Achieving sustainability in urology: a consensus study by the European association of urology (EAU) section office

Purpose: To assess the awareness, attitudes, and practices related to environmental sustainability among urologists and to explore targeted interventions, educational initiatives to enhance sustainability in urological practice while maintaining high standards of patient care. Methods: A focus group defined objectives and methodology. Ethical approval was obtained (NEU IRB: 22425), and the study was registered on ClinicalTrials.gov (NCT06723574). A two-stage approach was adopted: a cross-sectional survey among EAU Section Office and Working Group members to assess sustainability awareness and practices; followed by a single-round structured consensus statement to validate key findings and inform practical recommendations. While referred to as a ‘consensus statement’ in this manuscript, this process did not follow formal Delphi or multi-round consensus methodology. Results: A total of 83 out of 390 participants completed the first step survey (21.3% response rate), and 26 of 32 individuals responded to the consensus statement (81.3% response rate). The environmental awareness was reported as 61.5%, with 49.3% considering sustainability in instrument use. Respondents showed importance on implementing environmentally sustainable practices in the operating room, with 83.2% agreement rate. This study’s limitations include a restricted sample of participants, potential exclusion of early-career perspectives, single-round consensus limiting depth, and survey length possibly inducing fatigue. Broader, multi-phase research is recommended. Conclusion: Sustainability in urology appears to be increasingly recognized as an important aspect of high-quality care. Respondents in this cohort emphasized priorities such as improving waste management, adopting reusable instruments where feasible, and incorporating sustainability training into medical education.