Primum Non Discernere: Glass Ceilings and Female Representation at the European Association of Urology and European Society for Paediatric Urology Annual Meetings, 2012-2022

Background

The term glass ceiling coined by Loden in 1978 is commonly used to describe difficulties faced by minorities and women when trying to move into senior roles.

Objective

To analyse trends and patterns for female representation at the European Association of Urology (EAU) and European Society for Paediatric Urology (ESPU) annual general meetings over the past decade.

Design setting and participants

We used objective data on female representation in the roles of chairs, moderators, and lecture speakers at the EAU and ESPU meetings from 2012 to 2022.

Outcome measurements and statistical analysis

We evaluated gender based representation in paediatric urology sessions at the EAU and ESPU meetings, collecting data on the overall number of sessions, lectures, symposiums, abstract/poster sessions, and courses, and analysed the male/female ratio. Data were derived from printed and digital programmes for the relevant meetings.

Results and limitations

During the period from 2012 to 2022, the percentage female representation varied from 0% (2012) to a maximum of 35% (2022) at EUA paediatric urology sessions, and from 13.5% (2014) to a maximum of 32% (2022) at ESPU meetings. Both associations show clear progression towards equality.

Conclusions

Female representation at EAU and ESPU meetings has risen over the years, reaching 35% and 32%, respectively, in 2022, which is in line with the number of female members. We hope that this motivates a move towards the equality objectives for 2030. A clear and fundamental societal change is needed, with fair and more consistent institutional policies and framework commitments in the areas of science, medicine, and global health. Gender equality and diversity taskforces are essential to achieve these goals.

Patient summary

We analysed the male/female ratio for participants in annual meetings held by the European Association of Urology and the European Society for Paediatric Urology. From a low level in 2012, the ratio increased to over 30% in 2022, in line with the female membership of the societies. Focus on fair and consistent policies is needed to ensure that women are well represented in medicine.

Xanthogranulomatous endometritis. Report of six cases and a proposed mechanism of development

Xanthogranulomatous endometritis is a rare pathologic finding with only five cases reported in the literature. On review of our files over the past 12 years, we found six cases of xanthogranulomatous endometritis, all associated with endometrial adenocarcinoma that had been irradiated by external beam and/or intracavitary implants prior to surgery. Histologically, these cases were characterized by foamy histiocytes with variable amounts of associated multinucleated giant cells, other chronic inflammatory cells, necrosis, calcium, cholesterol clefts, and hemosiderin. Xanthogranulomatous features were not present in the pretreatment endometrial biopsy specimens from any of the six patients. Contributory factors to the development of xanthogranulomatous endometritis such as necrosis, hemorrhage, obstruction, tumor bulk, or delay in treatment were identified. The mechanism of development of xanthogranulomatous endometritis may involve a complex interaction of elements common to the development of xanthogranulomatous change in other organs (obstruction, inflammation, and a lipid source) as well as elements unique to irradiated tissue (generation of free radicals and lipid peroxidation). These cases indicate that radiation injury in the setting of endometrial adenocarcinoma is an additional etiopathologic finding ofulomatous endometritis.

Effects of prostaglandins on the pulmonary vascular bed of newborn rats with chronic hypoxia

We investigated the effects of prostaglandins (PG) E1, I2 and D2 on the pulmonary vascular bed of newborn rats subjected to chronic hypoxia. Forty seven newborn rats were exposed to chronic hypoxia (10% oxygen) for 23 days and divided into five groups which received PGE1 (N = 10), PGI2 (N = 9), PGD2 (N = 11), placebo (N = 9) or served as controls (N = 8). The PG's were administered by implanting slow release subcutaneous pellets delivering an average daily dose of 1 microgram. Thirteen newborn rats in room air received either placebo or served as controls. All rats were killed after 23 days and heart-lung preparations were perfusion fixed with glutaraldehyde. Appropriate blocks were processed for quantitative morphometry of the pulmonary parenchyma, arteries and arterioles. For analysis the pulmonary vessels were grouped by external diameter, i.e. 30-50 mu and 50-100 mu. External diameter/lumen diameter, an index of medial smooth muscle mass, was 1.39 +/- 0.02 in room air controls, this index of medial muscle mass was significantly increased (p less than 0.01) to 1.53 +/- 0.03 in hypoxic controls and the PGD2 and PGI2 groups. However, the PGE1 group did not have medial hypertrophy evidenced by a medial muscle mass index of 1.34 +/- 0.04, similar to room air controls. These findings suggest that PGE1 may prevent the development of medial hypertrophy that occurs in chronic hypoxia.

Placental exchange area in guinea pigs following long-term maternal exercise: a stereological analysis

We have used stereological techniques to measure the peripheral labyrinth exchange area of the guinea pig placenta in groups of animals which were exercised 0, 15, 30, 45, or 60 min daily throughout pregnancy. The surface area of the maternal lacunae in the peripheral labyrinth decreased linearly as a function of exercise duration, and the maternal volumes of each exercised group were consistently lower, but not linearly. Placental diffusing capacity for carbon monoxide decreased as a function of exercise duration (r = - 0.88, P less than 0.05). Placental CO diffusing capacity was directly proportional to both maternal surface area of a given volume of peripheral labyrinth (mm2/mm3) (r = 0.43, P less than 0.01), and to the total surface area of the placenta (mm2 . g/mm3) (r = 0.53, P less than 0.001). In addition, diffusing capacity correlated to the total fetal surface area (mm2 . g/mm3), (r = 0.53, P less than 0.001). Average fetal and placental weights did not change significantly in the different exercise groups. Individual fetal weights were proportional to placental diffusing capacity and to both the total maternal and fetal placental exchange area. These results demonstrate for the first time that diffusing capacity of the guinea pig placenta is a function of the surface area of the placenta.