Objective To evaluate the urethroplasty learning curve. Published success rates of urethral reconstruction for urethral stricture disease are high even though these procedures can be technically demanding. It is likely that success rates improve with time although a learning curve for urethral reconstruction has never been established. Materials/Methods We retrospectively reviewed anterior urethroplasties from a prospectively maintained multi-institutional database. Success was analyzed at the 18-month mark in all patients and defined as freedom from secondary operation for stricture recurrence. A multivariate logistic regression was performed for outcomes versus time since fellowship and case number. Results A total of 613 consecutive cases from six surgeons were analyzed, with a functional success rate of 87.3%. The success for bulbar urethroplasties was higher than for penile urethroplasties (88.2% vs 78.3%, p = 0.0116). The success of anastomotic repairs was higher than for substitution repairs (95.0% vs 82.4%, p = 0.0001). There was a statistically significant trend towards improved outcomes with increasing number of cases (p = 0.0422), which was most pronounced with bulbar repairs. There was no statistical improvement in penile repairs over time. The case number to reach proficiency (> 90% success), was approximately 100 cases for all types of reconstruction were considered and 70 cases for bulbar urethroplasties. There were statistical differences in success rates among the participating surgeons (p = 0.0014). Complications decreased with time (p = 0.0053). Conclusions This study shows success rates of anterior urethral reconstruction improve significantly with surgeon experience. Proficiency occurs after approximately 100 cases.

Background COVID-19 has disrupted the 2020–2021 residency application cycle with the cancellation of away rotations and in-person interviews. This study seeks to investigate the feasibility and utility of video conferencing technology (VCT) as an opportunity for applicants to interact with faculty from outside programs. Methods 18 prospective urology applicants were randomized to 6 urology programs to give a virtual grand rounds (VGR) talk. Presentations were recorded and analyzed to determine audience engagement. Students were surveyed regarding perceived utility of VGR. Faculty were surveyed to determine system usability of VCT and ability to evaluate the applicant. Results 17 students completed the survey, reporting a 100% satisfaction rate with VGR. A majority felt this was a useful way to learn about outside programs. 85 physicians completed the faculty survey, with nearly half feeling confident in their ability to evaluate the applicant. Video transcription data shows sessions were interactive with minimal distractions. Conclusions VGR can be a useful means for medical students to express interest in programs as well as an additional marker for faculty to evaluate applicants.

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Postoperative oral antibiotics are prescribed to nearly two-thirds of patients but are not associated with reduced odds of explant following IPP or AUS placement. Given the risks to individuals associated with use of antibiotics and increasing bacterial resistance, the role of oral antibiotics after prosthetic placement should be reconsidered and further studied in a prospective fashion.

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