The Gender Divide: The Impact of Surgeon Gender on Surgical Practice Patterns in Urology.

There is a perception within urology that female urologists encounter gender-based role assignments and are often "pigeonholed" into caring for more female patients and female-specific urologic issues than their male colleagues. We assessed the influence of surgeon gender on patient gender demographics by exploring the surgical case logs of US urologists.

Six-month case logs of certifying urologists from 2003 to 2012 were obtained from the American Board of Urology. We reviewed case logs based on CPT codes of common urologic procedures, focusing on six index gender-neutral and gender-specific procedure groups: treatment of nephrolithiasis, nephrectomy, resection of bladder tumors, treatment of stress urinary incontinence, elective sterilization, and treatment of prostate cancer.

Among a cohort of 6,166 urologists, 1,011,800 cases were logged. Female surgeons operated on a significantly higher percentage of female patients compared to their male peers (54.4% vs. 32.5% female patients, respectively, p<0.01). Female surgeons performed significantly more female-specific procedures, such as slings, compared to their male counterparts (18 vs. 10/year, respectively, p<0.001). Male urologists performed significantly more male-specific procedures as their female colleagues, including three times as many vasectomies (32 vs. 12/year, p<0.001) and over twice as many prostatectomies (15 vs. 6/year, p<0.001). These trends were consistent across all subspecialties and geographic regions (p<0.01).

Female surgeon gender has a significant influence on patient gender demographics among index urologic procedures. As the number of women in urology grows, increasing attention to gender biases is necessary to understand how these disparities will shape the clinical landscape.

The Journal of urology. 2016 May 10 [Epub ahead of print]

Daniel T Oberlin, Amanda X Vo, Laurie Bachrach, Sarah C Flury

Northwestern University Feinberg School of Medicine; Department of Urology, Chicago, IL USA., Northwestern University Feinberg School of Medicine; Department of Urology, Chicago, IL USA., Northwestern University Feinberg School of Medicine; Department of Urology, Chicago, IL USA., Northwestern University Feinberg School of Medicine; Department of Urology, Chicago, IL USA.

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