Threshold volumes for urological cancer surgery: A survey of UK urologists

Martin C. Nuttall*, Jan Van Der Meulen, Gregor McIntosh, David Gillatt, Mark Emberton

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

14 Citations (Scopus)


OBJECTIVE: To determine minimum threshold levels of activity set by surgeons for urological cancer surgery, and to relate threshold levels to stated current procedural volume. METHODS: In all, 307 consultant urological surgeons were sent a questionnaire asking them to state for four urological cancer operations of different complexity their current procedural volume; whether minimum volume thresholds per surgeon should be implemented; and if so, the level of such thresholds; 212 (690/0) replied. RESULTS: For all four procedures ≥75% of surgeons advocated the setting of a minimum volume threshold. Overall, surgeons set the highest thresholds for radical prostatectomy and the lowest for radical cystectomy with continent diversion. There was no significant association between either the principle of supporting minimum volume thresholds or the level of such a threshold and the number of years worked as a consultant surgeon. The level of surgeon-derived minimum thresholds increased with increasing surgeon procedural volume. CONCLUSION: Most surgeons supported the principle of setting minimum volume thresholds. These thresholds appear to be influenced by current procedural volume and by procedural complexity. By setting thresholds greater than their current volume, some surgeons implicitly indicate that their current volume is insufficient to maintain their surgical competency.

Original languageEnglish
Pages (from-to)1010-1013
Number of pages4
JournalBJU international
Issue number7
Publication statusPublished - Nov 2004
Externally publishedYes


  • Surgical outcomes
  • Urological cancer
  • Volume thresholds


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