Evaluating Surgical Ergonomics: An Analysis of Musculoskeletal Pain Across 11 Urologic Procedures

Introduction: Poor ergonomics in the operating room contributes to musculoskeletal (MSK) disorders, leading to surgeon discomfort, chronic pain, burnout, and early retirement. Urologists perform diverse procedures with unique ergonomic demands, yet little is known about procedure-specific MSK complaints. This study aimed to assess MSK pain among urology residents and attendings across 11 common urologic procedures. Methods: A prospective survey was conducted at a high-volume academic institution, collecting responses from attending urologists and residents who rated MSK discomfort after 11 distinct urologic procedures. Pain location and severity were assessed using a modified Likert scale. Responses to the pain scale were categorized as none (0), mild (1), moderate (2), severe (3), very severe (4), and worst possible pain (5). Statistical analyses compared pain levels and severity between residents and attendings. Results: Of 79 responses, 88.6% reported some degree of MSK pain, with no significant difference between residents and attendings (89.3% vs 88.2%, respectively, P = .889). The shoulders/upper back (56.5%), mid/lower back (54.3%), and head/neck (45.8%) were the most frequently reported areas of pain. Procedures with the highest pain scores included urethroplasty, gender-affirming surgeries, and percutaneous nephrolithotomy, each of which reported severe pain in at least 1 region of the body. Conclusions: MSK pain is prevalent among urologists, particularly in specific high-risk procedures. These findings highlight the need for targeted ergonomic interventions, including surgical training modifications and microstretch breaks to improve surgeon well-being and career longevity. Addressing ergonomic risks in urology residency training may mitigate long-term MSK burden and workforce attrition.