A 15-year longitudinal analysis of trends in elective urological surgery - an evidence base for Modernising Medical Careers.
BACKGROUND
The impact of Modernising Medical Careers on the differential need for consultant urologists and urological surgeons is as yet unknown. This study's aim was to determine what changes there had been in operative urological activity so as to predict the need for urological surgeons in the future.


METHODS
A retrospective study of all elective operative urological surgery over a 15-year period was performed. The absolute numbers of patients presenting for different grades of surgery were aggregated and analysed using the Spearman's rank correlation test.


RESULTS
Aggregated data from 27,839 procedures demonstrated no change in the number of operations (r 0.01; NS) or the number of diagnostic endoscopic procedures (r 0.21; NS) carried out over the study period. There was a decrease in endoscopic surgery related to a 70% reduction in trans-urethral resection of the prostate (TURP) (r -0.89; P = <0.0001) and an increase in ureteroscopic interventions (r 0.82; P = 0.0002) for stone disease. There was no change in the amount of major surgery carried out (r -0.43; NS) over the 15 years.


CONCLUSIONS
There have been changes to the pattern of surgery urologists have provided over the last 15 years but the need for complex surgical interventions has not altered. This suggests there will be as great a need for operating surgeons in the future, as currently exists.
Nathaniel
C
C
Department of Urology, Manchester Royal Infirmary, Manchester, UK.
Sangar
V K
VK
Payne
S R
SR
D002322:Career Mobility; D003558:Cystoscopy / Q000379:methods / Q000639:trends; D017558:Elective Surgical Procedures / Q000639:trends*; D004739:England; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate / Q000639:trends; D014570:Urologic Diseases / Q000175:diagnosis / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000639:trends*; D014659:Vasectomy / Q000639:trends