# The Future Is Bright for Women in Urologic Oncology: Trends over Two Decades

## TL;DR

This study shows that female surgeons are increasingly contributing to urologic oncology surgeries, despite still being underrepresented.

## Contribution

The paper provides a two-decade analysis of female surgeons' involvement in urologic oncology using American Board of Urology case logs.

## Key findings

- Only 2.1% of oncologic surgeries from 2003 to 2023 were performed by female surgeons, but this number increased steadily over time.
- Female surgeons performed a higher proportion of open procedures like partial nephrectomy and radical prostatectomy compared to male surgeons.
- The number of oncology fellowship-trained female urologists increased significantly over the study period.

## Abstract

This study examined trends in women’s involvement in urologic oncology over the past two decades using American Board of Urology case logs from 2003 to 2023. Among the nearly 55,000 oncologic surgeries performed, only 2.1% were performed by female surgeons; however, the number of cases performed by women annually has increased steadily. Female surgeons increasingly adopted minimally invasive surgery and also performed a higher proportion of open procedures than male surgeons for certain operations, including partial nephrectomy and radical prostatectomy. The number of oncology fellowship-trained female urologists rose throughout the twenty-year period. Overall, the findings support the growing contributions of women in urologic oncology and highlight the meaningful progress despite continued underrepresentation.

Background/Objectives: The role of female surgeons in urology has been steadily increasing. We performed a contemporary review of American Board of Urology (ABU) case logs focused on oncologic procedures and evaluated the role of female surgeons over the past two decades. Methods: Operative logs from ABU examinees from 2003 to 2023 were analyzed. We identified open-approach (OA) and minimally invasive (MIS) radical nephrectomy (RN), partial nephrectomy (PN), radical nephroureterectomy (RNU), radical prostatectomy (RP), and adrenalectomy (RA) using CPT codes. Total case volumes as well as reported fellowship training were recorded and tabulated. The counts and proportions of OA and MIS procedures were analyzed over time and by surgeon gender. Results: From 2003 to 2023, 54,972 surgical procedures were reported to ABU with only 2.1% (1127) being performed by female surgeons. Of these, 32.5% (366) were OA and 67.5% (761) were MIS. Despite the low overall composition of female-performed procedures, the number of surgeries performed by females increased over time. Among female surgeons, the proportion of MIS surgeries increased over time, from 37.5% to 71.5% in 2003–2009 to 2017–2023, respectively. Females versus males performed comparably for OA for RN and RA; however, females performed more open PN, RNU, and RP than their male counterparts. Moreover, the number of procedures performed by oncology fellowship-trained females increased significantly. Conclusions: Our analysis of over twenty years of data submitted to the ABU indicates that the surgical volume of oncologic procedures by female urologists has been increasing. These findings demonstrate the increased contributions by female surgeons to the field urologic oncology.