20 minute read
Vol. 32 No.1 - January/February 2020
Prof. M. Wirth says goodbye after 16 years EAU Executive responsible for Finance and Communications Urgency urinary incontinence in MS patients The disease, urological treatment and therapeutic guidelines Dr. S. Charalampous 2 12 27
Advertisement
The European robotic curriculum fellowship How do you prepare to get the most out of it
Dr. J. Vicente
EAU20: Europe’s finest in urology premieres in Amsterdam Novel scientific updates to expect at the Plenary Sessions
The upcoming 35th Annual EAU Congress (EAU20) will bring practice-changing updates to the forefront when it commences in Amsterdam this March. One of the exemplary elements of EAU20’s Scientific Programme is its Plenary Sessions. In this article, seven respected and prominent urologists, who will chair the sessions, offer a glimpse of the novel scientific content that constitute the Plenary Sessions.
New frontiers in infections Modern PCa imaging in daily practice LUTS and storage symptoms The role of innovation in stone management
Dr. John Heesakkers (NL), Plenary Session 1: New frontiers in infections, 21 March
Views on the diagnosis and treatment of urinary tract infections (UTIs) substantially vary per country. In some, the use of antibiotics in UTI treatment is extensive and tailor-made to the patient. In others, disease management is based on the restriction of antibiotics usage to overcome antibiotic resistance.
What are the consequences of these contrasting assessments? Is one better than the other? Is it possible to create guidelines on infections when local situations concerning bacteria load and antibiotic resistance differ from region to region? This Plenary Session will investigate to find the answers to these questions.
Testis cancer and surgical andrology
Dr. Jochen Walz (FR), Plenary Session 3: Modern prostate cancer imaging in daily practice, 22 March
Modern imaging is substantially changing the way how we diagnose and treat prostate cancer (PCa). Multiparametric MRI improved the detection of the disease but the new MRI pathways generate new problems, i.e. decisions to biopsy or whether to favour treatment or surveillance need to be adapted and put into context with regard to new developments such as biomarkers and genomics.
This Plenary Session will address these issues in detail and offer answers on how imaging can be integrated in new clinical pathways and clinical decision-making.
Moreover, molecular imaging provides substantial improvements in detection and location of recurrent disease. The challenge is how to integrate this information into the clinical decision-making and risk stratification. Perhaps the use of artificial intelligence will be the solution in the future. The last presentation will give answers to this hypothesis.
If complication cases came to court...
Dr. Maarten Albersen (BE), Plenary Session 2: #Testis cancer and surgical andrology, 21 March
Plenary Session 2 will kickstart with updates on surgical andrology and a review of the new 2020 EAU Guidelines on Peyronie’s disease. The session will also focus on diseases that result from the testicular dysgenesis syndrome, and review the links with fertility, carcinoma in situ, and invasive testicular cancer. In addition, the esteemed Prof. Kyle Orwig (US) will present pioneering research in fertility preservation.
To reduce treatment burden in testis cancer, the Plenary Session will explore the promising role of micro RNAs in patient selection, and conduct a case-based discussion on the role of robotic-assisted complex retroperitoneal surgery.
January/February 2020 Mr. Tim O’Brien (GB), Plenary Session 4: Nightmare on robotics, 22 March
Plenary Session 4 will explore the complications of robotic surgery through the prism of the law courts. Leading medico-legal lawyer, Mr. Bertie Leigh (GB), is back for his fourth EAU congress and ready to hold urologists accountable for their decisions.
The session will feature three scenarios: Should I proceed to perform open surgery after machine failure during robotic-assisted radical prostatectomy (RARP)? Was I ready for the transition to inferior vena cava (IVC) surgery in renal cell carcinoma? Who is responsible for table-side errors?
