European Urology Today Official newsletter of the European Association of Urology 10 Vol. 24 No. 4 - August/September 2012 Ten questions for Anthony Atala Old infections, new challenges Canadian Tour 2012 Anthony Atala speaks on opportunities and missed chances in an informal chat Profs. E. Kulchavenya and T. Bjerklund Johansen write on the challenges of managing urogenital TB Participants to the Canadian Tour deliver a detailed account of their experience 26 32 EAU Bladder Guidelines Panel comments on BCG shortage Panel members: M. Babjuk (chairman), A. BГ¶hle, M. Burger, E. CompГ©rat, E. Kaasinen, J. Palou Redorta, B. Van Rhijn, M. RouprГЄt, S. Shariat, R. Sylvester, R. Zigeuner The current situation The company Sanofi Pasteur has announced a suspension of the production of the BCG Connaught strain in June 2012. Because of the ongoing renovation of its manufacturing facility, production is not expected to resume before the end of 2013. As the Connaught strain supplies a significant segment of the world market, the suspension of its production may result in a global shortage of BCG in the treatment of non-muscle invasive bladder cancer. Although the situation is different in individual countries depending on the BCG strain on the market, it represents potential danger for patients and requires the attention of urologists. Each urologist has an obligation to provide optimal treatment according to the current evidence for individual patients with non-muscle invasive bladder cancer. This statement summarizes information which can help the urologist with treatment decisions in the absence of BCG Connaught or with a suboptimal supply of BCG on the market. Current role of BCG in the treatment of non-muscle invasive bladder cancer and EAU guidelines recommendations BCG intravesical immunotherapy is the most effective conservative management for bladder carcinoma in situ (CIS) and for Ta T1 tumours at intermediate and high risk of recurrence and progression (EORTC risk calculator) after complete TURB (transurethral resection of the bladder), where it significantly reduces the recurrence rate and has an impact on the early progression rate. According to EAU guidelines on non-muscle invasive bladder cancer, BCG intravesical instillations are indicated in patients with bladder CIS and in patients with Ta T1 tumours at intermediate and high risk of recurrence and/or progression. For optimal efficacy, the induction course (6 weekly instillations) should be followed by at least one year of maintenance. Is the efficacy of different BCG strains comparable? Only a small number of published studies have compared different BCG strains when used as induction treatment. The publication of a prospective randomized comparison of induction BCG Connaught and induction BCG TICE is expected soon. No head-to-head comparisons of the clinical efficacy of different BCG strains when used as maintenance therapy have been published in the literature. The published meta-analysis of prospective randomized trials did not suggest any difference in efficacy of the BCG strains (Pasteur, Frappier, Connaught, TICE, RIVM). There are no data which provide information on whether switching from one BCG strain to another during the treatment schedule can have an impact on antitumor efficacy. How long should the optimal BCG schedule be? When can BCG instillations be terminated without compromising efficacy? For optimal efficacy, BCG should be given with a maintenance schedule. Many maintenance schedules have been used with a maximum of 27 instillations over 3 years. The optimal length of maintenance is, however, not known. According to meta-analyses, BCG should be given for at least one year to be superior to intravesical chemotherapy. With the current BCG shortage, instillations can be safely terminated when the patient has completed one year of BCG treatment. References about the use of only an induction course (6 weekly instillations without maintenance) are controversial. A recently presented cohort study showed promising results, however meta-analyses have shown induction only BCG to have inferior efficacy compared to intravesical chemotherapy. Can be BCG instillations be replaced by another treatment? In patients with Ta and T1 tumours at intermediate or high risk of recurrence and intermediate risk of progression, intravesical chemotherapy (multiple instillations for up to 12 months) represents an alternative treatment option to BCG immunotherapy. It has a higher risk of recurrence but a lower risk of side effects. In Ta and T1 tumours at high risk of progression and in CIS, EAU guidelines provide two treatment options, intravesical BCG immunotherapy and radical cystectomy. Cystectomy represents an oncologically safe but more invasive treatment which should be discussed, particularly with younger and fit patients. Some promising data have been presented about device assisted chemotherapy (Synergo or EMDA) which might replace BCG instillations in patients with high risk tumours who are not fit for cystectomy. The current evidence however is limited and this treatment is considered to be experimental. Conclusions and recommendations: 1.The efficacy of different BCG strains seems to be comparable 2.There is no information about the consequences of switching from one BCG strain to another. This seems, however, to be a reasonable solution during the first year of maintenance in the situation where BCG Connaught is no longer available, but another strain can be obtained. 3.In the current situation of BCG shortages, instillations can be safely terminated when the patient has completed one year of BCG. 4.In patients with Ta and T1 tumours at intermediate or high risk of recurrence and intermediate risk of progression, adjuvant BCG treatment can be replaced by intravesical chemotherapy, which represents an alternative treatment option. 5.In younger and fit patients with Ta T1 tumours at high risk of progression and with CIS, an immediate radical cystectomy should always be considered. This should be underlined, particularly in the current situation with BCG shortages. 6.In patients with Ta T1 tumours at high risk of progression or with CIS who are unfit or unwilling to undergo a cystectomy, there is no scientifically proven alternative to BCG treatment. Thus every effort should be made to obtain an available BCG strain. As an alternative, device assisted chemotherapy seems to provide promising results and could be considered. Passive intravesical chemotherapy can achieve some responses in CIS, influence the recurrence rate in TaT1 tumours and thus provide some benefit for the patient. Urologists should not forget, however, that the effect of passive intravesical chemotherapy on tumour progression has never been confirmed. 7.It should be emphasized that the most important modality in the treatment of non-muscle invasive bladder cancer remains a complete and precisely performed TURB, independent of the availability of BCG on the market. Revisiting the PSA screening debate Between caution and responsive treatment Prof. Manfred Wirth Editor-in-Chief European Urology Today Dresden (DE) Manfred.Wirth@ uniklinikumdresden.de In recent months the US debate regarding PSA testing reached another so-called bend down the road in the light of the U.S. Preventive Task Force (USPSTF) recommendation against routine PSA screening tests. The ensuing contrary arguments from our US colleagues and other cancer specialists amply demonstrates the dilemma of finding a straightforward treatment plan in situations where the complexities of medical evidence, patient need and psychology all have bearing, if not impact, in the way healthcare is provided. A few weeks ago we saw two developments that attempt to inform and add nuance to the debate and here I am referring to the ASCO Provisional Opinion [E. Basch, et al., “Screening for Prostate Cancer With Prostate-Specific Antigen Testing: American Society of Clinical Oncology Provisional Clinical Opinion,” 10.1200/ Journal of Clinical Oncology.2012], and the findings from the University of Rochester in New York [E. Scosyrev, et al., “Prostate-specific antigen screening for prostate cancer and the risk of overt metastatic disease at presentation. Analysis of trends over time,” Cancer 2012]. recommendations are made regarding PSA screening,” the authors further wrote. In the US, the PSA screening debate would obviously not simply fade away considering the polarized, intractable positions that some sectors have taken. In the meantime, in the confines of our clinics and hospitals, and when we are faced with patients seeking for answers and by their families looking for straightforward management, the debate becomes muted and is often reduced to a more humane scale. We respond in various ways, guided by individual judgment and experience. The challenge, however, may not only be in threshing out persuasive or fine arguments, but rather the more difficult task of finding the balance that takes into full account the unsaid and, therefore, unexamined human need to find diagnosis and treatment at all costs. We have to acknowledge and take this into consideration for concerned patients and to those looking for early detection. The ASCO provisional opinion discouraged PSA screening of men with a life expectancy of less than 10 years, while at the same time recommending individualised decision-making for patients with a longer life expectancy. Of further interest in the ASCO statement is the careful nuance given to the strength of evidence for each recommendation. Meanwhile, in the Rochester retrospective review, the study warns that eliminating PSA testing would triple the number of men who have advanced prostate cancer at diagnosis. “Our analyses suggest that, if the pre-PSA era incidence rates were present in the modern US population, then the total number of men presenting with M1 (metastatic) prostate cancer would be approximately three times greater than the number actually observed,” stated Dr. Edward Messing, of the University of Rochester in New York, and co-authors. 28th Annual EAU Congress Registration opens on 1 October www.eaumilan2013.org “We believe that these estimates must be taken into consideration (bearing in mind the limitations of observational data) when public health policy-level August/September 2012 European Urology Today 1 Incontinence complicates POP repair Informed consent and pelvic organ prolapse repair for suitable patients may offer the best strategy to avoid over-treatment Prof. Massimo Porena University of Perugia Clinica Urologica ed Andrologica Sant’Andrea Delle Fratte Perugia (IT) [email protected] Interestingly, in clinical practice AUGS members have not uniformly implemented prophylactic Burch colposuspension at the time of abdominal sacrocolpopexy4. Some centres have advised against it in patients without symptomatic stress incontinence due to high rates of voiding dysfunction and de novo urge incontinence when procedures were performed concomitantly5. Since the CARE Trial was a single trial, providers might well prefer to see more data before changing clinical practice. The picture of UI after POP repair is complicated by other studies reporting opposite results (6-8). One Is urogynaecology a new star in medicine? It may single centre RCT included continent patients who seem so considering that in recent months the underwent colposacropexy with or without Burch prestigious New England Journal of Medicine has colposuspension. At a mean follow-up of 39.5 published two articles on the subject: Nager and months, Costantini et al6 found post-operative colleagues’ (Urinary Incontinence Treatment Network) incontinence in respectively 35.3% vs 9.3% of “A Randomized Trial of Urodynamic Testing before patients, with a significantly higher rate in patients Stress-Incontinence Surgery” which appeared on May who had undergone colposuspension (p < 0.05). The 71, and Wei et al’s (Pelvic Floor Disorders Network) eight-year follow-up confirmed these results as 29% of patients were incontinent after Burch compared, “A Midurethral Sling to Reduce Incontinence after with 16% in the group without Burch (p < 0.553)7. Vaginal Prolapse Repair” published on June 202. Today, one of the hot topics in urogynaecology is urinary incontinence (UI) after pelvic organ prolapse (POP) repair. It is beset by many open controversies due to lack of 1) diagnostic tools to evaluate UI in patients with POP before surgery, and 2) data on urinary incontinence after POP repair because many studies reported objective data on POP resolution and little or nothing on functional results. European Urology Today Editor-in-Chief Prof. M. Wirth, Dresden (DE) Section Editors Dr. A. Cestari, Milan (IT) Mr. Ph. Cornford, Liverpool (GB) Prof. O. Hakenberg, Rostock (DE) Prof. P. Meria, Paris (FR) Prof. J. Rassweiler, Heilbronn (DE) Prof. O. Reich, Munich (DE) Dr. Th. RoumeguГЁre, Brussels (BE) Dr. C. Ruf, Hamburg (DE) Special Guest Editor Prof. F. Montorsi, Milan (IT) Founding Editor Prof. F. Debruyne, Nijmegen (NL) Editorial Team H. Lurvink, Arnhem (NL) E. Starkova, Arnhem (NL) J. Vega, Arnhem (NL) L. Keizer, Arnhem (NL) EUT Editorial Office PO Box 30016 6803 AA Arnhem The Netherlands T +31 (0)26 389 0680 F +31 (0)26 389 0674 [email protected] Disclaimer No part of European Urology Today (EUT) may be reproduced without written permission from the Communication Office of the European Association of Urology (EAU). The comments of the reviewers are their own and not necessarily endorsed by the EAU or the Editorial Board. The EAU does not accept liability for the consequences of inaccurate statements or data. Despite of utmost care the EAU and their Communication Office cannot accept responsibility for errors or omissions. The other controversial point is the concept of “social continence.” We do not know precisely if a certain grade of incontinence could be considered acceptable. The real outcome evaluation, based on the patient’s perspective is often not considered in the majority of the study, and objective or subjective results can be considerable different. Furthermore, divergent results are due to differences in surgical techniques for POP repair (abdominal, vaginal, laparoscopic) and how various defects in different compartments are corrected. For example central compartment POP can be corrected by the vaginal route using a range of apex fixation methods: sacrospinoous, utero-sacral, ileococcigeus suspension etc. More variations are added with a prophylactic anti-incontinence procedure. Different surgical procedures often lead to different results. Wei and colleagues reported the results of the Outcomes Following Vaginal Prolapse Repair and Midurethral Sling (OPUS) trial which included women without symptoms of stress incontinence and patients with positive prolapse-reduction tests2. The study was designed to determine whether prophylactic placement of a midurethral synthetic sling during vaginal repair of prolapse reduced the risk of postoperative urinary incontinence. Compared with women in the sham-incision group, women who had been randomly assigned to the sling group had lower rates of urinary incontinence three months postoperatively (23.6% vs. 49.4%), with benefits maintained at 12 months. We might well argue that 49.4% of patients with post-operative incontinence are a major problem! In almost half of the patients POP surgical repair corrected one problem but created another, probably worsening, rather than improving, quality of life. And how are the 27.3% of patients with de novo incontinence in the sling group to be treated? More surgery worsens results and incontinence rates are generally higher than after a primary MUS. Furthermore, there is no evidence to show which procedure is the best. POP repair These findings add to evidence from the Colpopexy and Urinary Reduction Efforts (CARE) trial3 which reported that a prophylactic Burch colposuspension at the time of transabdominal prolapse surgery reduced the risk of postoperative urinary incontinence, but resulted in more postoperative complications. Adding a bladder-neck suspension at the time of abdominal prolapse surgery in women without preoperative stress incontinence significantly reduced the risk of postoperative stress urinary incontinence (23.8% vs. 44.1% in the control group). Isn’t the 44.1% rate of post-operative urinary incontinence rather too high? EAU Section of Female and Functional Urology (ESFFU) 2 European Urology Today These findings cast doubt as to whether Burch colposuspension should be performed during POP repair in continent women. Clearly colposacropexy alone does not cause post-operative incontinence as UI was present only in 9.3% at the mid-term follow-up and 16% at the long-term. The surgical technique for POP repair may account for the discrepancies in the findings. The Porena and Costantini technique6-8 was described as an Integral Pelvic Floor reconstruction. The technique was designed to provide support and suspension, to restore the pelvic floor and to replace ruptured ligaments using meshes. In this matter it is possible to correct anterior and posterior segments, central and lateral defects, vault, uterine prolapse and enterocele. The wide preparation of the anterior vaginal wall as far as the bladder neck corrected also urethrocele, did not cause de novo incontinence and cured 61% of incontinent patients. Conflicting evidence Taking into consideration all this conflicting evidence, the 2010 Cochrane Review on Surgical management of POP in women9 concluded that 1) continence surgery in concomitance with prolapse surgery in continent women did not significantly reduce the rate of post-operative or the novo SUI (RR 1.39, 95% CI 0.53 to 3.70); 2) de novo SUI will be prevented in approximately 20% of women if continence surgery is performed with POP surgery in all women who have occult stress incontinence pre-operatively, but 80% will have an unnecessary procedure; and finally 3) further evaluations are required and the benefit needs to be balanced against differences in costs and adverse effects. It is likely that the conclusions will depend on different healthcare systems and that the women’s own priorities and attitudes will vary. It is interesting to note that the OPUS study also concluded that “The decision to perform — or not to perform — prophylactic anti-incontinence surgery should factor in the goals and desires of the patient, the skill and experience of the surgeon, and the risks and potential benefits for a particular patient.” Finally, to prevent over-treatment, the best strategy seems to be a clear informed consent and only POP repair for women who are continent, being careful to use a technique that will not cause incontinence after surgery. Surgical approaches that are associated with high post-operative incontinence rates should be analysed carefully for appropriateness. References 1. C.W. Nager, L. Brubaker, H.J. Litman, H.M. Zyczynski, R.E. Varner, C. Amundsen, L.T. Sirls, P.A. Norton, A.M. Arisco, T.C. Chai, P. Zimmern, M.D. Barber, K.J. Dandreo, S.A. Menefee, K. Kenton, J. Lowder, H.E. Richter, S. Khandwala, I. Nygaard, S.R. Kraus, H.W. Johnson, G.E. Lemack, M. Mihova, M.E. Albo, E. Mueller, G. Sutkin, T.S. Wilson, Y. Hsu, T.A. Rozanski, L.M. Rickey, D. Rahn, S. Tennstedt, J.W. Kusek, E. A. Gormley for the Urinary Incontinence Treatment Network. A Randomized Trial of Urodynamic Testing before Stress-Incontinence Surgery. The New Engl Journal of Medicine 366: 1-11 2012 2. J.T. Wei, I. Nygaard, H.E. Richter, C.W. Nager, M.D. Barber, K. Kenton, C.L. Amundsen, J. Schaffer, S.F. Meikle and C. Spino, for the Pelvic Floor Disorders Network. “A Midurethral Sling to Reduce Incontinence after Vaginal Prolapse Repair” N Engl J Med. 366:2358-67, 2012 3. L. Brubaker, G. W. Cundiff, P. Fine et al., “Abdominal sacrocolpopexy with burch colposuspension to reduce urinary stress incontinence,” The New England Journal of Medicine, vol.354, 15:1557–1566, 2006. 4. Matthew J. Aungst & Thaddeus D. Mamienski & Todd S. Albright & Christopher M. Zahn & John R. Fischer. Prophylactic Burch colposuspension at the time of abdominal sacrocolpopexy: a survey of current practice patterns. Int Urogynecol J 20:897–904, 2009 5. de Tayrac R, Gervaise A, Chauveaud-Lambling A, Fernandez H (2004) Combined genital prolapse repair reinforced with a polypropylene mesh and tension-free vaginal tape in women with genital prolapse and stress urinary incontinence: a retrospective case–control study with short-term follow-up. Acta Obstet Gynecol Scand 83:950–9546 6. E. Costantini, A. Zucchi, A. Giannantoni, L. Mearini, V. Bini, M. Porena. Must Colposuspension be Associated with Sacropexy to Prevent Postoperative Urinary Incontinence? Eur Urol 51:788–794, 2007 7. E. Costantini, M. Lazzeri, V. Bini, M. Del Zingaro, A. Zucchi, M. Porena. Pelvic Organ Prolapse Repair With and Without Prophylactic Concomitant Burch colposuspension in Continent Women: A Randomized, Controlled Trial With 8-Year Follow up. J Urol 2011, Vol. 185, 2236-2240, June 2011 8. E. Costantini, M. Lazzeri, V. Bini, M. Del Zingaro, A. Zucchi, M. Porena. Burch Colposuspension Does Not Provide Any Additional Benefit to Pelvic Organ Prolapse Repair in Patients With Urinary Incontinence: A Randomized Surgical Trial. J Urol 180: 1007-1012, 2008 9. Maher C, Feiner B, Baessler K, Glazener CMA. Surgical management of pelvic organ prolapse in women. Cochrane Review 2010 John вЂ�Jack’ Thomas Grayhack, 1923-2012 Surgeon, scientist and loving father The European Association of Urology conveys its condolences to the family of Dr. John вЂ�JackвЂ� Thomas Grayhack, 89, a worldrenowned physician, surgeon, researcher and scholar. Grayhack received his BA and MD from the University of Chicago. After a general surgery internship and residency at Johns Hopkins, Grayhack spent a year at Brady Research Laboratory and became interested in urology. He completed his urological training at Brady in 1953. He was an assistant professor at Hopkins and served two years in the Air Force before moving in 1956 to Northwestern University where he was appointed chairman and Herman Kretchmer Professor of Urology in 1963, a position he held until 1989. Grayhack was a recipient of some of urology’s most prestigious awards, including the AUA’s Hugh Hampton Young Award (1979), the Eugene Fuller Prostate Award (1989), the Russell and Mary Hugh Scott Education Award (1991), Ramon Guiteras Award (1994) and Presidential Citation (2002). He served on numerous AUA committees and as president of the American Board of Urology and the American Association of Genitourinary Surgeons. He was awarded the Keyes Medal (2001) and the Barringer Medal (1980). Grayhack also edited the Yearbook of Urology (1963 -1978) and the Journal of Urology (1985-1994). Grayhack and his late wife Betty were married for 62 years. His children and grandchildren remember with fondness his passion for hunting, fishing and summers on Diamond Lake in Canada. August/September 2012 Johann Heinrich Kesselring (1713-1741) Young German surgeon experiences the renaissance of French surgery in Paris Dr. Peter Paul Figdor Archivist, Austrian Society for Urology and Andrology Vienna (AT) ppfigdor.uroarchiv@ gmx.at When we examine the development of medicine- the transition from traditional medicine to “modern medicine”- it becomes apparent that the renaissance of surgery in Paris at the beginning of the 18th century is a truly unique event, which was initially limited to France. Following the integration of surgery into the Barber’s guild, surgeons only had fleeting contacts with “academic medicine,” the prevailing medical practitioners (internists). Thus, it is remarkable that the outstanding physicians coming from universities could get by without resorting to “surgical medicine.” We can also assume that the close connection to barbers, which was forced upon the surgeons, consequently meant a great loss of social status. For example, there is the fact that a “barber surgeon” had to establish his practice not in a house or a large office, but in a shop on the street. It was also required to be “adorned” with the emblem of a barber’s soap dish! Kesselring’s introduction In the introduction to Kesselring’s 1738 dissertation, among others it was stated: “The surgeons experienced a number of terrible centuries (the undesirable liaison with the Barbers). After the surgeons divested themselves of their status as mere craftsmen, as well as their humiliating title, they succeeded in re-establishing themselves within the scientific community and rising in society’s estimation. “Surgery quickly returned to its former glory, as it once enjoyed two thousand years ago in Greece. Eventually, the field’s amassed knowledge would far exceed that of the ancient Greeks. Surgery can finally raise its head above the stars, as high as never in the past. Kesselring’s 1738 thesis on the “Foubert Method” “Especially during these days there is an abundance of scholars who exert diligent efforts to enrich surgery with the advancement in physics, mechanics and anatomy and in all other areas where relations with surgery can be revealed. Therefore, we must establish with admiration that currently this art is trying to surpass medicine: in France it strives at least to be at the same level. However, if today the opinion of other nations still counts for anything, one would have to conclude unambiguously that the French surgery is already regarded as greater than the French medicine.” A few historical observations Understandably, separation from the Barber’s guild was a desire expressed repeatedly by French surgeons. Already under Louis XIV, by the edict of November 1691, there was a partial separation of these two professional groups. Only by the declaration of his successor, Louis XV on November 30, 1717 was there a formal and “Examination of an apothecary”, early 18th century, France. complete separation of the surgeons and barbers. (The Bridgeman Art Library) We can safely assume that it was not the French kings who were the driving force behind these reforms and the subsequent “renaissance of surgery.” Actually, there were a number of outstanding, successful and influential surgeons at the French court; for instance, Charles Francois Felix de Tassys (1635-1703), and particularly Georges Mareschal de Bievres (1658-1736), as well as “our” Francois La Peyronie de Gigot (1678-1747). They managed, surprisingly and under pressure from a large number of other “surgical masters,” to force through many reforms for surgery. Medical historian Julius Leopold Pagel (1851-1912) writes: “[T]his is why Mareschal must be seen as one of the most deserving promoters of surgery of his time. Mainly through his efforts, together with those of La Peyronie, he managed to create the famous AcadГ©mie de chirurgie, which was opened on the December 18, 1731. By a decree in the year 1743, it was considered equal to the medical faculty. The great upsurge was mainly due to these mentioned measures, which the French surgery took during the latter period, of which (indirectly) therefore, Mareschal has become the initiator.” In order to obtain the equivalent of the doctor’s degree taken at the faculty and at the academy, medical historian Ernst Julius Gurlt (1825-1899) writes about La Peyronie: “Also in the fierce conflict between Parisian physicians and surgeons, he was a strong supporter of the latter, for which he knew how to gain the King’s favour and declaration (1743) to regulate their relationships.” Johann Heinrich Kesselring (1713-1741) Kesselring was a young Prussian surgeon, who would later become professor of surgery at the University of KГ¶nigsberg. We came across him not while studying the above-mentioned “Parisian renaissance of surgery,” but by our dealing with the lithotomy procedure of Pierre Foubert (1696-1766), who can be described as a pioneer of what we now call “lessinvasive surgery”. The main topic of Kesselring’s dissertation was Foubert’s operating procedure, which involved “blind” lateral incision through the perineum into the posterior wall of the filled bladder, and was far ahead of its time. In the first few pages, however, one can find his account of being an outsider in Paris at the time of the resurgence of surgery at the beginning of the 18th century. EAU History office August/September 2012 Apparently, in connection with the surgical academy founded seven years earlier, Kesselring reckons: “Without any shadow of doubt, the surgeons are also concerned with science in general. Indeed, highlyregarded institutions have been directing surgery in France with recommendations for quite a while, so that the number of France’s masters of surgery can hardly be counted. They are excellent surgeons in their own right, and they are also prepared to instruct students of surgery, who are sent by the rest of the world to France, suggesting there is a market for these arts (medicine, surgery) over there. “The perfection of modern surgery is also reflected in the following: every illness can be treated in different ways, and admittedly in so many ways, that the masters of the art of treatment (in fact) have a choice, which one is best for the patient concerned. “After all, which tools are already at our disposal nowadays for the treatment of bladder stones: a disease which was almost considered incurable, sent to man as vengeance of the gods, and which the godly Hippocrates not only never treated, but also demanded from his pupils to swear never to treat this suffering with surgery? How many methods are already available to us nowadays to treat the bladder by incision without any risk?” The German situation Here, two remarks should still be made. Firstly, for the description of the “renaissance of surgery” we decided to opt for Kesselring’s report, because the report of this young Prussian surgeon has been cited with so much enthusiasm and excitement. However, he also knew – compared with the renaissance of the surgery in Paris- the situation in his homeland. After all he quotes, in a footnote to his report, the English medical historian John Freind (1675-1728). In Kesselring’s quotation from Freind’s book, The history of physic from the time of Galen to the beginning of the 16th century from 1725-26, it states: “That at the time of the dissolution of the (German) Empire around 1548, even the sons and also further family members of surgeons were “ostracised,” and that only with the new rise of the empire, around 1577, the surgeons wanted to have their reputation back again and wanted to enjoy the rights of the other colleagues.” Accordingly, there were times before the Parisian “renaissance of surgery” –possibly in Germany- in which the “situation” for surgeons was even worse than in Paris before the renaissance! Surgery in Vienna Our second commentary, concerns the comparison of the state of surgery in Paris with the situation in Vienna. The medical surgical Josephinische Akademie was opened in 1785; thus, more than 50 years after the founding of the AcadГ©mie Royale de Chirurgie (1731). Furthermore, the Vienna academy aimed particularly at the discipline of surgery and a notable surgeon and organiser played an important role in its emergence-Giovanni Alessandro Brambilla (1728-1800, Knight of Carpiano) who was the chief army doctor of the Austrian monarchy in Vienna, and who - just like the surgeons in Paris- had good relations with the monarchy. We do note a difference with the monarch himself. Since while it is actually not known from Paris how significant the establishment of the surgical academy was for both French kings, Joseph II repeatedly declared that the establishment of the Josephinische Akademie was the most important achievement during his reign. EAU Bladder Guidelines Panel comments on BCG shortage . . . . . . . . . . . . . . . . . . . . . . 