Objectives: To evaluate if the use of a photographic handbook (PH) can be a useful tool to improve the detection of disorders during cystoscopy training, as several hands-on tools have been proposed to improve technical skills but very few aim to improve specificity and sensitivity. Subjects and methods: Eight junior residents (JRs) were divided into two groups: Group A, comprised four JRs with previous limited experience of performing cystoscopies; and Group B, including four inexperienced JRs who were asked to study a specific PH before performing cystoscopies. The findings of the two groups were compared using the chi-squared test. Results: A total of 401 consecutive cystoscopies, of which 214 (53.4%) were performed by Group A and 187 (46.6%) by Group B, were considered. Group B showed superior ability in detecting uncommon findings (i.e., carcinoma in situ, bullous oedema, interstitial cystitis, etc.) with 24/46 (52.2%) detected vs eight of 32 (25%) in Group A (P = 0.016). Conclusions: The PH was a useful tool for improving identification of pathological conditions, which could be used to enhance hands-on simulator and practical tutored training. Abbreviations: CIS: carcinoma in situ; JR: junior resident; PH: photographic handbook; VR: virtual reality Classification: Stones/Endourology.

Arab journal of urology. 2019 Apr 24*** epublish ***

Guglielmo Mantica, Federica Balzarini, Federico Dotta, Moises Rodriguez-Socarras, Silvia Proietti, Guido Giusti, Francesco Oneto, Marco Di Pierro, Paolo Traverso, Carlo Terrone

Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy., Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy.