The authors are to be congratulated for this intriguing study of ABU certification logs. Their findings are thought provoking, particularly given the comprehensive nature of their source material. As a young pediatric urologist at the start of my career, I certainly found this article to be quite eye opening. It is by no means surprising that the most frequent procedures performed by pediatric urologists are circumcisions and groin cases. It is also not surprising that a specialty which is devoted to rare congenital anomalies operates on those conditions only infrequently, As the authors highlight, however, more frequently encountered conditions are also infrequently repaired. I was struck by the fact that procedures such as pyeloplasty, ureteroneocystostomy, and hypospadias repair were infrequently performed, despite the fact that UP] obstruction, reflux, and hypospadias are relatively common conditions. Despite my preconception, however, it is hard, to argue with these being infrequent procedures when their median case log volumes are 10 or less over the study period.
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