The field of urology is diverse and highly multidisciplinary. This has a huge number of advantages – we can benefit from all the technological as well as pharmacological advances and we can rely on a large knowledge base of scientific evidence accumulated over the decades. At the same time, this immense scope poses a number of challenges as to the definition of urology as a medical specialty and the role it plays in the comprehensive care of urology patients.
These challenges were discussed during a meeting of the EAU with representatives of 34 national urological societies, which took place on 1 June 2012, in Mallorca, Spain. Participants of the meeting agreed that a common European perspective and effort are needed to ensure that urology keeps up with various societal and economic transformations.
Urology: a surgical and medical specialty
Urologists are in the unique position to provide a wholesome approach to the management of urological malignancies – from diagnosis to treatment and follow-up, as well as palliative care. This in-depth understanding of the disease in the context of the entire urinary tract enables us to lead a multidisciplinary team of specialists. The representatives of all urological societies in Europe concurred that this position must remain strong and agreed to develop common mechanisms to support it.
This strategic consideration is of vital importance as we find ourselves in the age of numerous breakthroughs in the field of medical treatment modalities and imaging technologies.
All national societies agreed to actively stimulate applied education initiatives in medical urology next to surgical programmes. Additionally the EAU will aim to bring in uro-oncologists into the steering committees related to science and education to promote multidisciplinary working practice and create more exposure to these issues.
Finally, national societies and the EAU will formulate a strategy by which the involvement of urologists will be increased in the upcoming uro-oncological trials. This step is essential, as urologists must have the opportunity to actively contribute to the development and evaluation of comprehensive treatment strategies for urological malignancies, and this includes medical treatment.
Urology research: what is missing?
During the meeting, various aspects of research in the field of urology were discussed. All participants agreed that there is a great need to address areas where high-quality scientific data is highly necessary but currently missing and discussed a number of possibilities of their involvement with the EAU Research Foundation’s mission to build an effective trial and communication infrastructure at the European level.
A number of other important issues were addressed, including the differences and best practices in urological research training in various countries and the need to emphasise European research and fellowship initiatives in the international and national communication.
Quality of urological care
Quality of urological care is an essential aspect of our work as medical practitioners. At the same time, the topic raises many debates and there are no unified initiatives at a pan-European level which address this issue. The EAU is now launching a project aimed at developing a structure for quality assessment in European urology care to even out the highly unbalanced standards of urological care in various EU countries – a true necessity in our age of cross-border health practices.
The involvement of urological societies in this project is extremely important and during the meeting many ideas and recommendations were put forward by the participants. Several similar initiatives launched at a national level were discussed.
Urology scholarship: nurturing talent
Nurturing leadership qualities, academic ambition and supporting talent in the upcoming generation of experts is key to ensuring the future of urology as a medical specialty. The European Urology Scholarship Programme (EUSP) aims to do just that. This programme is well financed and has been successfully running for many years. At the same time, the EAU is aiming to take this programme a step further by making sure that scholarship opportunities are communicated to as many potential candidates across Europe as possible. In this initiative, the role of national societies is essential, and the meeting’s participants agreed to distribute EUSP information through their own channels and feedback their ideas and suggestions back to the EAU.
Urology patients: the dialogue
Another subject matter which was actively discussed during the working group sessions was the involvement of patients in the activities of professional urological societies – both at the national and the European levels. It is evident that this involvement varies significantly from country to country and while some societies actively engage patient organisations in its educational and scientific activities, for example national clinical guidelines, the other experience only limited involvement.
The participants expressed support to several new patient-oriented initiatives of the EAU, which are also in line with the association’s mission to raise and harmonise the level of urological care in Europe.
One of such initiatives is the pan-European patient information project which is currently in active development in collaboration with EAU Sections, EAUN and the EAU Guidelines. This project aims to offer reliable and regularly updated information on urological diseases to all European citizens. Here, national societies will play an important role, localizing and communicating the information through their channels and providing feedback on the issues related to local medical practices as well as legal and political implications.
Additionally, it was very exciting to hear that Urology Week, an annual initiative to increase awareness about urological conditions, has become a tradition in the majority of countries. In many Eastern European countries this initiative has become extremely popular with the media and the general public, and some representatives have mentioned that they have already started preparation for the 2012 campaign, which will take place on 17-21 September. We only hope more countries, cities, hospital departments and even individual urologists (which has been done in the past years) will join this initiative and organise an event aimed at urology patients or the general public. We strongly believe that step by step over the next couple of years we will turn Urology Week into a true international movement helping us to engage in a meaningful dialogue with our patients and profile urology among the general public.
EAU Guidelines: going strong
In the context of clinical guidelines development the national society representatives stressed the importance to ensure appropriate stakeholder involvement. Guidelines should reflect clinical reality. In particular, nurses’ involvement was discussed but since the European Associaton of Urology Nurses (EAUN) produce separate guidelines – generally including participation and review by urologists – this aspect seems appropriately covered. The EAU Guidelines Office will include listings of individual guidelines panel members in their publications to visualise the multidisciplinary aspect better.
Additionally, following comments from prior meetings with the national urological associations, the newer guidelines publications now include a section on what changes were made for updates. This practice should facilitate adaptation of the EAU guidelines documents by the national associations. In general, it was felt that the role of guidelines will not be diminished in the years to come.
Let’s get to work!
In conclusion, I would like to thank all European national societies for their participation and contribution during this meeting, and more importantly for their commitment to the upcoming collaborative programmes.
The EAU will continue to strengthen its links with the national associations. The meeting’s participants have agreed to appoint national representatives who will link their society with the EAU to work on joint programmes. The other national societies within Europe will also be contacted to see whether they would also agree to provide a similar contact person in their association. It is hoped that this structure will provide feedback, contributing to the establishement of a pan-European urology thinktank. This will allow closer coordination and integration of our activities, working with national societies on behalf of all urologists in Europe.
In the next months we will have a lot of work to do – but together, we are strong and together we can leverage this strength to achieve the goals that we could never achieve through isolated individual efforts.