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A Global Survey of Ergonomics Practice Patterns and Rates of Musculoskeletal Pain Among Urologists Performing Retrograde Intrarenal Surgery.
J Endourol. 2022 09; 36(9):1168-1176.JE

Abstract

Purpose: Retrograde intrarenal surgery (RIRS) requires urologists to adopt an awkward body posture for long durations. Few urologists receive training in ergonomics despite the availability of ergonomic best practices utilized by other surgical specialties. We characterize ergonomic practice patterns and rates of musculoskeletal (MSK) pain among urologists performing RIRS. Methods: A web-based survey was distributed through the Endourological Society, the European Association of Urology, and social media. Surgeon anthropometrics and ergonomic factors were compared with ergonomic best practices. Pain was assessed with the Nordic Musculoskeletal Questionnaire (NMQ). Results: Overall, 519 of 526 participants completed the survey (99% completion rate). Ninety-three percent of urologists consider ergonomic factors when performing RIRS to reduce fatigue (68%), increase performance (64%), improve efficiency (59%), and reduce pain (49%). Only 16% received training in ergonomics. Residents/fellows had significantly lower confidence in ergonomic techniques compared with attending surgeons with any career length. Adherence to proper ergonomic positioning for modifiable factors was highly variable. On the NMQ, 12-month rates of RIRS-associated pain in ≥1 body part, pain limiting activities of daily living (ADLs), and pain requiring medical evaluation were 81%, 51%, and 29%, respectively. Annual case volume >150 cases (odds ratio [OR] 0.55 [0.35-0.87]) and higher adherence to proper ergonomic techniques (OR 0.67 [0.46-0.97]) were independently associated with lower odds of pain. Limitations include a predominantly male cohort, which hindered the ability to assess gender disparities in pain and ergonomic preferences. Conclusions: Adherence to ergonomic best practices during RIRS is variable and may explain high rates of MSK pain among urologists. These results underscore the importance of utilizing proper ergonomic techniques and may serve as a framework for establishing ergonomic guidelines for RIRS.

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Authors+Show Affiliations

Gabrielson AT
Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Tanidir Y
Marmara University, Istanbul, Turkey.
Castellani D
Polytechnic University of Marche, Ancona, Italy.
Ragoori D
Asian Institute of Nephrology and Urology, Hyderabad, India.
Jean LE
Department of Urology, Singapore General Hospital, Singapore, Singapore.
Corrales M
Sorbonne University, GRC Urolithiasis, Tenon Hospital, Paris, France.
Winoker J
Endourology and Center for Kidney Stone Disease, Lenox Hill Hospital, New York, New York, USA.
Schwen Z
Cleveland Clinic Glickman Urological and Kidney Institute, Cleveland, Ohio, USA.
Matlaga B
Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Seitz C
Department of Urology, Medical University of Vienna, Vienna, Austria.
Skolarikos A
Department of Urology, National and Kapodistrian University of Athens, Athens, Greece.
Gozen A
Department of Urology, SLK-Kliniken, Heilbronn, Germany.
Monga M
Department of Urology, University of California San Diego School of Medicine, California, USA.
Chew B
Stone Centre at Vancouver General Hospital, Vancouver, British Columbia.
Teoh J
Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Traxer O
Sorbonne University, GRC Urolithiasis, Tenon Hospital, Paris, France.
Somani B
Department of Urology, University Hospital Southampton, Southampton, United Kingdom.
Gauhar V
Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore.

MeSH

Activities of Daily LivingErgonomicsFemaleHumansMaleMusculoskeletal DiseasesMusculoskeletal PainOccupational DiseasesSurveys and QuestionnairesUrologists

Pub Type(s)

