The Learning Curve for Functional Urology: A Systematic Review

Abstract

With the emergence of new surgical methods, there is a period when the surgeon's inexperience makes the operation more complicated or longer, regardless of preclinical training. This course is also known as the 'method development learning curve', which should be distinguished from the learning curve of a surgeon learning a fixed method. Urology education is changing, and classic surgical internship models are becoming increasingly obsolete. These educational methods do not have a specific structure and rely on different operational flows experienced by individuals and institutions. There is no evidence-based definition of the term 'learning curve' or how to measure it, but it can be thought of as performance improvement over time. Based on this, we decided to systematically review the published articles on functional urology learning curves. Materials and methods: In this study, with the help of an experienced librarian, a basic search strategy was designed and used in the PubMed database on July 3, 2023, and this search strategy was modified in other databases according to the characteristics of each. Keywords used include: Search (((((Learning Curve) OR Learning Curve[Title/Abstract])) OR "Learning Curve"[Mesh])) AND (((((((surger* ) OR surge*[Title/Abstract])))) AND ((((urinary incontinence) OR urinary incontinence[Title/Abstract])) OR "Urinary Incontinence"[Mesh]))) OR "Urinary Incontinence/surgery"[ Mesh]))) OR "POPs" OR ("pelvic organ prolapse"[MeSH Terms] OR ("pelvic"[All Fields] AND "organ"[All Fields] AND "prolapse"[All Fields]) OR "pelvic organ prolapse"[All Fields]) After extracting from the databases, the abstract and full text of the articles were studied respectively, and the studies that did not met our eligibility criteria were discarded. After the final selection of the studies, the required information was extracted and summarized according to the table designed in the Excel software. Results: A total of 7104 studies were identified by searching electronic databases, manual searches, and reviewing sources. After removing the duplicate cases, and by reading the title and summary of the article, a total of 115 studies were included in the present systematic review. The first study was in 2002 and the last one was in 2023. The methods used in functional urology included laparoendoscopic single-site surgery, TOT, TVT, Sacrospinuse ligament fixation, urethral (bulky agent) injection therapy, and urodynamics.