Introduction: Work-related musculoskeletal disorders (MSD) are highly prevalent in surgeons and urologists. Unique ergonomics in urology, including those of laparoscopy, endoscopy, and microsurgery, are especially concerning. As urologic microsurgeons have not been studied, we sought to evaluate the prevalence and risk factors of MSD in urologic microsurgeons.
Methods: An anonymous online survey was distributed to approximately 6,000 urologists via email from a curated email database which included specialty society members. This survey included questions on demographics, operative time, exercise frequency and type, ergonomic interventions, and musculoskeletal symptoms. Symptoms were assessed using a de novo, modified Nordic Musculoskeletal Questionnaire.
Results: A total of 50 responses were collected, proportional to the relatively small number of urologists performing these surgeries. The average age of respondents was 48.5 years, BMI was 26.4, and years in practice was 15.7. 29 (58%) completed a formal fellowship in andrology, male infertility, or microsurgery. The average number of operative days per week was 1.6 and the average number of microsurgical cases per month was 7.2. A total of 42 (84%) respondents reported musculoskeletal trouble in the past 12 months, 30 (60%) reported trouble in the past week, and 8 (16%) were forced to miss work due to their MSD in the past 12 months. Of those with symptoms in the past year, 24 (57%) respondents sought professional medical help and 29 (69%) respondents used medication. 96% of respondents exercised, with the median respondent exercising three days a week for one hour each day. There was no association between hours of exercise, operative volume, years in practice, or fellowship status with prevalence of MSD. Of surgeons who sit to operate, only 40% experienced weekly symptoms, compared to 73% of surgeons who stand (p=0.02). This was most pronounced with low back pain, as 5% of surgeons who sit experienced weekly low back symptoms compared to 30% of those who stand (p=0.04).
Conclusions: Work-related MSD are highly prevalent in urologic microsurgeons. Operating while seated was associated with a significantly lower incidence of MSD compared to standing. Ergonomic considerations in the operating room should be of concern for all urologists to ensure health and career longevity.
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