International Volunteers in Urology (IVU), founded by Dr Catherine deVries in 1995, has become synonymous with urologic international medicine, and since its induction, has continued to succeed on the mission of “Teach One, Reach Many.” But why should it remain important to urologists? A quick Google search will highlight numerous nonprofit organizations that offer opportunities for dedicated surgeons to volunteer their skills and abilities to treat those in need both nationally and internationally. Larger organizations may offer certain advantages, so why support a “mom and pop” nonprofit organization like IVU? Our answer is simple: urologists, a small group of highly specialized surgeons who are individuals that thrive in the humble modesty of our expertise. Let’s face it, urologists aren’t typically the poster children for surgical care either locally or nationally, and prime time will likely never be ready for the sensitive nature of our specialty, except the occasional shout-out from a celebrity treated for prostate cancer. Despite the COVID-19 pandemic, which notably did not discriminate among organizations based on size or funding, urologic needs continue to exist, and this brief intermission only highlighted the importance of strong collaborations among urologists all over the world, particularly with IVU.

The pandemic only seemed to make IVU stronger. Admittedly, we are biased, but the brief downtime allowed us to restructure, refocus, and connect on a whole other level with our local and international partners. We transitioned from travel-heavy, always scrapping for donations of both supplies and funding to critically evaluating who we are as an organization and where we see IVU in the future. We have always had strong relations with international partners and dedication to training, but the desire for educational support and connectivity not only persisted but increased among the travel restrictions. Out of COVID, a new curriculum was born with the creation of visiting virtual professorships, where over 68 volunteers have provided a total of 116 live lectures, case presentations, and consultations, covering a broad range of topics including all subspecialties.¹ Interestingly, 62% of the lecturers had never conducted an in-person IVU workshop. Despite the obstacles at the forefront of the pandemic, more evidence has come forth of urologists wanting to be involved with a known entity, providing education and training to others. IVU has added an easily accessible archive of all lectures, including a YouTube channel, and continues to expand this program with question-and-answer sessions and expert consultations.

One of the criticisms of all global health efforts has been lack of follow-up and tracking of outcomes. This hasn’t been lost on IVU, and the time off from active trips has allowed us to further our ongoing efforts for research and asking tough, but pivotal questions. While many patients have been served and many urologists trained, have we made a lasting impact? Have we made things worse by bringing supplies not readily available to hosts? Is the local team able to offer these procedures on a regular basis for their patients? IVU has critically assessed the impact, good or bad, that it has had as an organization to understand the durability of its workshops. IVU took inventory of its global impact as highlighted in a review of its 20th anniversary.² In this time, 292 workshops were conducted in 39 countries for a total of 104,805 volunteer hours by 3024 doctors, 1068 nurses, 104 residents, and 559 other volunteers. During these workshops, 11,297 patients were evaluated with 7540 surgeries performed. Another important outcome has been the development of an electronic record system, in its infancy currently, to provide more formalized documentation of IVU work which enables long-term follow-up of more concrete outcome measures. Once COVID restrictions were lifted and international travel safely resumed, a small, 2-surgeon pediatric workshop was conducted in April 2022 to collaborate and work alongside one of our long-standing colleagues in Zambia. Since then, IVU has traveled to 18 sites with workshops covering various subspecialties including 7 oncology, 6 adult reconstruction, 4 pediatrics, and 1 female medicine pelvic and reconstructive surgery. More than 300 patients were evaluated with nearly 250 procedures performed with over 300 participating international physicians, nurses, and support staff.

One of the best attributes of IVU is its commitment to exposing the next generation of urologists to international medicine. Historically, this has been through scholarships graciously donated by the AUA Sections with highlights from the scholars at the section meetings. The impact, however, has been so significant and recognized by both volunteering urologists and institutions who will often offset the financial burden, thus allowing even more opportunities for trainees to participate. The mission of these trips from a trainee’s perspective is not about case volume and enhancing operative experiences; instead, these workshops provide a unique understanding of different health care systems, increasing cultural sensitivity while forming lasting relationships, and ultimately gaining an awareness of the global burden of surgical disease. Trainees experience firsthand knowledge of practicing in resource-limited areas, and it is always entertaining to watch the bewildered faces while witnessing the placement of a suprapubic catheter without a “kit.” The idea of incorporating humanitarian trips into resident curriculum is not new, and many specialties have already done so with a universal theme of high interest among participants, but significant barriers still exist before widespread incorporation can become standard practice.³ Since the return of in-person workshops in 2022, IVU and its volunteers have supported 18 trainees. IVU has been committed to supporting resident scholars since the beginning and will continue to impact future generations of urologists and global humanitarians.

Urologic diseases remain a global burden, and IVU’s mission has not wavered despite limited access during the COVID-19 pandemic. In fact, the commitment to “teach one, reach many” has only strengthened with further efforts to enhance access, outcomes-based research, and building close relationships with colleagues to create global centers of excellence. While larger organizations have their merits, IVU offers urologists unique opportunities for meaningful contributions, personal satisfaction, and a sense of camaraderie among colleagues and patients locally and internationally.