Evidence map›Paper›PMID 41145905›Full record

ArticleInternational urology and nephrology2026

Establishing a sustainable urology program in northern Guatemala: an implementation report from El Petén (2024-2025).

Nellie Fisher, Jesus Herrera Murillo, Carol Kashefi, Diana Kang, Robert Kolosseus, Ramsey Chichakli, Juan Carlos Macias Flores, Christopher Cole, Sergio Huerta

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Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

9 authors.

Nellie FisherBurrell College of Osteopathic Medicine, Las Cruces, NM, USA.ORCID http://orcid.org/0009-0004-5645-7453
Jesus Herrera MurilloRio Grande Urology, El Paso, TX, USA.
Carol KashefiDepartment of Urology, Scripps Clinic Medical Group, San Diego, CA, USA.
Diana KangDepartment of Urology, Scripps Clinic Medical Group, San Diego, CA, USA.
Robert KolosseusRio Grande Urology, El Paso, TX, USA.
Ramsey ChichakliDepartment of Urology, Scripps Clinic Medical Group, San Diego, CA, USA.
Juan Carlos Macias FloresHospital Nacional de San Benito, El Petén, Guatemala.
Christopher ColeCole Surgical, LLC, Rio Rancho, , NM, USA.
Sergio HuertaDepartment of Surgery, VA North Texas Health Care System, University of Texas Southwestern Medical Center, 4500 S. Lancaster Road (112), Dallas, TX, 75216, USA. Sergio.Huerta@UTSouthwestern.edu.ORCID http://orcid.org/0000-0001-7720-419X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSubspecialty surgical care is limited in low- and middle-income countries (LMICs). Nongovernmental organizations (NGOs) attempt to bridge this gap through short-term medical trips (SMTs), but sustainability remains challenging. This report describes establishing a urology program in El Petén, Guatemala's largest region, as a model for sustainable subspecialty surgical care in LMICs.

methodsThis retrospective, single-institution review evaluated the Aid Via Action Inc. (AVA) urology program at Hospital Nacional de San Benito (HNSB), a departmental public hospital in El Petén, Guatemala, from June 2024 to June 2025. All AVA cases were reviewed, with a descriptive analysis of program development and implementation. Institutional approval was obtained from the hospital ethics committee and director. Patient selection included medical, anesthesia, and urologic evaluation. Equipment was obtained through donations and partnerships. Sterilization used a 2% glutaraldehyde (Cydex®) protocol. Data were analyzed descriptively in Microsoft Excel, complications categorized by the Clavien-Dindo system, and follow-up conducted through clinic visits, phone calls, and coordination with local physicians.

resultsDuring this period, a total of 37 urologic procedures were performed: 31 TURPs, 2 cystolithotomies, 2 vesicovaginal fistula repairs, 1 cystoscopy, and 1 circumcision. There were three complications-two cases of urinary retention following TURP and one surgical-site infection (all Clavien-Dindo Class II) following a cystolithotomy. The median follow-up was 88 days (IQR 73-98 days). There were no mortalities.

conclusionEarly outcomes demonstrate the feasibility of implementing a urology program in a resource-limited setting. Long-term success depends on local engagement and sustained urology staffing at HNSB.

Indexed as

Urologic Surgical ProceduresUrologyAdultFemaleGuatemalaHumansMaleMiddle AgedProgram DevelopmentProgram EvaluationRetrospective StudiesBenign prostatic hyperplasiaCapacity buildingClavien–DindoGlobal surgeryLancet Commission indicatorsProgram evaluationTransurethral resection of the prostate

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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.