1 Revisiting the PSA screening debate . . . . . . . 1 ESFFU section: Incontinence complicates POP repair . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 History Office: Johann Heinrich Kesselring . . . 3 ESOU goes for 10th annual meeting. . . . . . . . 4 FEBU Oral Exam results . . . . . . . . . . . . . . . 6-7 1st International da Vinci Single-Site Masterclass . . . . . . . . . . . . . . . . . 8 Clinical challenge . . . . . . . . . . . . . . . . . . . . . 9 Ten Questions. . . . . . . . . . . . . . . . . . . . . . . . 10 Book reviews . . . . . . . . . . . . . . . . . . . . . . 11 3rd ESGURS Meeting . . . . . . . . . . . . . . . . . 11 Key articles from international medical journals . . . . . . . . . . . . . . . . . . 12-13 YUO section: My first year as a resident urology doctor. . . 14 4th GeSRU workshop on urologic oncology . . 14 Residency in an EBU training centre. . . . . . . 15 Completion of Training - What Now. . . . . . . 15 Tom Lue visits UZ Leuven . . . . . . . . . . . . . . . 16 Social networking for urologists. . . . . . . . . . 16 EU-ACME section: Credit Registry Report 2012 . . . . . . . . . . . . . 17 Win free registration for Milan. . . . . . . . . . . 17 www.reviews. . . . . . . . . . . . . . . . . . . . . . . . 19 ESU section: ESU offers courses at 7th ECA Meeting in Berlin, Germany. . . . . . . . . . . . . . . . . . . . 20 ESU-Weill Cornell Masterclass . . . . . . . . . . . 22 Medical oncology course on genito-urinary cancers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 EULIS section: Minimal Invasive Surgery for Renal Stones . . . . . . . . . . . . . . . . . . . . . . . . 23 EULIS meets South America. . . . . . . . . . . . . 23 49th ERA-EDTA Annual Meeting in Paris . . . 24 Who’s Who in Urology. . . . . . . . . . . . . . . . . 24 ESIU section: Old infections and new challenges. . . . . . . . 26 ESUT section: Rome hosts laparoscopy and robotics meeting. . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Congress calendar . . . . . . . . . . . . . . . . . 30-31 Canadian Tour 2012 . . . . . . . . . . . . . . . . 32-33 1st World Congress on Pelvic Pain . . . . . . . . 33 EAUN section: Delivering urology services in New Zealand . . . . . . . . . . . . . . . . . . . . . . 35 European Urology Today 3 ESOU goes to Rome for 10th annual meeting Prostate and bladder cancer issues top ESOU agenda By Joel Vega Management issues in prostate, bladder and kidney cancers will be among the main topics that will be closely discussed and examined in the EAU Section of Oncological Urology (ESOU) 10th Annual Meeting to be held in Rome, Italy from January 18 to 20, 2013. (STEPS) programme. With an unrestricted educational support from Ipsen, STEPS will follow-up on the success of the last two STEPS events. A mentor-type consultation meeting of 15 promising young urologists with three veteran uro-oncology experts, STEPS aims to boost the ESOU’s recruitment efforts. “As expected from the ESOU’s annual meeting, we are preparing not only a comprehensive update on pertinent issues in urooncology but also aim to find out which diagnostic and management Prof. M. Brausi issues require a closer look and how we can best serve the needs of urological cancer specialists,” said ESOU chairman Prof. Maurizio Brausi. Prostate cancers will be covered in two sessions, one focusing on screening, diagnosis, staging and treatment, while the other will examine advanced and metastatic disease. “Point-counterpoint discussions will debate and challenge radical prostatectomy, focal therapy and active surveillance,” Brausi added. The meeting’s social programme will be highlighted with a gala dinner at Villa Miani, an old Roman villa in the outskirts of Rome. Recently specialised clinicians with a firm interest in the diagnosis and management of urological cancers Demonstrated support from their Head of Department (by letter) Understand and speak English fluently • Long-term ambition to be part of a network of European physicians focusing on the continued research and improved management of patients with urological cancers How to take part in STEPS? Application forms are available through European Academic Centres Please return the completed application and all supporting materials to: [email protected] or fax to +44 (0)1245 808 267 19th January 2013, Rome, Italy The STEPS programme is supported by an unrestricted grant from Ipsen. The STEPS Programme is supported by an unrestricted grant from Ipsen. EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations For more information please contact Congress Consultants at [email protected] or go to http://esou.uroweb.org Friday, 18 January 2013 08.30–08.40 Welcome 08.40–09.00 Opening 09.00–11.30 11.10–11.30 Prostate cancer I: Screening, diagnosis, staging and treatment Prostate cancer screening Discussion Is there an association between inflammation and PCa? How to identify low risk PCa Genetic profiles to identify biologically aggressive low-risk PCa Debate: The time for radical prostatectomy in low risk desease is over Discussion 11.30–11.50 Coffee break 11.50–13.20 11.50–12.10 12.10–12.30 Renal cancer I: Localised Indications for renal biopsy in 2013 Role of expectant management for renal masses > 3 cm Open/laparoscopic or robotic organ sparing surgery: Is zero ischemia so crucial? Discussion 13.10–13.20 13.20–14.30 14.30–15.00 14.30–14.45 14.45–15.00 15.00–18.00 15.00–15.20 15.20–16.00 Meet-the-Expert Session during the 10th Meeting of the EAU Section of Oncological Urology (ESOU) Maurizio Brausi Preliminary Programme 12.30–13.10 Creating a network of European clinicians focused on continuing research and improving management of patients with urological cancers By complementing the overall ESOU programme, STEPS will give promising young clinicians and researchers a direct opportunity to maximise their involvement in ESOU, access established thought leaders to discuss relevant case study and research questions, and create a network of colleagues to run future research across Europe in the years to come. 18-20 January 2013, Rome, Italy 10.40–11.10 Sessions To Evaluate ProgresS in the management of urological cancers Consisting of scientific sessions on prostate, bladder, renal, testicular and other rare urological malignancies, ESOU 2013 will discuss optimal diagnosis, treatment guidelines, latest controversies, and the newest technologies available. Sessions will be delivered by international leaders in the field who will take part in state-ofthe-art lectures, panel discussions, head-to-head debates, and, demonstrations of surgical techniques. 10th Meeting of the EAU Section of Oncological Urology (ESOU) 10.00–10.20 10.20–10.40 STEPS The EAU Section of Oncological Urology (ESOU) held its first annual meeting in January 2004 with the intention of broadening the debate in urological cancers and stimulating high-level scientific teachings and exchange. With this objective in mind, and in recognising the need to encourage wider debate involving younger clinicians, ESOU has developed the STEPS programme. Keen to participate in ESOU and EAU programmes Prof. Vincenzo Altieri, local organiser, welcomed the hosting of the ESOU meeting which has attracted in recent years the participation of many urological cancer experts from various disciplines such as oncology, radiology and gynaecology. The 10th ESOU will also include the third Sessions To Evaluate ProgresS in the management of urological cancers 09.00–09.30 09.30–09.40 09.40–10.00 Accredited by the European Board of Urology, the annual ESOU meeting is in compliance with the UEMS/EACCME regulations. For details, check out the ESOU meeting website at http://esou2013.uroweb. org/ or contact Susan Heeren, Project Manager, at [email protected] Why we feel STEPS is an important progression: A statement from ESOU STEPS aims to engage with up to 15 clinicians each year, but who are they? In addition: Renal cancer will be examined in two sessions: localised and advanced. The sessions on urothelial tumours will take up non- muscle invasive bladder cancer and muscle invasive and advanced disease. Debates and update lectures by key opinion leaders will look into emerging therapies and their impact on the delivery of optimal services for cancer patients. In testicular and penile cancers, among the salient issues to be examined are organ preservation techniques, inguinal lymphadenectomy and post-chemo retroperitoneal lymph node dissection (RPLND). As in previous years, ESOU will award the best publication in uro-oncology in 2012. Lunch Penile cancer Organ preservation in penile cancer: When and how Inguinal Lymphadenectomy: When and how Urothelial cancer I: Non muscle invasive TURBT: One of the strongest predictor of outcome in NMIBC Debate: Treatment of BCG failures 16.00–16.30 Coffee break 13.20–13.40 Award ceremony 16.30–17.10 17.10–17.20 17.20–17.40 17.40–18.00 Debate: Active surveillance in low grade Ta Discussion Can we reduce BCG toxicity? Discussion 13.40–15.40 STEPS programme (closed programme: participation by invitation only) Saturday, 19 January 2013 08.30–10.20 08.30–08.50 08.50–09.10 09.10–09.20 09.20–09.50 09.50–10.20 10.20–11.20 10.20–10.40 10.40–11.00 11.00–11.20 Prostate cancer II: Localised Note of technique: Apical preparation to avoid positive margins Debate: High risk clinically localised PCa: Primary surgery is the preferred option? Discussion Debate: Adjuvant radiotherapy after radical prostectomy who, how and when? Complications during laparoscopic and robotic radical prostatectomy: How to avoid them Testicular cancer Organ preservation for solid testis neoplasm: When? Open vs. laparoscopic vs. robotics RPLND: Where do we stand? Post-chemo RPLND: Modifies template vascular reconstruction Sunday, 20 January 2013 09.00–10.50 09.00–09.20 09.20–09.40 09.40–10.00 10.00–10.20 10.20–10.30 10.30–10.50 10.50–11.10 Coffee break 11.10–13.30 13.20–13.30 Prostate cancer III: Advanced and metastatic disease Progression after local treatment for curative intent: Role of imaging studies to differentiate local from systemic disease Role of salvage radical prostatectomy Point-Counterpoint discussion: Treatment of PSA failure after RP Ablative therapy (cryo/Hi-FU) in the 21st century Castration resistant prostate cancer: How do I treat it today and prospectives for tomorrow? Discussion 13.30–13.40 Meeting close 11.10–11.30 11.30–11.50 11.50–12.30 12.30–12.50 11.20–11.40 Coffee break 11.40–13.20 Urothelial cancer II: Muscle invasive and advanced disease Robotic radical cystectomy and diversion in 2013: Where do we stand? Debate: Is orthotopic neobladder indicated in patients > 75? Chemo-Radiotherapy in elderly patients with MIBC: Last results Chemotherapy in the elderly: Actual perspectives Discussion 12.50–13.20 11.40–12.00 12.00–12.20 12.20–12.40 12.40–13.00 13.00–13.20 Renal and urothelial cancer The role of lymphadenectomy in renal and upper urinary-tract cancer Minimal invasive surgery for UUT Nephron sparing surgery for complex ureteral tumours: Indications and techniques Neo-adjuvant chemotherapy for MI, TCC or UUT Discussion Robotic radical nephrectomy for renal masses: Is it worth? Cost effective analysis Chairman of the ESOU M. Brausi, Modena (IT) Chairman of the 10th Meeting of the ESOU V. Altieri, Salerno (IT) ESOU Board F. Bladou, Montreal (CA) M. Brausi, Modena (IT) S. Brewster, Oxford (GB) B. Djavan, New York (US) A. Govorov, Moscow (RU) A. Heidenreich, Aachen (DE) J.E. Hugosson, GГ¶teborg (SE) H. Г–zen, Ankara (TR) G. Thalmann, Berne (CH) Early Registration Deadline: 1 November 2012 Meeting costs and subsistence supported by educational grants from European Association of Urology 4 European Urology Today August/September 2012 - 28th Annual EAU Congress www.eaumilan2013.org Scientific Programme highlights Friday, 15 March 2013 10.30-13.00 13.15-15.45 16.15-17.45 Urology beyond Europe Urology beyond Europe Simultaneous Sponsored Sessions Saturday, 16 March 2013 07.30-08.30 08.30-10.15 08.30-10.00 10.00-16.45 10.15-14.00 10.15-17.30 14.15-15.45 16.00-17.30 18.00-19.30 EAU General Assembly Plenary Session 1: Urology: From young to old Update: The management and long-term outcome of vesicoureteral reflux Update: The long-term outcome of genital surgery in boys Debate: Pelvic floor implants: Artificial mesh or autologous fascia? State-of-the-art lecture: Incontinence and age State-of-the-art lecture: Is ageing a disease? Simultaneous Abstract Sessions Residents Day Section Meetings: • EULIS meeting • Joint ESFFU/ESUI meeting • Joint ESAU/ESIU meeting • ESTU meeting • ESGURS meeting • Joint section meeting of the EORTC-GU group in conjunction with ESUR, ESOU and ESUP • ERUS meeting ESUT live surgery section meeting in collaboration with ERUS and EULIS Simultaneous Abstract Sessions Simultaneous Abstract Sessions Simultaneous Sponsored Sessions Several European School of Urology courses will take place Sunday, 17 March 2013 07.30-11.00 09.15-10.45 11.00-12.00 Plenary Session 2: Upper urinary tract Highlight session 1 Update: The dilemmas of diagnosing upper tract urothelial cancer Debate: How much surgery for upper tract urothelial cancer? Case discussion/Guidelines: Upper urinary tract tumours SociГ©tГ© Internationale d’Urologie (SIU) lecture: The role of ESWL in upper urinary tract stones Update: Interventional imaging in upper urinary tract stone disease: What’s new? Case discussion: From above or below: Flexible, rigid or percutaneous management of upper urinary tract stones Update: Observation and deferred intervention in the management of stones Simultaneous Abstract Sessions Simultaneous Thematic Sessions Thematic Session 1: EAU 2013 guidelines recommendation updates Thematic Session 2: How minimally invasive should we be? Thematic Session 3: From bench to bedside: What may replace PSA? Thematic Session 4: Non-muscle invasive bladder cancer Thematic Session 5: Infections 12.15-13.45 14.00-15.30 15.45-17.15 17.45-19.15 Thematic Session 6: Small renal masses: To treat or not to treat? Thematic Session 7: Management of complications Thematic Session 8: A session by the European Society of Urogenital Radiology Simultaneous Abstract Sessions Simultaneous Abstract Sessions Simultaneous Abstract Sessions Simultaneous Sponsored Sessions Several European School of Urology courses will take place Monday, 18 March 2013 07.30-11.00 Plenary Session 3: Lower urinary tract management: How to balance benefits with side effects Highlight Session 2 Update: Anatomy and imaging of the pelvic floor Debate: The role of urodynamic assessment in contemporary practice American Urological Association (AUA) Lecture: Cellular based therapy of urinary incontinence Case discussion: Sling, sphincter or balloon for male incontinence Debate: What the practising urologist needs to know about new therapies for LUTS. When, where and how they work? State-of-the-art lecture: Is TURP the gold standard for benign prostatic obstruction 09.15-10.45 Simultaneous Abstract Sessions 11.00-12.00 Simultaneous Thematic Sessions Thematic Session 9: Expert challenges the expert Thematic Session 10: Andrology Thematic Session 11: Systemic therapy in urological cancer Thematic Session 12: Paediatric urology Thematic Session 13: Joint session with the European Society of Nuclear Medicine Thematic Session 14: Neurourology Thematic Session 15: Management of pain in urology Thematic Session 16: A session by the European Society of Urogenital Radiology 12.15-13.45 Simultaneous Abstract Sessions 14.00-15.30 Simultaneous Abstract Sessions 15.45-17.15 Simultaneous Abstract Sessions 17.45-19.15 Simultaneous Sponsored Sessions Several European School of Urology courses will take place Tuesday, 19 March 2013 08.00 – 13.00 Plenary Session 4: Hot topics in prostate cancer Souvenir session by the EAU Scientific Congress Office Update: New urological weapons in the treatment of CRPC Late breaking news State-of-the-art lecture: Is there a role for intermittent androgen deprivation? Debate: High risk PC: Surgery vs radiation vs systemic therapy Late breaking news Debate: Why focal therapy instead of active surveillance for low risk prostate cancer Clinical cancer prevention group Debate: Update on European PSA screening Don’t forget! Registration opens on 1 October Registration for the 28th Annual EAU Congress opens on 1 October and participants are encouraged to register early (before 4 January 2013) to benefit from reduced fees. You can register via http://registrations.uroweb.org Important dates Congress dates 15-19 March 2013 Exhibition dates 16-18 March 2013 Registration open 1 October 2012 Programme overview online The scientific programme is what makes the Annual EAU Congress one of the most prestigious international urology events. Versatile, intensive and always on the cutting edge of urological science – the congress brings together opinion leaders, researchers and teaching professionals from all over the world. Already today you can get a glimpse of what is planned for this event, and follow the programme as we add more exciting topics, presentations, courses and features! We update the programme regularly, as speakers confirmations come in almost daily! Furthermore, you can always save the sessions of interest in your EAU Planner and export them into your Outlook calendar. Submit your abstracts Deadline: 1 November 2012 Abstracts can only be submitted through the online abstract submission system at http://abstracts.uroweb.org. Faxed, e-mailed or posted abstracts will not be accepted. Before submitting your abstract, carefully read the abstract submission rules on our website. Abstract submission deadline 1 November 2012 EAU Awards submission deadline 15 November 2012 Early registration deadline 4 January 2013 Will you be an EAU Award Winner in 2013? Deadline: 15 November 2012 Submission and nominations for the EAU Awards is now open. Further details on entry requirements can be found at http://www.uroweb.org/about-eau/awards Inquiries can be directed at Ms. Marian Smink at [email protected]. http://www.eaumilan2013.org/scientific-programme/ EAU congresses and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations August/September 2012 European Urology Today 5 FEBU Oral Exam: The examinee’s perspective A step in the right direction for attaining a specialist status in urology Dr. Andrew John Mercieca Mater Dei Hospital Urology Unit Msida (MT) My experience of the EBU Oral Examination was overwhelmingly positive. A short exam that deals with three topics from a vast curriculum, one has to be thoroughly prepared by having a very good knowledge of the EAU Guidelines, a strong clinical experience and be abreast with current urological issues to succeed in this exam. European Board of Urology (EBU) One of the difficulties, though, that I faced when current literature and recommendations, and the preparing for this oral exam was the relative lack of necessary clinical experience will also prove crucial— sample questions. Having sat for previous clinical all these give the candidate the necessary confidence. post-graduate exams in surgery I always prepare in a methodical manner. But I do appreciate my training at “Hence the exam, ultimately, also the Mater Dei Hospital, an EBU-certified training centre in Malta, which served me well in this exam. serves our patients who rightly Briefly, the examination was presented as I anticipated with the questions aimed to assess my knowledge depth on the three particular subjects. The cases were purely clinical and I was pleased that my years in urology and general surgery training helped a lot. Feedback was given to me during the exam. My response to the questions included the basics in patient management such as discussing thorough patient history, physical examination, list of investigations, differential diagnosis and treatment. Professional links In my opinion an excellent knowledge or grasp of the EAU Guidelines is essential to pass this exam. And as I mentioned earlier, having an updated knowledge of deserve the best treatment..” Why take the EBU Oral Exam? I consider this examination as a step in the right direction for attaining or affirming a specialist status in urology. Moreover, my participation in this exam reflects the close ties between the EBU and Malta. For a urologist in Malta, having the FEBU title also links our small island nation, with its proud track record of medical excellence, to the recognised European body that invests and pioneers in the training of urology residents. Furthermore, the challenge and necessary discipline to pass the whole process makes one a well-read and pro-active urologist who is well-informed of the latest literature and recommended best practice. Hence the exam, ultimately, also serves our patients who rightly deserve the best treatment they can have. Tips for candidates To reiterate, it is necessary to be very familiar with the EAU Guidelines and have a working knowledge of the basic sciences. Obviously, candidates also have to believe in themselves, keeping a level-headed, confident appearance when responding to the examinees. I will also recommend to the exam candidate to enroll in a reputable training centre preferably EBU-certified since the examination focuses on or reflects what we have learned in our clinical practice and training. With this in mind, I convey my thanks gratitude to my programme director Mr. K. German and consultant urologists Mr. P. Zammit, Mr. S. Mattocks and Prof. L. Cutajar who is a pioneer in urological training in Malta. Statistics FEBU Oral Examination 2012 Overall average score 7.43 Average score participants UEMS/EBU member countries (> 5 examinees) • Austria • Czech Republic • France • Germany • Greece • Hungary • Italy • Netherlands • Poland • Portugal • Spain • Sweden • Switzerland • Turkey • United Kingdom 7.33 7 6.18 7.76 7.45 7.78 7.46 8 7.07 8 7.57 7.4 8.29 6.43 7.25 ANNOUNCEMENTS In-Service Assessment: Friday, 1 March 2013 Starting 2013 the annual In-Service Assessment is offered as an online assessment only. Internet access is the only requirement to participate. There are no restrictions as to where and at what time on 1 March 2013 the test is taken. The assessment can be taken by an individual, or organised by a programme director/head of department for a group of participants. Registration fee (per participant) • Regular fee: € 40 • Reduced fee for applicants working at an EBU Certified Training Centre: € 20 Registration starts on 1 October 2012 and ends on 31 January 2013. For more information and registration visit our website www.ebu.com FEBU Written Examination: Saturday, 17 November 2012. FEBU Oral Examination: Saturday, 8 June 2013. 6 European Urology Today 2012 Oral Examination - Board of Examiners Brussels K. Ackaert, Belgium D. Ackermann, Switzerland I. Adamakis, Greece G. Alivizatos, Greece A.A. Antoniewicz, Poland J. Bellringer, United Kingdom M.O. Bitker, France G. Bogaert, Belgium E. Breinl, Austria L. Campos Pinheiro, Portugal J. Campos Pinheiro, Portugal M. Г‡ek, Turkey C. Cracco, Italy H.J. Danuser, Switzerland A. Feyaerts, Belgium A. Figueiredo, Portugal F. Fusco, Italy N. George, UK S. Giannakopoulos, Greece A. Giannantoni, Italy M. Gunst, Switzerland M. Heuser, Germany W. Hochreiter, Switzerland J. Hofbauer, Austria U. Humke, Germany C. Imbimbo, Italy E. Lledo, Spain N. Longo, Italy C. Mamoulakis, Greece L. Martinez Pineiro, Spain A. Matos Ferreira, Portugal D. Mitropoulos, Greece E. Montanari, Italy B. Montgomery, United Kingdom G. Moutzouris, Greece J. Nawrocki, United Kingdom J.M. Nijman, Netherlands P. Nunes, Portugal A. Papatsoris, Greece A. Pytel, Hungary C. Radmayr, Austria T.M. De Reijke, Netherlands D. Rengifo Abbad, Spain K. Van Renterghem, Belgium O. Rodriguez Faba, Spain C. Romano, Italy C. Saussine, France S. Siracusano, Italy A. Skolarikos, Greece A. Strauss, Germany S. Tekgul, Turkey C. Terrone, Italy V. Tzortzis, Greece A. Volpe, Italy S. Walter, Denmark P. Whelan, United Kingdom T. Zellweger, Switzerland Budapest I. Buzogany, Hungary L. Farkas, Hungary A. Majoros, Hungary P. NyГrГЎdy, Hungary L. Pajor, Hungary A. Varga, Hungary Warsaw W. BiaЕ‚ek, Poland A. BorГіwka, Poland P. ChЕ‚osta, Poland T. Demkow, Poland P. DobroВґnski, Poland J. Dobruch, Poland T. Drewa, Poland P. Jarzemski, Poland A. KoЕ‚odziej, Poland S. Listopadzki, Poland J. Matych, Poland W. Pypno, Poland A. Sikorski, Poland M. SЕ‚ojewski, Poland M. Sosnowski, Poland T. SzopiВґnski, Poland P. Szostek, Poland Z. Wolski, Poland S. WroВґnski, Poland R. Zdrojowy, Poland H. ZieliВґnkski, Poland August/September 2012 FEBUs from Europe and beyond Ammar Abid, Iraq Amr Ahmed, Germany Nasser Al Muliki, Germany Stefano Alba, Italy Thomas Alber, Austria Aristeidis Alevizopoulos, Greece Jorge Hugo Almonacid Grunert, Spain Diego Alonso Rodriguez, Spain Markus Aly, Sweden Umberto Anceschi, Italy Anders Christian Andersson, Sweden Michiel Arnolds, Netherlands Bernhard Fleischmann, Austria James Forster, United Kingdom Melanie Gan, Netherlands Roman Ganzer, Germany Tarek Ghoneim, France Magnus Gockel, Germany Bert Goossens, Belgium Katja Goossens - Laan, Netherlands Tiago Gorgal Rodrigues De Carvalho, Portugal Gilles Gourtaud, France Anuj Goyal, United Kingdom Philipp Grimsehl, Switzerland Bruno Alexandre Guerra Jorge Pereira, Portugal Gonzalo Morales Solchaga, Spain Eduardo Jose Moran Pascual, Spain Luz Maria Moratalla Charcos, Spain Dimitrios Moschonas, Greece Raffaele Muscariello, Italy Yamini Nagaraj, Germany Petr Nencka jr., Czech Republic Pierre Nevoux, Guadeloupe Eleni Nikolaraki, Greece Antonios Ntafos, Greece John Paul O’Donoghue, United Kingdom Alice Obaje, Germany Giuseppe Ocello, Italy Anastasios Asimakopoulos, Italy Grigorios Athanasiadis, Greece Ninaad Shashank Awsare, United Kingdom Alessandro Baccos, Italy Severine Banek, Germany Jan BaГџ, Switzerland Ioannis Belimpasakis, Greece Ahmed Benkirane, France Stratos Bisias, Greece LukГЎЕЎ Bittner, Czech Republic Cosimo Bizzarri, Italy Sarmad Hanna, Sweden Eva Harlander - Weikert, Germany Gencay Hatiboglu, Germany Anne Heermann, Germany Lukas Hefermehl, Switzerland Stefan Heidler, Austria Kai Heinze, Germany Dirko Hercher, Germany Roman Hrabec, Czech Republic Petre Cristian Ilie, Romania Igino Intermite, Italy Tayfun Mevlut Oktar, Turkey Idir Ouzaid, France Adil Ouzzane, France Orkunt Г–zkaptan, Turkey Paola Andrea Pardo Duarte, Spain Teija Parpala-SpГҐrman, Finland Jose Ignacio Perez Reggeti, Spain Daniel Pfalzgraf, Germany Nikolaos Polymeros, Greece Mihai Pop, Germany Silvia Proietti, Italy Felipe Villacampa Auba, Spain Gianni Vittori, Italy Stamatia Vlachou, Greece Christian Von Bodman, Germany Friedrich-Carl Von Rundstedt, Germany Christian Wagner, Germany Sebastian Walther, Germany Maren Werther, Switzerland Annekathrin Witte, Germany Ioannis Xoxakos, Greece George Yardy, United Kingdom VladimГr BoroviЛ‡cka, Czech Republic Pradeep Bose, United Kingdom Stefanie BГ¶ttcher, Germany Andreas Bourdoumis, Greece Ali Cansu Bozaci, Turkey Johanna Brandtner, Germany Anthonius Breeuwsma, Netherlands Simone Brunnschweiler, Switzerland Johannes Bub, Germany Tommaso Ciro Camerota, Italy Umberto Capitanio, Italy Otakar CЛ‡apoun, Czech Republic Emanuele Cappa, Italy Vasile Cristian CaЛ›su, Spain Ana Celma Domenech, Spain Maurizio Cerabino, Italy Emmanouil Chrysafis, Greece Giuseppe Ciccarello, Italy Antonio Cioffi, Italy Alexandru Ciudin, Spain Matteo Ciuffreda, United Kingdom Daniela Colleselli, Germany Daniele D’Agostino, Italy AndrГ© Da Quinta Pereira Martins, Portugal Carla Da Silva SimГµes Soares, Portugal Fabrizio Dal Moro, Italy David De Martinho, Portugal Ivo De Oliveira Lopes, Portugal Giacomo De Stefano, Italy Karel Decaestecker, Belgium Donato Dente, Italy Joris Derksen, Netherlands Giuseppe Di Paola, Italy Charalampos Dimitriadis, Greece Catarina Diogo Gameiro, Portugal Mario Dominguez Esteban, Spain Francisco JosГ© Dos Santos Botelho, Portugal Volker Eisenschmidt, Germany JГ¶rg Ellinger, Germany Emad Fadhel Sabir, Sweden