Pattern of key opinion leaders talks at major international urological meetings reflects the main differences in flexible ureteroscopy and PCNL diffusion

Objective To analyze the pattern of speaker activity related to both flexible ureteroscopy (fURS) and percutaneous nephrolithotomy (PCNL) during plenary sessions at the main (endo)urological international meetings over the last 10 years. Methods We reviewed the meeting programs of the main endourological international meetings (EAU, AUA, WCE, and SIU) during 2011-2019. We detected all invited speakers at plenary sessions regarding fURS or PCNL. The proportion of fURS and PCNL talks was evaluated yearly during the study period. In order to analyze plenary session speaker composition, we estimated and compared the mean number of talks per speaker according to surgical technique. We also analyzed possible differences in age distribution according to the topic of the talk as well as the presence of young (i.e., < 45 years) speakers. Data were analyzed using descriptive statistics. Results During the last 10 years, a total of 498 plenary talks were found. Of those, 260 (52.2%), 211 (42.4%), and 27 (5.4%) discussed PCNL, fURS, or both, respectively. PCNL was more frequently discussed at the beginning and the end of the study period. Mean [SD] number of talks per speaker was higher for PCNL (2.9 [3.4] vs 1.6 [1.4], p < 0.001), meaning that a wider variety of speakers was invited to give fURS talks. Speakers discussing fURS were younger (median [interquartile range, IQR] age 48 [44-56] vs 52 [47-60] years, p < 0.001), and a higher proportion of young speakers was observed in the fURS group (26% vs 15% p < 0.001). PCNL speakers were more commonly discussing fURS than fURS speakers discussing PCNL (23% vs 17%, p = 0.43). Conclusions We found a wider variety of speakers at fURS plenary sessions as compared to PCNL ones. It is easier and quicker to become an internationally recognized expert in the field of fURS rather than PCNL. PCNL speakers were able to master fURS more frequently than the other way around.