Background: Upper ureteric and renal pelvic calculi can be managed using endourological, laparoscopic, open, or retroperitoneoscopic techniques. Retroperitoneoscopy enables stone extraction while avoiding peritoneal violation. This study compares the outcomes of retroperitoneoscopic and endourological approaches for stones measuring 1.5–2.5 cm. Methods: Sixty patients with renal pelvic or upper-third ureteric calculi (1.5–2.5 cm) were randomized into two groups: Group A: retroperitoneoscopic ureterolithotomy/pyelolithotomy and Group B: ureteroscopic lithotripsy/retrograde intrarenal surgery. Primary outcomes included operative time, hospital stay, stone-free rate, and postoperative complications (Clavien–Dindo). Stone-free status was assessed using NCCT KUB on day 3. Results: Group A achieved significantly higher mean clearance rates (99.5% ± 1.2% vs 93.2% ± 4.5%) and fewer overall complications (20% vs 30%). Group B demonstrated shorter operative time (48.3 ± 3.6 vs 74.2 ± 4.1 minutes; p < 0.001) and shorter hospital stay (1.4 ± 0.5 vs 1.9 ± 0.6 days; p < 0.01). All complications were Clavien–Dindo grades I–II. Conclusion: Retroperitoneoscopic surgery provides superior stone clearance with a favorable safety profile, although this is achieved at the expense of longer operative duration. Endourology offers faster surgery and shorter hospitalization, but lower one-session clearance. Surgical choice should be individualized based on stone characteristics and patient factors.
Objective: To evaluate the safety, completeness, and performance of a fully automated electronic ureteric stent registry designed to ensure full traceability and reliable capture of both retrograde and antegrade stents. Patients and Methods: All stent journeys between May 2022 and December 2024 were analysed. The registry is generated prospectively via electronic procedure requests with automated validation, cross-checking, and alert systems. Outcomes included completeness of capture, dwell time distribution, delayed stents, and classification of registry errors. Results: The system captured all stent journeys during the study period. Delayed stents were identified and monitored through automated alerts. Major registry errors present during the first audit cycle were eliminated following targeted staff education and clinical oversight. No stents were lost, including antegrade interventional radiology insertions. Conclusion: A fully automated electronic stent registry can achieve complete traceability, improve safety, and provide a scalable model for ureteric stent surveillance in modern clinical practice. Level of Evidence: Level III (retrospective observational study).
Background: Seminal vesicle invasion (pT3b disease) is a strong predictor of poor oncological outcomes in prostate cancer. The role of robotic-assisted laparoscopic prostatectomy in this setting remains debated, and the accuracy of multiparametric magnetic resonance imaging in staging T3b disease remains uncertain. The primary aim of this study was to identify pre- and postoperative predictors of biochemical recurrence in pT3b prostate cancer treated with robotic-assisted laparoscopic prostatectomy using time-to-event survival analysis. The secondary aim was to evaluate the diagnostic accuracy of multiparametric magnetic resonance imaging in staging seminal vesicle invasion. Methods: Patients with pathological T3b disease were identified retrospectively from a prospectively maintained institutional robotic-assisted laparoscopic prostatectomy database (December 2015 to August 2023). Data included demographics, preoperative variables, and pathological findings. Biochemical recurrence was defined as prostate-specific antigen ⩾0.1 ng/mL on two consecutive occasions. Biochemical recurrence-free survival was estimated using the Kaplan–Meier method, and univariate and multivariate Cox proportional hazards regression models were used to identify predictors of recurrence. A subgroup of patients staged as cT3b on multiparametric magnetic resonance imaging was compared with pathological outcomes to assess staging accuracy, with 95% confidence intervals calculated for sensitivity and specificity estimates. Results: Of 149 patients with pT3b disease, 146 were included in the descriptive clinicopathological analysis after exclusion of duplicate or inconsistent records. Of these, 139 had complete time-to-event data and were included in the survival analysis. Seventy-three patients (52.5%) developed biochemical recurrence during a median