Claudia Falkensammer, Austria Loukas Fasoulis, Greece Vincenzo Ficarra, Italy Boris Fischer, Switzerland Sanjay Isaac, Germany Annelies Jansonius, Netherlands Kamila KarmaЕЎovГЎ, Czech Republic Tobias Karutz, Germany Torben KaГџ, Germany Nikolaos Katsenis, Greece Niko KavЛ‡ciЛ‡c, Slovenia Adamantios Kavouras, Greece Ioannis Kavvouris, Greece Muhieddine Khodari, France Michael Kimuli, United Kingdom Marwin Klebe, Germany Max Christian Klitsch, Austria Andreas Konandreas, Greece Artan Koni, Turkey Stylianos Kontos, Greece Michail Kontraros, Greece Nikolaos Koskinas, Greece Ilmari Koskinen, Finland Katarina Koss Modig, Sweden Sotirios Koukos, Greece Epameinondas Koutsiaris, Greece Ulrich Kratzer, United Kingdom Hussain Kunbus, Syria Remo Largo, Switzerland StГ©phane LarrГ©, United Kingdom Jan Moritz Laturnus, Germany Branimir Lodeta, Croatia David Lorente Garcia, Spain Gabriele Lotter, Germany Fernando Lozano Palacio, Spain Mariangela Mancini, Italy Patrick Markart, Switzerland Christian Martenstein, Germany VГctor MartГnez Silva, Spain Georgios Megas, Greece Mark Meier, Switzerland Susan Meierhans Ruf, Switzerland Andrew Mercieca, Malta Nicolas Mingat, France Badereddin Mohamad Al-Ali, Austria BenoГ®t Molimard, France Roberto Molina Escudero, Spain Ana Montoliu Garcia, Spain Luigi Pucci, Italy Philipp Reich, Germany Roman Reunkoff, Germany Andrea Ringressi, Italy Michael Rogenhofer, Germany Javier Romero Otero, Spain Christian Ruf, Germany Birgit Ruf, Germany Daniel SГЎnchez Zalabardo, Spain Josep Maria Santillana Altimira, Spain Anna Scavuzzo, Italy Sina Kristin Schmidt, Germany Christopher Schultz, Switzerland Christoph Schwab, Switzerland Elmar Schweigreiter, Austria Silvia Secco, Italy JГјrgen Seweryn, Austria Vasileios Sfingas, Greece Vasileios Simaioforidis, Greece Paolo Soggia, Italy Farzen Soleimanzadeh Ardebili, Iran Christos Stavaras, Greece Ayman Fawzy Hakim Stephanos, United Arab Emirates Pascal Stijns, Netherlands Jochen StГјrner, Germany Kari SyvГ¤nen, Finland Monika SzakГЎcsovГЎ, Czech Republic Volkmar Tauber, Austria Hasan HГјseyin TavukГ§u, Turkey Antonella Tocco, Italy Mahmoud Toma, Germany Armin TГ¶pfer, Germany Jose Torremade Barreda, Spain Petros Tsafrakidis, United Kingdom Spyridon Tsifetakis, Greece Ioannis Tsochatzis, Greece Massimo Valerio, Switzerland Emile Valimberti, Austria Felip Ruben Vallmanya Llena, Spain Francesco Varvello, Italy Antonio Vavallo, Italy Domenico Veneziano, Italy Ourania Vergetaki, Greece Beatrice Vezzu’, Italy Faruk Yencilek, Turkey Outi YlГ¶nen, Finland Anton Zarraonandia Andraca, Spain Matthias Zimmermann, Switzerland August/September 2012 FEBUs from Poland Joanna BagiВґnska Szymon Bak Л› JarosЕ‚aw BobiВґnski Lukasz Curylo Marcin Galeski Artur Gibas Albert Gugala Adam GuВґzniczak Grzegorz KapuВґsciВґnski Tomasz Konecki Andrzej Kubicz RafaЕ‚ Kuczera PaweЕ‚ LeВґsniak PaweЕ‚ Malik MichaЕ‚ Marszolik PaweЕ‚ Pawlicz Marek Piotrowski Pawel Plaza Maciej Salagierski Krzysztof Skomski Piotr Slupski Krzysztof Sobkowiak Piotr Trybek Marek Zawadzki PrzemysЕ‚aw Zimnoch PrzemysЕ‚aw Zugaj FEBUs from Hungary TamГЎs BenkЛќ o MГЎtyГЎs BenyГі SГЎndor Guruzda NГіra HagymГЎsi KГЎroly Nagy Lehel PГ©terfi Melinda Sajthy Zita SoГіs European Urology Today 7 1st International da Vinci Single-Site Masterclass Dr. Andrea Cestari UniversitГ Vita e Salute San Raffaele Dept. of Urology Milan (IT) Co-Authors: Dr. NicolГІ Buffi, Dr. Giorgio Guazzoni Under the patronage of ESUT and ERUS, the Department of Urology of San Raffaele Hospital – Turro in Milan organised the First International da Vinci Single-Site Masterclass in Urology on May 10 to 11, 2012. Almost 100 participants from 10 different countries attended this masterclass which offered the opportunity to discuss and focus on the potential indications, future perspectives and current limitations of the novel single-site platform in urology recently created by Intuitive for the da Vinci Si system. The new da Vinci single-site platform has been specifically designed to allow surgeons to properly apply the robotic technology to the concept of LESS surgery. It includes a multichannel port that provides access for two single-site semi-rigid robotic instruments, the 8.5 mm 3D – HD scope and two additional standard laparoscopic ports for the assistant. The new system’s key feature is the use of two robotic curved trocars that allow for the restoration of intracorporeal instruments triangulation and the absence of external clashes of the robotic arms. Moreover, the da Vinci software automatically detects and re-associates the surgeon’s hands with the instrument tips to create an intuitive movement through crossed cannulae. The first day of the masterclass offered a limited number of urologists the possibility to train with the Uro-Technology new platform during a dry lab session and learn the basic skills in single-site robotic surgery. They were divided into two small groups to provide each participant the opportunity to practise the ancillary manoeuvres (gel port insertion, trocar insertion, robotic docking and undocking), as well as perform increasingly difficult “single-site dexterity exercises,” under the supervision of Intuitive technicians and urologists of the San Raffaele Hospital. Live surgeries The second day of the masterclass offered a full day interactive course outlining the robotic assisted single-site surgical technique with enhanced step-bystep video material and lectures, which focused on the codification of the robotic single-site pyeloplasty. The masterclass also included two live surgeries. The first one featured a simple case (symptomatic renal cysts decortication) to demonstrate all steps in properly placing the single-site port, trocars, robotic arm docking and to explain how the new platform works. The second surgery, a single-site pyeloplasty (Fig. 1), mainly focused on the codification and various tips and tricks. The day ended with a lecture updating participants on what to expect for single-site surgery in the future including new Intuitive instruments. The da Vinci Single-Site Masterclass international faculty, panellists and moderators have shared valuable insights gained through veteran experience in robotic or LESS surgery. The sessions led to The Multidisciplinary Joint Committee on Sexual Medicine (MJCSM) was established by the UEMS specialist sections of Urology, Obstetrics and Gynaecology, and Psychiatry, and functions, within the framework of their respective statutes and bylaws. Its principle objective is to guarantee and promote the highest standards of healthcare in the field of Sexual Medicine, by ensuring that training in Sexual Medicine in Europe is established at an optimal level. The MJCSM determines the standards for training and assessment in Sexual M edicine. This year the first examination of the MJCSM will take place. Eligibility The exam is set under the auspices of the UEMS but all physicians of all nationalities, including countries outside the EU, are able to take the exam. Examination format The exam duration will be 3 hours and include 100 MCQ in 5 domains of Sexual Medicine. Who can apply? Only registered medical practitioners, who are accredited as medical specialists in their country of practice, or who are General Practitioners with more than 5 years’ clinical experience of unsupervised independent practice, are eligible to apply. Information and application form is available on the MJCSM website: www.mjcsm.org European Urology Today Fig. 1: Robotic assisted single-site pyeloplasty A: The novel single-site system with curved trocars B: The da Vinci arm system docked to the single-site platform C: Dr. Andrea Cestari explains the procedure D: Endoscopic view shows the two instruments One of the meeting’s core messages described the potential advantages of this new platform for the treatment of urological pathologies in selected patients. However, new instruments, namely bipolar forceps and monopolar scissors must be introduced into clinical practice to expand the range or types of procedures to be performed. Some sort of endowrist technology to offer an even greater range of motion should be implemented in the single-site technology as mentioned by Prof. Giorgio Guazzoni during his lecture. “Currently, the new da Vinci single-site platform offers some significant advantages of robotic surgery, such as the 3D stable image, the surgeon’s precise movement with optimal filtration of the physiological tremor, but at the same time this requires good laparoscopic skill, especially during the suturing phases of the procedure since the instrument tips are similar to laparoscopic instrumentarium without endowrist technology,” Guazzoni said. In addition to the new single-site platform, the new “tissue sealant” devices were introduced which allow for strong coagulation for vessels up to 7 mm, employing the modern bipolar currents and subsequent tissue cut in the middle of the coagulated tissue during the same manoeuvre. This new device could potentially be used for vascular pedicles control in robotic radical cystectomy procedures and mesenterial work during the urinary diversion steps. A robotic articulating linear stapler should also be available in the market in the future which would allow for further implementation of the armamentarium for robotic surgery. Furthermore, an update on Firefly technology was given. The First Qualification Examination in Sexual Medicine under the auspices of the UEMS and the ESSM Examination Preparation Courses 2012 8 enthusiastic discussions throughout the two-day meeting and captured the interest of the participants. The discussions also closely examined and focused on all aspects of single-site surgery in combination with robotic technology. B C A The contents will be according to the curriculum of Sexual Medicine defined by the MJCSM. The content will also be described in an ESSM publication, The Syllabus of Sexual Medicine. This will be published in mid-2012 by the ESSM educational committee. D EUROPEAN SOCIETY FOR SEXUAL MEDICINE 15th CONGRESS OF THE EUROPEAN SOCIETY FOR SEXUAL MEDICINE 6 – 8 December 2012, RAI Amsterdam Convention Centre, The Netherlands www.essm.org Exam date: 5 December 2012 Location: Amsterdam, The Netherlands Registration deadline: 1 October 2012 ESSM Exam Preparation Courses This year, ESSM will offer examination preparation courses for medical practitioners intending to take the first examination in December 2012. The courses are intended for physicians with experience of specialistlevel practice in Sexual Medicine who wish to increase their chance of passing the exam. Preparation courses of 3 days are being planned from 2 – 4 December 2012; these will provide an overview of all subjects in the MJCSM curriculum of Sexual Medicine that may be included in the examination, as well as advice about exam-taking skills and practice in completing Sexual Medicine MCQs. The teaching faculties for courses will include recognised experts in the field of Sexual Medicine. The location and dates are published on the ESSM website. Application will be made for CME recognition for these courses, so that participants may gain CME credits.Further details are available on the ESSM website: www.essm.org NEW Preparation Course MJCSM Exam a 2 – 4 December 2012 a 5 December 2012 Hosted by: the Dutch Society for Sexual Medicine Wetenschappelijke Vereniging voor Seksuele Disfuncties, WVSD August/September 2012 Clinical challenge Prof. Oliver Hakenberg Section editor Rostock (DE) Oliver.Hakenberg@ med.uni-rostock.de Case study No. 29 This 27-year-old male presented to the outpatient department with an increasing left-sided abdominal mass and vague abdominal pain which had been noticed for the last few weeks. with central areas of necrosis and a few foci of tiny calcifications. The radiological evaluation reported that the lesion arose from the upper pole of the left kidney, displaced the stomach and bowel loops, and abutted the splenic hilum and the posterior aspect of the pancreas which was displaced superiorly and anteriorly. However, no evidence of definite invasion of any of the adjacent organs could be seen on the CT films. The left adrenal gland was not visualised, nor were any enlarged lymph nodes seen. There were only a few small left paraaortic lymph nodes reported, with the largest measuring 1.2 cm. The lungs were clear without any evidence of pleural or pericardial effusion. Case study No. 30 Left radical nephrectomy was performed. Histopathology reported adrenocortical carcinoma with negative resected lymph nodes and negative surgical margins. Discussion points: 1. Are further post-operative investigations needed? 2.Is any adjuvant treatment indicated? 3.What follow-up should be done? Case provided by M.A. Aggamy, Assistant Consultant Urologist, King Fahd Specialist Hospital, Dammam, Saudi Arabia, [email protected] Fig. 1 and 2: Pre-operative CT scan Fig. 3: Surgical removal Examination showed a large bulging abdominal mass in the upper left abdominal quadrant. CT of the chest, abdomen and pelvis showed a huge mass of soft tissue density mass, approximately 22 x 20 x 15 cm Adjuvant radiation therapy is a management option Comments by Axel Heidenreich Aachen (DE) The patient described was diagnosed with a large adrenocortical carcinoma infiltrating the left kidney and he was treated by radical nephrectomy and locoregional lymphadenectomy. The resection margins and the resected lymph nodes were negative. Preoperative staging included a CT scan of the chest, the abdomen and the pelvis and it did not reveal lymphpnodular or systemic metastases. Discussion points Based on the information given the patient has locally advanced adrenocortical carcinoma which represents stage pT4pN0cM0 according to the WHO classification. The recently modified staging system aimed at improving the prognostic accuracy has been proposed by the European Network for the Study of Adrenal Tumors. Applying this system, however, does not change the classification of the patient. The expected five–year survival rate ranges between 25% and 35% in such cases. To adequately assess the risk of relapse and metastases in this patient, we would need some important information regarding the mitotic index and the number of dissected lymph nodes. Locoregional lymphadenectomy including the first-order drainage lymph nodes at the renal hilum, the paraaortic or paracaval and the celiac regions is mandatory according to the international recommendations of a standardised Chemotherapy is an option Comments by Joaquim Bellmunt Barcelona (ES) surgical approach to adrenocortical carcinomas. According to a recent retrospective study by the German ACC registry, local recurrence rates (hazard ratio: 0.65; 95% confidence interval: 0.43-0.98; P = 0.042) and disease-related deaths (hazard ratio: 0.54; 95% confidence interval: 0.29-0.99; P = 0.049) were significantly lower in patients undergoing complete locoregional lymphadenectomy. chemotherapy. However, adjuvant radiotherapy has been shown to significantly reduce local recurrence rates from 79% to 14% if tumours were resected completely. But adjuvant RT did neither improve cancer-specific nor overall survival. Based on the high probability of local recurrence in this specific case, I would strongly recommend adjuvant radiation treatment with 50.4 Gy delivered to the tumour bed. Staging Due to the size and the stage of the carcinoma and taking into account the increased frequency of osseous and brain metastases seen in association with advanced adrenocortical carcinoma, I recommend to complete staging with a bone scintigram and brain MRI for complete baseline staging. Alternatively, an FDG-PET/CT can be done which has been shown to be highly sensitive and specific for the detection of metastases from adrenocortical carcinoma if maximum standard uptake values (SUV) > 5 are observed. The role of adjuvant mitotane treatment is limited due to the lack of prospective randomised trials. There is evidence from a case-matched control study indicating that adjuvant mitotane might increase the recurrence-free survival from 25 to 42 months. However, the frequency of grade 3/4 toxicities was 13% and there was no benefit with regard to overall and cancer specific survival. Therefore, I would not advise adjuvant mitotane treatment in this patient. Adjuvant treatment options Tumour diameter > 12cm, clinical stage III, a mitotic index > 20 mitoses per 50 high power fields and significant intratumoral hemorrhages are established risk factors associated with the development of local recurrence and systemic metastases. Since the patient exhibited most of these prognostic risk factors, there seems to be a rationale for an adjuvant treatment. There, however, is no evidence from prospective randomised clinical phase-III trials available to support this. Current clinical trials have only shown a minimal role for both adjuvant radiotherapy and than anatomic imaging had suggested, implying that FDG-PET/CT can assess the effectiveness of systemic chemotherapy for ACC and help surgical planning in some patients with ACC [6]. The mainstay of treatment for “localised” ACC is aggressive surgical excision with complete surgical resection. This represents the only chance of cure. Radical resection without any microscopic residual Adrenocortical carcinoma (ACC) is a rare disease disease (R0 resection) and low proliferative activity with an incidence of approximately one per million (based on mitosis count or Ki67 expression) are the [1] and with an overall five-year survival rate of most important prognostic factors for a good outcome in ACC. Open adrenalectomy is optimal in 35% [2]. It behaves aggressively even if detected early. Most cases are diagnosed at an advanced order to minimise tumour spillage in tumours stage. beyond stage II (> than 5 cm N-). However, despite radical resection, patients with ACC are still destined to experience relapse (in up to 80% in In disseminated disease, the two-year survival some series) [7]. For patients who present with without treatment is only 5-10% [2[. Mitotane has been the treatment of choice producing response in advanced disease, the benefits of major surgical 25-30%. Currently, the best treatment is a intervention are more questionable [8]. combination of the adrenolytic drug mitotane and chemotherapy [3]. Due to the aggressive behaviour and the high risk of systemic relapse after surgery, the use of In addition to whole body CT, (18)F-fluorodeoxyadjuvant mitotane is considered in patients with glucose positron emission tomography ((18)F-FDG clinically or histologically aggressive tumours even PET) is useful. (18)F-FDG PET helps to manage after complete resection [9]. The evidence for the suspicious CT scan lesions [4] and can give a correct use of adjuvant mitotane in patients with ACC is classification of the disease stage (metastasis or based only on retrospective studies. Terzolo et al primary) [5]. In a recently reported case, PET/CT retrospectively studied both the Italian and imaging predicted a greater response to therapy German experiences with mitotane in 177 patients. August/September 2012 Follow-up examinations Taking into consideration the high risk of locoregional recurrence and systemic metastases, close follow-up for the first 3 postoperative years appears to be mandatory. According to the recommendations of various national and international registers of adrenocortical carcinomas, staging should be performed every three months with abdomino-pelvic CT scans and chest X-rays. CT/MRI of the brain or a bone scan should only be performed for follow-up in case of symptoms or in case of elevated serum alkaline phosphatase concentrations. Since the patient apparently did not demonstrate any endocrinological tumour activity preoperatively, no routine hormonal studies are necessary. Their analysis demonstrated a clear prolongation of recurrence-free survival in treated patients [10]. Some have suggested that mitotane should be used only in patients with a high likelihood of recurrence (i.e. large tumours with elevated mitotic rate and small or questionable surgical margins) [11]. However, it is now widely accepted that patients with potential residual disease (R1 or Rx resection) and/or Ki67 over 10% are those that should receive adjuvant mitotane. Adjuvant therapy is not mandatory in patients with stage I or II disease (tumours < 5 cm without positive lymph nodes), histologically proven R0 resection and Ki67 expressed in < 10% of neoplastic cells [7]. Regarding adjuvant radiotherapy in patients at high risk of local relapse, a pilot study and a larger case series [12] suggested a potential reduction in local recurrence without an effect on overall survival. Thus, radiotherapy may have a role in selected patients. This 70-year-old man underwent negative prostate biopsy with a PSA of 15 ng/ml, a normal DRE and a prostate volume of 40 ml for the first time in 2001 and again with a PSA of 22 ng/ml in 2002. With a steadily increasing PSA of 47 ng/ml the patient went for a PET/ CT scan in 2009 and this was reported as showing a small malignancy in the ventral part of the prostate. Following this, prostate cancer was confirmed by TRUS biopsy with 4/12 cores showing Gleason 7 (4 + 3). The patient declined to undergo radical prostatectomy and instead chose to undergo HIFU treatment elsewhere in 2009 followed by adjuvant androgen ablation which led to a PSA nadir of 0.09 ng/ml. PSA recurrence under continued androgen ablation occurred in 2011. With a PSA of 0.7 ng/ml a transurethral resection of the bladder neck was performed for obstructive LUTS which showed Gleason score 6 adenocarcinoma. Another PET/CT and a bone scan then did not show any indication for metastatic disease. With a PSA of 2.1 ng/ml and a testosterone of 0.07 ng/ml the patient then requested salvage treatment. Salvage radiotherapy was performed in November 2011 as external beam radiotherapy including the pelvic nodal fields with a dose of 50 Gy followed by saturation of the prostatic field with an additional 16 Gy. This was well tolerated but the PSA continued to rise during the 50 days of radiotherapy and was 5.5 ng/ml under continued androgen ablation at the end of treatment. In July 2012 the patient presented again with a PSA of 47 ng/ml and another PET/CT scan showing tracer uptake in proximal iliac lymph nodes bilaterally (fig. 1/2), in a region which had not been included in the radiotherapy field. Another bone scan was negative. Throughout the patient has been physically and mentally well, being very fit for his age and biologically younger, with a healthy life-style including regular jogging, swimming and cycling. The patient now requests, if possible, further salvage treatment short of chemotherapy. Discussions points: 1. What treatment options are available? 2.Is salvage lymphadenectomy indicated? 3.Is any other salvage treatment reasonable? Case provided by O. Hakenberg, Dept. of Urology, Rostock University, Germany. [email protected] Fig. 1 and 2: 18-F-choline PET scan showing bilateral iliac nodal activity Editorial note: Due to space constraints the reference list is ommitted. Interested readers can send an email to request for the references to [email protected]. Case Study No. 29 continued The first post-operative months were uneventful. However, a CT performed nine months postoperatively for persistent persistent cough showed newly developed multiple pulmonary metastases (more than 10) with the largest one in the apical segment of the left upper lobe and the presence of a large metastatic mass in the right lobe of the liver, measuring 17 x 11 cm. This case was discussed in the вЂ�tumour board’ and he was referred to the oncology unit for mitotane plus chemotherapy. Currently, the standard in patients with metastatic disease is combination chemotherapy (etoposide, doxorubicin, cisplatin) together with mitotane (EDP/M) based on the recently published randomised trial comparing EDP/M versus Sz/M (streptozocin plus mitotane) (FIRM-ACT trial) as initial therapy for patients presenting with stage III or IV ACC [3]. European Urology Today 9 • What project are you working on now? In our institute we are currently working on 80 projects, which we divide in various categories. • What’s the first operation you ever did? In training, it was appendectomy. • What do you think is the biggest challenge in urology? There is the challenge of shrinking resources which may lead to decrease discovery. That would mean we are not advancing our field as much as we could, both scientifically and clinically. • If you were not a urologist, what would you be? If I were not a physician I would have probably chosen architecture. I like building things, the design process… • What’s the last great book you have read? I try to read a book at least once a month, but most are so-so. The most recent remarkable book I’ve read, which I can recommend, was “The Botany of Desire.” (ed. by Michael Pollan) • What’s the last thing that surprised you? That’s a tough question. The last thing that surprised me was when I found out that the US spends more money in potato chips than the FDA spends in regulation. But what is more relevant is the statistic that life expectancy for a male in 1900 was approximately 40 years. A hundred years later life expectancy almost doubled. We’ve come a long way in terms of longevity. • Do you collect anything? I’ve never been a big collector of things. As a child, I collected stamps and coins. • What’s your favourite hour in a day and why? Definitely, the early hours. I usually wake around 4 or 4:30 in the morning. • What question you haven’t found an answer to yet? There are millions of questions I haven’t found an answer yet. I guess the design of the universe. • What is your biggest fear? TEN QUESTIONS Interview by Joel Vega Photography by Jack Tillmanns Age: 53 Specialty: Regenerative medicine, urology City: Winston-Salem, North Carolina, USA Current position: Director of the Wake Forest Institute for Regenerative Medicine and W.H. Boyce Professor and Chair of the Department of Urology, Wake Forest School of Medicine, Winston-Salem, North Carolina The dark (laughs hard). I’m kidding. My biggest fear… (long pause). Maybe my biggest concern is the continued conflicts around the world. Things don’t seem to quiet down, not only internationally but also in the national level. It’s a tough time. ANTHONY ATALA 3rd Meeting of the EAU Section of Genito-Urinary Reconstructive Surgeons (ESGURS) EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations For more information please contact Congress Consultants at [email protected] or go to http://esgurs.uroweb.org 14-15 December 2012, Istanbul, Turkey Friday, 14 December 2012 08.30 – 08.45 Opening and welcome to the meeting B. Alici, Istanbul (TR) S. Deger, Ostfildern (DE) O. Demirkesen, Istanbul (TR) 08.45 – 09.05 Lecture: Redo hypospadias S. TekgГјl, Ankara (TR) 09.05 – 10.45 Live surgeries Moderators: S. Deger, Ostfildern (DE) S. TekgГјl, Ankara (TR) OR 1: Hypospadias repair R. Dahlem, Hamburg (DE) OR 2: Urethroplasty E. Palminteri, Arezzo (IT) 10.45 – 11.00 Coffee break 11.00 –11.20 Lecture: Penile corporoplasty in Peyronie’s disease: Which graft to use? A. Esen, Izmir (TR) 11.20 –11.40 Lecture: The complications of artificial urinary sphincter implantation I. Moncada, Madrid (ES) 11.40 – 13.30 Live surgeries Moderators: B. Alici, Istanbul (TR) I. Moncada, Madrid (ES) OR 1: Penile corporoplsty in Peyronie’s disease R. Djinovic, Belgrade (RS) OR 2: Penile prosthesis implantation E. Austoni, Milan (IT) 13.30 – 14.30 Lunch break 14.30 – 14.50 Lecture: Bulbar and penile urethral strictures: Which is the best technique for urethroplasty? E. Palminteri, Arezzo (IT) 10.45 – 11.05 Lecture: Surgical alternatives in the treatment of postprostatectomy incontinence A. Ergen, Ankara (TR) 14.50 – 15.50 Moderated Poster session I Chairs: C. Ozyurt, Izmir (TR) V. Pansadoro, Rome (IT) 11.05 – 11.25 Lecture: Female urethral reconstruction R. Dahlem, Hamburg (DE) 15.50 – 16.10 Lecture: Treatment of vesico-urinary fistulas after radical prostatectomy E. Austoni, Milan (IT) 11.25 – 13.15 Live surgeries Moderators: R. Dahlem, Hamburg (DE) A. Ergen, Ankara (TR) OR 1: Laparoscopic pyeloplasty S. Deger, Ostfildern (DE) OR 2: Robotic diverticulectomy V. Pansadoro, Rome (IT) 16.10 – 17.10 Moderated Poster session II Chairs: R. Djinovic, Belgrade (RS) A. Esen, Izmir (TR) 19.30 – 22.00 Congress dinner 13.15 – 14.15 Lunch break Saturday, 15 December 2012 14.15 – 15.15 Panel I: The future of tissue engineering in reconstructive urology Moderator: T. Tarcan, Istanbul (TR) 08.30 – 08.50 Lecture: The diagnosis and treatment of mesh complications in female reconstructive urology B. Seckin, Konya (TR) 08.50 – 10.30 Live surgeries Moderators: O. Demirkesen, Istanbul (TR) T. Tarcan, Istanbul (TR) OR 1: Robotic sacrocolpopexy A. Mottrie, Aalst (BE) OR 2: Artificial urinary sphincter implantation I. Moncada, Madrid (ES) OR 3: Male Sling K-D. Sievert, TГјbingen (DE) 10.30 – 10.45 Coffee break Panel: R. Djinovic, Belgrade (RS) K-D. Sievert, TГјbingen (DE) 15.15 – 16.15 Panel II: The role of robotics and laparoscopy in reconstructive urology Moderator: A. Kural, Istanbul (TR) Panel: 16.15 S. Deger, Ostfildern (DE) A. Mottrie, Aalst (BE) V. Pansadoro, Rome (IT) Closing remarks S. Deger, Ostfildern (DE) ESGURS Board S. Deger, Ostfildern (DE) E. Austoni, Milan (IT) G. Barbagli, Arezzo (IT) E. Belgrano, Trieste (IT) M. Fisch, Hamburg (DE) A. Mundy, London (GB) M. Sohn, Frankfurt am Main (DE) W. Stackl, Vienna (AT) T. Sulser, ZГјrich (CH) Faculty B. Alici, Istanbul (TR) E. Austoni, Milan (IT) R. Dahlem, Hamburg (DE) S. Deger, Ostfildern (DE) O. Demirkesen, Istanbul (TR) R. Djinovic, Belgrade (RS) A. Ergen, Ankara (TR) A. Esen, Izmir (TR) A. Kural, Istanbul (TR) I. Moncada, Madrid (ES) A. Mottrie, Aalst (BE) C. Ozyurt, Izmir (TR) E. Palminteri, Arezzo (IT) V. Pansadoro, Rome (IT) B. Seckin, Konya (TR) K-D. Sievert, TГјbingen (DE) T. Tarcan, Istanbul (TR) S. Tekgul, Ankara (TR) Extended abstract deadline: 1 October 2012 European Association of Urology 10 European Urology Today August/September 2012 Book reviews Prof. Paul Meria Section Editor Paris (FR) cancer and related problems such as screening, diagnosis and treatments, including current minimally invasive therapies. Prostate physiological movements and their interference with the treatments were considered in the third part. Their mechanisms of occurrence were described such as various methods of adaptive re-planning, based on imaging systems for treatment guidance. paul.meria@ sls.aphp.fr Robotic Radiosurgery: Treating Prostate Cancer and Related Genitourinary Applications Emerging applications were considered in a special chapter, including various treatments applicable to renal tumours, muscle-invasive bladder cancers and gynaecologic cancers. Many tables and illustrations completed each chapter. Undoubtedly, this textbook is intended for radiotherapists and oncologists. Nevertheless, urologists involved in prostate cancer management will find ample amount of information, essential in pluri-disciplinary clinical exchanges. Editors ISBN E-book Publisher Publication Edition Binding Pages Price Website : L. Ponsky, D. Fuller, R. Meier, C.M. Charlie Ma : 978-3-642-11494-6 : 978-3-642-11495-3 : Springer-Verlag : 2012 : 1st : Hard Cover : 265 : €129.95 (net price) : www.springer.com Radiosurgery is a targeted application of high-dose radiation to an organ, aiming to reduce adverse effects on surrounding tissues. Currently, it remains of little use in the field of urology. Besides technical aspects, one of the limiting factors is probably the need of a pluri-disciplinary team, requiring various practitioners involved in different fields. Nevertheless, many applications have to be developed in the future. Sexual Dysfunction in Women Lee Ponsky and co-editors, helped by more than 40 worldwide experts, wrote an original textbook dedicated to urological applications of radiosurgery. The first part provided the reader with general information. Historical aspects and current indications of radiosurgery were described, focusing on intracranial diseases. Forthcoming developments were separately considered, including advances in genitourinary diseases. Practitioners involved in sexual dysfunctions management and who are faced with women problems will have to determine their origin and schedule the most accurate treatment. Marta Meana compiled in this textbook a comprehensive amount of information dealing with a rarely considered problem. Special consideration was given to the organisation of radiosurgery of prostate cancer, including a description of the required team members and their specific role. The second part dealt with prostate Sexual problems are probably underestimated in women population. The decrease of desire, arousal and orgasm intensity occur frequently and such difficulties may be associated with painful intercourse. These problems raise important questions and debates about women sexual function. An important part of the book was dedicated to hypofractionated radiation therapy and based on radiobiological aspects of the treatment. This chapter addressed the rationale and the results of hypofractionated treatments, supported by various studies. High-dose brachytherapy and stereotactic treatments of prostate cancer were also described in this chapter. Book reviews 3rd ESGURS Meeting Reflecting increased interest in minimallyinvasive approach to reconstructive surgery The EAU Section of Genito-Urinary Reconstructive Surgeons (ESGURS) will use its section meeting to offer participants a chance to familiarise themselves with minimally invasive surgery (MIS). The meeting takes place in Istanbul from December 14 to 15 later this year. In this interview, ESGURS Chairman Prof. Serdar Deger explained which surgeons the meeting hopes to attract. Preliminary programme “This meeting addresses a specific need among our members. In the past two to four years, we have seen an increased interest in minimally invasive procedures among reconstructive surgeons. Prof. Serdar Deger Reconstructive surgery is more and more able to use these techniques, spurring interest in these procedures,” said Deger. “We are hoping to attract reconstructive working urologists, who are just starting to work with minimally invasive procedures,” he added. A scientific programme (see previous page), which has been carefully prepared, features lectures, poster presentations and discussions about submitted cases. Participants are encouraged to submit abstracts on male and female urethroplasty, hypospadias repair, penile corporoplasty, surgical treatment of male incontinence, pelvic organ prolapse and any other surgical techniques using minimally invasive surgery, including laparoscopy and robotics in reconstructive urology. The meeting will also feature live surgery sessions and will be broadcasted from Istanbul University, with the support and coordination of the Cerrahpasa Medical Faculty. August/September 2012 The EAU and Turkey “Cerrahpasa is a well-known and renowned institution, and I am personally acquainted with many of the surgeons there. The live surgery will be performed from two locations, both of which have been previously used for live surgery transmission,” said Deger. According to Deger, the ESGURS meeting will have a вЂ�historic atmosphere.’ “That’s a reference to Istanbul as a historic capital as well as to the meeting venue, which is a historic auditorium in Istanbul University,” he said. Editor ISBN E-book Publisher Publication Volume Series Binding Pages Price Website : M. Meana : 978-088937-400-3 : 978-3-61676-400-5 : Hogrefe Publishing : May 2012 : 25th : Soft cover : 98 : €24.95 : www.hogrefe.com Sexual Dysfunction in Men Sexual problems in men have generated increasing interest and new therapeutic approaches were developed in recent years. Nevertheless, many concerns remain regarding various sexual problems in men. Current treatments are frequently based on drugs, and a psychosexual approach remains very important for many patients. This textbook complemented the previous one dedicated to women problems and the aims and scope of both editions were identical. Author David Rowland aimed to provide the reader with a strong basis of information, which is helpful in clinical practise. The first part was dedicated to descriptive information, including epidemiology, definitions and various considerations such as diagnostic procedures for each sexual problem in men. A brief paragraph described psychophysiology of male sexual function. Questionnaires, useful for clinical assessment of various problems such as erectile dysfunction and premature ejaculation, were described. The first part included epidemiologic data and various descriptions and definitions of sexual problems in women. Traditional models, based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) criteria were explained, focusing specifically on each disorder. The succeeding part described theories and models of sexual dysfunction. Different theories were described, and the selective review of such theories demonstrated the complexity and wide range of female sexuality. Diagnosis and treatment problems were described in the third part. Organic, psychological and sociocultural origins of sexual dysfunctions were considered, focusing on various difficulties encountered in practise. The methods of treatment were considered in the fourth part and the author emphasised the paucity of psychological interventions. Pre-therapeutic assessment was described including measures of global sexual function, followed by a thorough review of current methods of management. Multicultural issues were considered in this chapter, including religious and cultural norms and sexual identity. A case report concluded the textbook and corroborated the complexity of sexual problems in women, and the ambiguity of treatment outcome success. A summary of selected readings was added. He added: “Turkey is an upcoming country within the EAU. We have seen a significant increase in EBU fellowships, and the number of participants attending international meetings and congresses has also increased. Turkey has also proven to be an attractive location for meetings, partly due to the relatively lower costs of holding a conference in the city.” Various theories and models of sexual dysfunction were explained in the second part, including physiological, social and psychological aspects. The first part was dedicated to diagnosis and evaluation of the problem including identification of etiological factors, either psychosexual or organic. A comprehensive part was dedicated to the treatments of each clinical problem. Psychosexual approach and pharmacotherapy were described. Erectile dysfunction, the most common of the encountered problems, was exhaustively considered and various methods of treatment were described. The management of other problems, such as low desire, premature or delayed ejaculation were also addressed. The authors emphasised psychosexual approaches, such as behavioural, and the combination of methods. Two chapters dedicated to “final thoughts” and clinical cases concluded the textbook. Resource books were listed and an appendix summarised male sexual functioning questionnaires and the dedicated websites where one can obtain such questionnaires. Deger also noted that the Turkish Urological Association is involved in many meetings which have examined minimally invasive procedures. This textbook, clearly and exhaustively written, was intended for most practitioners, including urologists and sex therapists. Readers will obtain accurate information, which is very useful in daily practise. “Certainly, there is a clear and growing interest in these techniques among doctors in Turkey,” he said. For more information: http://esgurs.uroweb.org This up-to-date and concise textbook addressed a very difficult clinical subject, underestimated and probably inadequately considered. Undoubtedly, all practitioners will have a new and better approach of these problems after reading this textbook which adequately presented useful information. Editors ISBN E-book Publisher Publication Volume Series Binding Pages Price Website : D.L. Rowland : 978-0-88937-402--7 : 978-1-61676-402-9 : Hogrefe Publishing : June 2012 : 26th : Soft cover : 108 : €24.95 : www.hogrefe.com European Urology Today 11 Key articles from international medical journals Prof. Oliver Reich Section editor Munich (DE) Oliver.Reich@ klinikummuenchen.de Pioglitazone and bladder cancer risk Pioglitazone is an oral anti-diabetic agent effective at reducing glycated haemoglobin (HbA1c) levels and probably effective in decreasing cardiovascular events although it has been associated with weight gain and an increased risk of congestive cardiac failure. More recently there has been some observational data suggesting a possible increase in the reported incidence of bladder cancer especially in patients who Intermittent VEGF therapy for have been on the medication for over 24 months. This paper reports a population-based study to evaluate if metastatic RCC- is it safe? there is an association between pioglitazone and an The standard of care for patients with metastatic renal increased risk of bladder cancer in people with type 2 cell carcinoma (mRCC) has been vascular endothelial diabetes. growth factor (VEGF)-targeted agents until progression of disease (PD) or unacceptable toxicity. Using the UK general practice research database to Although this has been shown to extend overall interrogate the medical records of more than 10 survival, this is not felt to be curative and a high million people in more than 600 practices, they proportion of patients treated with these agents have identified all patients who were prescribed their first to discontinue treatments secondary to adverse ever oral anti-diabetic agent between 1 January 1988 events. This study assessed the consequences of and 31 December 2009, and who also had at least one stopping treatment in patients who had achieved year of previous medical history in the database. disease control. Patients who started treatment with insulin were A total of 40 patients, treated in either Institut excluded as were those under the age of 40 years or Gustav-Roussy (18) or the Cleveland Clinic (22), with a known history of bladder cancer. Participants between January 2004 and December 2009 were were followed until a diagnosis of bladder cancer, included. Patients had achieved stable disease, a death from any cause or end of registration with the partial response or a complete response by RECIST general practice. criteria and were then taken off therapy for reasons other than disease progression. Data was collected on ...it would appear that pioglitazone the sites of metastases, the therapy that had been used, the reason for discontinuation and Heng risk is associated with an increased risk group. Follow-up investigations were at the physicians’ of bladder cancer... discretion but generally involved a CT scan of chest abdomen and pelvis every 3-4 months. The primary objective was to measure time-to-disease progression. A nested case-control analysis was carried out. For each case of bladder cancer diagnosed up to 20 All patients included had clear cell histology, had controls were randomly selected after matching on undergone a prior nephrectomy and had a Karnofsky year of birth, year of cohort entry, sex and duration of score of 80% or better. 18 (45%) were considered of follow-up. For cases and controls, data on favourable risk whilst 20 (50%) were intermediate prescription of all anti-diabetic agents prescribed at risk and just 2 were in the unfavourable prognostic any time before the index date was collected although group. VEGF-targeted therapy held at the start of the new medications initiated in the year immediately study was sunitinib (55%), bevacizumab (23%) and before the index date were excluded to take into sorafenib (18%) and just one patient was on a account a biologically meaningful latency time combination of sunitinib plus bevacizumab. Therapy window. Patients were classified into one of 4 groups: was stopped for reasons of toxicity (73%), patient only used pioglitazone, only used rosiglitazone, used preference (15%), for a procedure and not restarted both and never used either. The length of time the (10%) and cost for 1 patient. drug was taken and the cumulative dose were also calculated. ...Perhaps of more concern was the finding that 8 patients developed metastases in new sites during expectant management... With a median follow-up of 29.7 months (4.2 - 84.7 months), 15 patients continued expectant management whilst 25 patients had progressed with a median progression- free survival of 10 months (1.4 - 27.2 months). Despite RECIST evidence of progression 8 patients chose to continue expectant management given the low volume and pace of disease. The other 17 had a variety of treatments and, unfortunately, information on the response to re-initiation of systemic therapy is not available. On multivariate analysis the more favourable Heng risk group (HR 2.24; CI, 1.05-4.80; p = 0.04) and achievement of a CR prior to discontinuing therapy (HR 0.19; CI 0.42-0.84, p = 0.03) were independent predictors of a longer PFS off therapy. Perhaps of more concern was the finding that 8 patients developed metastases in new sites during expectant management. One patient with brain metastasis and one with bone metastasis presented with clinical symptoms requiring immediate radiation therapy. There is no evidence that this would have been avoided with continuous therapy, but patients are bound to question this. There is a current phase II clinical trial underway at Cleveland Clinic which might help answer some of the questions raised by this retrospective study. Source: Cessation of vascular endothelial growth factor-targeted therapy in patients with metastatic renal cell carcinoma. Sadeghi S, Albiges L, Wood LS, Black SL, Gilligan TD, Dreicer R, Garcia JA, Escudier BJ, Rini BI. Cancer 2012; 118: 3277-82. Key articles 12 A study cohort of 115,727 patients met the inclusion criteria. The mean age was 64.1 years with a mean duration of follow-up of 4.6 years. A total of 376 cases with adequate information were matched to 6,699 controls. Use of pioglitazone was associated with an 83% increased rate of bladder cancer (HR 1.83, CI 1.1-3.05). This effect was not seen with use of rosiglitazone, the other thiazolidinedione available in the UK during the study period. ultrasound (HIFU) has been used as salvage therapy and this paper presents the data of the Sonablate 500 HIFU system in the salvage setting. Between 2004 and 2009, 84 men received salvage HIFU treatment, 44 at University College, London and 40 in London Ontario. All men underwent histological verification of locally recurrent disease as well as cross-sectional imaging and radioisotope bone scan to exclude macroscopic regional and distant metastases. Radiological T3a disease was allowed but patients with clinical T3a disease were excluded. HIFU treatment required the insertion of a suprapubic catheter and treatment to the complete prostate. The catheter was removed 2-6 weeks later as soon as urethral voiding was adequate. Patients were reviewed every 3 months for the first year and then every 6 months. Data was collected on serum PSA, IPSS UCLA-EPIC urinary domain to determine continence status and International Index of Erectile Function-5 point (IIEF-5). Progression was defined as a positive biopsy and/or last PSA >nadir +2 ng/ml and/or adjuvant hormone therapy. HIFU is seen by many men as technology with a low side-effect profile but whole gland HIFU is a high-risk procedure… Although data were incomplete the available data suggested 93% of men were discharged within 23 hours of treatment. Seventeen of 84 patients required intervention for bladder outflow obstruction and 2 men developed rectourethral fistulae (interestingly 2 further men out of 6 retreated with HIFU also developed fistulae). Treatment was also associated with a statistically significant decrease in the mean IIEF-5 score and a clinical deterioration in IPSS. 38% of men require protection for urinary incontinence. Mean follow-up was 19.8 months (range 3.0 - 35.1 months). Seven men showed no PSA response and were assumed to have metastatic disease. Of the PSA responders 1- and 2-year progression free survival rates were 62% and 48% respectively. Outcome was not apparently related to pre-HIFU PSA or Gleason score but was related to PSA nadir. Men who achieved a PSA of < 0.5 ng/ml were significantly less likely to show evidence of progression (HR 0.16; CI 0.08 – 0.34, p < 0.001) HIFU is seen by many men as technology with a low side-effect profile but whole gland HIFU is a high-risk procedure and in this scenario was associated with significant levels of toxicity. Repeat HIFU should clearly be avoided. Salvage HIFU after ERBT was feasible but in 21 of 49 patients (43%) who underwent biopsy after treatment, residual cancer was identified Source: Whole-gland salvage high-intensity focused ultrasound therapy for localised prostate cancer recurrence after external beam There was also evidence of a dose response relation- radiation therapy. Ahmed HU, Cathcart P, ship between exposure to pioglitazone and the rate of Chalasani V, Williams A, McCarten N, Freeman A, Kirkham A, Allen C, Chin J, Emberton M. bladder cancer with the rate highest in patients who had taken the drug for more than 2 years (HR 1.99, CI 1.14 - 3.45), or had received more than 28000 mg as a cumulative dose (HR 2.54, CI 1.05 - 6.14). Although there is not a clearly understood biological mechanism to explain the findings it would appear that pioglitazone is associated with an increased risk of bladder cancer. The absolute rates are relatively low but doctors and patients should be aware of this association when assessing the overall risks and benefits of this therapy. Source: The use of pioglitazone and the risk of bladder cancer in people with type 2 diabetes: nested case-control study. Azoulay L, Yin H, Filion KB, Assayag J, Majdan A, Pollak MN, Suissa A. Cancer 2012; 118: 3071-8. Global cancer transitions according to the Human Development Index (20082030): A population-based study Cancer is set to become a major cause of morbidity and mortality in the coming decades in every region of the world. The authors aimed to assess the changing patterns of cancer according to varying levels of human development. BMJ 2012; 344:e3645. Does HIFU for prostate cancer work? Men who have external beam radiation therapy (ERBT) for clinically localised prostate cancer have a 20% to 63% chance of experiencing biochemical failure. Whole gland high-intensity focused They used four levels (low, medium, high, and very high) of the Human Development Index (HDI), a composite indicator of life expectancy, education, and gross domestic product per head, to highlight cancer-specific patterns in 2008 (on the basis of GLOBOCAN estimates) and trends 1988-2002 (on the basis of the series in Cancer Incidence in Five Continents), and to produce future burden scenario for 2030 according to projected demographic changes alone and trends-based changes for selected cancer sites. In the highest HDI regions in 2008, cancers of the female breast, lung, colorectum, and prostate accounted for half the overall cancer burden, whereas in medium HDI regions, cancers of the oesophagus, stomach, and liver were also common, and together these seven cancers comprised 62% of the total cancer burden in medium to very high HDI areas. In low HDI regions, cervical cancer was more common than both breast cancer and liver cancer. …we predict an increase in the incidence of all-cancer cases from 12.7 million new cases in 2008 to 22.2 million by 2030... Nine different cancers were the most commonly diagnosed in men across 184 countries, with cancers of the prostate, lung, and liver being the most common. Breast and cervical cancers were the most common in women. In medium HDI and high HDI settings, decreases in cervical and stomach cancer incidence seem to be offset by increases in the incidence of cancers of the female breast, prostate, and colorectum. If the cancer-specific and sex-specific trends estimated in this study continue, we predict an increase in the incidence of all-cancer cases from 12.7 million new cases in 2008 to 22.2 million by 2030. The authors conclude that their findings suggest that rapid societal and economic transition in many countries means that any reductions in infectionrelated cancers are offset by an increasing number of new cases that are more associated with reproductive, dietary, and hormonal factors. Targeted interventions can lead to a decrease in the projected increases in cancer burden through effective primary prevention strategies, alongside the implementation of vaccination, early detection, and effective treatment programmes. Source: Global cancer transitions according to the Human Development Index (2008-2030): A population-based study. Bray F, Jemal A, Grey N, Ferlay J, Forman D. The Lancet Oncology, Early Online Publication, 1 June 2012; doi:10.1016/S1470-2045(12)70211-5. A midurethral sling to reduce incontinence after vaginal prolapse repair Women without stress urinary incontinence undergoing vaginal surgery for pelvic-organ prolapse are at risk for postoperative urinary incontinence. A midurethral sling may be placed at the time of prolapse repair to reduce this risk. The authors performed a multi-center trial involving women without symptoms of stress incontinence and with anterior prolapse (of stage 2 or higher on a Pelvic Organ Prolapse Quantification system examination) who were planning to undergo vaginal prolapse surgery. Women were randomly assigned to receive either a midurethral sling or sham incisions during surgery. One primary end point was urinary incontinence or treatment for this condition at 3 months. The second primary end point was the presence of incontinence at 12 months, allowing for subsequent treatment for incontinence. …a prophylactic midurethral sling inserted during vaginal prolapse surgery resulted in a lower rate of urinary incontinence at 3 and 12 months but higher rates of adverse events... Of the 337 women who underwent randomization, 327 (97%) completed follow-up at 1 year. At 3 months, the rate of urinary incontinence (or treatment) was 23.6% in the sling group and 49.4% in the sham group (p < 0.001). At 12 months, urinary incontinence (allowing for subsequent treatment of incontinence) was present in 27.3% and 43.0% of patients in the sling and sham groups, respectively (p = 0.002). The number needed to treat with a sling to prevent one case of urinary incontinence at 12 months was 6.3. The rate of bladder perforation was higher in the sling EAU EU-ACME Office European Urology Today August/September 2012 Prof. Oliver Hakenberg Section editor Rostock (DE) Oliver.Hakenberg@ med.uni-rostock.de immunosuppression to sirolimus instead of a calcineurin inhibitor should be considered. ml survival was significantly better in the radical prostatectomy group (12.6% and 13.2%, respectively). Source: Sirolimus and secondary skin-cancer prevention in kidney transplantation. Euvrard S, Morelon E, Rostaing L, Goffin E, Brocard A, Tromme I, Broeders N, del Marmol V, Chatelet V, Dompmartin A, Kessler M, Serra AL, Hofbauer GF, Pouteil-Noble C, Campistol JM, Kanitakis J, Roux AS, Decullier E, Dantal J; for the TUMORAPA Study Group. Above all, the definition of efficacy of radical prostatectomy cannot simply be defined by looking at disease-specific survival. Prostate cancer is becoming a chronic disease and the long period of living with metastatic disease would be a much more relevant end-point when discussing the potential efficacy of treating localised prostate cancer. N Engl J Med. 2012 Jul 26;367(4):329-39. group than in the sham group (6.7% vs. 0%), as were rates of urinary tract infection (31.0% vs. 18.3%), major bleeding complications (3.1% vs. 0%), and incomplete bladder emptying 6 weeks after surgery (3.7% vs. 0%) (p ≤ 0.05 for all comparisons). The authors conclude that a prophylactic midurethral sling inserted during vaginal prolapse surgery resulted in a lower rate of urinary incontinence at 3 and 12 months but higher rates of adverse events. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institutes of Health Office of Research on Women’s Health; OPUS ClinicalTrials.gov number, NCT00460434.) Source: A midurethral sling to reduce incontinence after vaginal prolapse repair. Wei JT, Nygaard I, Richter HE, Nager CW, Barber MD, Kenton K, Amundsen CL, Schaffer J, Meikle SF, Spino C for the Pelvic Floor Disorders Network. N Engl J Med 2012; 366:2358-2367, June 21, 2012. Sirolimus has proven antitumoral effect in renal transplant recipients Renal transplant recipients are at increased risk of developing malignancies and the most common of these are cutaneous squamous-cell carcinomas with a high risk for multiple subsequent skin cancers. This risk is attributable to immunosuppression. This study investigated whether sirolimus is useful in the prevention of secondary skin cancers in organ transplant recipients. Radical prostatectomy vs watchful waiting in a high comorbidity cohort – what does it prove? N Engl J Med. 2012 Jul 19;367(3):203-13. This trial reports data which fit into the ongoing debate about PSA-based screening and early prostate cancer detection programmes. The authors stated that Coffee drinkers live longer effectiveness of surgery versus observation alone for men with localised prostate cancer detected by means (unless they smoke) of prostate-specific antigen (PSA) testing is not known. Coffee is one of the most widely consumed beverages. Whether coffee is beneficial or unhealthy is a matter They conducted a study in which from November 1994 of opinion and this can change over time. This large through January 2002, 731 men with localised prostate study looked at the potential association between cancer were randomly assigned to radical coffee consumption and the risk of death remains prostatectomy or observation and followed through to unclear. January 2010. Mean patient age was 67 years and the median PSA value was 7.8 ng/ml). …coffee consumption was inversely Efficacy was defined as a significant effect on disease-specific and overall mortality; thus, the primary outcome was all-cause mortality; the secondary outcome was prostate-cancer mortality. About 50% of men had clinically stage T1c tumours, 75% had a Gleason score under 7 and 40% of cases were classed as low risk. During the median follow-up of 10.0 years, 171 of 364 men (47.0%) assigned to radical prostatectomy died, as compared with 183 of 367 (49.9%) assigned to observation (hazard ratio, 0.88; 95% confidence interval [CI], 0.71 to 1.08; p=0.22; absolute risk reduction, 2.9 percentage points). In this multicenter trial, transplant recipients who were taking calcineurin inhibitors and had at least one cutaneous squamous-cell carcinoma were randomly assigned either to receive sirolimus as a substitute for calcineurin inhibitors (in 64 patients) or to maintain their initial treatment (in 56). The primary end point was disease-free survival regarding squamous cell skin cancer at 2 years. Secondary end points included the time until the onset of new squamous-cell carcinomas, occurrence of other skin tumours, graft function, and problems with sirolimus. The authors concluded that among men with localised prostate cancer detected during the early era of PSA testing, radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality, as compared with observation… Disease-free survival free of cutaneous squamous-cell carcinoma was significantly longer in the sirolimus group than in the calcineurin-inhibitor group. Overall, new squamous-cell carcinomas developed in 14 patients (22%) in the sirolimus group (6 after withdrawal of sirolimus) and in 22 (39%) in the calcineurin-inhibitor group (median time until onset, 15 vs. 7 months; p=0.02), with a relative risk in the sirolimus group of 0.56 (95% confidence interval, 0.32 to 0.98). Among men assigned to radical prostatectomy, 21 (5.8%) died from prostate cancer or treatment, as compared to 31 men (8.4%) assigned to observation (hazard ratio, 0.63; 95% CI, 0.36 to 1.09; p=0.09; absolute risk reduction, 2.6 percentage points). The effect of treatment on all-cause and prostate-cancer mortality did not differ according to age, race, coexisting conditions, self-reported performance status, or histologic features of the tumor. …switching from calcineurin inhibitors to sirolimus has an antitumoral effect in kidneytransplant recipients with previous squamous-cell carcinoma... There were 60 serious adverse events in the sirolimus group, as compared with 14 such events in the calcineurin-inhibitor group (average, 0.938 vs. 0.250). There were twice as many serious adverse events in patients who had been converted to sirolimus with rapid protocols as in those with progressive protocols. In the sirolimus group, 23% of patients discontinued the drug because of adverse events. Graft function remained stable in both study groups. The authors concluded from their study that switching from calcineurin inhibitors to sirolimus has an antitumoral effect in kidney-transplant recipients with previous squamous-cell carcinoma. Thus, in patients after renal transplantation who have had a squamous-cell skin cancer converting the Source: Radical prostatectomy versus observation for localized prostate cancer. Wilt TJ, Brawer MK, Jones KM, Barry MJ, Aronson WJ, Fox S, Gingrich JR, Wei JT, Gilhooly P, Grob BM, Nsouli I, Iyer P, Cartagena R, Snider G, Roehrborn C, Sharifi R, Blank W, Pandya P, Andriole GL, Culkin D, Wheeler T for the Prostate Cancer Intervention versus Observation Trial (PIVOT) Study Group. associated with total and causespecific mortality. Obviously, the data do not ascertain whether these were causal or associational findings... In a large epidemiological study the association of coffee drinking with subsequent total and causespecific mortality among 229,119 men and 173,141 women in the National Institutes of Health-AARP Diet and Health Study who were 50 to 71 years of age at baseline was examined. Participants with cancer, heart disease, and stroke were excluded. Coffee consumption was assessed once at baseline. Mr Philip Cornford Section editor Liverpool (GB) Philip.Cornford@ rlbuht.nhs.uk women died. In age-adjusted models, the risk of death was increased among coffee drinkers. However, coffee drinkers were also more likely to smoke, and, after adjustment for tobacco-smoking status and other potential confounders, there was a significant inverse association between coffee consumption and mortality. Adjusted hazard ratios for death among men who drank coffee as compared with those who did not were as follows: 0.99 (95% confidence interval [CI], 0.95 to 1.04) for drinking less than 1 cup per day, 0.94 (95% CI, 0.90 to 0.99) for 1 cup, 0.90 (95% CI, 0.86 to 0.93) for 2 or 3 cups, 0.88 (95% CI, 0.84 to 0.93) for 4 or 5 cups, and 0.90 (95% CI, 0.85 to 0.96) for 6 or more cups of coffee per day (P<0.001 for trend); the respective hazard ratios among women were 1.01 (95% CI, 0.96 to 1.07), 0.95 (95% CI, 0.90 to 1.01), 0.87 (95% CI, 0.83 to 0.92), 0.84 (95% CI, 0.79 to 0.90), and 0.85 (95% CI, 0.78 to 0.93) (P<0.001 for trend). Inverse associations were observed for deaths due to heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, but not for deaths due to cancer. Results were similar in subgroups, including persons who had never smoked and persons who reported very good to excellent health at baseline. A serious drawback of the study may have been that coffee consumption was assessed only once and habits may change. However, in summary, in this large prospective study, coffee consumption was inversely associated with total and cause-specific mortality. Obviously, the data do not ascertain whether these were causal or associational findings. Source: Association of coffee drinking with total and cause-specific mortality. Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R. N Engl J Med. 2012 May 17;366(20):1891-904. During 5,148,760 person-years of follow-up between 1995 and 2008, a total of 33,731 men and 18,784 Do not forget to share your event at www.urologyweek.org Radical prostatectomy was associated with reduced all-cause mortality among men with a PSA value greater than 10 ng/ml (p=0.04 for interaction) and possibly among those with intermediate-risk or high-risk tumors (p=0.07 for interaction). Adverse events within 30 days after surgery occurred in 21.4% of men, including one death. The authors concluded that among men with localised prostate cancer detected during the early era of PSA testing, radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality, as compared with observation, through at least 12 years of follow-up. Absolute differences were less than 3 percentage points. However, this study is not free of significant bias. There was surprisingly high all-cause mortality in both groups of almost 50% inmen with a mean age of 67 at study entry. This mortality was e.g. mu7ch higher than in other comparable studies as that by Bill-Axelson. The high mortality suggests severe comorbidity in both groups which would certainly affect an outcome looking at mortality. In the subgroups of men with an intermediate risk tumour and in those with an initial PSA above 10 ng/ Key articles August/September 2012 European Urology Today 13 Young Urologists/Residents Corner My first year as a resident urology doctor Young urologist writes on her experience at the University of Rostock Dr. Gesa Kellermann University of Rostock Dept. of Urology Rostock (DE) gesakellermann@ web.de Why do you want to be a urologist, especially since you’re a woman? That is one of the most frequently asked questions I encounter as a resident. It is a question that I consider a bit awkward since nowadays women are active in all medical specialties. I used to get really annoyed with this question, but now I instead ask a counter-question: why are there so many male gynaecologists and no one ever asks them why they choose that specialty? A silence would usually follow, which allows me to prepare for the next question, which is usually: But don’t you find it awkward to do a prostate exam in older men and look at their genitals? Why are you so interested in prostate glands? I’ll spare readers my reply to that question since we all know how diverse urology is, which fortunately encompasses more than just the prostate gland. This brings us to the fact that if one surveys the medical field one will discover that more and more women are specialising in urology. And why shouldn’t they? Recently, at the OR, an anaesthesiologist said he would never marry a surgeon or urologist. When I asked him why, he replied that she would never have any free time, especially to build or have her own family. I consider that a вЂ�lazy’ or convenient excuse. Some men are afraid of strong women, or rather women who have careers or go into specialties that used to be a purely male-dominated field. There are many women in my department that are not really вЂ�outspoken feminists’ and yet they raise their children, take their career seriously and are very successful. I believe it is very important that there are roughly the same number of men and women in a department since they complement each other with their special abilities. But there are also many things that both genders succeed at equally, such as surgical operation, among other things. My experience With my colleagues in the department, I experience, thankfully, an absolutely respectful and equal work environment. Like with other people my interest on a career in urology began during my medical studies. My last clinical rotation at the Department of Urology at the University of Rostock Hospital impressed me so much that I chose urology as my elective rotation during my final year in medical school. University of Rostock Hospital After completing my medical board exams, I began my residency in urology. What impressed me so much about urology? I always wanted to enter a specialty that requires good manual skills. General surgery failed to interest me since that would have been too unremarkable - being in the OR and never seeing patients- well, never seeing patients not under anaesthesia-- I do not want that. I consider urology a specialty with many small procedures as well as long operations, while at that same time allowing me to still have patient contacts in the ward and outpatients, which to me is very important. I like the challenge not only of kidney transplantations, but other small routines or procedures, even if it is just as simple as making a patient really happy with a well-performed circumcision. Throughout my first year in Rostock, I am lucky to have the chance to operate and assist in many cases. In the OR, I am taught a lot and encouraged to be critical and ask questions. I also have a lot of responsibility in the ward, which I found pretty daunting during the first month. Now I really appreciate making decisions on my own and having consultations with patients, seeing their contentment and relief after treatment. My first few nights on-call were no piece of cake, but I am glad that my colleagues offered to let me join them on a few calls during my first few weeks in the department. I learnt so much in those first few weeks which greatly helped me when, months later, I had my first night call of my own. On my very first call a patient with urosepsis came in. The consultant gave me immediate back-up and we managed the situation together. I did not feel left alone at any time and that feeling has stayed with me in all of my calls. I can call the consultant when I’m not sure what to do and that gives me reassurance. I am working in a good team all the way down to the medical student doing rotations where no one is ever left to fend for him or herself since everyone is in the same boat. Getting support both personally and professionally is almost equally important in the choice of a field of medicine to go into. Rostock offers other interesting aspects with very attractive recreational activities due to its seaside location. If one works efficiently, one can usually leave the hospital at around 4:30 p.m., which is great during the summer when you can have a great time on the beach with surf kiting, beach volleyball or just sun-bathing! 4th GeSRU workshop on urologic oncology Intensive, insightful uro-oncology workshop for residents bone metastases and the medical treatment of anemia and thrombocytopenia. MГјnster, lectured on the andrological aspects in the treatment of tumour patients. She discussed the long-term effects of chemotherapy on fertility and the Empathy with patients andrological aspects. These issues included nerve and In his last lecture, Dr. Mayer discussed the topic of vascular damage, disturbances on gonadal and informing patients about the diagnosis and treatment, endocrine function ( e.g. surgical damage), metabolic including alternative ways and side effects, a subject syndrome or cardiovascular disease. Also discussed in which also tackled the emotional challenges in such her lecture were the role of testosterone and sensitive situations. Taking the time to talk with the replacement therapy, and the prevention and Dr.ChristianRuf@ patient is one of the most important duties of a treatment of decreased fertility in cancer patients gmx.de physician, according to Dr. Mayer, as he stressed that including sperm cell cryopreservation. despite the busy schedule of doctors, what makes a Urologic oncology includes not only the surgical good physician is the doctor’s ability to be empathic Prostate and testis cancers Prof. Graefen and Dr. Steuber, associate professor, who treatment options for all types of urologic tumours with patients. He encouraged the participants to see both lead Martini Clinic, a specialised centre on but also diagnosis, treatment planning, medical cancer therapy through the patient`s eyes, Prostate cancer at the University Hospital Hamburgtreatment, handling side effects as well as follow- up acknowledging life-changing events and situations and palliative treatment. such as having a stoma, the fear of undergoing major Eppendorf, gave three lectures on prostate cancer. Prof. Graefen`s first lecture covered all types of primary operations, experiencing pain, chemotherapy’s side therapies for prostate cancer including localised, Urologic oncology is a dynamic field with new drugs effects and a shortened life expectancy. locally advanced and initially metastasised tumours. being developed and new insights influencing therapy His second presentation was about adjuvant treatment strategies. Oncology, as a main topic in urology and a Prof. Sauter, Head of the Department of Pathology, major part in the training of residents, means that University Hospital in Hamburg-Eppendorf specialises options for different stages of prostate cancer, including indications for early and delayed treatment both practicing urologists and residents have to be on urologic tumours. He gave an overview about the such as radiotherapy and hormonal therapies. updated on the latest developments. work of a pathologist, the need for clinical information, difficulties about correct staging for The German Society of Residents in Urology (GeSRU) tumour stage as well as grading, citing urothelial cell Dr. Steuber focused on the therapy for advanced disease and relapses in prostate cancer including has organised the 4th workshop on urologic oncology carcinoma as an example. hormonal treatment, systemic chemotherapy in for residents in Hamburg. Over 50 participants from Regarding urologic tumours, Dr. Protzel, associate chemo-naive patients and second-line chemotherapy. all over Germany joined this two-day workshop held professor from the University Hospital in Rostock, This presentation also included effects on the body at the Federal Armed Forces Hospital in Hamburg. lectured on penile cancer, a field where he is and the side effects of new, shortly available drugs for specialises. Since penile cancer is a rare disease, The programme included the diagnostic workup, Protzel gave a comprehensive overview on diagnostic second-line therapy in castration refractory prostate cancer. surgical and pharmaceutical treatment as well as workup and stage- adapted treatment for this second-line therapy and follow-up for all urological disease. His presentation included not only guideline tumours. The workshop was specifically organised recommendations but also practical tips for surgery Dr. Wagner, Head of the urological department at the for residents as they may have other queries and medical treatment based on his daily clinical Federal Armed Forces Hospital, a testis cancer centre compared with veteran oncologists and specialist routine experience and taking into account the newest and host for the workshop, lectured on testicular consultants. Thus, the workshop also dealt not only scientific results. cancer. He gave an overview of the treatment options with therapy regimes but also practical tips and tricks. for both seminoma and non-seminoma, and all stages Prof. Jocham, Head of the Urological Clinic of the of disease. He included a diagnostic work-up and The first speaker, Dr. Mayer, a medical oncologist and University Hospital LГјbeck gave two lectures on treatment options such as the latest information on risk head of the department of medical oncology at the factors and recommendations from the 3rd European urothelial cell carcinoma, which included diagnosis, Federal Armed Forces Hospital in Ulm, gave an primary treatment as well as medical treatment and Consensus Conference on Diagnosis and Treatment of overview on chemotherapeutic drugs used in urologic follow-up. He also highlighted special cases such as Germ Cell Cancer (held in November 2011 in Berlin), oncology. This included the effects on the body, doses, tumours refractory, instillation therapy and following the newest guidelines (from the 2012 EAU Guidelines) necessary previous investigations and knowledge and from his own personal experience. In the treatment options. The second lecture was about about and treatment of possible side effects. concluding part, he presented interesting and unusual systemic chemotherapy for urothelial cell Carcinoma including indications and contraindications, selecting testis cancer cases that he discussed with the audience. Dr. Mayer also presented the treatment of oncologic the correct therapy regimen and the use of secondProf. WГјlfing, Head of the Urologic clinic at the emergencies including extravasation of line drugs. Asklepios Hospital in Hamburg-Altona , gave a lecture chemotherapeutic agents and the indication of on renal cell carcinoma. His presentation included supportive treatment, such as antiemetic drugs, Prof. Kliesch, Head of the Center of reproductive pre-operative staging and classification (e.g. PADUA prophylactic and therapeutic use of GCSF, treatment of medicine and andrology of the University Hospital Dr. Christian Ruf Chairman-elect, ESRU Federal Armed Forces Hospital Hamburg Hamburg (DE) 14 European Urology Today classification) of tumours that enable decision-making on surgical treatment. He also gave an overview on the therapy of advanced disease and new drugs. He also presented clinical cases and asked the audience about their recommended treatment strategies. Finally, Dr. Buntrock, urologist and Head of the Urologic Centre for Rehabilitation in Bad Wildungen, lectured on the possibilities and limitations of rehabilitative procedures in urologic cancer patients. He focused on prostate cancer patients after surgical treatment but also included other urologic tumours. He showed data on the effects of rehabilitation on continence and sexual functions and pointed out the importance of the psychological effects in cancer patients. Interactive summary The last session was an interactive summary of the two-day event. Speakers were asked to prepare some questions on their topic that will help participants summarise the workshop’s main highlights and issues. Some of the speakers joined this session and it was used as a preparation for the exam on medical therapy in urologic oncology. Participants positively assessed this workshop, describing it as properly oriented on actual practice, comprehensive, with a special focus on the educational needs of residents. The GeSRU is also satisfied to offer a resident-focused, low-budgeted workshop but with the participation of excellent speakers. Some of the residents have used the workshop to prepare for their exam on medical tumour therapy in urology, and benefited from the Q&A session where they discussed open points and check their own knowledge. Many participants described this feature of the event as very helpful and outstanding compared with other similar meetings. The GeSRU pointed out that such a quality can only be possible since all speakers did their presentations free-of-charge and shared their time to provide high-quality training. The GeSRU team conveyed its appreciation to all speakers and to the Federal Armed Forces Hospital in Hamburg for providing the free use of the rooms and workshop equipment. They also thanked the various companies for the generous support, without which it would have been difficult to organise and offer such a comprehensive workshop. August/September 2012 Young Urologists/Residents Corner Residency in an EBU training centre Italian resident writes of a comprehensive training in Bozen Dr. David D’Andrea Dept of Urology Central Hospital Bozen (IT) dd.dandrea@ googlemail.com “Every morning, when the ashes of the night turn into grapevines and the mountains paint themselves in every colour of nature, I wake up and am excited about the day ahead.” Bozen, capital city of South Tyrol in north-eastern Italy, exemplifies the fusion of Italian lifestyle, Tyrolean tradition and European efficiency. With its 100,000 inhabitants, it is a city where life is not only pleasant but also offers something not only to the eye, but also to the soul. In other words, Bozen is a people-friendly city. In the city’s southern district, amid acres of vineyards and apple orchards, one finds the Central Hospital of Bozen. The Department of Urology has 30 beds plus two paediatric beds. I am one of three residents in the hospital’s Resident Programme. In the urology department there is a friendly air atmosphere, which is important for a resident since one is just at the beginning of one’s career, confronted with a new set of challenges and faced with various responsibilities and decisions. Having someone who can lend support in difficult times is therefore important. Certified training centre On our first day, we received a handbook listing the duties and goals of our training. We were required to attend once every week the continuing education programme and prepare our own lessons with short presentations and case reports. We are also expected to actively participate in the pathological meeting and assist in a tele-conference with two partner hospitals in Austria. Attendance in national and international congresses that are held every year is also required. But the people of Bozen have a more leisurely pace. In the city one can reach the shops, one’s workplace or the theatre by bike. There is a good network of bike paths also in the surroundings of the city that will satisfy even the most demanding cyclist. Thus, places outside the city limits are all conveniently accessible by bicycle. Bozen’s Department of Urology is a certified EBU training centre. As trainees it is our responsibility to fill in a log-book and an OP catalogue. Once a year, we undergo the online EBU examination and are tested on our clinical and surgical skills by one of the senior physicians through so-called “checkoperations.” The work begins every morning at 7:30 with a ward visit. After a short meeting we are assigned to either the major surgery OR, the endo-urology OR, the ward, the ambulance or the stone unit. Our training programme was prepared in such a way that we have the chance to observe, join in or perform a wide range of surgical procedures, every step of which we received constant guidance and instruction. Moreover, the department’s chairman and senior physicians are always willing to train and share their valuable experience. “Bozen is where I work, where I live and it is a place that I enjoy every single day.” The day before we can check on the operation list the procedures we can perform, including the assigned tutor, so we can prepare and study the anatomical, physiological and pathophysiological aspects of the case. In the first year, we focused on the external genitalia and were introduced step-by-step in endo-urology. We also have the chance to assist in major surgeries like prostatectomy or renal tumour enucleation. In the second year we progressed in open surgery and begun with endoscopical resection of the prostate and bladder. In the third year we took up laparoscopy to improve our skills and competences. Unfortunately, we do not have a personal mentor. Thus, when we learn a procedure it’s always a little Bozen has its own charms with places for recreation such as wine-bars, hotels and entertainment clubs. There are discotheques for music lovers and partying. But since the city is not big, there are a limited number of shops, museums and cinemas. A visitor therefore cannot expect the varied attractions usually found in a bigger metropolitan centre. However, Bozen compensates for it with very good sport facilities, and sports enthusiasts can find or engage in virtually any sport. In summer one can hike through green woods and climb to the top of the Alps. A few kilometres from Bozen there are lakes easily reachable by bike, where one can go swimming after Furthermore, we are given practical instructions on a hard day’s work in the hospital. In winter, there are how to achieve effective communication with patients. wonderful skiing facilities in the beautiful Dolomites, We constantly aim to improve our clinical knowledge where there are also many wellness centres. Some in order to avoid errors. Therefore, we have to be skiing slopes, on certain days, are also open until completely reliable and must have the opportunity to 10.00 in the evening! It is therefore easy to have the perform many procedures. Many students practise in feeling that one is working in a holiday resort. our department for a month or two, and we residents have to supervise them, which gives us the chance to Bozen is where I work, where I live and it is a place improve our skills and first teaching experience. that I enjoy every single day. bit different, depending on the physician who was assigned to teach us, and this means that it is important for us to ask questions whenever we have some doubts. Twice to four times a year we host a visiting professor who presents alternative diagnosis paths and operation techniques, providing us valuable tips to improve our skills and gain more experience. Living in Bozen There is always a lot to do in our department. We residents have to manage the ward, the stone unit and the smaller procedures that take place in endourology such as removing urethral catheters or injecting contrast medium for a urography. Since it often happens that we have to perform these procedures by ourselves, we have hectic daily schedules. Completion of Training – What Now? Careful research and planning is crucial to residents in search of sub-speciality training Mr. Christian Bach Senior Endourology Fellow The Royal London Hospital - Barts Health NHS Trust London (UK) dr.christian.bach@ gmail.com After completing my urological training in Germany I wanted to further enhance my skills and, if possible, to combine this with a stay abroad to benefit from the experience of working in a different healthcare system. Since working in the UK National Health Service (NHS) has become popular among German doctors I started to look for jobs in the UK. All NHS jobs are advertised on www.jobs.nhs.uk, where a comprehensive job description is provided along with an outline of the remuneration package. But I did note that the advertised jobs do not always offer training opportunities. Most often these jobs are either locum or temporary posts, where a fully trained and experienced urological specialist is hired to provide services such as seeing patients in outpatient clinics, conducting flexible cystoscopies and other minor surgical interventions. Other jobs are suited for junior doctors at Senior House Officer (SHO)/clinical fellow level, who mainly provide cover for ward-based activity within the August/September 2012 Mr. Anuj Goyal Urology Registrar The Royal London Hospital - Barts Health NHS Trust London (UK) My colleague, Mr. Anuj Goyal, a final-year urology resident explained the following: means the training within the fellowships is usually of a very high standard. “These fellowships are usually offered by highly specialised centres and aim to train the fellow over a one to two-year period until he/she becomes independent in their respective field. As I was particularly interested in endourology, I was looking for such a post and finally got a fellowship that focused on the treatment of complex stone disease in one of the UK’s leading endourology units. Anuj.Goyal@ bartsandthelondon. nhs.uk A solid knowledge of core urology following completion of an approved residency programme is usually a pre-requisite for entry into such fellowships. Commonly offered are the Endourology Fellowships for stone disease and upper urinary tract laparoscopy urology department. As a fully trained urologist, these or Uro-oncology Fellowships, nowadays, usually with a focus on laparoscopic or robot-assisted laparoscopic posts did not appeal to me as they hardly offer any surgery. possibilities for training and specialisation. More interesting were the so-called LAT (Locum Appointment for Training) jobs, which are deaneryapproved training posts and open to applicants outside the official UK residency-training programme. According to the specific job description, these posts can offer good opportunities for developing surgical skills and training, thereby opening doors to a further career in the NHS. To enter the formal structured five-year UK speciality training programme did not seem an alternative since the prospect of another five years of training was unappealing to me, notwithstanding that this requires a lot of determination due to its competitive nature, and is therefore quite difficult especially for non-UK graduates. It quickly became evident to me that the best choice for high quality training was to enter a fellowship programme. But what exactly is a fellowship and how does it work in the UK? This way of sub-specialised post-residency training is usually pursued by the UK residents too (usually undertaken post award of Certificate of Completion of Training). A key advantage to this is that in the UK there is a clear and growing trend towards subspecialisation leading to individual surgeons performing a limited variety of urological operations in centralised facilities. Centres performing such high-volume and complex work would allow for the attached Fellow to gain excellent exposure to the desired area of super specialisation.” “...knowledge of core urology...is usually a pre-requisite for entry into such fellowships.” And indeed, a key difference when compared to the German system is the consultant-led/consultantdelivered patient care and sub-specialisation. This The Endourology and Stone Services have recently moved from the oldest hospital in the UK, St. Bartholomew’s Hospital, to the Royal London Hospital and is led by two consultant urological surgeons, Mr. Noor Buchholz and Mr. Junaid Masood. It is certified by the International Endourology Society (IES) as a subspecialty training centre and became the first European Board of Urology (EBU)-certified subspecialty centre for the treatment of upper urinary tract stone disease in 2009. (For a more detailed description of the fellowship check out the EUT, Volume 23 – No. 5 – October/November 2011) It turned out to be a clear advantage of having a fellowship in the European Economic Area since the General Medical Council of the UK recognised my German specialist qualification. Moreover, I encountered no problems with visa requirements. However, there are highly interesting fellowships are offered worldwide. Offers can be found, for example, at http://www.endourology.org/fellowship/fellowship. php or on the homepage of the SociГ©tГ© Internationale d’Urologie. With my fellowship now coming to an end after two years, I must emphasise that my experience is highly valuable to my professional and personal development - a unique opportunity that I can only highly recommend to trainees who are planning to hone their skills in a sub-specialty. European Urology Today 15 Tom Lue visits UZ Leuven US expert gives support to Belgian colleague Internationally renowned professor Dr. Tom Lue (San Francisco, California) has recently visited UZ Leuven in Belgium during the thesis defence of Dr. Maarten Albersen, one of Lue’s mentees. “The university is honoured to welcome Dr. Tom Lue who visited the institute last June 25 to 26,” said Prof. Hein Van Poppel. Lue is professor at University of California-San Francisco and medical director and founder of the Knuppe Molecular Urology Laboratory. One of the first urologists in the US to offer penile injection therapy for erectile dysfunction (ED), Lue is credited with breakthrough work in treating male dysfunction. 