Gender Differences Among Urologists in the Assessment and Utilization of ESWL Treatment: Insights from a Multinational Survey of 3747 Participants
Abstract
Background/Objectives: This study aimed to examine gender-associated differences in extracorporeal shock-wave lithotripsy (ESWL) utilization as well as urolithiasis diagnostic evaluation, treatment strategy, and follow-up across a multinational sample of urologists and trainees. Methods: A multinational cross-sectional survey of members of the Société Internationale d'Urologie (SIU) was conducted from June to July 2022 in seven languages. The survey was completed by 3747 urologists and trainees (283 female and 3464 male respondents) from 108 countries. To reduce baseline differences, propensity-score matching was performed with exact matching on years of clinical practice, continent, and career stage, yielding a matched cohort of 1191 respondents (279 female and 912 male). Categorical comparisons used Cochran-Mantel-Haenszel analyses stratified by a matched-set identifier, and 0-10 scored items were compared using stratified Wilcoxon rank-sum analyses with the matched set as the stratum. Results: In the matched cohort, annual procedural-volume distributions differed by gender for ureterorenoscopy (URS) (p = 0.0009), open surgery (p = 0.002), laparoscopy/robotics (p = 0.010), and percutaneous nephrolithotomy (PCNL) (p = 0.018), whereas ESWL volume did not differ significantly (p = 0.077). Among ESWL-specific categorical practices, coupling-gel use differed by gender (p = 0.029), while alpha-blocker use, antibiotic prophylaxis, JJ-stent use, stone-fragment collection,…
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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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