Sarah Razavi, MD, discusses the physical toll of ureteroscopy on urologists

Investigators recently conducted an anonymous survey to assess body and hand region discomfort when performing flexible ureteroscopy. Study author Sarah Razavi, MD, discussed the findings with Urology Times^®.¹

“This was a multi-institutional study, and the goal was to evaluate the urologist fatigue and discomfort in different body parts and different hand regions after performing flexible ureteroscopy. What we found was that, unfortunately, there was a significant increase in overall fatigue after performing flexible ureteroscopy, and also significant increase in discomfort in different body and hand regions. And what we found was that unfortunately, women were significantly more affected,” said Razavi, assistant professor of urology at Wake Forest University School of Medicine in Winston-Salem, North Carolina.

During the interview, Razavi was asked, given the significant increase in overall fatigue post-ureteroscopy, particularly among female surgeons, to elaborate on potential ergonomic or procedural factors that might contribute to this disparity. She said, “I think one of the most important hypotheses we had was the size mismatch, because we know that women have smaller hand size compared to men, and what we found in this study is that urologists with larger glove size have lower discomfort. I think 1 important hypothesis is that the currently available ureteroscopes are not designed for urologists with small hands, and that will put women at a disadvantage, especially because you have to use the scope repeatedly. You have to use your muscles repetitively, and if the scopes are not designed for your small hands, you have to sometimes exert more force into your different hand muscles, and that might be the reason for increased discomfort in women.”

She added, “One other hypothesis is that we know women have lower body mass compared to men, and performing ureteroscopy requires the urologist to be in a static position, sometimes for a long period of time, and so women with lower body strength might be at a disadvantage.”

REFERENCE

1. Razavi S, Udedeibia E, Chrouser KL, et al. Urologist's fatigue and discomfort in different body regions after performing flexible ureteroscopy. Urology. 2025 Apr 4:S0090-4295(25)00314-0. doi:10.1016/j.urology.2025.04.004