follow-up of 20.5 months, with a median time to biochemical recurrence of 3.6 months. The Kaplan–Meier analysis demonstrated a median biochemical recurrence-free survival of 31.4 months. On univariate Cox regression, higher Grade Group (hazard ratio = 1.27, 95% confidence interval = 1.03–1.55; p = 0.022), positive surgical margins (hazard ratio = 2.24, 95% confidence interval = 1.40–3.59; p < 0.001), and positive lymph nodes (hazard ratio = 1.84, 95% confidence interval = 1.05–3.21; p = 0.033) were significant predictors of biochemical recurrence, whereas age, prostate-specific antigen, and prostate size were not. On multivariate analysis, positive surgical margins remained the only independent predictor (hazard ratio = 2.20, 95% confidence interval = 1.18–4.09; p = 0.013). Of 53 patients staged as cT3b on multiparametric magnetic resonance imaging, 37.7% were downstaged to pT3a, and 3.8% were upstaged to pT4. T2-weighted imaging showed high sensitivity (96.6%, 95% confidence interval = 82.8–99.4%) but low specificity (26.1%, 95% confidence interval = 12.5–46.5%) for seminal vesicle invasion. Conclusion: In pT3b prostate cancer treated with robotic-assisted laparoscopic prostatectomy, positive surgical margins are the strongest independent predictor of biochemical recurrence, with Grade Group and nodal status providing additional prognostic value on univariate and Kaplan–Meier analysis. Preoperative prostate-specific antigen, age, and prostate volume were not associated with recurrence. Multiparametric magnetic resonance imaging frequently overstages seminal vesicle invasion, and treatment decisions should incorporate integrated radiological and pathological assessment. These findings support early consideration of salvage or adjuvant therapy in patients with positive margins.
Objective: Thulium fibre laser has emerged as an alternative to Holmium:YAG laser lithotripsy for ureteroscopic management of kidney stone disease. However, real-world comparative data from the United Kingdom remain limited. This study compared outcomes following thulium fibre laser and Holmium:YAG laser lithotripsy during ureteroscopy. Methods: A retrospective matched analysis was performed of adult patients undergoing ureteroscopy with laser lithotripsy for kidney stone disease at a single tertiary centre between September 2023 and July 2025. The co-primary outcomes were endoscopic stone-free rate and radiological SFR at follow-up. Secondary outcomes included operative time, number of procedures, length of stay, stent indwelling time, and complications. Results: Following matching, 47 patients were included in each group. Baseline characteristics were comparable, although bilateral stones and ureteral access sheath use were more common in the Holmium:YAG group. Endoscopic stone-free rate was similar between groups (93.6% Holmium:YAG vs 97.9% thulium fibre laser; p = 0.617). Radiological SFR was higher in the thulium fibre laser group for all patients (85.1% vs 91.5%; p = 0.06) and also for patients with single stones (80% vs 97.8%; p = 0.014). Holmium:YAG was associated with a higher mean number of procedures (1.6 vs 1.1; p < 0.001) and longer stent indwelling time (24.6 vs 19.0 days; p = 0.010). Complication rates were low and did not differ significantly. Conclusion: Both thulium fibre laser and Holmium:YAG achieved comparable endoscopic stone-free rates following ureteroscopy. Thulium fibre laser was associated with higher stone clearance at radiological follow-up, required fewer procedures per patient and was associated with shorter stent dwell times. Further prospective multicentre studies are needed to confirm these findings and evaluate their cost-effectiveness. Level of evidence: 3
Multidisciplinary team (MDT) discussions are increasingly recognized as a cornerstone of high-quality prostate cancer (PCa) management. This mini-review explores the growing evidence supporting MDT implementation in PCa care pathways, its impact on treatment planning, and evolving tools to streamline decision-making. Evidence from recent cohort studies and implementation research suggests improved guideline concordance, reduced rates of overtreatment, and enhanced patient engagement when multidisciplinary evaluation is applied, particularly in complex cases or cases where management is uncertain. Future directions include evaluating structured decision-support tools and case complexity scoring systems. The integration of MDTs is a scalable model that should be adapted across healthcare settings.
