Women in urology: Gender differences in urologists' authorship in high impact journals.

Background: The number of women among medical doctors and surgeons continues to rise. However, urology remains one of the least preferred specialties by female physicians, resulting in the inadequate academic representation of female urologists. In this study we examined changes in the representation of female urologists in the journals European Urology (EU) and Journal of Urology (JOU) and investigated in which urology subspecialties female urologists focus their academic studies.

Methods: Original articles, reviews and case reports published in EU and JOU were included in the study. The analysis was limited to 4 years, starting with 2004 and continuing at 5-year intervals until 2019.The publications were also classified according to urology subspecialty and geographic location.

Results: In total, 2708 articles were analysed. Overall, women accounted for 9.9% of first authors (267/2708) and 5.9% of senior authors (161/2708).The proportion of female first authors was 8.2% in 2004 and increased to 10.7% in 2009, 10.6% in 2014, and 11.6% in 2019 (P = 0.062). The proportion of female last authors was 7% in 2004 and 5.3%, 6.1%, and 2.5% in 2009, 2014, and 2019, respectively (P = 0.011). Women accounted for a significantly higher proportion of first authors than men in publications related to female and paediatric urology (P = 0.001 and P = 0.002, respectively).

Conclusions: The increasing number of women urologists worldwide is not reflected in the scientific authorship of female urologists. Multicenter studies focusing on the elimination of gender disparity in academic representation are needed in surgical branches such as urology.