Mauro Gacci

Background/Objectives: Recently, the European Association of Urology (EAU) guidelines presented the EAU guidelines bot to assist urologists in the reading of the guidelines; however, to date, no external validation is available. The aim of our study is to assess the accuracy, completeness, and clarity of the guidelines bot in reading renal transplantation guidelines and clinical cases. Methods: A total of 103 questions derived from the recommendations included in the EAU guidelines on renal transplantation, together with 10 distinct clinical scenarios, were created. Each question and clinical case was submitted to the EAU guidelines bot, and the corresponding responses were independently evaluated by two expert urologists in terms of accuracy, completeness, and clarity. Each domain was scored using a 5-point Likert scale. In cases of disagreement between the two reviewers, a third urologist was consulted. Accuracy, completeness, and clarity were analyzed for the clinical cases and per chapter and grade of recommendation for the questions. Results: Overall, 103 questions were generated. Regarding accuracy, 101/103 responses (98%) were classified as accurate, corresponding to scores of 4–5, whereas 2/103 responses (2%) showed fair accuracy, corresponding to a score of 3. No responses were considered inaccurate, defined as a score of 1–2. In terms of completeness, 101/103 responses (98%) were judged to be complete, with scores of 4–5, while 2/103 responses (2%) were rated as fairly complete, with a score of 3. No responses were classified as incomplete. With regard to clarity, 102/103 responses (99%) were considered clear, corresponding to scores of 4–5, whereas 1/103 response (1%) was rated as fairly clear, with a score of 3. No responses were deemed unclear. No significant differences were observed when comparing responses related to strong versus weak recommendations. For the clinical scenarios, 8/10 responses (80%) were rated as accurate, with scores of 4–5, while 2/10 responses (20%) showed fair accuracy, with a score of 3. Regarding completeness, all 10 responses (100%) were classified as fairly complete, corresponding to a score of 3. Finally, in terms of clarity, 8/10 responses (80%) were judged to be clear, with scores of 4–5, whereas 2/10 responses (20%) were rated as fairly clear, with a score of 3. Conclusions: The EAU guidelines bot represents an accurate tool for renal transplantation. Besides some occasional inaccuracies the bot is an excellent tool for urologists, especially to clarify doubt about the EAU guidelines. At the same time, it can give good support when facing a clinical case.

Background/Objectives: Recently the European Association of Urology (EAU) guidelines presented the EAU Guidelines bot to assist urologists in the reading of the guidelines; however, there is a lack of up-to-date external validation. The aim of our study is to assess the accuracy, completeness, and clarity of the guidelines bot in urethral strictures. Methods: A total of 117 questions based on the EAU urethral strictures guidelines recommendations were developed. Each question was input to the EAU guidelines bot and the response was assessed by two expert urologists to assess the accuracy, completeness, and clarity. Moreover, 10 simple clinical cases were input. A 5-point Likert scale was used as a score and, in case of discrepancies, a third urologist was queried. Accuracy, completeness and clarity were assessed per chapter and per grade of recommendation. All questions and answers were recorded in an Excel file. Results: Overall 117 questions were developed. In terms of accuracy, 111/117 (95%) were defined as accurate (scores 4–5), 4/117 (3%) presented a fair accuracy (score 3), and 2/117 (2%) were deemed not accurate. In terms of completeness, 93/117 (80%) were defined as complete (scores 4–5), 22/117 (19%) presented a fair completeness (score 3), and 2/117 (2%) were deemed not complete. Finally, in terms of clarity, 104/117 (89%) were defined as clear (scores 4–5), 13/117 (11%) presented a fair clarity (score 3), and 0/109 (0%) were deemed not clear. When comparing strong and weak recommendations, no differences were recorded. Overall the answers to simple clinical cases were in line with the guidelines with good accuracy, completeness and clarity scores. Conclusions: The EAU guidelines bot represents an accurate tool for urethral stenosis guidelines. Some fine-tuning is needed to improve readability and clarity.

Background/Objectives: Urology residency training widely varies across countries, and evidence comparing residents’ experiences at an international level is limited. This study reports the results of an international survey of urology residents from different countries worldwide, aiming to characterize training environments, educational exposure, and trainee expectations across diverse healthcare systems. Methods: A 39-item online survey was administered to urology residents during the Société Internationale d’Urologie (SIU) Regional Meeting (Florence, November 2024), assessing demographics, training exposure, educational resources, workload, satisfaction, and career perspectives. The results were compared between trainees at different postgraduate years (PGYs) to explore associations for key outcomes. Results: Overall, 208 urology residents from 21 countries completed the survey. Most residents were actively involved in research (76.4%), although confidence in independent scientific production was moderate (significantly lower among junior trainees). Surgical exposure increased with PGY, with good experience in endoscopy but limited hands-on exposure and expected autonomy in laparoscopic, robotic, and major open surgery. Despite high overall satisfaction with urology, residents described heavy workloads, inconsistent access to structured teaching and international fellowships, and a long-term shift in career expectations toward private practice. Conclusions: Urology residents worldwide report high engagement in research, strong satisfaction with their specialty choice, and interest in international mobility. Nonetheless, persistent disparities in surgical exposure, research confidence, workload, and gender representation highlight the need for competency-based curricula, structured mentorship, and improved training organization to promote equitable and high-quality urology education globally.