Background/Aim: Prostate cancer screening remains limited by the biological heterogeneity of the disease and the inability of current approaches to reliably distinguish indolent from high-risk cancer. Population-based screening has demonstrated only modest reductions in prostate cancer-specific mortality, accompanied by substantial overdiagnosis and overtreatment, highlighting the need for more selective strategies. Risk-stratified screening has therefore emerged as a potential solution, aiming to enrich the detection of aggressive disease while minimising harm. This mini-review evaluates the evidence supporting targeted screening approaches, focusing on high-risk groups including men with a family history, inherited genetic susceptibility, Black ethnicity, and older age. Methods: A narrative review of the literature covering targeted screening approaches, focusing on men with a family history of prostate cancer, inherited genetic susceptibility to cancer, Black ethnicity, and older age. Results: While family history, inherited genetic susceptibility, Black ethnicity, and older age are consistently associated with increased prostate cancer incidence, their utility in identifying men at risk of high risk of disease is variable. Germline BRCA2 mutation carriers represent the most clearly defined high-risk group, with evidence of earlier onset, higher incidence, and a greater proportion of aggressive disease, although their low population prevalence limits impact at scale. In contrast, family history and ethnicity are heterogeneous and context-dependent, while older age reflects a high burden of disease but uncertain screening benefit due to competing mortality and delayed treatment effects. Advances in imaging, biomarkers, and multivariable risk models have created the potential for layered screening pathways that combine low-cost triage tests with progressively more specific risk-enrichment tools. Conclusions: Current evidence suggests that effective screening will require an integrated, risk-adapted approach delivered within organised programmes. Ongoing trials are expected to define optimal implementation strategies, including eligibility criteria, screening intervals, and diagnostic pathways. Level of evidence: Not applicable
Urology is a clinically important speciality, representing a substantial proportion of surgical referrals and presentations in primary care. Despite this, evidence spanning two decades consistently demonstrates that it remains under-represented in UK medical school curricula. This review examines the structural challenges in undergraduate urological education and the evidence-based interventions developed to address them. It draws on national survey data, international comparators, and educational trials to propose a practical framework for improvement across several stakeholder groups: medical schools, BAUS, clinical educators, the GMC, and Royal Colleges. The return of the BAUS Annual Scientific Meeting to London provides an apt moment to take stock of what has been achieved—and to define clearly what the speciality still owes its future graduates and patients. Level of evidence: 2b
Introduction: The National Health Service (NHS) accounts for 4%–5% of the UK’s greenhouse gas (GHG) emissions, approximately 20–25 million tonnes of carbon dioxide equivalent (CO2e) annually. Recognising the increasingly harmful effects of climate change on human health, the NHS aims to achieve net zero GHG emissions by 2045. The Environmental Lessons Learned and Applied (ELLA) methodology, developed and tested by the Getting It Right First Time (GIRFT) programme in the NHS in England, sets out a stepwise process for redesigning a clinical care pathway to reduce carbon emissions while maintaining or improving clinical standards. Methods: We reviewed peer-reviewed and grey literature to identify clinical pathways within urology with probable large decarbonisation potential if the ELLA methodology was applied. Results and discussion: Opportunities lie in applying the ELLA methodology to uro-oncology, UTIS and outpatient care, catheter care and elective surgery. Suspected cancer pathways and outpatients are some of the highest volume pathways. The highest intensity modifiable hotspots at a per-patient level likely include surgery, particularly robot-assisted. The ELLA methodology guides identification of sustainable interventions through care pathway mapping, rather than focusing on individual procedures. This allows a wide range of potential sustainable improvements to be considered and prioritised. This approach can potentially drive greater reductions in the GHG emissions of urological care and avoid the pitfall of single-action bias. Conclusion: We have applied the first steps of the ELLA framework to consider where future opportunities for decarbonisation of UK urology might lie. We have identified several pathways that have either very high levels of activity and/or very carbon-intensive processes. Full application of the ELLA framework to urological pathways can develop pragmatic strategies for decarbonising UK urology practice. We encourage multidisciplinary efforts to advance and build on the ideas raised and form action plans for the ongoing decarbonisation of urological care. Level of evidence: 3