The Plenary Session will be raw and likely, entertaining. It will challenge assumptions concerning decision-making, consent and safety during surgery. Prof. Jean-Nicolas Cornu (FR), Plenary Session 6: Bladder dysfunction, storage symptoms and benign prostatic disease, 23 March
Lower urinary tract symptoms (LUTS) in men often include storage symptoms (e.g. overactive bladder) and/or nocturia. Whilst the underlying pathophysiology of non-neurogenic storage symptoms is more understood and mainly relying on bladder dysfunction, their management remains complex in clinical practice. This is especially so when benign prostatic obstruction is present. Mixed symptoms are also a major cause of persistent LUTS after surgery which are a daily challenge for the urologist.
The discussants will deliver key practical messages on how to identify the symptoms and rule out a neurological origin. Through real-life cases, panels will discuss the best medical treatment for overactive bladder (OAB) in men; the best ablative surgical option between resection, vaporization, enucleation and aquablation in case of concomitant storage symptoms and proven obstruction; and an update about minimally invasive, day-case surgical strategies.
Challenges across the BCa spectrum
Prof. Thomas Knoll (DE), Plenary Session 7 Stones: The role of innovation, 24 March
The removal of stones, which is a daily business for most urologists, is driven by innovation. Treatment has shifted from open and shock wave lithotripsy to endoscopic approaches; and ureteroscopy and percutaneous nephrolithotomy became the standard. However, safety aspects have to be respected for the reduction of septic complications such as intrarenal pressure or antibiotic prophylaxis.
Since fluoroscopy is used as a standard imaging modality, radiation safety includes both the patient and the surgical team. The second part of the Plenary Session will determine when and if new lasers, ballistic lithotripters, and scopes are required. This will be followed by a round-table deliberation among experts on a challenging stone case. Plenary Session 7 will raise your knowledge on stone intervention to the next level. Don’t miss it!
You are invited!
Join us for the Opening Ceremony on Friday 20 March, 18.00-19.30, in eURO Auditorium 1*
Prof. Morgan Rouprêt (FR), Plenary Session 5: Challenges across the spectrum of bladder cancer, 23 March
The landscape for novelties in bladder cancer (BCa) has not changed as quickly as it did in the past few years. Molecular pathway, description of new biological mechanisms, markers in blood and urine, and several drugs in the pipeline make this topic extremely appealing.
We aim to find more solutions to challenges in organ preservation, personalised medicine, proper usage of tools, a wise indication of cystectomy, follow-up schedule, and implementation of immunotherapy in the management of local and locally-advanced BCa.
*) Including prestigious EAU Awards
The Opening Ceremony will be followed by a Networking Reception in the foyer of eURO Auditorium 1 until 21.00 hrs.
EAU20 Amsterdam March will see the publication of the full text and pocket versions of the 2020 European Association of Urology Guidelines. As always, the Guidelines will be available to collect - free for EAU full members - from the EAU Booth at EAU20, Amsterdam.
European Association of Urology Guidelines 2020 edition
The Guidelines Office is pleased to announce that it will once again facilitate multiple interactive activities during EAU20, these include:
• Two interactive workshop sessions on Guidelines Controversies – Saturday, 21 March, 14.30-16.30 hrs. and Sunday, 22 March, 14.00-16.00 hrs. These sessions will see pro and con presentations on areas within the EAU Guidelines which have highly conflicting evidence. Each set of presentations will be followed by a methodological comment/elaboration, and audience voting. Topics to be discussed include: • Small renal mass: Treat or observe? • Treatment options of bladder neck contracture and incontinence after radical prostatectomy: Does it change after adjuvant radiotherapy? • Flexible ureterorenoscopy or imaging for upper tract urothelial cancer? • Standard TURB or office fulguration or active surveillance for small papillary recurrence in the bladder? Are hospital urologists really necessary? • Haematuria: Always cystoscopy? • High-risk non-seminoma CS 1: 1x BEP or surgery?
• A thematic session on the new EAU guidelines on Male Sexual and Reproductive Health: Challenges and Controversies – Monday, 23 March, 10.30- 12.00 hrs.
