A cross-sectional survey of endourology expertise and practice among urologists in Nigeria

Abstract Background Endourology, a minimally invasive subspecialty of urology, has transformed the diagnosis and management of various urological conditions. Despite its advances and global adoption, access to endourology treatment remains limited in Nigeria. There is inadequate information on the availability of expertise, equipment, and the training needs of urologists across the country. Objective This study assessed the level of endourology expertise among Nigerian urologists, examining their training background, proficiency in various endourological procedures, availability of equipment, and the challenges they face in adopting advanced techniques. Methods A cross-sectional survey was conducted among practising urologists in Nigeria. A structured questionnaire covering areas such as demographic data, training in endourology, types of endourological procedures performed, availability of appropriate equipment, and perceived barriers to further skill acquisition was administered. Responses were analysed using descriptive statistics. Results In total, 63 (42%) of the estimated 150 practising urologists in Nigeria responded. While most urologists had basic endourology training, only a minority performed complex procedures routinely. Only 23% performed percutaneous nephrolithotomy (PCNL) and 8% performed holmium laser enucleation of the prostate (HOLEP) as part of their routine work. The availability of modern endourological equipment, including flexible ureteroscopes and laser machines, was limited to a few centres in major cities. Significant barriers to advancing endourology expertise included lack of specialised training opportunities, limited access to modern equipment, and funding constraints. Conclusion Endourology expertise among Nigerian urologists is limited by insufficient access to advanced training and equipment. There is a need for structured training programs and increased investment in modern endourological tools to bridge the gap in skills and enhance urological care in the country.