Is Your Career Hurting You? The Ergonomic Consequences of Surgery in 701 Urologists Worldwide

Purpose Our objective was to seek correlations between the type, volume and duration of surgical work performed, surgeon habits and characteristics, and the prevalence of neck and back musculoskeletal complaint and intervention across career from training to retirement. Materials and Methods An anonymous web-based multi-national survey of urologists was conducted. The primary outcome measured was pain. Secondary outcomes included pain requiring intervention and surgery. Responses were sub-grouped according to geography, practice patterns, and demographics. Student t-test, Fisher's exact and Chi-Square tests were used for analysis. Results 701 complete responses were received from this multi-national survey. Gender, pain distribution, and private or academic practice did not correlate with pain, while exercise, lower weight and BMI were protective. Dose- response of surgical type was assessed with high and low volume density quartiles and frequency of each pain severity; no correlation was found. Secondary analysis showed female practitioners seek invasive therapy less than male counterparts, and practitioners of direct optical cystoscopy report no more neck trouble than others. Length of career since residency shows very little relationship to pain or pain-free rates. Conclusions In this, the largest surgical ergonomic study to date: surgical type, duration, volume, setting, and physician gender were unrelated to surgeon pain throughout career. Exercise was associated with lower prevalence of pain in a dose- related fashion; increasing weight and BMI were positively associated with pain. Although 47% of urologists with spinal pain blame their career, we are unable to identify any dose-response relationship that supports that assumption.