4. What is the major gene responsible for male sexual differentiation? a) TDF b) SOX c) WT 1 d) SRY e) ZFY 2. What is the normal size of the urethral meatus of a 2-year old boy usually? a) 6 Fr b) 8 Fr c) 10 Fr d) 12 Fr e) 14 Fr 5. The feature associated with worse survival in children with Wilms’ tumour is: a) Diffuse anaplasia b) Diffuse tumour spill c) Incomplete tumour resection d) Tumour spread to periaortic lymph nodes e) Lung metastasis 3. a) b) c) d) e) The correct answers of this Guidelines Quiz can be found elsewhere on this page. Micropenis is associated with Ear anomalies Cardiac anomalies Midline brain defects Myelodysplasia VATER Syndrome From: Campbell-Walsh Urology EAU PO Box 30016 6803 AA Arnhem The Netherlands T +31 (0)26 389 0680 F +31 (0)26 389 0674 [email protected] www.uroweb.org 9th Edition Review, 3rd edition, by Alan J. Wein, MD, PhD(hon), Louis R. Kavoussi, MD, Andrew C. Novick, MD, Alan W. Partin, During his Leuven visit, Lue also performed a 16-dot plication in a male patient with recurrent Peyronie Disease which, according to Van Poppel, did not only demonstrate Lue’s expertise but also showed his very comprehensive approach in teaching. MD, PhD and Craig A. Peters, MD (eds). Copyright Saunders/ Elsevier (Philadelphia) (2007). Reprinted with permission. European Association of Urology Guidelines 2012 edition Guidelines Albersen has worked in Lue’s laboratory for a year and conducted research on treatment options with adipose tissue-derived stem cells after cavernous nerve-injury induced erectile dysfunction. This research was also the subject of his PhD thesis that he successfully defended on June 26. As Albersen’s mentor, Lue observed and provided moral support during the defence. Lue is a recipient of numerous awards, including the American Urological Association’s “Gold Cystoscope” award and American Foundation of Urologic Disease’s “Most Innovative Research Award.” He has authored or co-authored more than 380 publications and 12 books on male sexual dysfunction. His research team has pioneered on a new class of compound which later led to the development of ED drugs such as Viagra and Levitra. 1. The serum metabolic pattern that occurs most often after gastrocystoplasty is a) Hypochloremic metabolic acidosis b) Hyperchloremic metabolic acidosis c) Hypochloremic metabolic alkalosis d) Hyperchloremic metabolic alkalosis e) Hyponatremic metabolic acidosis European Association of Urology “He contributed to a lot of our knowledge about erectile dysfunction, intracavernosal injections with papaverine and stem cell therapy for erectile dysfunction,” said Van Poppel. “We are privileged and grateful for Dr Lue’s visit at UZ Leuven.“ From left, Dr Karlien Peeters, Prof. Tom Lue and Dr Maarten Albersen Guidelines Quiz 2012 edition Social networking for urologists There is more than meets the eye The internet has become a very social experience – social networks, such as Facebook, LinkedIn and Twitter provide an easy way to keep in touch and keep up with news and developments. At the same time, social networks are so much more that an opportunity to be in touch with friends and colleagues, there are also a great platform for professional discussions, global networking, job hunting, profiling and forming partnerships. No wonder, with 901,000,000 users, Facebook has ceased to be just a playground for college students. In fact, according to the March 2012 Study conducted by Online MBA, 46% of all Facebook users are over 45. On LinkedIn, this percentage is even higher, nearing 50%. The majority of those who use social media have completed college or postgraduate education and have medium to high-income jobs. All in all, it is estimated, that over 66% of adult online users are connected through social platforms. With such high-potential demographic statistics, companies and organisations are eager to communicate through these channels. And it is through social network that time-sensitive information and “special offers” are often communicated. Whether we are talking about fellowship application deadlines or reduced registration offers – social media is often the channel of choice. How can urologists use social media to achieve professional goals? There are many ways to approach this, but first and foremost it is important to decide whether you will be using social media as an individual urologist, as a representative of an organisation (society, hospital department, university department, research group etc.) or as an organiser of an event. Facebook If you already have a Facebook account, you can “like” all sorts of pages created by urology interest groups or associations. That way you can easily follow their updates and news all in one place – on your own 16 European Urology Today Facebook feed. You can, for example “like” the EAU on Facebook (www.facebook.com/EAUpage), follow and comment on all our activities, post your questions, talk to other urologists who “like” the page, and post photos and reports directly on our page. “With over 66% of adult online users connected through social platforms... companies and organisations are eager to communicate through these channels” For example, if you attended the EAU Congress, you can post your photos from the congress on our page – it is always great to see various perspectives of the same event as experienced by other people. Many of the other urology associations, as well as pharmaceutical and medical technology companies are also on Facebook so it is a great way to network and come in contact with people interested in the same field of work. If you are representing an organisation, however big or small, and still don’t have a Facebook page – consider starting one. You can easily do it from your personal profile. This is a good opportunity not only to communicate your own information to your audience, but also get feedback from them. It is also an opportunity to be a little less formal in your communication – what is not always suitable for the official website, such as backstage impressions from your latest event – will be well-received on a Facebook page. Social networks are much more than an opportunity to meet friends, but also a platform for professional discussions and partnerships The EAU actively uses Twitter during its events – especially the EAU Congress and the Urology Week. For example during the last congress, the EAU and more than 200 congress participants marked all their updates with #eau12. This way we could all see the photos, opinions and expressions in one Twitter feed, which we conveniently integrated into the congress website for everybody to see. This made the EAU Congress more human, we heard a lot of useful feedback and it was also a great platform for everybody to post their impressions as the day progressed. Twitter This microblogging site makes it easy to follow short updates from all the people and organisations that you find interesting. It is great for people who don’t have a lot of time, so they just screen through all the latest news in a quick glance. If you are active in research or teaching – this is a great way to attract audience to the information you produce and also to profile yourself in the digital world of urology. If you are representing a company, you can organise tweetchats with those who follow you to discuss an issue or event. One large professional association set up a tweetchat about their accreditation programme, which was a useful means for people to get all their questions answered and promote the programme among the potential candidates. You can find the EAU on Twitter under the name @uroweb. LinkedIn LinkedIn is a social network which allows people to build professional contacts and maintain their professional portfolio. LinkedIn is all-in-one: it offers an easy tool to maintain your online resume, an opportunity to grow professionally, participate in professional discussions and meet new people in your line of work. Organisations are also allowed to profile themselves in two different ways. They can have a company page which is more like a short profile and they can also have their own group, where discussions, promotions, polls and event announcements can be hosted. The EAU has such groups, as do many other national and international associations. You can find the EAU group on LinkedIn by searching for European Association of Urology in the groups section. Quiz answers The EAU Twitter page The correct answers of this issue’s Guidelines Quiz are: 1c, 2c, 3c, 4d, 5a By Evgenia Starkova August/September 2012 Credit Registry Report 2012 EU-ACME to register participation in accredited 2012 events until 15 January 2013 More than 20,000 urologists from Europe and beyond have already joined the EU-ACME programme including almost 4,000 EAU Junior Members. However, only 40% have collected last year CME/CPD credit points, while 15% have obtained the required minimum of 250 CME credits. Members of the EU-ACME programme are collecting the credits in compliance with EBU/UEMS rules. The CME/CPD credit management system recommends EU-ACME Office obtaining a minimum of 300 credits in five years – 250 CME credits and 50 CPD credits. So far only 15% of all EU-ACME members have obtained the required minimum of 250 CME credits. The EU-ACME programme provides online access to the accounts, allowing its members to register and check, at any time, the listed attended events. Some members have already used our online system and have sent copies of documented proof of participation in an accredited event in 2012 to the EU-ACME office. Check your online account The EU-ACME office will collect and register participation in accredited events in 2012 until 15 January 2013. If you’re not registered through your EU-ACME card at the time of the meeting, please send copies of documents, such as the certificate of attendance, written articles, text or copies of lectures delivered, etc., by e-mail, fax or regular post to our office so we can update your account. Kindly also check your online account by logging in at www.eu-acme.org and check if all accredited activities you have attended are properly listed under your name. Make sure your personal data are correct to enable the EU-ACME office to send your Credit Registry Report 2010 to the correct address! Online Credit Registry Reports EU-ACME members may generate and print Credit Registry Reports online at any time. If you do not wish to receive a hard copy of the CRR, log in to your online account and check the box for the option: “I will generate and print my CRR online. I do not wish to receive a copy by regular mail.” Win a free registration for Milan! Since 2006, members of the EU-ACME programme can earn continuing medical education (CME) credits by answering multiple choice questions (MCQs) published with all accredited articles of the EAU EU-ACME Office journals, namely: European Urology, EU Supplements and the EAU-EBU Update Series. To increase awareness about on-line CME and promote this modern educational approach, which have seen further success in 2011, the EU-ACME committee decided to continue with this initiative. EU-ACME participants are invited to answer multiple choice questions published in the European Urology journals. From all participating members, the three highest scoring participants who topped the MCQ quizzes published in the European Urology, from January 1 to December 31, 2012, will be entitled to a free registration for the 28th Annual EAU Congress to 2nd Meeting of the EAU Section of Urological Imaging (ESUI) Friday, 19 October 2012 09.00 – 09.10 Welcome J. Walz, Marseille (FR) 09.10 – 09.20 Imaging and imaging based treatment in urology: Is the urologist still the primary actor? J. Walz, Marseille (FR) 09.20 – 13.15 Imaging and diagnosis for prostate cancer Moderators: H.U. Ahmed, London (GB) G. Salomon, Hamburg (DE) J. Walz, Marseille (FR) 09.20 – 09.35 What characterises the ideal tool for the diagnosis of prostate cancer? F. Frauscher, Innsbruck (AT) 09.35 – 09.50 Randomised TRUS guided biopsies for the diagnosis of prostate cancer V. Scattoni, Milan (IT) 09.50 – 10.00 How I do it: Randomized TRUS guided biopsy V. Scattoni, Milan (IT) 10.00 – 10.15 3D ultrasound and template biopsy for the diagnosis of prostate cancer H.U. Ahmed, London (GB) 10.15 – 10.25 How I do it: 3D ultrasound or template biopsy H.U. Ahmed, London (GB) 10.25 – 10.40 C-TRUS for the diagnosis of prostate cancer T. Loch, Flensburg (DE) 10.40 – 10.50 How I do it: C-TRUS guided biopsy T. Loch, Flensburg (DE) 10.50 – 11.05 Contrast enhanced ultrasound for the diagnosis of prostate cancer H. Wijkstra, Amsterdam (NL) 11.05 – 11.15 How I do it: Contrast enhanced ultrasound guided biopsy H. Wijkstra, Amsterdam (NL) 11.15 – 11.30 Coffee break and poster viewing 11.30 – 11.45 Real time elastography for the diagnosis of prostate cancer G. Salomon, Hamburg (DE) 11.45 – 11.55 How I do it: Elastography guided biopsy G. Salomon, Hamburg (DE) 11.55 – 12.10 Histoscanning for the diagnosis of prostate cancer L. Simmons, London (GB) 12.10 – 12.20 How I do it: Histoscanning guided biopsy L. Simmons, London (GB) 12.20 – 12.35 MRI an image fusion for the diagnosis of prostate cancer A. Villers, Lille (FR) 12.35 – 12.45 How I do it: MRI/US image fusion biopsy A. Villers, Lille (FR) 12.45 – 13.00 PET-CT for the diagnosis of prostate cancer G. Giovacchini, Milan (IT) 13.00 – 13.15 What needs to be improved in the diagnosis of prostate cancer? H. Huland, Hamburg (DE) 13.15 – 14.15 Lunch European For details check our website at: www.eu-acme.org/europeanurology EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations For more information please contact Congress Consultants at [email protected] or go to http://esui.uroweb.org 19-20 October 2012, Berlin, Germany Preliminary Programme be held in Milan from March 15 to 19, 2013. The winning members will be formally notified in early January next year, with their names published in the February 2013 issue of this newsletter. Good luck! 14.15 – 15.30 Innovative imaging of the bladder and the urinary tract Moderators: B. Carey, Leeds (GB) D.A. Georgescu, Bucharest (RO) 14.15 – 14.30 What is new in ultrasound imaging of the urinary tract? D.A. Georgescu, Bucharest (RO) 14.30 – 14.45 What is new in MRI of the urinary tract? G. Schneider, Homburg (DE) 14.45 – 15.00 What is new in CT scan and PET-CT of the urinary tract? T. Maurer, Munich (DE) 15.00 – 15.15 What is new in photodynamic imaging of transitional cell cancer? B. Geavlete, Bucharest (RO) 15.15 – 15.30 Future techniques and virtual reality for imaging of the urinary tract V. Panebianco, Rome (IT) 15.30 – 17.55 Imaging based treatment of small renal masses Moderators: S. Joniau, Leuven (BE) C. Trombetta, Trieste (IT) A. Volpe, Novara (IT) 15.30 – 15.45 Why focal therapy or nephron sparing surgery for small renal masses? T.B.C. 15.45 – 16.00 The role of active surveillance in small renal masses and how can imaging help J. De La Rosette, Amsterdam (NL) 16.00 – 16.15 Coffee break and poster viewing 16.15 – 16.30 The role of kidney biopsy in the treatment of small renal masses A. Volpe, Novara (IT) 16.30 – 16.40 How I do it: Biopsy of small renal masses A. Volpe, Novara (IT) 16.40 – 16.55 How can imaging improve radiofrequency of small renal masses? S. Joniau, Leuven (BE) 16.55 – 17.10 How can imaging improve cryotherapy of small renal masses? M.P. Laguna, Amsterdam (NL) 17.10 – 17.25 How can imaging improve surgery of small renal masses? R. Zigeuner, Graz (AT) 17.25 – 17.40 The role of imaging and biopsy in the follow-up of small renal masses H-C. Klingler, Vienna (AT) 17.40 – 17.55 Future techniques and what needs to be improved in the management of small renal masses H. Wijkstra, Amsterdam (NL) Saturday, 20 October 2012 09.00 – 11.00 Future tools for imaging in urology Moderators: F. Frauscher, Innsbruck (AT) V. Scattoni, Milan (IT) H. Wijkstra, Amsterdam (NL) 09.00 – 09.15 Molecular and biomolecular imaging in urology H. Wijkstra, Amsterdam (NL) 09.15 – 09.30 Raman spectral imaging in urology R. Draga, Amsterdam (NL) 09.30 – 09.45 Lymphotrophic nanoparticle enhanced MRI in urology A. Fortuin, Nijmegen (NL) 09.45 – 10.00 Future tracers for PET-CT in urology M. Eder, Heidelberg (DE) 10.00 – 10.15 Image fusion in urology D. Teber, Heilbronn (DE) 10.15 – 10.30 Triple spectroscopy in urology G. Salomon, Hamburg (DE) 10.30 – 10.45 DYNA-CT in urology M. Ritter, Mannheim (DE) 10.45 – 11.00 Optical coherence tomography (OCT) imaging in urology K. Barwari, Amsterdam (NL) Faculty H.U. Ahmed, London (GB) C. Bangma, Rotterdam (NL) K. Barwari, Amsterdam (NL) A. Bossi, Villejuif (FR) B. Carey, Leeds (GB) J. De La Rosette, Amsterdam (NL) R. Draga, Amsterdam (NL) M. Eder, Heidelberg (DE) M. Ferreira Coelho, Lisbon (PT) A. Fortuin, Nijmegen (NL) F. Frauscher, Innsbruck (AT) B. Geavlete, Bucharest (RO) D.A. Georgescu, Bucharest (RO) H. Huland, Hamburg (DE) S. Joniau, Leuven (BE) H-C. Klingler, Vienna (AT) M.P. Laguna, Amsterdam (NL) T. Loch, Flensburg (DE) T. Maurer, MГјnchen (DE) V. Panebianco, Rome (IT) M. Ritter, Mannheim (DE) G. Salomon, Hamburg (DE) V. Scattoni, Milan (IT) G. Schneider, Homburg (DE) L. Simmons, London (GB) T. Steuber, Hamburg (DE) D. Teber, Heidelberg (DE) C. Trombetta, Trieste (IT) A. Villers, Lille (FR) A. Volpe, Torino (IT) J. Walz, Marseille (FR) H. Wijkstra, Amsterdam (NL) R. Zigeuner, Graz (AT) 11.00 – 11.15 Coffee break and poster viewing 11.15 – 12.15 Poster session Moderators: M. Ferreira Coelho, Lisbon (PT) A. Villers, Lille (FR) 12.15 – 17.00 Imaging and treatment of prostate cancer Moderators: J. De La Rosette, Amsterdam (NL) H. Huland, Hamburg (DE) T. Loch, Flensburg (DE) 12.15 – 12.30 What are the aims of focal therapy and who is candidate for focal therapy? J. De La Rosette, Amsterdam (NL) 12.30 – 12.45 The role of active surveillance in prostate cancer and how can imaging help C. Bangma, Rotterdam (NL) 12.45 – 13.00 Staging of prostate cancer by imaging T. Loch, Flensburg (DE) 13.00 – 13.15 Staging of prostate cancer by statistical models T. Steuber, Hamburg (DE) 13.15 – 14.15 Lunch 14.15 – 14.30 The role of the prostate cancer index lesion H.U. Ahmed, London (GB) 14.30 – 14.45 Identification of the index lesion by template or saturation biopsy V. Scattoni, Milan (IT) 14.45 – 15.00 Identification of the index lesion by MRI A. Villers, Lille (FR) 15.00 – 15.15 Identification of the index lesion by other imaging tools F. Frauscher, Innsbruck (AT) 15.15 – 15.30 How can imaging improve focal therapy of prostate cancer by - HIFU - Cryotherapy - Photo thermal treatment - Electroporation H.U. Ahmed, London (GB) 15.30 – 15.45 How can imaging improve surgical treatment of prostate cancer? H. Huland, Hamburg (DE) ESUI Board J. Walz, Marseille (FR) Chairman B. Carey, Leeds (GB) M. Ferreira Coelho, Lisbon (PT) P.A. Geavlete, Bucharest (RO) H. Heynemann, Halle (DE) T. Loch, Flensburg (DE) C. Trombetta, Trieste (IT) H. Wijkstra, Amsterdam (NL) Registration Deadline: 1 October 2012 15.45 – 16.00 Coffee break and poster viewing 16.00 – 16.15 How can imaging improve radiotherapy of prostate cancer? A. Bossi, Villejuif (FR) 16.15 – 16.30 The role of imaging in the follow-up of prostate cancer M. Ferreira Coelho, Lisbon (PT) 16.30 – 16.45 Where do we need to do further research? J. Walz, Marseille (FR) 16.45 – 17.00 What have we learned and where do we go with imaging and the ESUI? T. Loch, Flensburg (DE) C. Trombetta, Trieste (IT) 17.00 – 17.30 Summary and end of programme by the ESUI Association of Urology August/September 2012 European Urology Today 17 Call for Applicants for the Position of EDITOR-IN-CHIEF EUROPEAN UROLOGY European Association of Urology Qualifications Overview • Urologist and Active EAU member, based in Europe European Urology, published by Elsevier, owned by the European Association of • Strong interpersonal skills and leadership ability Urology and its official journal, has been a prestigious urological forum for over 35 • Interest in, and broad knowledge of the clinical, research and practice years, and is currently read by more than 20,000 urologists across the globe. With an impact factor of 8.493, the journal has become the leading scientific monthly publication in the field of urology. To keep up with the rapidly evolving world of medicine, technology and surgical techniques, European Urology is constantly updating and innovating its features and aspects of urology • Awareness of current trends within the specialty • Excellent writing and verbal skills • Ability to meet tight deadlines • Experience in the editing and reviewing process for a peer-reviewed system • Proficient in the use of the latest electronic technology (EES system) to expedite reviewing and publication of submitted manuscripts layout in order to provide the best clinical guidance, research and education for urologists across Europe and the world. Candidates should All members of the EAU receive the journal as a benefit of their membership. Supplements to European Urology are published under the title European Urology Supplements (ISSN 1569-9056). All subscribers to European Urology automatically receive this publication. • be proficient in scientific English • have a proven record of scientific writing • have proven managerial experience • have experience in editing and/or reviewing • recognise the need for the daily checking of the Journal’s website • agree with the mission of the EAU • be an active member of the Association, based in Europe For more details about responsibilities and application procedure please visit: www.uroweb.org/about-eau/announcement Other • • Important announcement EAU Best Papers published in Urological Literature Awards To be awarded at the 28th Annual EAU Congress in Milan, 15-19 March 2013 ly p Ap ow! n 18 European Urology Today The Editor-in-Chief is ex-officio member of the EAU Board and is invited to their meetings. Or use this QR code to access the information on your mobile device. The Editor-in-Chief maintains the uniformity of editorial policy. The two EAU Prizes for Best Paper published in Urological Literature are tools through which the EAU encourages young and promising urological scientists to continue their work and to communicate their achievements to the European urological community. Two awards of € 5,000 each will be made available for the two Best Papers published in Urological Literature on Clinical and Fundamental Research. These papers have to be prepared, published or accepted for publication between 1 July 2011 and 30 June 2012. Rules and Eligibility • Eligible to apply for the EAU Best Paper published in Urological Literature are urologists, urologists-in-training or urology-related scientists. All applicants have to be a member of the EAU. • The submitting author must be either the first or the corresponding senior last author. • Each author is allowed to submit no more than one paper. • The paper must be written in the English language (or translated into the English language). • The subject of the paper must be urological or urology related. • The deadline for submission is 15 November 2012. • The awards will be handed out at the 28th Annual EAU Congress in Milan, 15-19 March 2013 during a special session. How to apply • Please send your paper to the following e-mail [email protected], indicating clearly the category in the subject line: “EAU Best Paper on Clinical Research” or “EAU Best Paper on Fundamental Research.” • Include a copy of your curriculum vitae. • Supply a list of all authors who have significantly contributed (if relevant). • Indicate clearly for which category the paper is intended (clinical or fundamental research). • Mention any financial support by companies, government or health organisations. • A publisher’s letter of acceptance has to be submitted along with your paper. A review committee consisting of members of the EAU Scientific Congress Office will review all submitted papers and select the winner of the two EAU awards for Best Paper published in Urological Literature. All correspondence is to be sent to the EAU Central Office, at [email protected], clearly indicating the relevant category in the subject line: “EAU Best Paper on Clinical Research” or “EAU Best Paper on Fundamental Research”. August/September 2012 www.reviews Dr. Andrea Cestari Section Editor Milan (IT) JAPAN FUKUOKA 2012 32 Congress of the information, for you to download, adapt and use.“ Website users are also encourage to explore the websiteвЂ�s guide and view the case studies listed under either the symptoms or the individual disease pathways. According to the website creators, the value of using what is offered in their website is when “ you use it to provide you and the urology team with very real benefits by saving time, improving performance and providing patients with an even better experience.“

 nd SociГ©tГ© Internationale d’Urologie September 30 -October 4, 2012 Fukuoka International Congress Center [email protected] Innovation in Urology www.innovationinurology.nhs.uk Innovation in Urology is an interesting website, probably- and in my opinion- not in a practical sense but mainly as an interesting example on how a clinical practice can be organised to make the lives of urologists and those of their patients much easier. On the landing page, the website creators stated their goal : “Two major urology Modernisation Agency programmes, Action on Urology and the Cancer Services Collaborative вЂ�Improvement Partnership’, have been involved in coordinating the delivery of service improvement in urology services within the NHS in England.
