PSH following ileal conduit creation. Patients underwent robotic repair using a retrorectus extended totally extraperitoneal (eTEP) approach. The procedure begins by entering the retrorectus contralateral to the ostomy, crossing midline in the upper abdomen, and bringing down the posterior components from xiphoid to pubis while reducing any ventral hernias. The parastomal hernia is then encircled with a partial transversus abdominis release for adequate mesh coverage. Following parastomal reduction, the anterior and posterior rectus sheaths are then closed around the conduit, as well as any midline hernias. Polypropylene mesh is positioned in keyhole fashion around the bowel, with an additional mesh placed to cover the entire dissected retrorectus space. We collected demographic profiles, perioperative, and postoperative outcomes among patients at our institution who underwent ileal conduit eTEP PSH repair. Results: Six patients were eligible, with a median age of 63 years (range 49-80) and median body mass index of 32.63 kg/m2 (range 30.85-34.14). All patients underwent eTEP repair of their PSH without intraoperative complications. Median operating time and length of stay (LOS) were 195.5 min (range 149-224) and 1.5 days (range 1-11), respectively. Postoperatively, the median change in creatinine and glomerular filtration rate was 0.08 mg/dL (range 0-1.27) and 79.5 mL/min (range 17.7-90).
• Figure 4: Education, Laparoscopy, Robotics, and Surgical Innovation ment in their ability to use assistants (2.00 vs. 2.75, p=0.040). VN model users felt more confident in their ability to place a VN following the training (p=0.003).Conclusions:The novel VN insertion model increased medical student confidence and proficiency in VN placement. This additional exposure can help students become more familiar with surgical techniques prior to their clinical years and residency. Future studies with larger sample sizes can help determine whether this model is robust enough to be implemented in medical education.
• Figure 5.

Conclusion

Conclusions: Nine urology residents rated the hydrogel-based vasectomy simulation model as overall realistic and acceptable. Therefore, hands-on workshops can improve the quality and diversity of future applicants to urology and other surgical subspecialties.

Overall, 51% were burned out; 45% had maladaptive perfectionism.