• Three European School of Urology courses: • Updates and controversies: Incontinence, bladder/paediatric stones and Male LUTS – Friday, 20 March, 15.30-17.30 hrs. • Updated renal, bladder and prostate cancer guidelines 2020: What has changed? – Monday, 23 March, 8.30-11.30 hrs. • Prostate cancer challenges and controversies from guidelines to real world – Monday, 23 March, 12.00 – 15.00 hrs.
These courses will offer a bird’s eye overview of changes in the recommendations of each Guideline and their relevance for clinical practice giving attendees a quick insight into how the different fields are progressing.
• EAU Guidelines Poster Walk – Friday, 20 March, 11.30-13.30 hrs. Take a guided tour through the best poster abstracts from the EAU Guidelines Panels and Committees.
In addition to this exciting programme of events, the Guidelines Office will also have a presence at the EAU20 exhibition. We would encourage everybody to please stop by the EAU Publications booth and meet our Guidelines Office staff, who will be more than happy to answer any questions you may have regarding the many activities of the Guidelines Office.
Systematic Review Training Workshop The Room Mate Aitana Hotel in Amsterdam was the venue for a well-attended Guidelines Office Systematic Review Workshop at the end of November 2019. The intensive two-day event saw established Guidelines Panel members, experienced associates and newer recruits participate in a packed programme of events, which featured presentations from the faculty in the morning and practical sessions in the afternoon.
The training covered topics such as the development of a search strategy, abstract and full text screening, data abstraction, and data analysis and interpretation. The Guidelines Office Chairman, Prof. James N’Dow, opened the event as usual and particularly welcomed the new recruits to the Guidelines team.
The training workshop was coordinated by the Guidelines Office Methods Committee. Post-course feedback showed a high level of satisfaction among all those that attended. Particularly well-received were the practical sessions which allowed attendees to apply the lessons learned in the presentations.
Recent publications from Panels We are very pleased to announce that several papers from Guidelines Panels have recently been accepted for publication:
• EAU/ESPU Guidelines on the Management of Neurogenic Bladder in Children and Adolescent - Part I: Diagnostics and Conservative Treatment Stein, R, et al. Neurourol Urodyn. 2019 Nov 13, [ahead of print].
• EAU/ESPU Guidelines on the Management of Neurogenic Bladder in Children and Adolescent - Part II: Operative Management Stein, R, et al. Neurourol Urodyn. 2019 Dec 3, [ahead of print].
• Practical Recommendations of the EAU-ESPU Guidelines Committee for Monosymptomatic Enuresis—Bedwetting Bogaert, G, et al. Neurourol Urodyn. 2019 Dec 2, [ahead of print].
• Male life expectancy is still inferior to that of women: Urologists must refine and develop the concept of men’s health Tharakan, T, et al. Eur Urol. Focus 2019 Dec; 76(6): 712-713.
• Management of Sporadic Renal Angiomyolipomas: A Systematic Review of Available Evidence to Guide Recommendations from the European Association of Urology Renal Cell Carcinoma Guidelines Panel Fernández-Pello, S, et al, Eur Urol Oncol 2019, [ahead of print].
• Treatment of Bladder Stones in Adults and Children: A Systematic Review and Meta-analysis on Behalf of the European Association of Urology Urolithiasis Guideline Panel Donaldson, J, et al. Eur Urol 2019 Sep;76(3):352-367.
• Benefits and Harms of Electrical Neuromodulation for Chronic Pelvic Pain: A Systematic Review Cottrell, A, et al. Eur Urol Focus 2019 Oct;. pii: S2405-4569(19)30287-1.
• EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer-An International Collaborative Multistakeholder Effort: Under the Auspices of the EAU-ESMO Guidelines Committees Witjes J & Horwich A, et al. Eur Urol 2019, ahead of print & Ann Oncol 2019 Nov 1;30(11):1697-1727.
• EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel Consensus Statements for Deferred Treatment with Curative Intent for Localised Prostate Cancer from an International Collaborative Study (DETECTIVE Study) Lam, T, et al. Eur Urol 2019 Dec;76(6):790-813.