Objective: To synthesize current evidence on generative artificial intelligence (AI) integration in urology and propose a structured, patient-centered framework for its responsible implementation in daily urological workflows. Methods: A narrative review was conducted examining applications of large language models (LLMs), ambient documentation platforms, retrieval-augmented generation (RAG) systems, and multimodal clinical decision-support tools across the urology care continuum, including pre-visit triage, patient education, clinical decision support, surgical planning, and academic productivity. Results: A four-agent model was developed defining complementary roles for the digital AI agent, staff urologist, resident or fellow, and institutional AI champion. RAG systems reduced hallucinations by anchoring outputs to guideline-based sources. AI-assisted documentation decreased administrative burden and clinician burnout, while validated predictive models improved risk stratification and reduced unnecessary interventions. Safe deployment requires continuous human oversight, systematic bias auditing, transparent patient opt-out mechanisms, and ongoing guideline-aligned validation. Conclusion: The proposed framework demonstrates that generative AI can enhance efficiency and clinical quality across urological care when governed responsibly. Generative AI should function as a supervised clinical co-pilot rather than an autonomous decision-maker. A governance-first, patient-centered approach is essential to preserve safety, equity, and scientific integrity in modern urology.
Introduction: Interest in targeted prostate cancer screening has increased following the UK National Screening Committee’s November 2025 draft recommendation and public consultation, which supported a risk-stratified approach rather than population-wide prostate-specific antigen (PSA) screening. This literature review summarises current evidence for screening in high-risk groups, including men of Black ethnicity, those with a family history of prostate cancer, and carriers of pathogenic BRCA1/2 variants. Methods: A narrative review of landmark randomised screening trials, guideline documents, modelling studies, and prospective cohort data was performed, focusing on the effectiveness and limitations of targeted screening strategies in high-risk populations. Results: PSA-based screening reduces prostate cancer mortality in some settings but remains associated with substantial overdiagnosis. Contemporary pathways incorporating pre-biopsy magnetic resonance imaging (MRI) and active surveillance have improved the balance between benefit and harm. Recent UK modelling suggests that population screening is unlikely to be cost-effective, whereas targeted screening may offer greater value in selected high-risk groups, particularly BRCA2 carriers and potentially men of Black ethnicity. Discussion: Current evidence supports a move away from universal PSA screening towards structured, risk-stratified early detection. The strongest rationale exists for targeted screening in men with pathogenic BRCA2 variants, while evidence for other high-risk groups continues to evolve. Ongoing studies, including TRANSFORM, will be important in defining future UK screening policy. Level of evidence: Not applicable.
Objectives: Urologists are noting a surge in patients they see who are concurrently taking weight-loss injections, due to exponential rises in prescriptions of glucagon-like peptide-1 receptor agonists (GLP-1RAs) for medical and aesthetic purposes. This study aims to summarise current evidence around GLP-1RAs by categorising their unintended benefits and side effects across common urological conditions that may have important ramifications within the field of urology. Materials and methods: Comprehensive literature review using PubMed ® , MEDLINE ® and Google™ Scholar for relevant scientific articles published in English. Manual bibliography search and “ related article ” functions were employed to supplement original searches. Results: Current knowledge of the collateral impact of GLP-1RA on common urological conditions, such as erectile dysfunction (ED), UTIs, urolithiasis, urological malignancies and hypogonadism is conflicting and predominantly based on weak levels of evidence. Pubmed ® identifies 79 relevant studies relating GLP-1RA to the chosen common urological conditions. There are no randomised controlled trials (RCTs) dedicated to GLP-1RA whose primary outcome pertains directly to urological symptoms and/or sequelae. Conclusion: GLP-1RA may exert clinically relevant effects across multiple urological domains; however, current evidence is insufficient to draw definitive conclusions. Long-term safety data are lacking. Urologists should remain vigilant while prospective, urology-focused RCTs are urgently needed. Levels of evidence: Not applicable.
