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Obstetrics & Gynecology 2000;96:1014-1017
© 2000 by The American College of Obstetricians and Gynecologists
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GRADUATE EDUCATION

CREDENTIALING RESIDENTS FOR INTRAOPERATIVE CYSTOSCOPY

Milo L. Hibbert, MD, Eric R. Salminen, MD, Louis A. Dainty, MD, Gary D. Davis, MD and Romeo P. Perez, MD

From the Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington; and the Department of Obstetrics and Gynecology, Tripler Army Medical Center, Honolulu, Hawaii.

Address reprint requests to: Milo L. Hibbert, MD, Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, WA 98431, E-mail: Milo.Hibbert{at}nw.amedd.army.mil

Objective: To determine whether incorporation of routine intraoperative cystoscopy for evaluation of potential urinary tract injury into gynecologic residency training provides sufficient experience to justify hospital credentials after graduation.

Methods: We developed a curriculum to train residents in intraoperative cystoscopic evaluation of potential lower urinary tract injury. Cystoscopy was performed when indicated with hysterectomy and routinely in conjunction with pelvic reconstruction. Faculty members evaluated conceptual and technical proficiency by oral examination and direct observation in the operating room. Once the resident demonstrated a thorough understanding and proficiency in performing intraoperative cystoscopy, a competency certification document was issued by the Program Director. This certification was transmitted to the postresidency hospital credentials committee to justify granting privileges.

Results: Since 1994 over 400 transurethral cystoscopic evaluations have been done in conjunction with major gynecologic abdominal and vaginal surgeries, and since 1997 an additional 50 transvesical microcystoscopies have been done in selected abdominal cases. Twenty-five residency graduates have been certified as fully trained in intraoperative diagnostic cystoscopy. All these graduates have been granted intraoperative cystoscopy privileges at their subsequent hospital practice.

Conclusion: Incorporation of cystoscopic urinary tract evaluation into routine gynecologic surgical training is good medical practice and provided a mechanism whereby obstetrics and gynecology residents could obtain intraoperative cystoscopy hospital privileges after graduation.




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 Obstet GynecolHome page
D. T. Gilmour, S. Das, and G. Flowerdew
Rates of urinary tract injury from gynecologic surgery and the role of intraoperative cystoscopy.
Obstet. Gynecol., June 1, 2006; 107(6): 1366 - 1372.
[Abstract] [Full Text] [PDF]


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