title: Applying translabial ultrasound to detect synthetic slings-You can do it too! A comparison of urology trainees to an attending radiologist.
abstract: OBJECTIVE
  Translabial ultrasound (TUS) is a useful tool for identifying and assessing synthetic slings. This study evaluates the ability of urology trainees to learn basic pelvic anatomy and sling assessment on TUS.
  
  
  METHODS
  Eight urology trainees (six residents and two medical students) received a lecture reviewing basic anatomy and sling assessment on TUS followed by review of two training cases. Next, they underwent a 126-question examination assessing their ability to identify anatomic planes and structures in those planes, identify the presence of slings, and assess the location and intactness of a sling. The correct response rate was compared to that of an attending radiologist experienced in reading TUS. Non-parametric tests (Fisher's exact, chi-squared tests, and Yates correction) were used for statistical analysis, with P < 0.05 considered significant.
  
  
  RESULTS
  847/1008 (84.0%) of questions were answered correctly by eight trainees compared to 119/126 (94.4%) by the radiologist (P = 0.001). The trainees' correct response rates and Fisher's exact test P values associated with the difference in correct answers between radiologist and trainee were as follows: identification of anatomic plane (94.4%; P = 0.599), identification of structure in sagittal view (80.6%; P = 0.201), identification of structure in transverse view (88.2%; P = 0.696), presence of synthetic sling (95.8%; P = 1.000), location of sling along the urethra in (71.5%; P = 0.403), intactness of sling (82.6%; P = 0.311), and laterality of sling disruption (75.0%; P = 0.076).
  
  
  CONCLUSIONS
  Urology trainees can quickly learn to identify anatomic landmarks and assess slings on TUS with reasonable proficiency compared to an experienced attending radiologist.
authors.affiliation: Department of Urology, Loma Linda University Health, Loma Linda, California.
authors.forename: Jim K
authors.initials: JK
authors.lastname: Shen
authors.affiliation: Department of Urology, Loma Linda University Health, Loma Linda, California.
authors.forename: Daniel
authors.initials: D
authors.lastname: Faaborg
authors.affiliation: Department of Radiology, Loma Linda University Health, Loma Linda, California.
authors.forename: Glenn
authors.initials: G
authors.lastname: Rouse
authors.affiliation: Department of Urology, Loma Linda University Health, Loma Linda, California.
authors.forename: Isaac
authors.initials: I
authors.lastname: Kelly
authors.affiliation: Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Roger
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Urology, Loma Linda University Health, Loma Linda, California.
authors.forename: Muhannad
authors.initials: M
authors.lastname: Alsyouf
authors.affiliation: Department of Urology, Loma Linda University Health, Loma Linda, California.
authors.forename: Kristene
authors.initials: K
authors.lastname: Myklak
authors.affiliation: Department of Counseling and Family Sciences, Behavioral Medicine Center, Loma Linda University Health, Loma Linda, California.
authors.forename: Brian
authors.initials: B
authors.lastname: Distelberg
authors.affiliation: Department of Urology, Loma Linda University Health, Loma Linda, California.
authors.forename: Andrea
authors.initials: A
authors.lastname: Staack
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D000072177:Radiologists; D053825:Suburethral Slings; D014463:Ultrasonography / Q000379:methods*; D014521:Urethra / Q000000981:diagnostic imaging*; D014572:Urology / Q000193:education*
keywords: pelvic organ prolapse; suburethral sling; surgical mesh; ultrasound; urinary incontinence