[Crisis, disaster and war: the role of urology in resilient healthcare structures].

Abstract

Europe's changed security environment requires the German healthcare system to prepare for crises, disasters, and war. Planning must address not only a sudden influx of casualties but also failures of energy supply, information technology, communications, supply chains, and staffing. This does not justify unrestricted expansion of the urologist's professional remit. In mass casualty incidents, urological contributions should follow a graded competency model: trauma bay and team tasks, surgical assistance, defined core urological procedures, and advanced capabilities restricted to selected experts. Resilience depends on prioritized care, network-based capacity management, analogue fallback procedures, critical stockpiles, and regular exercises. Surgical training for rare open emergency procedures can be supplemented by simulation-based training and interdisciplinary courses. The authors propose a modular, assessable qualification pathway combining stepwise training in routine clinical care, simulation, rotations, and competency assessment. Its purpose is to reinforce interdisciplinary teams while safeguarding routine and emergency urological care.