The CAMUS Initiative: A Multiphase, Multicentre International Collaboration to Redefine Risk Stratification, Reporting, and Grading of Surgical Complications in Urology
Issued Date
2026-05-01
Resource Type
ISSN
26661691
eISSN
26661683
Scopus ID
2-s2.0-105034928791
Journal Title
European Urology Open Science
Volume
87
Start Page
57
End Page
70
Rights Holder(s)
SCOPUS
Bibliographic Citation
European Urology Open Science Vol.87 (2026) , 57-70
Suggested Citation
Soliman C., Sathianathen N.J., Corcoran N.M., Lawrentschuk N., Wuethrich P.Y., Furrer M.A., Ali F.A., Shah Bin Abd Karim M.F., Abouelenein M., Ghanem Y.A., Adam A., Adami A., Adamos K., Adamou C., Adeyeye A., Aellen F., Afferi L., Agarwal A., Agarwal D.K., Agarwal V., Agostini E., Agrawal M., Agüera Sánchez M.Á., Ahmad S., Ahour R.T., Akbarov I., Akbas S., Akdogan N., Aksaray E.E., Al-Bermani O., Al-Monajjed R., Al-Rammahi D., Albala D.M., Albers P., Albertsen P.C., Albuheissi S., Ali H.A., Ibrahim Ali Mohsen M.A., Almarzouq A., Altaylouni T., Ambulkar R., Amend B., Ameye F., Amparore D., Anastasiyeuskaya Y., Anceschi U., Anderson E., Anderson P.D., Angsurak C., Aning J., Antonelli L., Arif F., Rojas Y.A., Ascalone L., Asero V., Ather M.H., Atkinson J., Aufderklamm S., Aulenkamp J.L., Autorino R., Aziz A., Aziz E., Babjuk M., Babst C., Bachmann K., Badan S.C., Badani K.K., Badiger S., Baekelandt L., Bahlburg H., Bailey C.R., Barletta F., Barns M., Bashir A., Batura D., Beckmann D., Begum S., Beh M., Beilstein C.M., Bellos T.C., Benamran D., Bendova B., Benedetti M., Beraud F., Berg S., Bergauer L., Berger F.P., Berger Y., Marques Bernardino R.M., Berquin C., Berrens A.C., Berti L., Bertolo R., Betschart P., Bex A., Beyer B., Beyer J., Bhadranavar S., Bhojani N., Bianchi A. The CAMUS Initiative: A Multiphase, Multicentre International Collaboration to Redefine Risk Stratification, Reporting, and Grading of Surgical Complications in Urology. European Urology Open Science Vol.87 (2026) , 57-70. 70. doi:10.1016/j.euros.2026.01.012 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116153
Title
The CAMUS Initiative: A Multiphase, Multicentre International Collaboration to Redefine Risk Stratification, Reporting, and Grading of Surgical Complications in Urology
Author(s)
Soliman C.
Sathianathen N.J.
Corcoran N.M.
Lawrentschuk N.
Wuethrich P.Y.
Furrer M.A.
Ali F.A.
Shah Bin Abd Karim M.F.
Abouelenein M.
Ghanem Y.A.
Adam A.
Adami A.
Adamos K.
Adamou C.
Adeyeye A.
Aellen F.
Afferi L.
Agarwal A.
Agarwal D.K.
Agarwal V.
Agostini E.
Agrawal M.
Agüera Sánchez M.Á.
Ahmad S.
Ahour R.T.
Akbarov I.
Akbas S.
Akdogan N.
Aksaray E.E.
Al-Bermani O.
Al-Monajjed R.
Al-Rammahi D.
Albala D.M.
Albers P.
Albertsen P.C.
Albuheissi S.
Ali H.A.
Ibrahim Ali Mohsen M.A.
Almarzouq A.
Altaylouni T.
Ambulkar R.
Amend B.
Ameye F.
Amparore D.
Anastasiyeuskaya Y.
Anceschi U.
Anderson E.
Anderson P.D.
Angsurak C.
Aning J.
Antonelli L.
Arif F.
Rojas Y.A.
Ascalone L.
Asero V.
Ather M.H.
Atkinson J.
Aufderklamm S.
Aulenkamp J.L.
Autorino R.
Aziz A.
Aziz E.
Babjuk M.
Babst C.
Bachmann K.
Badan S.C.
Badani K.K.
Badiger S.
Baekelandt L.
Bahlburg H.
Bailey C.R.
Barletta F.
Barns M.
Bashir A.
Batura D.
Beckmann D.
Begum S.
Beh M.
Beilstein C.M.
Bellos T.C.
Benamran D.
Bendova B.
Benedetti M.
Beraud F.
Berg S.
Bergauer L.
Berger F.P.
Berger Y.
Marques Bernardino R.M.
Berquin C.