Introduction: Conventional flexible ureteroscopy (fURS) techniques are limited by residual fragments, infectious complications and stone size. Flexible and Navigable Suction Ureteral Access Sheaths (FANS) have been developed to address these limitations through controlled suction and pressure modulation within the pelvico-calyceal system (PCS). Methods: This narrative review summarises the design principles of FANS, outlines practical considerations for their use, and synthesises evidence on their use. Results: FANS incorporate a flexible distal tip permitting advancement into the PCS. By bypassing the pelvico-ureteric-junction (PUJ), FANS establish a low-resistance outflow, lowering IRP and increasing effective irrigation flow. Higher flow rates and continuous evacuation of stone dust may improve endoscopic visibility and enhance heat dissipation. Clinical studies demonstrate higher stone-free rates and lower infectious complications compared with conventional fURS. Non-inferior stone-free rates have been reported compared with mini-percutaneous nephrolithotomy for high stone burdens, with lower major complications. Their optimal use requires understanding the interaction between sheath and scope size, irrigation and suction pressure to avoid PCS collapse or over-pressurisation. Conclusions: FANS represent a potential paradigm shift in RIRS with improved SFRs and reduced infectious complications. Long-term data are required to quantify the risk of PUJ strictures and to quantify cost-effectiveness and clinical benefits, especially in larger stone burdens. Level of evidence: 5
To critically appraise the safety and efficacy of male genital augmentation and enhancement procedures, and to formulate consensus recommendations for urologists and medical professionals. A systematic search of the literature published between 2000 and 2025 was conducted. Outcomes of interest focused on penile length and girth changes, complications, and validated patient-reported outcomes. Risk of bias was assessed using Cochrane RoB-2 for randomised controlled trials (RCTs) and the Newcastle–Ottawa Scale (NOS) for non-randomised studies. Evidence was synthesised qualitatively by intervention type. Consensus recommendations were generated through structured group appraisal by the British Association of Urological Surgeons (BAUS) Section of Andrology and Genitourethral Surgery (AGUS), integrating the evidence base with expert opinion, quality assessments, and patient safety considerations. Thirty-six studies ( n = 3748) were included: 12 injectable fillers and 24 surgical. Injectable fillers produced short-term girth gains with mild, transient complications. Surgical procedures demonstrated modest increases in length and girth, though complicated by infection, fibrosis, and/or device removal. Across the eligible evidence, the risk of bias was high, the quality of evidence was low, and expert opinion was consistently low. Evidence quality remains poor, heterogeneous, and methodologically limited. As such, five key recommendations were generated by the BAUS AGUS committee on genital augmentation and enhancement with either injectable fillers or surgical procedures. 2
One of the major pathophysiology linked to male infertility is oxidative stress. Due to its antioxidant properties, micronutrient supplementation has been shown to lower oxidative stress in critically ill patients. Recent meta-analysis revealed the significance of micronutrients, but no long-term fertility outcomes were reported in the study. This study investigates the role of micronutrient supplementation in improving semen quality, hormonal parameters, and fertility outcomes in male with infertility. Databases include PubMed, Cochrane, Scopus, ProQuest, and MEDLINE followed by citation searching until August 2024. The risk of bias was assessed using the Cochrane Risk-of-Bias Tool 2 (RoB2) and the ROBINS-I tool for intervention studies. Data synthesis was carried out using R Studio software. A total of 35 studies were included for analysis. Semen volume was lower in patients receiving vitamin E (MD −0.27 mL, 95% CI −0.49, −0.04; p = 0.02). A combination consisting of L-carnitine, L-arginine, coenzyme Q10, and zinc was associated with higher sperm count (MD 9.44 mil, 95% CI 1.30, 17.59; p = 0.02). Folic acid was associated with higher sperm count (MD 4.27 mil, 95% CI 2.61, 5.93; p < 0.01). No significant difference was seen in sperm concentration, sperm vitality, proportion of sperm with normal morphology, sperm total motility, DNA fragmentation, hormonal parameters (i.e. Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), testosterone), and fertility outcomes between micronutrients and control groups. Micronutrient supplementation using antioxidants (i.e. L-carnitine, L-arginine, coenzyme Q10), vitamins, and folic acid may improve sperm parameters in males with infertility. Level 1 and 2