 Aside from the case studies the website also offers “… additional documents, e.g. proformas and patient Website visitors and users are also invited to contribute a service improvement case study to this guide by completing the Innovation in Urology Service Improvement Template (Word document) and returning the completed form. Featuring the ICUD Consultation on Male LUTS Medical Videos www.medicalvideos.us/ This website is not to be missed in your favourite or preferred list of websites. Medical Videos provides easy navigation. By simply inserting the key word “urology” after the main URL address, the user gets a page with a long list of and full access to hundreds of videos, which are periodically updated. Medical Videos, however, is not only a video website but also offers the possibility to upload your own video for the community, and to have access to several forums (ranging from residency, nursing, surgery to dentistry). www.siucongress.org www.reviews 1018_SIU2012_EUT_FukuokaAD_APR.indd 1 12-03-12 8:52 AM Client: SIU 2012 Docket number: 22-1018 File Size: 100 % Description: FUKUOKA Trim Size: 133,4 mm X 194,3 mm Publication : European Urology Today 2013 Ad number : 22-1018-P Type Size: prize N/A given to a young PROOF # The EAU Crystal Matula Award is the most prestigious Date: European 2012 -10urologist under the age of 40 who Bleed Size: promising has theN/Apotential to become oneMAR of12, 2012 - 8:51 DATE: Operator: LAP in academic European urology. The Visible Size: also N/A includes a honorarium of the future leaders award Filename : and1018_SIU2012_EUT_FukuokaAD_APR PDF Size: Euro 10,000 will be presented at the Opening Ceremony of100% the upcoming 28th Annual 1:0 The EAU Crystal Matula Award 2013 EAU Congress COLOUR S: in Milan. M C Y K SAMDESIGN | 5049 Garnier, MontrГ©al QC CANADA H2J 3T1 | TГ©l: +1 514 953-7227 | Fax: +1 514 875-0205 The list of previous awardees includes many well-known names: 2012 Paris P.J. Bastian, Munich, Germany 2011 Vienna S.G. Joniau, Leuven, Belgium 2010 Barcelona J.W.F. Catto, Sheffield, United Kingdom 2009 Stockholm M.J. Ribal, Barcelona, Spain 2008 Milan V. Ficarra, Padua, Italy 2007 Berlin M.S. Michel, Mannheim, Germany 2006 Paris A. De La Taille, Creteil, France 2005 Istanbul M.P. Matikainen, Nokia, Finland 2004 Vienna P.F.A. Mulders, Nijmegen, The Netherlands 2003 Madrid B. Malavaud, Toulouse, France 2002 Birmingham M. Kuczyk, Hanover, Germany 2001 Geneva B. Djavan, New York, United States of America 2000 Brussels A. Zlotta, Toronto, Canada 1999 Stockholm G. Thalmann, Berne, Switzerland 1998 Barcelona F. Montorsi, Milan, Italy 1996 Paris F.C. Hamdy, Oxford, United Kingdom ly p Ap ow! n Nomination process National Societies can nominate a candidate by supplying a letter of endorsement, a motivation letter and a complete curriculum vitae of the proposed candidate. However, please note that eligible candidates can also apply for this award by contacting their national urological societies directly. The candidate is then expected to supply their national society with a CV and motivation letter, requesting a letter of endorsement. How to apply All correspondence can be sent to: [email protected] Deadline for submission is: 15 November 2012 The EAU Crystal Matula Award is supported by an unrestricted educational grant from LABORIE. Send your nominations today! August/September 2012 LABORIE European Urology Today 19 ESU offers courses at 7th ECA Meeting in Berlin, Germany http://esudavos.uroweb.org European Urology Forum 2013 Experts to tackle prime topics in andrology The European School of Urology (ESU) will organise at the 7th European Congress of Andrology (ECA), to be held in Berlin, Germany from November 28 to December 1 this year, several courses on operative andrology that will cover a range of pertinent topics. Challenge the experts 2-5 February 2013, Davos, Switzerland EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations Scheduled on November 29 and 30 (Thursday and Friday), the ESU teaching courses will take up six important topics, namely: special penile surgery (including prothetics), Peyronie’s disease, varicocele, obstruction of the seminal pathways, sperm retrieval, vasectomy and spermatic nerve pain surgery. “The speakers are well-known experts and specialists in their respective fields and we expect a very highly engaged discussion of major issues,“ said Professors Wolfgang Weidner and Andreas Meinhardt, conference chairmen. “We would be very happy to welcome interested specialists and participants to this meeting.“ ..key lectures will be presented with a short video to demonstrate technique... Weidner said the surgical programme complements the general topics of the congress with the plenary session panels to be led by international experts. Various andrology topics will be presented such as impaired spermatogenesis, Klinefelter syndrome, genetics, urogenital infections, among others. European Association of Urology “All key lectures will be presented with a short video to demonstrate technique details,“ according to Weidner. He added that young researchers from the surgical field have also been invited to submit their own 5th ESU Masterclass on Female and functional reconstructive urology Wolfgang Weidner contributions, adding newer perspectives and insights to the issues that will be presented for discussions. “This course structure will provide a very interactive type of scientific discussion,“ he said. Organised by the European Academy of Andrology (EAA), the EAU Section of Andrological Urology (ESAU) and the German Society of Andrology (DGA), and with the collaboration of the ESU, the event highlights the importance of organising the first joint meeting with European andrologists. With the participation of many non-surgical experts in the meeting, organisers said there are many opportunities for congress participants to closely look into the “non-surgical” part of andrology. “The carefully prepared plenary sessions will provide a good balance of various perspectives, medical management and treatments, plus a comprehensive overview of the latest developments in andrology,“ added Wiedner. For further information and details on the scientific programme check out the meeting website at www.andrology2012.de EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations For more information please contact Congress Consultants at [email protected] or go to http://esuberlin.uroweb.org 9-11 November 2012, Berlin, Germany Friday, 9 November 2012 Saturday, 10 November 2012 Sunday, 11 November 2012 08.15-08.30 Introduction W. Artibani, Verona (IT) C.R. Chapple, Sheffield (GB) 08.00-10.15 08.00-09.15 Chronic pelvic pain syndrome/ interstitial cystitis D. Pushkar, Moscow (RU) 08.30-11.10 Female stress urinary incontinence Definition, diagnostic evaluation, management decision making W. Artibani, Verona (IT) The anatomo-physiological basis of SUI and related treatments (video) A. Vaze, Mumbai (IN) An evidence based approach to the management of stress urinary incontinence C.R. Chapple, Sheffield (GB) Presentation on various techniques Management of recurrent incontinence W. Artibani, Verona (IT) Complications and their management D. De Ridder, Leuven (BE) 09.15-11.30 Male sphincteric incontinence Prevalence and pathophysiology of sphincteric incontinence J.P.F.A. Heesakkers, Nijmegen (NL) Conservative treatment, bulking agents and paraurethral balloons J.P.F.A. Heesakkers, Nijmegen (NL) Male slings W. Artibani, Verona (IT) Artificial urinary sphincter D. Castro Diaz, Santa Cruz De Tenerife (ES) Troubleshooting, retreatment, neurogenic and irradiated patients D. Castro Diaz, Santa Cruz De Tenerife (ES) 11.30-12.00 Cases by participants 12.00-13.00 Urinary tract infections Classification and definitions J.P.F.A. Heesakkers, Nijmegen (NL) Diagnosis J.P.F.A. Heesakkers, Nijmegen (NL) Treatment and prophylaxis D. Castro Diaz, Santa Cruz De Tenerife (ES) UTI in special situations EAU Guidelines 14.00-16.30 Urinary fistula Fistula following vaginal/abdominal surgery: etiology and management D. Pushkar, Moscow (RU) Obstetric fistula management D. De Ridder, Leuven (BE) Management of ureterovaginal fistula C. R. Chapple, Sheffield (GB) Radiation fistula D. Pushkar, Moscow (RU) Use of laparoscopy for VVF repair A. Vaze, Mumbai (IN) Video and case presentation C. R. Chapple, Sheffield (GB) 16.45 Adjournment 11.10-12.00 Cases by participants 13.00-14.30 Female sexual disorders: Overview and practical management A. Graziottin, Milan (IT) Discussion 14.30-15.30 OAB - Urgency-frequency syndrome Urgency incontinence J.P.F.A. Heesakkers, Nijmegen (NL) 15.45-16.45 Neurogenic detrusor overactivity (MS, Parkinson, SPI) D. Castro Diaz, Santa Cruz De Tenerife (ES) 16.45-18.00 Cases by participants European Andreas Meinhardt Bowel disorders K. Matzel, Erlangen (DE) Patient with anal incontinence Patient with chronic constipation Discussion 10.30-11.15 Mixed urinary incontinence Mixed symptoms C.R. Chapple, Sheffield (GB) Definition, diagnostic evaluation, management decision making 11.15-12.15 Female urinary retention Definitions, causes and risk factors D. De Ridder, Leuven (BE) Assessment and management D. De Ridder, Leuven (BE) Retention after surgery for SUI D. Castro Diaz, Santa Cruz De Tenerife (ES) Urethral stricture in women D. Castro Diaz, Santa Cruz De Tenerife (ES) 12.15-13.15 Urethral diverticula & urethral fistula repair C. R. Chapple, Sheffield (GB) 14.00-17.00 Pelvic Organ Prolapse (POP) Index cases W. Artibani, Verona (IT) The anatomo-physiology of POP (video) A. Vaze, Mumbai (IN) Imaging of POP D. De Ridder, Leuven (BE) Management decision making D. De Ridder, Leuven (BE) Analysis of various surgical options D. De Ridder, Leuven (BE) Robotic sacropexy W. Artibani, Verona (IT) Large mesh vs minimal mesh D. Pushkar, Moscow (RU) Outcome evaluation and complications, management , ICS document D. De Ridder, Leuven (BE) What if: age, co-morbidity, pessaries D. De Ridder, Leuven (BE) 17.00-18.00 Cases by participants Faculty W. Artibani, Verona (IT) D. Castro Diaz, Santa Cruz De Tenerife (ES) C.R. Chapple, Sheffield (GB) D. De Ridder, Leuven (BE) A. Graziottin, Milan (IT) J.P.F.A. Heesakkers, Nijmegen (NL) K. Matzel, Erlangen (DE) D. Pushkar, Moscow (RU) A. Vaze, Mumbai (IN) Association of Urology 20 European Urology Today August/September 2012 ANNOUNCEMENT In combination with Masterclass Operative Andrology of the European School of Urology (ESU) Organised by European Academy of Andrology (EAA) 7th European congress of Andrology – ECA 2012 in combination with ESU Teaching courses on Operative Andrology Organised by European Academy of Andrology, EAU Section of Andrological Urology (ESAU), German Society of Andrology Thursday 29 November 2012 Friday 30 November 2012 08.30 – 10.15 Course 1 – Priapism, penile implants, reconstruction Moderator: V. Mirone, Naples (IT) 10.30 – 12.00 Course 4 – Obstruction of the seminal pathways Moderator: Z. Kopa, Budapest (HU) Priapism D. Ralph, London (GB) Penile implants E. Meuleman, Amsterdam (NL) Trouble shooting in penile implant surgery C. Bettocchi, Bari (IT) Phalloplasties M. Sohn, Frankfurt (DE) General considerations J.U. Schwarzer, MГјnchen (DE) Vasovasostomy H. Sperling, MГ¶nchengladbach (DE) Tubulovasostomy G. Dohle, Rotterdam (NL) TURED, Seminal vesicle puncture and wash-out G.M. Colpi, Milan (IT) 13.30 – 15.00 Course 2 – Peyronie’s disease Moderator: W. Weidner, Giessen (DE) Guidelines on surgical therapy M. Sohn, Frankfurt (DE) Surgical therapy of Peyronie’s disease A. Kadioglu, Istanbul (TR) Additional ESWT F. Fusco, Naples (IT) Case discussion 15.30 – 17.00 Course 3 – Varicocele Moderator: G. Dohle, Rotterdam (NL) Varicocele in infertility Th. Diemer, Giessen (DE) Varicocele in adolescents R. Kocvara, Prague (CZ) Microsurgical dissection A. Jungwirth, Salzburg (AT) Other therapy (e.g. embolization) C. Bettocchi, Bari (IT) Case discussion EAU Section of Andrological Urology (ESAU) German Society of Andrology (DGA) Conference Chairs Prof. Dr. med. Wolfgang Weidner Justus-Liebig-University GieГџen Department of Urology, Pediatric Urology and Andrology Topics • Basic Science meets Clinical Andrology • Andrology along the lifeline • Andrological implications of genital tract infections • Genetics and epigenetics • Hypogonadism • Klinefelter syndrome • Metabolic syndrome and reproductive function • Non-obstructive azoospermia • Determinants of male reproductive health • Sperm quality and selection for ART • Sexual dysfunction • Testicular cancer • New horizons in andrology/late breaking studies • Free communications 13.30 – 14.30 Course 5 – Sperm retrieval Moderator: N. Sofikitis, Ioannina (GR) General considerations S. Minhas, London (GB) MESA and Ductus Aspiration Z. Kopa, Budapest (HU) TESE and M-TESE Th. Diemer, Giessen (DE) Case discussion Prof. Dr. Andreas Meinhardt Justus-Liebig-University GieГџen Department of Anatomy and Cell Biology Topics • Operative Andrology • Priapism • Penile implants and penile reconstruction • PeyronieвЂ�s disease • Varicocele • Obstruction of the seminal pathways • Sperm retrieval • Vasectomy Courses and Lunch Time Symposia 28 November–1 December 2012 • Berlin (DE) 15.00 – 16.30 Course 6 – Vasectomy Moderator: A. Jungwirth, Salzburg (AT) The new EAU Guideline G. Dohle, Rotterdam (NL) Non scalpel-vasectomy W. Aulitzky, Vienna (AT) Case discussion For more information please visit www.andrology2012.de culture Information and Registration: www.andrology2012.de European School of Urology Activities 2012-2013 Organised courses at National Urological Society meetings Masterclasses November September 14 28 ESU organised course on Role of lymphadenectomy in surgical treatment of genitourinary tumours at the time of the national congress of the Polish Urological Association ESU Organised course on What’s new in Prostate cancer and female urology at the time of the national congress of the Armenian Urological Society 9-11 19-20 Advanced video based interactive ERUS-ESU Masterclass on Robotic-Assisted Radical Cystoprostatectomy Barcelona (ES) Yerevan (AM) Teaching courses ESU organised course on Urothelial cell carcinoma: Radical surgery in bladder cancer and infertility at the time of the national congress of the Hellenic Urological Association ESU organised course on Female and functional reconstructive urology at the time of the national congress of the Tunisian Urological Association November Athens (GR) ESU organised course on Bladder cancer at the time of the national congress of the Czech Urological Society ESU organised course on UPJ stenosis and reconstructive surgery at the time of the national congress of the Portuguese Association of Urology ESU organised course on Role and limits of laparoscopy in oncology and incontinence at the time of the annual educational meeting of the Austrian Society of Urology ESU organised course on Female urinary incontinence at the time of the national congress of the French Association of Urology ESU organised course on Endourology and stones at the time of the national congress of the Egyptian Association of Urology 15 29-30 ESU Medical oncology course on Genitourinary Cancer (MOGUC) ESU Teaching courses on Operative andrology Barcelona (ES) Berlin (DE) Tunis (TN) November 1 3 9 23 28 Berlin (DE) October Lodz (PL) October 13 19 5th ESU Masterclass on Female and functional reconstructive urology Combined EAU/ESU meetings Ostrava (CZ) Troia (PT) Linz (AT) Paris (FR) November 14-15 24-25 Chinese Urology Education Programme (CUEP II) 4th ESU – ASU teaching course at the time of the Annual Scientific Meeting of the Malaysian Urological Association Guangzhou (CN) Kuala Lumpur (MY) February 2013 2-5 European Urology Forum 2013 – Challenge the experts Davos (CH) Cairo (ET) ESU Office T +31 (0)26 389 0680 F +31 (0)26 389 0684 [email protected] www.uroweb.org ESU courses are accredited within the August/September 2012 programme by the EBU with 1 credit per hour European Urology Today 21 ESU-Weill Cornell Masterclass Urology experts provide insightful training Dr. Juan Manuel Villamizar Urology resident FundaciГі Puigvert Barcelona [ES] Last July I had the opportunity to participate in the ESU - Weill Cornell Masterclass in Urology in Salzburg, Austria, which is known as one of the most well–attended master classes annually organised by the European School of Urology (ESU). The permanent venue was at Schloss Arenberg, a beautiful palace that now houses an education resource centre which has excellent meeting facilities. Aimed to provide a comprehensive training, the master class fellows participated in the five- day programme which also included a critical review of the major topics and fields such as oncology, reconstructive urology, functional urology and pediatrics. The discussions of these topics were introduced or chaired by experts from both the Weill Cornell institution and the ESU, and led by course directors Dr. Shahrokh Shariat (USA) and Prof. Joan Palou (ES). The participants were mostly young urologists and residents from various European countries and other regions as well such as Mexico, Tanzania, Qatar and New Zealand. The ambience, although relaxed, provides enough stimuli for an enthusiastic discussion of the various cases presented by the participants, and on the first day alone the first session on female urology and basic urodynamics offered useful insights and tips from the faculty. The challenge for us was that every participant had to prepare a case presentation. In my opinion this approach was not only effective but also served as a really good experience on how to lose the fear of presenting before a panel of experts. To present a persuasive view to an audience and speak in another language was definitely good training for the neophytes among us. Afternoon sessions In the afternoons there were also hands-on laparoscopy training sessions led by experienced mentors, with the participants using the necessary set of equipment to enable them to develop important skills in laparoscopy and TUR. http://esusalzburg.uroweb.org ESU - Weill Cornell Masterclass in General urology 7-13 July 2013, Salzburg, Austria EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations From complications in prolapse surgery, diagnosis and management of bladder cancer, to re-operative hypospadias, the course was compact but very comprehensive. But despite the hectic schedule we still had the chance to stroll around Salzburg and get to know a little bit of its magic. The ESU also evaluated our progress with pre- and post-course tests to measure the effectiveness of the various lectures, workshops and forum discussions. On the last day we had a farewell dinner and a simple programme of recognition for the masterclass fellows that excelled in the tests and case presentations. I’d like to convey my gratitude to Prof. Wolfgang Aulitzky (AT), medical director of the American Austrian Foundation, ESU project assistant Ms. Stephanie van Borrendam, and to the organisers which all made this master class a truly wonderful and memorable experience. European Association of Urology Medical oncology course on genito-urinary cancers ESU to provide a focused and compact course ESU Medical Oncology course on Genitourinary Cancer (MOGUC) on the occasion of the 4th EMUC Place Date Chair 08.00 Genitourinary cancer: urologist and oncologist J. Palou, Barcelona (ES) H. Van Poppel, Leuven (BE) 11.45 08.05 Pre knowledge test 12.15 Lunch 08.30 Kidney cancer: surgery or targeted therapy in local recurrence and metastatic disease. Why, which and when. M. Kuczyk, Hanover (DE) 13.15 Testis cancer: cases in daily practice G. Kramer, Vienna (AT) S. Osanto, Leiden (NL) 13.45 Bone therapy: mechanism of action, useful, when and in which GU tumours? K. Miller, Berlin (DE) 09.00 09.30 Kidney cancer and metastatic disease: evaluation and sequential treatment. New advents in immunotherapy. T. Powles, London (GB) Interactive case discussion M. Kuczyk, Hanover (DE) T. Powles, London (GB) 10.00 Break 10.15 Prostate cancer: concepts and daily management in metastatic disease. Hormonal therapy N. Mottet, Saint Etienne (FR) 10.45 11.15 22 Barcelona 15 November 2012 J. Palou, Barcelona (ES) H. Van Poppel, Leuven (BE) Prostate cancer: drugs available in the last years. When and why? And the vaccines? LetВґs be clear K. Fizazi, Villejuif (FR) Interactive clinical case discussion K. Fizazi, Villejuif (FR) N. Mottet, Saint Etienne (FR) European Urology Today Testis cancer: chemotherapy according to histology and stage G. Kramer, Vienna (AT) S. Osanto, Leiden (NL) 14.15 Interactive case discussion K. Miller, Berlin (DE) 14.45 Break 15.00 Bladder cancer: what it is the advised combination therapy and when. Unmet medical needs in bladder cancer. J. Bellmunt, Barcelona (ES) F. Witjes, Nijmegen (NL) 15.30 Interactive case discussion J. Bellmunt, Barcelona (ES) F. Witjes, Nijmegen (NL) 16.00 Post knowledge test 16.30 Close For more information please go to www.emucbarcelona2012.org The European School of Urology (ESU) will hold on November 15 a special course on the medical treatment of genito-urinary (GU) cancers, a day before the opening of the 4th European Multidisciplinary Meeting on Urological Cancers (EMUC) in Barcelona, Spain. “ This is the first time the ESU is offering a day-long teaching event during the annual multidisciplinary meeting. This course will be a good chance for both experienced and young urological cancer experts to closely look into the latest developments in the medical treatment of GU cancers,“ said Profs. Hein van Poppel and Joan Palou, chairmen of the 1st Medical Oncology course on Genitourinary Cancer (MOGUC). “MOGUC will update participants on actual developments in GU issues and their impact on current treatment options...” “Whether they are specialists in oncologic urology, radiation or medical oncology, the range and depth of the lectures and discussions will offer unique perspectives and insights,“ added Van Poppel. Hein van Poppel Joan Palou practical issues and examine how the approaches of various specialists affect heathcare delivery. Palou said organising the course within the EMUC setting provides an advantage since it complements the focus on GU cancers, and with the added benefit that veteran speakers will lead the interactive discussions. “GU cancer specialists will have the opportunity to directly ask the invited experts who are among the most experienced teachers from the best multidisciplinary teams in Europe,“ said Van Poppel. He noted that course is certainly “a must“ not only for GU cancer sepcialists, but also to those who have a serious interest in specialising in this challenging and dynamic field. With the 4th EMUC scheduled from November 16 to 18, the ESU course will update participants on actual developments in GU issues and their impact on current treatment options, and how experts are tackling challenges in the management of these diseases. Issues often encountered in daily management and clinical practice will be carefully considered and discussed, and participants are also expected to share or contribute to the discussion. A pre and post tests for course participants will also be part of the course programme to measure not only the meeting’s The ESU course will cover renal, prostate, bladder and effectiveness but for the attendees to gauge their testis cancers, with the sessions taking up topics in knowledge. diagnosis, management approaches, complications, new drugs, bone therapy and prospects in treatment, For further information and details, visit among others. Clinical case discussions will end each www.emucbarcelona2012.org session to enable participants and experts to look into August/September 2012 Minimal Invasive Surgery for Renal Stones Jamaica Urological Society, EULIS collaborate for two-day workshop Dr. Athanasios Papatsoris EULIS Associate Member Sismanoglio General Hospital Dept. of Urology Athens (GR) Mr. Noor Buchholz EULIS Board Member Barts Health NHS Trust Dept. of Urology St. Bartholomew’s Hospital London (GB) nb@londonurology consultant.com Stone disease experts from both sides of the Atlantic met during the “Minimal Invasive Surgery for Renal Stones” workshop held in Montego Bay, Jamaica from April 13 to 14, 2012. Organised under the auspices of the Jamaica Urological Society, and with support from the EAU section of Urolithiasis (EULIS), the meeting attracted the attendance of many Jamaican urologists. CME-accredited, the workshop was also the first of its kind to be held in Jamaica. positions for PCNL, flexible ureterorenoscopy, modern diagnostic imaging and laparoscopy for stone disease. The local organiser lectured on the management of stone patients and the challenges in setting up a stone service in the developing world. In his talk titled “The 1,001 positions of PCNL,” Masood presented the initial results with the Barts “flank-free” modified supine PCNL position. Meanwhile, Papatsoris discussed stone analysis and the current developments in flexible ureterorenoscopy, such as the use of novel digital scopes and Narrow Band Imaging technology. Buchholz gave a state-of-the-art lecture on the metabolic work-up and medical management of recurrent stone formers, and also discussed prospects in urological stents. Trinchieri, on the other hand, gave a comprehensive lecture regarding the use of laparoscopy and robotics in stone treatment. The Jamaican participants are not only aware of EAU activities but are also well updated on relevant EAU guidelines on urolithiasis. The hands-on-training sessions elicited positive feedback and the participants appreciated the opportunity to practice percutaneous access on models that were shipped directly from the UK. There was also a lot of enthusiasm and great interest for the live surgery sessions on supine PCNL during the workshop. Junaid Masood and Athanasios Papatsoris led the live surgery session on Day 1, while Noor Buchholz and Alberto Trinchieri performed the procedures on Day 2. Several tips and tricks were demonstrated during the endourology cases and the surgeons and the audience discussed many practical issues. Despite financial constraints, most of the endourology equipment and materials were available, and the surgical theaters were used optimally, which prompted McGregor to note that “this was only possible due to charity funding from the local companies and community.” Stronger links The venue was the impressive Montego Bay Convention Center, which opened its doors last year. The Cornwall Regional Hospital is a 10-storey, 400-bed capacity multi-disciplinary institution that covers the needs of the County of Cornwall (one out of the three in Jamaica), and named after the EnglandВґs western county. Not only was the hospital staff friendly and cooperative, their expertise was exemplary. In recognition of Dr. McGregor’s efforts to make the workshop possible, a special plaque was given by EULISВґ representatives Alberto Trinchieri and Noor Buchholz. The scientific programme, which included state-of-the art lectures, hands-on-training sessions and live surgery performed at the Cornwall Regional Hospital, was organised by local urologist Dr Roy McGregor, who completed his urology training in the UK and has recently established a modern endourology unit in Jamaica. He joined an international faculty composed of Mr. Junaid Masood, Dr. Alberto Trinchieri, and the authors Mr. Noor Buchholz and Dr. Athanasios Papatsoris. A range of topics More than 50 participants attended the workshop which took up various topics such as the novel EAU Section of Urolithiasis (EULIS) From left: Alberto Trinchieri, Noor Buchholz, Roy Mc Gregor (holding a certificate of appreciation from EULIS), Junaid Masood, Athanasios Papatsoris Live supine PCNL demonstration with Noor Buchholz (middle) and Roy McGregor (right) Although most of the faculty had to travel almost a full day and stay for less than three days, the whole experience was very rewarding with the hospitality shown by the local hosts and the efficient arrangements. Although the social programme was limited by the extended live surgery sessions, we had the opportunity during the evenings to discuss with local colleagues the prospects in further developing endourology in the Caribbean, and the role of general health policy issues in Jamaica. In Montego Bay, we also have the unusual experience of sudden tropical rainstorms alternating quickly with bright sunshine. Holding and participating in the Minimal Invasive Surgery for Renal Stones workshop has shown that with the commitment of local urologists and the support of the EULIS faculty, scientific meetings which aim to transfer of state-of-the art knowledge are not only useful but also go a long way in creating stronger links. The visiting faculty congratulates and conveys their thanks to Roy McGregor for his superb hospitality and efforts in making this workshop a big success. With this workshop we are convinced that there is a role in the future for EULIS to guide and be a part of the development of stone services in the Caribbean. EULIS meets South America Stone experts gather in Chile and Brazil to discuss latest issues and challenges in urolithiasis Dr. Sergio GuzmГЎn Ass. Professor Universidad CatГіlica de Chile (CL) Senior Consultant Dept of Urology University Hospital Mannheim (DE) sguzmank@ gmail.com Dr. Renato Nardi Pedro SWL Center Coordinator AME-UNICAMP Endourology Clinica Padre Almeida Campinas, Sao Paulo (BR) Relations between EULIS and clinicians involved in the study and treatment of renal stones in various countries are growing. And with some countries newly emerging as centres of medical science, international collaboration is becoming crucial and will have its impact in future developments. In this context, members of the EULIS have actively participated in and supported congresses in other countries. EAU Section of Urolithiasis (EULIS) August/September 2012 Chile course The Annual Course for Endourology and Lithiasis was held from April 13 to 14 in Santiago de Chile. We were glad to have the support of good friends and expert faculty members. One of them, Prof. Thomas Knoll (DE) lectured on the EAU guidelines in urolithiasis, providing evidence-based recommendations and describing the latest state-of-the-art therapy. Dr. Olivier Traxer (FR) shared his experience in the use of modern endoscopic techniques, described new developments in scopes and imaging, and discussed diagnostic issues related to advanced retrograde procedures. Dr. Christopher Cooper (USA) shared his experience as a paediatric urologist and discussed modern endoscopic and robotic surgery in children with stone disease. Dr. Francisco Daels (AR) reported on the Latin American point of view for endoscopic and percutaneous renal surgery. Well-known Chilean experts showed local expertise on and new developments in Shockwave Lithotripsy (Dr. Fernando Coz) and modern radiology for urology (Dr. Paula Csendes). “In today’s medical practice we see fast changes in technologies, many pushed by different forms of marketing,” commented Dr. Cristian Trucco, chairman of the Sociedad Chilena de UrologГa and one of the course directors. “As members of the Sociedad Chilena de UrologГa, we believe that scientific cooperation and international exchange, built on knowledge and evidence-based technologic innovation, is the way to develop urology.” For his part, Dr. GuzmГЎn noted: “This is the first time our society formally relied on the support of EULIS and such cooperation is the way for us to grow and develop better medicine and technology. For this we are very thankful to EULIS and the EAU.” Brazil meeting Dr. Renato Nardi Pedro of the Endourology Clinica Padre Almeida in Campinas (Sao Paulo) reported on the 12th International Symposium on Urolithiasis (ISU 2012), held for the first time in Brazil (Ouro Preto) from May 9 to 12 this year. The quadrennial conference was organised by Prof. Augusto Meneses (Belo Horizonte), a well-known nephrologist with an