• What Is the Prognostic and Clinical Importance of Urothelial and Nonurothelial Histological Variants of Bladder Cancer in Predicting Oncological Outcomes in Patients with Muscle-invasive and Metastatic Bladder Cancer? A European Association of Urology Muscle Invasive and Metastatic Bladder Cancer Guidelines Panel Systematic Review Veskimae, E, et al. Eur Urol Oncol 2019 Nov;2(6):625-642.
• The Importance of Hospital and Surgeon Volume as Major Determinants of Morbidity and Mortality After Radical Cystectomy for Bladder Cancer: A Systematic Review and Recommendations by the European Association of Urology Muscle-invasive and Metastatic Bladder Cancer Guideline Panel Bruins, H.M., et al. Eur Urol Oncol 2019, [ahead of print].
• Intraoperative Adverse Incident Classification (EAUiaiC) by the European Association of Urology ad hoc Complications Guidelines Panel Biyani ,CS, et al. Eur Urol 2019, [ahead of print].
• Antibiotic prophylaxis for the prevention of infectious complications following prostate biopsy: A Systematic Review and Meta-analysis Pilatz, A, et al. J. Urol 2019, [ahead of print].
EURURO-8596; No. of Pages 28
E U R O P E A N U RO L O G Y X X X ( 2 0 1 9 ) X X X –X X X
ava ilable a t www.sciencedirect.com journa l homepage: www.europea nurology.com
Bladder Cancer
EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer—An International Collaborative Multistakeholder Effort y Under the Auspices of the EAU-ESMO Guidelines Committees
EUROPEAN UROLOGY 76 (2019) 790 –813
available at www.sciencedirect.com journal homepage: www.europeanurology.com
Review –Prostatic Disease –Editor’s Choice
EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel Consensus Statements for Deferred Treatment with Curative Intent for Localised Prostate Cancer from an International Collaborative Study (DETECTIVE Study)
EUROPEAN UROLOGY 76 (2019) 712 –713
available at www.sciencedirect.com journal homepage: www.europeanurology.com
EAU20: Europe’s finest in urology premieres in Amsterdam . . . . . . . . . . . . . . . .
New Seeding Grant Application now open! . . 2
A farewell after 16 years. . . . . . . . . . . . . . . . .
Update from the EAU Guidelines Office. . . . . .
EAU supports urology training in Tanzania. . .
Book review. . . . . . . . . . . . . . . . . . . . . . . . . .
Clinical challenge. . . . . . . . . . . . . . . . . . . . . .
Key articles from international medical journals. . . . . . . . . . . . . . . . . . . . .
Treatment of urgency urinary incontinence in MS patients. . . . . . . . . . .
ESUO: Sperm DNA fragmentation (SDF) . . . .
ESGURS: Penile transplantation programmes in Europe. . . . . . . . . . . . . . . . .
Myths and realities: The Pisa and Trento experiences. . . . . . . . . . . . . . . . . . . .
ESU section: A complete spectrum of clinical laser applications. . . . . . . . . . . . . . . . . . . . . . . . . Masterclass explores new FT techniques and technologies. . . . . . . . . . . . . . . . . . . . . EAU-CAU: Educational conduit for Europe & Latin America. . . . . . . . . . . . . . . . Iraqi community to bring “scientificity to the forefront”. . . . . . . . . . . . . . . . . . . . . . 1st E-BLUS course in Mexico exceeds expectations. . . . . . . . . . . . . . . . . . . . . . . . . ESU Boot Camp in Lisbon boosts residents’ skills. . . . . . . . . . . . . . . . . . . . . . . 1st SEA-UREP commences in Manila. . . . . . . PUA 2019 unveils the “Best of EAU”. . . . . . . ESU course imparts PCa & BCa essentials in Uzbekistan. . . . . . . . . . . . . . . . Art in Flexible step 2 prepares for minimally invasive field . . . . . . . . . . . . . . . .