Background: Active surveillance (AS) is an established management strategy for patients with low- and favorable intermediate-risk prostate cancer (PCa). Accurately distinguishing indolent from aggressive disease and identifying progression during follow-up remain significant clinical challenges. Artificial intelligence (AI) has appeared as a promising approach to enhance risk stratification and support clinical decision-making. Our aim was to evaluate the role of AI-based decision support systems in patient selection and monitoring during AS for PCa, as well as their potential to guide timely transition to definitive treatment. Methods: A scoping review was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines. The review protocol was prospectively registered in PROSPERO (CRD420261358519). Literature searches in PubMed and Scopus were performed, applying filters for English-language studies published within the past 5 years. Of 133 records identified, 24 studies met the inclusion criteria after screening and eligibility assessment. Results: Most included studies were retrospective and used machine learning (ML) or deep learning (DL) techniques on clinical, radiological, and histopathological data. AI models demonstrated stronger predictive performance than traditional statistical methods, with reported area under the curve (AUC) values ranging from 0.74 to 0.96. Radiomics-based models derived from magnetic resonance imaging (MRI) facilitated non-invasive characterization of tumor aggressiveness, while DL algorithms applied to biopsy whole-slide images improved grading accuracy and progression prediction. Multimodal models that integrated heterogeneous data sources consistently outperformed single-modality approaches. Finally, longitudinal models including serial prostate-specific antigen (PSA) measurements and imaging data enabled dynamic risk assessment and customized monitoring during AS. Conclusion: AI-based models show considerable potential to improve patient selection and predict progression in AS for PCa, potentially reducing overtreatment and unnecessary biopsies. However, current evidence is limited by retrospective study designs, lack of external validation, and variability in AS protocols. Prospective multicenter studies and enhanced model explainability are necessary before routine clinical implementation. Level of evidence: Not applicable.
Objective: To propose a surveillance approach for upper tract urothelial carcinoma (UTUC) recurrence in high-risk and very high-risk non-muscle invasive bladder cancer (HR NMIBC) patients. Method: Retrospective analysis in 2024 of 317 patients diagnosed with HR NMIBC in our centre between 2008 and 2018, including histology, CT urogram (CTU) frequency, radiation dose, UTUC recurrence, outcome, and risk factors for UTUC recurrence. Results: A total of 283 patients were included for analysis. Incidence of UTUC recurrence 5.7% (n = 16/283), with 3.5% (n = 10/283) undergoing nephroureterectomy. Mean time from initial diagnosis to UTUC recurrence is 5.2 years. At 5- and 10-year follow-up, UTUC incidence was 3.5% and 2.1%, respectively. No patients diagnosed with UTUC recurrence beyond 10 years. Patients underwent mean 2.2 surveillance CTU every 1.9 years, with 17.7 mSv mean radiation dose per scan. No significant increased risk of UTUC recurrence associated with carcinoma in situ (CIS) at diagnosis (chi(2) = 0.006, p value = 0.94). Risk of UTUC recurrence significantly increased in patients with recurrent HR NMIBC (27%) versus those without (4%) (relative risk = 7.12, chi(2) = 20.9, p value < 0.00001). Conclusion: Consider surgical fitness and HR NMIBC recurrence status when determining duration of surveillance for patients. We propose biennial CTU in patients fit for nephroureterectomy, continuing up to 10 years if recurrent HR NMIBC, or up to 5 years if recurrence-free.Level of evidence: 2b - Retrospective cohort study
