A revelatory experience in Vietnam
By Dr. Paul Irons
I recently had the pleasure of attending an IVU surgical workshop based at Binh Dan Hospital in Ho Chi Minh City, Vietnam. The focus was on urethral reconstructive surgeries for repairing complex urethral strictures of various pathologies. Dr. Gelman from the University of California Irvine and his fellow, Dr. Jeffrey Lee, were present in conjunction with the reconstructive urology team at the hospital led by Dr. Hung Do. Given that this workshop has been led by Dr. Gelman annually for around a decade now, I was not only able to learn from him, but also his fellow and attendings who have performed hundreds of these surgeries either with him or following his preceptorship.
As someone who does not come from a urology program with a large amount of reconstructive urology represented, it was invaluable to get this time learning from this team. Many of these operations involved high-complexity strictures, and I had not witnessed anything more than straightforward urethroplasties in residency thus far. Beyond participating in each surgery, I was able to gain insight into the work up and management of these patients that occurs peri-operatively to both get them to the OR and manage their post-op care after it. Additionally, learning about the ins and outs of a non-American healthcare system was exceptionally eye-opening.
Having done international medical trips previously, another aspect of this program that was impressive was the sustainability of the workshop allowing a lasting impact to be made over many years. This was also exhibited by how seamlessly they invited and encouraged my involvement as a resident throughout the week. The knowledge imparted to and by Dr. Hung’s team has very obviously contributed to the longevity of this workshop, but has ultimately led to the hospital being a leader in reconstructive urology in Asia, which I got the opportunity to witness firsthand.
While the workshop’s main focus was on reconstruction cases, I also got exposure to cases not typically seen in my training. Percutaneous nephrolithotomies, an endoscopic and more minimally invasive procedure to remove excessively large kidney stones, are often done both in the U.S. and at this hospital. However, much more commonly than in the U.S., the urology team at Binh Dan will perform larger open surgeries to remove bulky kidney stones for various reasons. This procedure, known as an open pyelolithotomy, was something I had never seen until this workshop. I was able to scrub into some of these cases and a few other non-reconstructive surgeries. Witnessing something considered rare in the U.S. was a great addition to my experience.
With my spare time outside of all these learning opportunities I was able to explore some of the city’s museums, temples, parks, and shops. The city and people were friendly, inviting, and surpassed my expectations for a host location. I have frequently thought back on my time in Vietnam and if given the chance would return without hesitation or recommend it to any resident considering applying to work with IVU.
Upon returning to my home program, I have already been able to contribute the wisdom imparted on me from this trip to how we manage complex urethral traumas and reconstructive urology cases to my attendings and co-residents. This served as a revelatory experience in many ways, and I am forever grateful to IVU for offering the opportunity to gain such knowledge. I also send a very sincere thank you to the Southeastern Section of the AUA for its sponsorship, and all others who made it possible. IVU and the team I had the privilege of working with have set the bar high for the international work I plan to incorporate into my future care.