Berrens A.C.
Berti L.
Bertolo R.
Betschart P.
Bex A.
Beyer B.
Beyer J.
Bhadranavar S.
Bhojani N.
Bianchi A.
Sathianathen N.J.
Corcoran N.M.
Lawrentschuk N.
Wuethrich P.Y.
Furrer M.A.
Ali F.A.
Shah Bin Abd Karim M.F.
Abouelenein M.
Ghanem Y.A.
Adam A.
Adami A.
Adamos K.
Adamou C.
Adeyeye A.
Aellen F.
Afferi L.
Agarwal A.
Agarwal D.K.
Agarwal V.
Agostini E.
Agrawal M.
Agüera Sánchez M.Á.
Ahmad S.
Ahour R.T.
Akbarov I.
Akbas S.
Akdogan N.
Aksaray E.E.
Al-Bermani O.
Al-Monajjed R.
Al-Rammahi D.
Albala D.M.
Albers P.
Albertsen P.C.
Albuheissi S.
Ali H.A.
Ibrahim Ali Mohsen M.A.
Almarzouq A.
Altaylouni T.
Ambulkar R.
Amend B.
Ameye F.
Amparore D.
Anastasiyeuskaya Y.
Anceschi U.
Anderson E.
Anderson P.D.
Angsurak C.
Aning J.
Antonelli L.
Arif F.
Rojas Y.A.
Ascalone L.
Asero V.
Ather M.H.
Atkinson J.
Aufderklamm S.
Aulenkamp J.L.
Autorino R.
Aziz A.
Aziz E.
Babjuk M.
Babst C.
Bachmann K.
Badan S.C.
Badani K.K.
Badiger S.
Baekelandt L.
Bahlburg H.
Bailey C.R.
Barletta F.
Barns M.
Bashir A.
Batura D.
Beckmann D.
Begum S.
Beh M.
Beilstein C.M.
Bellos T.C.
Benamran D.
Bendova B.
Benedetti M.
Beraud F.
Berg S.
Bergauer L.
Berger F.P.
Berger Y.
Marques Bernardino R.M.
Berquin C.
Berrens A.C.
Berti L.
Bertolo R.
Betschart P.
Bex A.
Beyer B.
Beyer J.
Bhadranavar S.
Bhojani N.
Bianchi A.
Author's Affiliation
The University of British Columbia
University of Melbourne
Charité – Universitätsmedizin Berlin
Icahn School of Medicine at Mount Sinai
Cleveland Clinic Foundation
Eberhard Karls Universität Tübingen
National and Kapodistrian University of Athens
University of the Witwatersrand, Johannesburg
Universitätsklinikum Hamburg-Eppendorf
UniversitatsSpital Zurich
Università degli Studi di Modena e Reggio Emilia
KU Leuven– University Hospital Leuven
University Hospital Bern
Hôpitaux Universitaires de Genève
CHU Lille
Tartu Ülikool
Universitätsklinikum Essen
UConn Health
Universitair Ziekenhuis Gent
Royal Melbourne Hospital
Guy's and St Thomas' NHS Foundation Trust
San Raffaele Scientific Institute
Khalifa University
The Netherlands Cancer Institute
Centre Hospitalier de L'Université de Montréal
Universitätsklinikum Düsseldorf
Universitätsklinikum Jena und Medizinische Fakultät
Singapore General Hospital
The Aga Khan University
Tata Memorial Hospital
Fakultní Nemocnice v Motole
Faculty of Medicine
University of Jeddah
Azienda Ospedaliera Universitaria Integrata Verona
Sir Charles Gairdner Hospital
IRCCS Regina Elena National Cancer Institute
Seth GS Medical College and KEM Hospital
Universitätsklinikum Halle und Medizinische Fakultät
Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona
Faculty of Medicine Ramathibodi Hospital, Mahidol University
The James Cook University Hospital
Fakultní Nemocnice Plzeň
North Bristol NHS Trust
Belfast City Hospital
University General Hospital of Patras
Afe Babalola University
Western Health
Central Lisbon University Hospital Center, EPE (CHULC)
Universiteit Ghent, Faculteit Geneeskunde en Gezondheidswetenschappen
Candiolo Cancer Institute-FPO- IRCCS
Çukurova Üniversitesi Tip Fakültesi
Universität Luzern
Marien Hospital Herne
Hospital Universitario de Fuenlabrada
Hospital Universitario de Puerto Real
Modibbo Adama University of Technology, Yola
Klinikum Lippe GmbH
Instituto de Assistencia Medica ao Servidor Publico Estadual
Bürgerspital Solothurn
Crouse Hospital
Kantonsspital St Gallen, Klinik fur Urologie
AZ Maria Middelares
Kliniken Hartenstein
Jupiter Hospital
München Klinik Bogenhausen
San Carlo di Nancy Hospital
State Hospital of Bregenz
London North West NHS Healthcare
Solothurner Spitäler AG
Kreiskrankenhaus Reutlingen
Urologie am Stephanshorn
Mediteranean Private Hospital
University of Melbourne
Charité – Universitätsmedizin Berlin
Icahn School of Medicine at Mount Sinai
Cleveland Clinic Foundation
Eberhard Karls Universität Tübingen
National and Kapodistrian University of Athens
University of the Witwatersrand, Johannesburg
Universitätsklinikum Hamburg-Eppendorf
UniversitatsSpital Zurich
Università degli Studi di Modena e Reggio Emilia
KU Leuven– University Hospital Leuven
University Hospital Bern
Hôpitaux Universitaires de Genève
CHU Lille
Tartu Ülikool
