Introduction: Since World Health Organization (WHO) declared COVID-19 as a global pandemic, urology services have developed strategies to prioritize and not to differ urgent and oncological patient's medical attention, in order to optimize resources and decrease infection probability among staff and patients. This unprecedented situation has generated a decrease in assistance and academic activities in most medical residences. The aim of this manuscript is to evaluate the impact of this health crisis on training programs through a survey addressed to urology medical residents. Materials and Methods: Cross sectional designed study, with multiple-choice non validated survey answered online by residents. Questionnaire was developed through the CAU EDUCACION platform. Results: A total of 148 responses from 18 countries coming from Latin America and Spain answering the survey. Of total, 82% answered that the activity of their urology department was significantly reduced, attending only urgent surgical pathologies, 15 % that, the urology activity has been closed completely and the staff was assigned to COVID-19 patients care, 3% continue with the regular clinic activity. Likewise, 75% stated that their surgical training has been completely affected, 93% receive urological information through tools such as Skype, ZOOM meeting, Cisco Webex, being Webinar modality the most used. Despite technological boom, 65% answered their academic training has been partially or completely affected. Most of the surveyed residents consider that period of residence should be extended to retrieve the educational targets. Conclusion: This unprecedented reality is negatively impacting the heterogeneous residency programs that American Confederation of Urology (CAU) nucleates. It is necessary to continue with technological innovation and allocate time and resources to easily generate accessible tools to favor the training of future urologists.

In selected cases, ureteroscopy may be performed without ureteral meatus dilatation with success and morbidity rates similar to when the procedure is performed with meatal dilatation.

Objective: The recently developed technological advances in urology are a challenge, both for the urologists responsible for training activities, as well as for residents. This has led to heterogeneous residency programs; in terms of training and access to these technologies, among the scientific societies of the countries that make up the American Confederation of Urology (CAU, by its Spanish initials). The aim of this study was to collect relevant information and to perform a situational analysis to promote the development of more homogeneous programs for the training of future professionals in urology. Methodology: A closed survey using the CAU EDUCACIÓN platform that included twenty-seven multiple-choice questions between September 2019 and September 2020. Results: The difference between programs was found, above all, in the duration of the residencies, accreditations, the possibility of publication in scientific journals, training modalities, access to technology and subsequent job opportunities. Limitations: The main limitation was the number of participants, which was much lower than the total number of active residents. Despite this, the number of participating countries, the distribution, and the results obtained, allowed us to assess the current training of CAU residents. Conclusion: It is important to gain more insight about residencies in Ibero-America, to establish a specific and uniform plan to ensure proper training, regardless of the unit in which the residency occurs.

Evaluar la factibilidad y seguridad de la ureterorrenoscopia semirrígida diagnóstica o terapéutica sin dilatación del meato ureteral. Material y métodos: Se realizó estudio retrospectivo comparativo de los pacientes sometidos a ureterorrenoscopia en el período comprendido entre enero del 2000 y mayo del 2008. Para el análisis de los datos se dividió a la población en dos grupos según procedimiento, con dilatación (grupo 1) y sin dilatación (grupo 2) del meato ureteral. Se evaluaron la edad, el sexo, el tipo de procedimiento, el diagnóstico operatorio, la dilatación pasiva o activa, el número de litiasis, la localización de la litiasis, el diámetro de los cálculos, las complicaciones intra y postoperatorias, la derivación urinaria interna posprocedimiento, la tasa de éxito terapéutico, el tiempo quirúrgico y la estancia hospitalaria. Se utilizó un ureteroscopio semirrígido Wolf 8-9.8 Fr. Se realizó una estadística descriptiva de la población y de las cohortes con medianas, cuartiles y valores límites para variables de intervalos sin distribución normal y frecuencias absolutas y relativas para variables categóricas. Se utilizaron las pruebas de Shapiro-Wilk, de la U de Mann-Whitney, de la c 2 y exacta de Fisher. Se consideró estadísticamente significativo un valor de p = 2 alfa ≤ 0,05. Se utilizó el programa estadístico Arcus Quickstat Biomedical 1.0. Resultados: De 306 ureteroscopias, se analizaron 286 procedimientos realizados a 256 pacientes. La mediana de edad fue de 50 años (16-83 años), el 59% eran varones; se programaron 183 (64%) procedimientos. Grupo 1: 191 ureteroscopias, grupo 2: 95 procedimientos. La localización de los cálculos fue: 149 en uréter distal, 60 en uréter medio y 35 en uréter proximal. El tamaño de la litiasis en el 69% fue entre 5 y 10 mm. La tasa global de éxitos fue del 86,5%. Hubo 5 complicaciones intraoperatorias y 22 postoperatorias, sin diferencias estadísticamente significativas entre ambos grupos. Conclusiones: En casos seleccionados puede realizarse ureteroscopia prescindiendo de la dilatación del meato ureteral, con tasas de éxitos y morbilidad comparables al mismo procedimiento con dilatación del meato.