Journal Article

Language

eng

PubMed ID

35521646

Citation

Gabrielson, Andrew T., et al. "A Global Survey of Ergonomics Practice Patterns and Rates of Musculoskeletal Pain Among Urologists Performing Retrograde Intrarenal Surgery." Journal of Endourology, vol. 36, no. 9, 2022, pp. 1168-1176.
Gabrielson AT, Tanidir Y, Castellani D, et al. A Global Survey of Ergonomics Practice Patterns and Rates of Musculoskeletal Pain Among Urologists Performing Retrograde Intrarenal Surgery. J Endourol. 2022;36(9):1168-1176.
Gabrielson, A. T., Tanidir, Y., Castellani, D., Ragoori, D., Jean, L. E., Corrales, M., Winoker, J., Schwen, Z., Matlaga, B., Seitz, C., Skolarikos, A., Gozen, A., Monga, M., Chew, B., Teoh, J., Traxer, O., Somani, B., & Gauhar, V. (2022). A Global Survey of Ergonomics Practice Patterns and Rates of Musculoskeletal Pain Among Urologists Performing Retrograde Intrarenal Surgery. Journal of Endourology, 36(9), 1168-1176. https://doi.org/10.1089/end.2022.0075
Gabrielson AT, et al. A Global Survey of Ergonomics Practice Patterns and Rates of Musculoskeletal Pain Among Urologists Performing Retrograde Intrarenal Surgery. J Endourol. 2022;36(9):1168-1176. PubMed PMID: 35521646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Global Survey of Ergonomics Practice Patterns and Rates of Musculoskeletal Pain Among Urologists Performing Retrograde Intrarenal Surgery. AU - Gabrielson,Andrew T, AU - Tanidir,Yiloren, AU - Castellani,Daniele, AU - Ragoori,Deepak, AU - Jean,Lim Ee, AU - Corrales,Mariela, AU - Winoker,Jared, AU - Schwen,Zeyad, AU - Matlaga,Brian, AU - Seitz,Christian, AU - Skolarikos,Andreas, AU - Gozen,Ali, AU - Monga,Manoj, AU - Chew,Ben, AU - Teoh,Jeremy, AU - Traxer,Olivier, AU - Somani,Bhaskar, AU - Gauhar,Vineet, Y1 - 2022/05/25/ PY - 2022/5/7/pubmed PY - 2022/9/9/medline PY - 2022/5/6/entrez KW - ergonomics KW - musculoskeletal pain KW - retrograde intrarenal surgery SP - 1168 EP - 1176 JF - Journal of endourology JO - J Endourol VL - 36 IS - 9 N2 - Purpose: Retrograde intrarenal surgery (RIRS) requires urologists to adopt an awkward body posture for long durations. Few urologists receive training in ergonomics despite the availability of ergonomic best practices utilized by other surgical specialties. We characterize ergonomic practice patterns and rates of musculoskeletal (MSK) pain among urologists performing RIRS. Methods: A web-based survey was distributed through the Endourological Society, the European Association of Urology, and social media. Surgeon anthropometrics and ergonomic factors were compared with ergonomic best practices. Pain was assessed with the Nordic Musculoskeletal Questionnaire (NMQ). Results: Overall, 519 of 526 participants completed the survey (99% completion rate). Ninety-three percent of urologists consider ergonomic factors when performing RIRS to reduce fatigue (68%), increase performance (64%), improve efficiency (59%), and reduce pain (49%). Only 16% received training in ergonomics. Residents/fellows had significantly lower confidence in ergonomic techniques compared with attending surgeons with any career length. Adherence to proper ergonomic positioning for modifiable factors was highly variable. On the NMQ, 12-month rates of RIRS-associated pain in ≥1 body part, pain limiting activities of daily living (ADLs), and pain requiring medical evaluation were 81%, 51%, and 29%, respectively. Annual case volume >150 cases (odds ratio [OR] 0.55 [0.35-0.87]) and higher adherence to proper ergonomic techniques (OR 0.67 [0.46-0.97]) were independently associated with lower odds of pain. Limitations include a predominantly male cohort, which hindered the ability to assess gender disparities in pain and ergonomic preferences. Conclusions: Adherence to ergonomic best practices during RIRS is variable and may explain high rates of MSK pain among urologists. These results underscore the importance of utilizing proper ergonomic techniques and may serve as a framework for establishing ergonomic guidelines for RIRS. SN - 1557-900X UR - https://www.unboundmedicine.com/medline/citation/35521646/A_Global_Survey_of_Ergonomics_Practice_Patterns_and_Rates_of_Musculoskeletal_Pain_Among_Urologists_Performing_Retrograde_Intrarenal_Surgery_ DB - PRIME DP - Unbound Medicine ER -