What we know about outpatient surgery in Europe

The EAU Section of Outpatient and Office Urology (ESUO), previously known as the EAU Section of Urologists in Office, sees one of its tasks in the exploration of the field of outpatient urology in Europe. We found that the designated terminology “office” was not comprehensive enough to describe the different forms of outpatient treatment sufficiently, so we renamed our section accordingly.

An outpatient urologist (OU), in our definition, treats outpatients in more than half of his/her working time in an established professional profile and not only temporarily. Outpatients are treated in urological offices, medical centres, and outpatient departments of hospitals. The respective urologists are either self-employed or employed or work in a combination of both, depending on their countries’ rules and traditions.

At present, there is a remarkable number of 16,532 outpatient urologists (out of 30,299 urologists in total) who are working in 26 European countries.

Survey
Outpatient surgery is assumed to be an important section in the professional field of OUs; to what extent, we did not know yet. Therefore, we conducted a survey in 16 countries that has been processed by the section members.

Unfortunately, the results can only be rough estimates, as the structures of the databases in the countries are either missing or not comparable with each other. Therefore, our aim could only be recording to what extent OUs perform outpatient surgery in which country; whether there are possibly characteristic structures and patterns in which institutions; and in which form of employment interventions are performed by OUs . To avoid the impression of scientific exactness, we present the results in a rough grid only.

The results show that in two-thirds of the responding countries, outpatient surgery is performed by OUs on a large scale (>50% of the countries’ OUs), and in one third of them to a smaller extent (<50% of the countries’ OUs) . In Greece and the Netherlands, all of OUs perform outpatient surgery.

In four countries (Albania, Greece, the Netherlands, and Poland) more than half of the OUs also treat inpatients, in the other countries in a minor extent.

We asked the status of employment (i.e. self-employed, employed, and combination) and the place of work of OU performing outpatient surgery. However, we did not find a correlation between these criteria and the score of outpatient surgery. It is performed as well in offices, medical centres, and outpatient departments of hospitals and in all forms of employment. Obviously, this depends on the country’s medical infrastructure and traditions. Outpatient surgery is an integral part of urology. In recent years, we have seen a trend to perform more and more procedures on an outpatient basis, including day surgery. Moreover, novel minimal invasive methods of prostate treatment are on their way to the outpatient institutions, supplementing the traditional interventions.

To support this development, the ESUO will deal with this subject in its meeting during the EAU22 congress.

See you at EAU22
The ESUO meeting “Urological surgery and interventions in an office and outpatient setting” at EAU22 will start with special measures in preparing surgery in an outpatient setting, including the support of nurses and the whole staff. Sedation, local and general anaesthesia will play an important role.

The various open operations (penile and testicular surgeries), transurethral interventions (e.g. treatment of urethral strictures, Botox injections, and management of ureteral stents), and prostate biopsy will be presented using instructive videos and discussed with the audience.

The emerging role of novel methods in treating benign prostate hyperplasia (e .g . Urolift, Rezum, iTind, and embolization) in outpatient and day-case surgery will be a hot topic. Prevention and
management of complications and legal aspects will complement the meeting. Our section aims to encourage European OUs to widen their therapeutic spectrum.

We encourage you to join us at the ESUO meeting at EAU22 on Saturday, 22 March 2022, from 10:30 to 14:00 CET at Room 4 located in the Green Area

This article first appeared in the June/July 2022 Congress edition of European Urology Today.