Evidence map›Paper›PMID 39820367›Full record

SynthesisInternational urogynecology journal2025

The Learning Curve in Urogynecology and Functional Urology: A Systematic Review.

Hanieh Salehi-Pourmehr, Fateme Tahmasbi, Shima Hosseinpour, Ozra Nouri, Behzad Lotfi, Pedram Iranmanesh, Fariba Pashazadeh, Sakineh Hajebrahimi

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International urogynecology journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hanieh Salehi-PourmehrResearch Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Attar-E-Neishabouri Sqr., Tabriz, 51666, Iran.ORCID 0000-0001-9030-2106
Fateme TahmasbiSocial Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.ORCID 0000-0002-0652-7693
Shima HosseinpourResearch Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Attar-E-Neishabouri Sqr., Tabriz, 51666, Iran.ORCID 0000-0001-6868-2069
Ozra NouriResearch Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Attar-E-Neishabouri Sqr., Tabriz, 51666, Iran.ORCID 0000-0002-5613-2868
Behzad LotfiDepartment of Urology, Tabriz University of Medical Sciences, Tabriz, Iran.ORCID 0000-0001-8835-8151
Pedram IranmaneshDepartment of Endodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.ORCID 0000-0003-1855-4119
Fariba PashazadehResearch Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Attar-E-Neishabouri Sqr., Tabriz, 51666, Iran.
Sakineh HajebrahimiResearch Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Attar-E-Neishabouri Sqr., Tabriz, 51666, Iran. ebrahimis@tbzmed.ac.ir.ORCID 0000-0003-1494-7097

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisWhen adopting new methods, surgeons may experience a period of complexity and longer operation times because of their inexperience. This period is known as the "learning curve." This study was aimed at systematically reviewing the current literature on functional urology learning curves.

methodsA comprehensive search was conducted across multiple databases from inception to July 2023 with no language restrictions. All original studies on urogynecological and functional urological procedures, including cross-sectional, cohort, and clinical trials, were eligible for inclusion. Relevant data were extracted, and methodological quality was appraised using standardized Joanna Briggs Institute critical appraisal tools. To quantitatively investigate learning curves, a mixed-effects generalized linear regression analysis was conducted on studies employing cumulative summation methods.

resultsFrom the 7,104 records, 68 studies met the inclusion criteria. The majority of studies were observational and the most common outcome measures were surgical duration, blood loss, and hospital stay. The learning curves varied by procedure type-for incontinence surgeries, 15-80 cases were required; for pelvic organ prolapse surgeries, 18-47 cases; for laparoscopic procedures, 10-105 cases; and for robotic procedures, 5-84 cases. The analysis showed that the number of cases required to surpass the learning curve decreased over time, likely reflecting technological advancements and increased surgical experience.

conclusionThe learning curve for surgical procedures varies significantly. It varies between 5 cases for robotic supratrigonal cystectomy to 75 cases for robot-assisted ventral mesh rectopexy or robotic sacrocolpopexy surgery in 84 cases. These variable learning curves highlight the need for structured training programs and ongoing assessment.

Indexed as

Gynecologic Surgical ProceduresGynecologyLearning CurveUrologic Surgical ProceduresUrologyClinical CompetenceFemaleHumansOperative TimeFunctional urologyLearning curveSystematic reviewUrology

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.