(047) INNOVATIVE PRIAPISM SIMULATION TRAINER IMPROVES RESIDENT COMFORT WITH BEDSIDE AND OPERATIVE MANAGEMENT
Authors: Bieniek J , Chhabra J , Faust W , Race B , Nowicki T 
Published: December 2024

Abstract

Introduction
Priapism, a prolonged and often painful penile erection, represents a urological emergency that necessitates immediate intervention. The complexity and infrequency of this condition pose significant challenges for urology residents in acquiring the necessary skills for effective bedside and operative management. This scarcity of practical experience underscores the pressing need for alternative training models. Simulation-based training provides a risk-free environment for trainees to practice, refine, and master the requisite skills for managing priapism. To date there is no commercially available priapism simulation training model.

Objective
This objective of this project was to develop a priapism training model, test it with a group of urology trainees, and assess pre- and post-training comfort with bedside and operative priapism management.

Methods
A low-cost high-fidelity priapism trainer was developed using a silicone-based material to mimic the structure and resistance of natural tissues to needles and scalpels (Fig. 1). Long party balloons filled with salt served as the dilated corpora during casting. Once set, the salt was drained and the hollow balloons attached to IV tubing and elevated bags of red-colored saline. Each training model was secured to a threaded bolt and baseplate to provide stability. These single-use trainers were utilized during a regional AUA training resident training course which included a priapism case presentation where trainees practiced penile aspiration, pharmacologic injection, and distal (or T) shunting. As part of novel training model improvement, users completed an anonymous REDCap survey before and after the session regarding priapism management experience and comfort. Wilcoxon ranked sum tests were used to compare groups on nonparametric continuous data.

Results
Thirty-three residents (1 PGY1, 16 PGY2, 14 PGY3, 2 PGY4) completed the priapism training survey as part of the regional course. On a 1 to 5 Likert scale corresponding to “not at all comfortable” to “very comfortable”, the average comfort level in managing a patient with priapism increased from 3.6 to 4.3 from pre- to post-training, respectively (p = .004). Mean estimated number of priapism procedures performed over the past year was aspiration/irrigation 4.9 (±4.3), intracavernosal injection 4.8 (±4.4), distal penile shunt 0.6 (±1.0), and placement of acute penile prosthesis 0.2 (±0.6). Only 15.2% of participants had previously attended a hands-on simulation for the management of priapism. Comfort level with each of bedside and operative priapism procedure was increased post-training (Fig. 2). Average impact on priapism knowledge and skills was 4.2 (moderate to major increase) and change in clinical practice as a result of attending training was 3.9 (moderate to significant impact). All participants would recommend this simulated priapism training to their colleagues.

Conclusions
An innovative priapism simulation trainer improves resident comfort level with overall priapism management across a broad group of trainees. Comfort level was also improved across all bedside and operative management techniques surveyed. The trainees noted a moderate to significant impact in their clinical practice as a result of the training session. Future studies will look to increase resident exposure to the priapism model, both early year urology and non-urology (eg, emergency medicine) residents.

Disclosure
No.