Objective: Kidney stone disease is a growing global health problem, with increasing diagnostic challenges due to heterogeneous clinical presentations and imaging demands. This review aims to evaluate the role of artificial intelligence (AI) in imaging-based detection and assessment of urinary tract stones. Methods: A systematic review was conducted by searching PubMed/MEDLINE, EMBASE, Cochrane CENTRAL, and Web of Science from database inception to May 2025 for studies evaluating AI-based imaging in the diagnosis of urinary tract stones. The search followed Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension (PRISMA-S) guidance and used a Population, Intervention, Comparison, Outcomes and Study (PICOS) framework to identify eligible adult studies applying AI models to computed tomography (CT), ultrasound, or radiographic imaging, with expert interpretation as reference and diagnostic performance outcomes. Results: From 1142 records identified, 11 studies published between 2017 and 2025 met the inclusion criteria. Most studies used CT imaging and reported high diagnostic performance, with accuracies exceeding 90% in eight studies and reaching over 95% in several deep learning–based approaches, while ultrasound-based AI models also demonstrated strong performance with sensitivities and accuracies above 90%. Conclusion: AI–based imaging demonstrates high diagnostic accuracy for urinary tract stone detection, particularly with CT. AI-enhanced ultrasound represents a practical and cost-effective alternative for implementation in resource-limited and rural settings. Level of evidence: 2
Objective: British Association of Urological Surgeons (BAUS) is the subspecialty organization for urologists in the United Kingdom. BAUS implemented structured equality, diversity, and inclusion initiatives to improve representation at its annual scientific meetings (ASM). Scientific meetings play a critical role in academic visibility, leadership development, and professional networking. Historically, women, ethnic minority clinicians, and international medical graduates (IMGs) have been underrepresented in conference leadership roles. This study evaluated demographic representation among Chairs and Speakers (C&S) at BAUS ASMs from 2022 to 2025 and compared these data with membership demographics. Methods: A retrospective observational analysis of publicly available BAUS ASM programs from 2022 to 2025 was conducted. Demographic variables including gender, ethnicity, and primary medical qualification (PMQ) region were extracted and compared with BAUS membership data. Descriptive statistics and trend analyses were performed. Results: A total of 682 C&S were identified. Women comprised 31.2% of participants and were significantly overrepresented relative to workforce proportions. Minority ethnicity representation increased significantly from 34.3% in 2022 to 48.7% in 2025 (p < 0.01). However, Caucasian clinicians and UK-trained doctors remained predominant overall. IMGs accounted for 25.1% of C&S and remained significantly underrepresented compared with workforce data, with only a modest upward trend. Conclusion: Representation among BAUS ASM C&S has improved, particularly for ethnic minority clinicians and women. Nonetheless, disparities persist for IMGs and minority groups. Continued targeted strategies and longitudinal monitoring are required to achieve sustained equity in academic participation.
Objective: High-quality data has transformed surgical practice, with consultant appraisal, quality improvement, and governance now relying on validated benchmarking of clinical outcomes. The General Medical Council (GMC) requires consultants to review their performance against local, regional, or national data as part of appraisal and revalidation. The National Consultant Information Programme (NCIP) provides a practical, clinician-led solution to meet this requirement. Materials and methods: Developed in response to the Paterson Inquiry, NCIP is a national, free data platform using routinely collected Hospital Episode Statistics and Office for National Statistics mortality data to deliver consultant-level activity and outcomes dashboards across surgical specialities. Results: In urology, NCIP provides procedure-specific metrics including volume, length of stay, day-case rates, readmissions, and mortality, benchmarked against national distributions and presented alongside patient demographics and co morbidity profiles. NCIP supports multiple clinical and professional uses, including data for appraisal and revalidation, morbidity and mortality meetings, clinical audit, quality improvement, and Clinical Impact Award applications. Case study evidence demonstrates how triangulating NCIP data with other datasets can identify unwarranted variation, support service redesign, and improve patient outcomes. Conclusion: Wider engagement with NCIP is essential to embed data-informed reflection and continuous improvement into routine urological practice.
