[Is volume of surgical activity relevant for surgeon's evaluation?]

"Often done, better done" is a popular saying that may lead health authorities to use the volume of surgical activity to assess surgical quality, including eventually this criteria in their certification manual. Very few data indeed support this idea in Urology. On the other hand, well-conducted studies clearly show that high volume activity does not always avoid surgical complications. Moreover, fair statistics should be applied to urologists, with proper calculation of confidence intervals, before scrutinizing reasons why they may appear "to differ" from the assigned goal or their colleagues' average. This, for major urologic operations, can only be done after a prolonged observation period, sometimes reaching over a decade.