Universitätsklinikum Essen
UConn Health
Universitair Ziekenhuis Gent
Royal Melbourne Hospital
Guy's and St Thomas' NHS Foundation Trust
San Raffaele Scientific Institute
Khalifa University
The Netherlands Cancer Institute
Centre Hospitalier de L'Université de Montréal
Universitätsklinikum Düsseldorf
Universitätsklinikum Jena und Medizinische Fakultät
Singapore General Hospital
The Aga Khan University
Tata Memorial Hospital
Fakultní Nemocnice v Motole
Faculty of Medicine
University of Jeddah
Azienda Ospedaliera Universitaria Integrata Verona
Sir Charles Gairdner Hospital
IRCCS Regina Elena National Cancer Institute
Seth GS Medical College and KEM Hospital
Universitätsklinikum Halle und Medizinische Fakultät
Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona
Faculty of Medicine Ramathibodi Hospital, Mahidol University
The James Cook University Hospital
Fakultní Nemocnice Plzeň
North Bristol NHS Trust
Belfast City Hospital
University General Hospital of Patras
Afe Babalola University
Western Health
Central Lisbon University Hospital Center, EPE (CHULC)
Universiteit Ghent, Faculteit Geneeskunde en Gezondheidswetenschappen
Candiolo Cancer Institute-FPO- IRCCS
Çukurova Üniversitesi Tip Fakültesi
Universität Luzern
Marien Hospital Herne
Hospital Universitario de Fuenlabrada
Hospital Universitario de Puerto Real
Modibbo Adama University of Technology, Yola
Klinikum Lippe GmbH
Instituto de Assistencia Medica ao Servidor Publico Estadual
Bürgerspital Solothurn
Crouse Hospital
Kantonsspital St Gallen, Klinik fur Urologie
AZ Maria Middelares
Kliniken Hartenstein
Jupiter Hospital
München Klinik Bogenhausen
San Carlo di Nancy Hospital
State Hospital of Bregenz
London North West NHS Healthcare
Solothurner Spitäler AG
Kreiskrankenhaus Reutlingen
Urologie am Stephanshorn
Mediteranean Private Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
Surgical complications remain a major source of preventable morbidity, mortality, and health care expenditure, but existing frameworks such as the Clavien-Dindo classification and Comprehensive Complication Index are clinician-centred and intervention-focused and fail to capture cumulative patient-centred outcomes. This protocol outlines the Complications After Major and Minor Urological Surgery (CAMUS) initiative, a global, multiphase effort to redefine complication reporting, risk stratification, and outcome measurement in urological surgery. CAMUS aims to address these limitations via an integrated, seven-arm programme combining retrospective and prospective data analysis, consensus development, and digital infrastructure design. Arm 1 has assembled a retrospective data set of 130 034 major urological procedures from 180 centres across 33 countries, the largest of its kind. Arms 2 and 3 have completed Delphi surveys with physicians (n = 1113) and pilot nursing participants (n = 20) and has generated consensus on novel grading domains and highlighted the importance of multidisciplinary perspectives. Arm 4 will incorporate patient-reported outcomes and behavioural economics methods to quantify subjective burdens, while arm 5 will develop the CAMUS Intraoperative and Postoperative Risk and Difficulty Estimation Index (IPRADES) for surgical risk and difficulty prediction. Arms 6 and 7 will build a secure e-database and dictionary and prospectively validate the system using >2000 new cases. Statistical methods include multivariable regression, meta-analysis of individual patient data, and machine-learning approaches to model predictors of morbidity and mortality. Outputs will be benchmarked internationally to facilitate both clinician- and patient-driven definitions of complication severity. Ultimately, CAMUS will deliver a reproducible, patient-inclusive classification system with broad applicability to clinical practice, audits, education, and policy. By integrating more than 130 000 procedures with global Delphi consensus, CAMUS represents the most comprehensive complication classification initiative undertaken in surgery. Its outputs are expected to improve transparency, standardise reporting, and inform patient-centred risk stratification worldwide.