Urethrography interpretation skills of urology and radiology residents at tertiary care medical centers.
OBJECTIVE
To assess the ability of urology and radiology residents to interpret retrograde urethrograms (RUGs) and voiding cystourethrograms (VCUGs).


METHODS
A standardized examination of 10 combination RUGs and VCUGs of the male urethra was administered to urology and radiology residents from all levels of training at Washington University, Stanford University, and Northwestern University. Residents were asked to evaluate stricture location(s) and length, if present.


RESULTS
Sixty residents participated, consisting of 26 from Washington University, 15 from Stanford University, and 19 from Northwestern University. Average years of training for urology and radiology were 3.6 and 2.8 years, respectively (P=.01). Normal RUGs and VCUGs were recognized by 18 of 31 radiologists (58%) and 19 of 29 urologists (65.5%; P=.5). Anterior strictures were correctly identified in 145 of 403 (36%) and 165 of 377 (43.8%) responses by radiologists and urologists, respectively (P=.03). Posterior strictures were correctly identified in 20 of 62 (32.3%) and 10 of 58 (17.2%) responses by radiologists and urologists, respectively (P=.09). When both groups of residents were combined, anterior strictures were identified correctly more often than posterior strictures (39.7% vs 25%; P<.01). Overall accuracy was 24.2% (75 of 310) for the radiology group and 27.9% (81 of 290) for the urology group (P=.30). In the presence of multiple strictures, accuracy declined to 7.26% (9 of 124) for the radiology group and 9.48% (11 of 116) for the urology group (P=.5), with a combined accuracy of 8.33% (20 of 240).


CONCLUSIONS
Radiology and urology residents in the United States have poor skills at interpreting urethrography, especially when multiple strictures or posterior strictures are present. A formal educational program for RUG and VCUG interpretation should be designed and implemented into the radiology and urology resident curriculum.
Division of Urologic Surgery, School of Medicine, Washington University in St Louis, St Louis, MO. Electronic address: eswaraj@wustl.edu.
Jairam R
JR
Eswara
Division of Urologic Surgery, School of Medicine, Washington University in St Louis, St Louis, MO.
Joseph B
JB
Song
Division of Urologic Surgery, School of Medicine, Washington University in St Louis, St Louis, MO.
Andrew J
AJ
Chang
Department of Urology, Stanford University School of Medicine, Stanford, CA.
Daniel I
DI
Rosenstein
Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Christopher M
CM
Gonzalez
Division of Urologic Surgery, School of Medicine, Washington University in St Louis, St Louis, MO.
Joel M
JM
Vetter
Division of Urologic Surgery, School of Medicine, Washington University in St Louis, St Louis, MO.
Steven B
SB
Brandes
D000046:Academic Medical Centers; D000328:Adult; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D011871:Radiology / Q000193:education*; D062606:Tertiary Care Centers; D014521:Urethra / Q000000981:diagnostic imaging*; D014567:Urography; D014572:Urology / Q000193:education*