First GUA-CCA meeting secures future editions. . . . . . . . . . . . . . . . . . . . . . .
EAU RF sessions at EAU20 . . . . . . . . . . . . . .
YUO section: Getting ready for the European robotic curriculum fellowship. . . . . . . . . . . . . . . . . . 27 E-BLUS exam now in Poland. . . . . . . . . . . . 27
EBU Certification for Erasme Hospital in Brussel. . . . . . . . . . . . . . . . . . . . . . . . . . .
eUROGEN and ESSIC work together against interstitial cystitis. . . . . . . . . . . . . . .
Preparing for Horizon Europe. . . . . . . . . . . .
‘Magic Bratislava’: Stimulating inter-academic collaboration . . . . . . . . . . . .
ESUT20: 54 Cases on three screens over two days. . . . . . . . . . . . . . . . . . . . . . . .
EAU20 beats EAU19’s abstract submission record Congress popularity leads to new record for most abstract submissions
EAU19 didn’t hold the record for most abstract submissions for longer than a year: 5,703 abstracts were submitted for EAU20 in Amsterdam, surpassing EAU19 by 242 submissions. Although the number of video abstracts slightly decreased compared to last year (465 versus 455), the amount of poster abstracts increased signifi cantly (4,996 versus 5,248). Prof. Albers
1,589 abstracts for poster presentations have been accepted, 107 video abstracts. This makes an acceptance rate of 30.28% and 23.52% respectively. 29.7% of the total abstracts submitted are accepted, a gentle decline of 2.34% compared to last year. “The number of abstracts submitted has been on the rise in the past years,” Prof. Dr. Peter Albers (DE), Chair-elect of the EAU Scientifi c Congress Committee, explains. “We already opened more spots for presentations. Altogether, we have more than one hundred poster sessions, and a lot of them are already in parallel. We cannot expand the congress more, because then the audience would not have enough time to see and discuss the scientifi c work.”
The submissions came from more countries than ever. Urologists and other health care professionals from 83 countries sent their abstracts of which 52 countries made the cut. Europe (926) and Asia (431) provided the most accepted abstracts. “The overall quality of the submitted abstracts was outstanding,” Prof. Dr. Albers continues. “All abstracts were selected after a thorough review by approximately 370 independent reviewers who had been selected themselves based on their CV and publication record. We work with a four-point rating system. Most of the abstracts selected had to have at least three points from at least four reviewers in order to get accepted. Sometimes even from six reviewers.”
Prostate cancer most popular topic Prostate cancer was the most popular topic by far, the statistics show. The following top fi ve presents the categories with the most accepted abstracts for poster presentations: • Prostate cancer – 443 accepted (1,367 submitted); • Urothelial cancer – 228 (808); • Benign lower urinary tract symptoms – 214 (582); • Renal tumour – 128 (574); • Urolithiasis – 105 (493).
And for video presentations: • Renal tumour – 18 accepted (66 submitted); • Uro-genital reconstruction – 15 (65); • Benign lower urinary tract symptoms – 15 (59); • Prostate cancer – 15 (42); • Urothelial cancer – 10 (50).
“Overall, the abstracts refl ect a lot of interesting scientifi c achievements all over Europe,” Prof. Dr. Albers said. “For the future, I hope that more comparative trials will be published in urology as this is done in oncology. Many research groups already produce very high-impact publications. However, the overall level of evidence with comparative trials is even higher, and scientists in the EAU should strive to get more of their work done in an investigator-initiated comparative trial on oncological and non-oncological topics.”
Additional poster sessions After its successful inception at EAU18 in Copenhagen and continuation at EAU19 in Barcelona, EAU20 will again feature the interactive expert poster-guided tours next to the poster sessions — and with more tours than the previous two years. Members of the Scientifi c Congress Offi ce and specialists in the fi eld will act as dedicated moderators who will lead and inform groups on highlighted abstracts. Abstracts of particular interest, in terms of new insights, best practices and prospective clinical role, will be presented by the authors and commented on by the moderators to participants in the poster tour.
Prof. Dr. Albers: “The expert tours provide a good opportunity to discuss an issue based on three to fi ve abstracts. With a good moderator, the scientifi c content can be transmitted in a much better way compared to a short presentation with only one additional question. In the poster tours, we tried to get topics together for discussion in a larger format.”
In total, sixteen expert tours are scheduled in Amsterdam. Check out the Scientifi c Programme on www.eau20.org.
ESU introduces new and updated courses Novel courses at EAU20 and e-courses with CME credits
ESU Courses at EAU20
Side-by-side with the expanding fi eld of urology, the European School of Urology (ESU) has been developing its educational activities since its inception twenty years ago. These ESU pursuits have increased in size and popularity among the young and seasoned healthcare professionals. This year, the ESU will introduce new ESU courses and e-courses.
The ESU organised an impressive 56 courses for the upcoming 35th Annual EAU congress (EAU20) wherein 148 distinguished experts from 22 countries will oversee the courses and mentor attendees. Out of the 56, two courses are new and one is offered every other year.
Under Course Chair Prof. Eva Compérat (FR), the biennial ESU Course 16: Practical aspects of cancer pathology for urologists. The 2020 WHO novelties aims to improve the urologist-pathologist interaction, explore the diagnostic spectrum as a whole, and update urologists with the new World Health Organization (WHO) classifi cation. attendees will learn how to optimally use the prostate-specifi c antigen (PSA), new biomarkers and MRI to minimise unnecessary biopsies.
Course attendees will familiarise themselves with how to stratify factors for different approaches; select risk patients to diagnose and manage after local progression; diagnose and treat advanced tumours; and critically review new alternatives.
Explore the EAU20 Scientifi c Programme to know more about all the ESU courses, then secure your place at your course(s) of choice by registering via https://eaucongress.uroweb.org/registration/ esu-courses/.
New e-courses and updates Whether attending EAU20 or not, individuals interested in enriching and testing their knowledge can do so via the new and/or updated e-courses. And upon completion, participants will receive European CME credits (ECMEC ® ). Metastatic Prostate Cancer”, “EAU Guidelines on Urological Infections”, and “EAU Guidelines on Urinary Incontinence”; and updated existing e-courses such as “EAU Guidelines on Prostate Cancer”, “EAU Guidelines on Renal Cell Carcinoma” and “Introduction to upper urinary tract endoscopy for stones”.
After EAU20, all EAU Guidelines courses will be reviewed again and updated according to the new EAU Guidelines.
For inquiries about the e-courses, please send an email to educationonline@uroweb.org. • 56 courses • 30 Hands-on training courses • Friday, Saturday, Sunday, Monday
You are strongly advised to book in advance
Full details at: www.eau20.org/scientifi c-programme/ esu-courses/
Download the
Attendees will learn about the optimal handling of a pathology specimen, understand the pathology report, receive vital information on the novelties in uro-onco pathology and their applications.
During ESU Course 42: Practical tips for laparoscopy of the pelvic fl oor, attendees will receive recommendations on patient positioning and trocar placement. They can expect tips and tricks on laparoscopic adenomectomy, radical cystectomy, radical prostatectomy, reconstructive surgery of the pelvic fl oor and sacrocolpopexy. Dr. Jose Maria Gaya Sopena (ES) will chair the must-attend course. This February, the ESU will introduce the new e-courses “EAU Guidelines on Chronic Pelvic Pain”, “EAU Guidelines on Renal Transplantation”, and the “Basis of ADT” which is the fi rst of fi ve sub-courses of the course series “Advanced prostate cancer”.
Before EAU20 commences, the ESU will update the e-courses “Non-muscle-invasive bladder cancer” and “Risk profi le-oriented management of BPE/ LUTS”.
Stay tuned for these new e-courses and updates via www.uroweb.org/e-courses/
NEW EAU App
European Association of Urology