interest in stone disease. Around 250 physicians (nephrologists and urologists) and researchers from around the world attended the conference, which was also supported by EULIS with the participation of a number of European experts. “It was a privilege to participate in such an important meeting on urolithiasis,” said Dr. Pedro. “Looking at the programme of the 12th International Urolithiasis Symposium I realised that practically all facets of urolithiasis were examined by some of the world’s veteran physicians and researchers. Having the opportunity to join these experts gives inspiration and motivates me to acquire knowledge for me to offer the best care to patients.” “We are really happy that for the first time there was attention given to trainees in urolithiasis,” said Prof. Jose Augusto Meneses, chairman and organizer of ISU 2012, at the end of the congress. “I am convinced that Cristian Trucco, chairman of Sociedad Chilena de UrologГa and Thomas Knoll, EULIS board member at the Annual Course for Endourology and Lithiasis held last April in Santiago de Chile we need to encourage young doctors in the study of urolithiasis. As we all know urolithiasis is not only a stone disease but is an epiphenomenon of some severe chronic diseases.” Meneses stressed that there is a need for more research and more people to specialise or focus on this field. “Fortunately we achieved this goal since we saw here the enthusiastic participation of young researchers and students who had the chance to learn about urolithiasis from some of the most renowned professors. Meneses also noted the participation of almost 60 speakers who tackled a wide range of topics in urolithiasis. “We nearly have 200 papers submitted for evaluation, 60 oral presentations and almost 100 posters coming from contributors from all over the world,” he added. European Urology Today 23 Who’s Who in Urology Antonio Alcaraz Oscar Brouwer Matthieu Durand Beatrice Stubendorff Chairman, Department of Urology, University Hospital Clinic of Barcelona; Head, Surgical Unit of Renal Transplant at Fundacio Puigvert, Barcelona. Februay 2002 to February 2005. Professor of Urology, University of Barcelona. Residency, Urology Department of Hospital ClГnic de Barcelona. Research Fellow, Mayo Clinic in Rochester, Minnesota, Department of Urology, February 1993 to May 1994; Coordinator, National Kidney Transplant Group of the Spanish Association of Urology (2004-2008); Secretary General, Spanish Association of Urology. Author of more than 90 international and 51 national publications; Board Member of the European School of Urology (ESU), the American Urological Association; Member, Board of the Editorial Committee of European Urology; Member, Scientific Committee of the European Association of Urology; Awarded, EAU Hans Marberger Award 2012, 27th Annual EAU Congress Paris. Attended, University Medical Center Groningen, Netherlands. Surgical ward Physician, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital (NKI-AVL); PhD researcher, Nuclear Medicine department of the NKI-AVL; Research focus on innovative surgical guidance technology (intraoperative navigation, radio- and fluorescence guided surgery). Visiting scientist, Interventional Molecular Imaging group, www.imageguidedsurgery. nl, Leiden University Medical Center, Urologist-intraining, Leiden University Medical Center; Nominated, Marie Curie Award, European Society of Nuclear Medicine; Nominated, Young Investigator Award, European Society of Molecular Imaging; Awarded, Vlietstra Award (best presentation at annual meeting), Dutch Urological Association; Awarded, Second prize for best abstract (Oncology), 27th Annual EAU Congress Paris 2012. Clinical Fellow, Department of Urology Nice University Hopital, Nice, France; Attended medical school in Dijon, France; Residency in Urology, Nice University Hospital; Fellow, Lefrack Prostate Cancer Institute (New York Presbytarian Hopsital - Weill Cornell Medical College). Research focus on prostate cancer imaging, ie., Multiphoton Microscopy (MPM) in and 7T-MR. Reviewer, BJUI and the European Urology. Editor-in-chief of “What’s Up Doc,” magazine on general medical training. Awarded, First Prize for the Best Abstract in Oncology, 27th Annual EAU Congress Paris 2012. Research fellow and PhD candidate; Jena University Hospital, Department of Urology Molecular Biology Research Laboratory, Jena, Germany; Research fellowship, University of Sheffield, Institute of Cancer Studies, Research group of Dr. James Catto, Sheffield, United Kingdom; Main studies of Biology and Microbiology, Friedrich-SchillerUniversity, Jena, Germany; Attended, FriedrichSchiller-University, Jena Awarded, Second prize for the best abstract (Non- Oncology), 27th Annual EAU Congress Paris 2012. This section “Who’s Who in Urology,” aims to provide readers an informative listing of decision-makers, leading researchers, faculty heads, industry representatives, medical scientists and other active medical professionals in urology. With this series we hope to reflect not only the milestones achieved in urology but also to show the multifaceted network and interdisciplinary nature of the urological field. 49th ERA-EDTA Annual Meeting in Paris EULIS shares insights and expertise in symposium on managing nephrolithiasis giovanni.gambaro@ rm.unicatt.it “Clinical questions for managing nephrolithiasis” was one of the four CME courses held on May 24 in Paris during the 49th European Renal Association and European Dialysis and Transplantation Association (ERA-EDTA) Annual Meeting. This marked the first time that the ERA-EDTA Annual Meeting hosted an educational symposium on renal stones which was co-chaired by the author and EULIS board member Noor Buchholz. EAU Section of Urolithiasis (EULIS) The meeting was also the first time that a joint educational initiative took place between the ERA-EDTA and EULIS-EAU. The ERA-EDTA Annual meeting gathered around 8,500 participants from 77 countries at the Palais des CongrГЁs, the same venue for this year’s 27th Annual EAU Congress held last February. The course was organised to provide nephrologists the tools for a very practical approach to kidney stone patients, and help manage or prevent recurrent renal stones and the most severe co-morbidities, such as chronic kidney disease (CKD), renal failure and metabolic bone disease. Approximately 10% of Europeans have some form of CKD, which predisposes those affected to the risk of developing end stage renal disease and cardiovascular morbidities. Nephrologists are therefore keen to acquire more skills and deeper insights to the management and prevention of CKD. Since the course was organised in cooperation with the EULIS, it benefited from the support and participation of an experienced and renowned faculty of nephrologists and urologists. The programme’s scope is reflected in the meeting agenda. Kim Hovgaard Andreassen (DK) tackled the role of radiology in the lecture “What do we ask the radiologist? - What can the radiologist tell us?” Michel Daudon (FR) discussed the benefits and insights in stone analysis, while the author provided his views on the role of genetics in patients with stones. On the other hand, Robert Unwin (UK) lecture examined the query “When and why do we suspect a tubular disorder in a patient with stones? The interpretation and management of hypercalciuria was taken up by Philippe Jaeger (UK), while Martino Marangella (IT) offered his views and approach on how to interpret the results of urine analysis. The vital role of diet and its impact on patients with stones was discussed by Alberto Trinchieri (IT). Multi-disciplinary issues and effective collaboration were examined by Noor Buchholz in his insightful lecture titled “What does the urologist ask the nephrologist? Around 461 participants attended the four-hour session, and the course turned out to be the second most highly attended in the meeting. Most of the participants came from Europe, Middle East and Africa. The lecturers also faced a lot of probing questions from the audience, demonstrating the strong interest of nephrologists in renal stones management and the vital role of multi-disciplinary links and collaborative work with urologists. For instance, Noor Buchholz in his lecture attempted to describe the common areas of concern among urologists and nephrologists in managing lithiasis, and noted the possible links or areas of cooperation. The lectures were not only provocative and stimulating, but also highlighted that many issues remain unresolved. The challenge, therefore, is to continue with current efforts in research and clinical investigations. The course demonstrated that effective collaboration between the two specialities is vital in achieving progress in clinical and research activities, which in the end can only lead to high quality and improved healthcare for patients. Thus, the goal of defining a template for effective cooperation between the specialities will hopefully be the theme of a future event or alliance between the EULIS-EAU and the ERA-EDTA. Apply for your EAU membership online! Would you like to receive all the benefits of EAU membership, but have no time for tedious paperwork? Becoming a member is now fast and easy! www.uroweb.org Prof. Giovanni Gambaro Div. of Nephrology and Dialysis Columbus-Gemelli University Hospital Rome (IT) Go to www.uroweb.org and click EAU membership to apply online. It will only take you a couple of minutes to submit your application, the rest - is for you to enjoy! 24 European Urology Today August/September 2012 EAU 12th Central European Meeting (CEM) EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations For more information please contact Congress Consultants at [email protected] or go to http://cem.uroweb.org 12-13 October 2012, Dresden, Germany Preliminary Programme 14.00-14.40 Friday, 12 October 2012 07.30-09.00 Registration 09.00-09.10 Welcome and introduction M. Wirth, Dresden (DE) B. Djavan, New York (US) M. Marberger, Vienna (AT) 09.10-10.50 Plenary session 1 LUTS and BPE Chair: P.J. NyirГЎdy, Budapest (HU) When is BPE the culprit and not the bladder? S. Madersbacher, Vienna (AT) When is a surgical intervention needed (and medical therapy fails)? Z. Bajory, Szeged (HU) 14.40-15.10 11.10-13.00 Poster sessions 1, 2 and 3 13.00-14.00 Lunch 08.00-09.40 Pro - Contra debate Lasers have replaced the resectoscope for surgery of BPE Chair: J. Kliment, Martin (SK) The role of biopsy A. SzendrГ¶i, Budapest (HU) Active surveillance: In whom, how and when? P. Dobronski, Warsaw (PL) Contra (TUR) O. Hakenberg, Rostock (DE) The role of partial nephrectomy in T1b RCC G. Stimac, Zagreb (HR) Coffee break and poster viewing 15.30-17.10 Poster sessions 4, 5 and 6 17.10-18.50 Plenary session 2 High risk prostate cancer Chairs: I. Sinescu, Bucharest (RO) M. Wirth, Dresden (DE) Risk assessment in prostate cancer P. Chlosta, Kielce (PL) The role of palliative nephrectomy M. Wirth, Dresden (DE) 09.40-10.10 Coffee break and poster viewing 10.10-12.10 Poster sessions 7, 8 and 9 12.10-13.10 Panel debate (Case discussions) High risk non-muscle-invasive bladder cancer Chairs: M. Babjuk, Prague (CZ) I. Mincik, Presov (SK) Role of surgery C. Surcel, Bucharest (RO) 18.50-19.50 Symposium New treatments strategies in metastatic castration-resistant prostate cancer Janssen-Cilag GmbH European Advisory Board W. Artibani, Verona (IT) M. Babjuk, Prague (CZ) A.P. Borkowski, Warsaw (PL) J. Breza, Bratislava (SK) B. Djavan, New York (US) Z.F. Dobrowolski, Cracow (PL) P.A. Geavlete, Bucharest (RO) T. HГЎnuЕЎ, Prague (CZ) K. Jeschke, Klagenfurt (AT) J. Kliment, Martin (SK) A. Kmetec, Ljubljana (SI) O. Kraus, Zagreb (HR) M. Marberger, Vienna (AT) P.J. NyirГЎdy, Budapest (HU) I. Romics, Budapest (HU) I. Sinescu, Bucharest (RO) M. Sosnowski, Lodz (PL) G. Stimac, Zagreb (HR) B. Trsinar, Ljubljana (SI) M. Wirth, Dresden (DE) O. Zechner, Vienna (AT) Panel: G. GlГјck, Bucharest (RO) O. Kraus, Zagreb (HR) M. Schmidt, Prague (CZ) M. Sosnowski, Warsaw (PL) S. Voinea, Bucharest RO) M. Wirth, Dresden (DE) Who is better off with non-surgical curative therapy? B. Djavan, New York (US) PSA persistence / recurrence after curative therapy T.A. Borkowski, Warsaw (PL) Faculty M. Babjuk, Prague (CZ) Z. Bajory, Szeged (HU) T.A. Borkowski, Warsaw (PL) A.P. Borkowski, Warsaw (PL) J. Breza, Bratislava (SK) P. Chlosta, Kielce (PL) B. Djavan, New York (US) P. Dobronski, Warsaw (PL) B. Geavlete, Bucharest (RO) G. GlГјck, Bucharest (RO) O.W. Hakenberg, Rostock (DE) T. HГЎnuЕЎ, Prague (CZ) J. Kliment, Martin (SK) A. Kolodziej, Wroclaw (PL) O. Kraus, Zagreb ((HR) P. Macek, Prague (CZ) S. Madersbacher, Vienna (AT) M. Marberger, Vienna (AT) I. Mincik, Presov (SK) P.J. NyirГЎdy, Budapest (HU) M. Schmidt, Prague (CZ) I. Sinescu, Bucharest (RO) M. Sosnowski, Warsaw (PL) G. Stimac, Zagreb (HR) C. Surcel, Bucharest (RO) A. SzendrГ¶i, Budapest (HU) S.N. Voinea, Bucharest (RO) M. Wirth, Dresden (DE) M. Zalesky, Prague (CZ) Plenary session 3 Update on the management of renal cell cancer Chairs: A.P. Borkowski, Warsaw (PL) T. Hanus, Prague (CZ) Pro A. Kolodziej, Wroclaw (PL) 15.10-15.30 Managing LUTS and BPE with post void residual >250ml B. Geavlete, Bucharest (RO) Coffee break and poster viewing Saturday, 13 October 2012 Phaeocromocytoma today P. Macek, Prague (CZ) Continuing LUTS in spite of вЂ�successful’ surgery M. Zalesky, Prague (CZ) 10.50-11.10 State-of-the-art lectures Managing adrenal incidentalioma J. Breza, Bratislava (SK) 13.10 Awards and closing remarks M. Wirth, Dresden (DE) B. Djavan, New York (US) M. Marberger, Vienna (AT) Awards for Best Poster Presentations are supported by an unrestricted educational grant from KARL STORZ GMBH & CO.KG and RICHARD WOLF Association of Urology American Urological Association (AUA) A chance to join the ... International Academic Exchange Programme American Urological Association (AUA) in collaboration with the European Association of Urology (EAU) 2013 American Tour To date ten American and ten European tours have been organised and each of those proved extremely successful. Therefore the European Association of Urology (EAU) and the American Urological Association are pleased to announce the 2013 American Tour! The AUA/EAU International Exchange Programme will send American faculty to Europe and European faculty to the United States. The programme aims to promote international exchange of urological medical skills, expertise and knowledge. This upcoming 2013 American Tour will provide grants which will enable four EAU members (3 junior and 1 senior faculty member) to travel to and attend the AUA congress in San Diego (May 4-8, 2013) and to participate in an extended two week travel programme, taking them to several urology centres in the United States. Eligibility criteria • Less than 42 years of age • Minimum academic rank of assistant professor • Letter from the departmental chairman of the applicant’s commitment to academic medicine • Membership of the EAU Information and application forms For all further information and programme application forms please visit www.uroweb.org, and select International Relations, AUA-EAU International Academic Exchange Programme or contact the EAU Central Office, T +31 (0)26 389 0680, F +31 (0)26 389 0674, E: [email protected]. EAU Central Office, Attn. Secretariat, P.O. Box 30016, 6803 AA Arnhem, The Netherlands August/September 2012 European Urology Today 25 Old infections and new challenges Revisiting urogenital tuberculosis Prof. Ekaterina Kulchavenya Urology Dept TB Institute Novosibirsk (RU) uropathogens in the urine. But when it evolved to a more resistant form, it had the capacity to fully destroy a tissue. Thus, the clinical picture of UGTB became clearer, with aseptic pyuria and gross haematuria as the main symptoms. The growth of MBT in culture was rather fast and prolific, with the pathomorphological picture also clear. however, no exact pathomorphological evidence of TB. Only emerging giant Pirogov-Langhans cell without clear signs of tuberculous inflammation was found in the tissue of epididymis. Due to pyospermia, a retrograde urethrography was performed which demonstrated caverns of the prostate consistent with UGTB. Chemotherapy for TB was continued (Fig. 2). ku_ekaterina@ mail.ru MBT evolution In the MDR period antibiotics have changed the character of MBT significantly2,3. MBT has responded to antibiotics in two main ways: by persistence and by resistance. Differential diagnosis Diagnostic of UGTB is based on four pillars: bacteriology, pathomorphology, radiology, and provocative test with therapy ex juvantibus. Bacteriology. At least six, but preferably nine and more, specimens of urine, expressed prostatic secretion and ejaculate should be cultured, each onto at least three culture media (Lowenstein - Jensen, Finn – II, Middlebrook 7H9-12). Prof. Truls E. Bjerklund Johansen Urology Dept Г…rhus University Hospital Г…rhus (DK) Mycobacterium tuberculosis (MBT) is known to exist for a long time; it was found in the bones of ancient bison that lived 17,000 years ago. For ages mankind has paid a fatal price to tuberculosis (TB), and today TB accounts for about 5,000 human deaths on a daily basis. Thus, TB is known to kill more people of all ages than any other infectious disease. A long list of famous people were known to have suffered and died of TB such as the Egyptian Pharaoh Tutankhamen, and many European kings including Napoleon II of France, historical figures such as Cardinal Richelieu, Baruch Spinoza, Jean-Jacques Rousseau, Robert Burns, Amedeo Modigliani, Vivien Leigh and many others. Even today TB kills more children and adults than any other infectious disease1. TB is a disease caused by Mycobacterium tuberculosis, first identified by Robert Koch in 1882. Before Koch’s time TB was known as a type of common colds and a congenital disease. There are no reports about the clinical features of TB in persons who lived before 18th century, such as in the case of Baruch de Spinoza or Cardinal Richelieu. However, we can learn from the history of Anton Chekhov, a famous Russian writer and also a doctor. He reported having pulmonary TB with haemoptysis, bone TB with skeletal deformation, intestinal TB with melena and urogenital TB with gross haematuria. The common symptoms of TBC have been coughing, weight and appetite loss, night sweats, pain, fever, dysuria, weakness, anemia and bleeding. Clinical presentation and spread of TB TB was most often seen in a generalised form, with many symptoms, of which bleeding was the most common. Urogenital TB in mono-local form was not distinguished until modern times. Generally, urogenital TB was diagnosed in patients with pulmonary and/or bone TB, who complained of flank pain, dysuria and haematuria. Since antibiotics were unknown, the only means of controlling the spread of infection was to isolate patients in private sanatoria or hospitals strictly limited to patients with TB. The most common route of MBT transmission is through the respiratory tract, with infection spreading through coughing, sneezing or close personal contact with MBT carriers. Alimentary transmission may occur through milk from cows infected with tuberculosis. Other routes are direct and indirect physical contact, including sexual; transplacental transmission (unusual); iatrogenic transmission; and even blood transmission through a mosquito bite (extremely rarely). Persistence. Mycobacterium is an intracellular parasite. In bad conditions (too cold, too heat, presence of some antibiotics, even in low doses, insufficient air, etc.) MBT doesn’t multiply, but hides in the cell and fades – it persists. In this status as persistor, MBT is insensitive to the action of anti-body or antibiotics, which may kill her only in a stage of division. Normally MBT replicates once in 12 to 18 hours, but in persistence it may divide only sporadically. A person infected with persistent MBT is said to have latent TB. In the stage of persistence self-recovery is possible due to apoptosis of infected cells4. Mycobacteria can remain in this form at any length of time. If the immunity of the host is strong, MBT can remain in persistence life-long. Accordingly, a person can be infected for a lifetime, but will not show signs of illness. Under certain conditions like colds, stress, inter-current diseases etc, MBT may wake up, and emerging from its persistence stage MBT may become very aggressive, and its progression may begin rapidly. Persistence excludes the old specific symptom of UGTB – aseptic pyuria. However, even in persistence MBT harms the tissue, and if a patient takes, for example, a fluorquinolon for “UTI,” MBT tissues are rapidly colonized by fluoroquinolone resistant E.Coli. Today, the co-morbidity of UGTB becomes evident and non-specific UTI may be seen in 75% of cases having received this type of antibiotic (8). Resistance. The second defence of MBT is drugresistance, which may be of four types: • mono – to one of any anti-tuberculous drugs; • poly – to more than one of any drugs used for the treatment of the disease, excluding isoniazid and A B Influence of treatment options on the presentation MBT The new antibacterial era started in the second half of the 20th century. The first anti-tuberculosis drug streptomycin was developed by Selman Abraham Waksman in 1945. The history of urogenital TB can be divided into three periods: before antibiotics, the antibacterial era and today`s – multi-drug resistance (MDR) period. Before the availability of antibiotics and in the beginning of the antibacterial era, MBT could be described as вЂ�dormant’ without causing symptoms, and with little evidence of virulence. In those days, it seemed that MBT didn’t thrive with other EAU Section of Infections in Urology 26 European Urology Today A C Fig. 1: Demonstrates the case of TB in the placenta of a young woman with genital TB, which was not diagnosed before delivery. A. Caseous inflammation in placenta B. TB granuloma in placenta C. Mycobacteria in the tissue of placenta B Fig. 2: A. The emerging giant cell Pirogov-Langhans without clear signs of tuberculous inflammation; B. Caverns of the prostate rifampicin simultaneously; • multi-drug resistance (MDR) - MBT are resistant to at least isoniazid and rifampicin • extensive drug-resistance (XDR) XDR means MBT is MDR plus resistant to any fluoroquinolone and, at least, to one of three reserve injectables (amicacin, kanamycin or capreomycin). MDR and XDR TB is both associated with a higher incidence of treatment failures and with disease recurrence, as well as with higher mortality, than other forms of TB which are sensitive to first-line drugs5. Reasons for development of drug resistant in M.tuberculosis may be: • Insufficient volume / duration of chemotherapy • Peculiarities of TB process • Condition of the patient and/or comorbidity • And non-optimal previous antibacterial therapy for UTI. Culture by the standard technique is positive in 36% to 44% of UGTB patients only. If bacteriological tests are performed 3 times in one day, positive cultures will be 15% higher8. For Male Genital TB, we recommend to investigate in the same day the prostatic secretion; post-massage urine; ejaculate and post-ejaculate urine – by microscopy, culture and PCR of each probe in the order mentioned above. It is very important that there is a short time span between collection of urine, prostatic secretion, and ejaculate which should be not more than 40 minutes. Pathomorphology. Another problem in diagnosing UGTB is loss of pathomorphological signs of TB, especially in patients who also have HIV infection. For this reason, biopsies and surgical specimens should be also investigated by the Ziehl - Nielsen method – for identification of MBT. Radiology. Radiological imaging is important for diagnosing UGTB – both in the prostate and in the kidney TB. However, imaging is most useful for late cavernous forms, while our aim is early diagnosis9,10. Provocation tests and therapy ex juvantibus. In many cases provocation with injection of 20-50-100 units of tuberculin subcutaneously may be useful. All laboratory investigations including body temperature are measured 24 and 48 hours after tuberculin injection. The test is positive if leucocytosis, lymphocytopenia, leucocyturia, leucocytospermia occurs and body temperature have increased by more than one degree. Also local reaction (hyperemia, induration where tuberculin was injected) is to be taken into account. After provocative subcutaneous tuberculin tests, identification of MBT by culture or PCR is increased by 16%. Provocation tests may improve the diagnosis of UGTB, especially the obscure, latent forms, by up to 63%8. What is today’s Male Genital TB? Male Genital TB seems to be a rare disease. Nevertheless, 70% of men who die from tuberculosis of all localizations have prostate tuberculosis. In Therapy ex juvantibus may be of two types: 1.When Russia, this means that more than 10,000 men the patient receives antibiotic which doesn’t inhibit annually are diagnosed with prostate tuberculosis, which again has become a sexually transmitted disease MBT; and 2.When the patient receives antibiotics which inhibit MBT only. For therapy ex juvantibus 1st type fosfomycin, cefalosporins, and nitrofurantoin are As a rule, tuberculosis of the prostate is present or detected with lesion of other organs of the urogenital suitable. For therapy ex juvantibus 2nd type, we use isoniazid, PAS, protionamid, etionamid, ethambutol system. However, we found isolated epididymitis in and pyrazinamid. For good results of therapy ex 22% of UGTB, but bilateral orchiepididymitis is more common. In our material, fistulas were seen in 12% of juvantibus, we also recommend using non-steroid anti-inflammatory drugs8. cases. In patients with an acute onset, 67% had fistulas6,7. An elusive disease UGTB is a part of a common infectious disease – Like all other forms of UGTB, Male Genital TB has no tuberculosis. The clinical features of UGTB are specific symptoms. Although leukocytes are a common finding in urine, MBT is found in every third variable and unstable and depend on external factors (epidemic situation, administration of antibiotics etc), patient only. Disseminated pulmonary TB has been properties of the host (immunity, co-morbidity, etc) diagnosed in 37% of patients with genital TB. In and properties of MBT (persistence and resistance). contrast, 16% of cases with generalized TB will The clinical features of UGTB and the properties of manifest themselves as a genital process8. MBT may differ in various regions. A patient history UGTB hides under the guises of other diseases, mostly Incorrect antibiotic therapy for “UTI” (actually misdiagnosed UGTB) also leads to pathomorphological – cystitis and prostatitis. A UGTB patient is never changes of TB. This is demonstrated by the history of a diagnosed during the first visit, because this disease has no pathognomonic features. UGTB should be 46-year-old patient. Two years ago he was operated for pulmonary TB, and suspected in any patient presenting with UTI, and if the patient has, or has had TB in any localization, or some months ago he presented with flank pain, dysuria and pyuria, which were diagnosed as UTI. He who has lived in a region with a TB epidemic. received a fluorquinolone for 2 weeks with good effect on symptoms, but after one more month he developed Early diagnosis by means of urine, prostatic secretion and ejaculate examination is necessary before the an acute epididymitis. The patient was admitted to a antibacterial therapy of MBT. general urological clinic, where he was again treated with fluorquinolone plus amicacin. In 10 days the References condition of the patient improved, but the epididymis The references of this article are available from the remained enlarged and hard. EUT Editorial Office by sending an e-mail to: The patient was transferred to the urogenital clinic of [email protected] with reference to the article “Old infections and new challenges” by Prof. E. the TB Institute. After a short course of anti-TB Kulchavenya, Aug/Sep. issue 2012. therapy, he underwent epididymectomy. There was, August/September 2012 20th Meeting of the EAU Section of Urological Research (ESUR) EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations For more information please contact Congress Consultants at [email protected] or go to http://esur.uroweb.org 25-27 October 2012, Strasbourg, France Scientific Programme Thursday, 25 October 2012 12.30-13.00 13.00-19.00 PRO-NEST symposium Chairs: G. Jenster, Rotterdam (NL) A. Bjartell, MalmГ¶ (SE) 13.00-13.30 Keynote lecture Rational drug development for metastatic castration resistant prostate cancer J.T. Isaacs, Baltimore (US) 13.30-14.00 Photo: В© C. Fleith Opening Prof. Z. Culig, ESUR Chairman Prof. A. De la Taille, ARTP Chairman Dr. G. Jenster, PRO-NEST Coordinator Dr. J. CГ©raline, Congress President Prof. D. Jacqmin, Congress VicePresident Androgen receptor-cell cycle crosstalk in prostate cancer: mechanisms and therapeutic implications K. Knudsen, Philadelphia (US) Friday, 26 October 2012 Saturday, 27 October 2012 09.00-19.00 ESUR-ARTP symposium 08.30-09.30 Symposium (tentative) 09.00-11.30 Plenary session 1 Chairs: C. Robson, Newcastle (GB) M. Sadar, Vancouver (CA) 09.30-10.30 Plenary session 3 Testicular tumours Chair: D. Jacqmin, Strasbourg (FR) 09.00-09.30 Repression of the androgen receptor in prostate cancer C. Bevan, London (GB) 09.30-10.00 Controversial topics in diagnosis and treatment of testis cancer P. Albers, Dusseldorf (DE) 09.30-10.00 Inhibition of the androgen receptor and human prostate cancer cell growth by corepressors and novel anatgonists A. Baniahmad, Jena (DE) 10.00-10.30 Towards identifying biomarkers of relapse in stage I non seminomatous germ cell tumours J. Shipley, Sutton (GB) 10.00-10.30 What’s wrong with LNCaP cells? F. Claessens, Leuven (BE) 10.30-11.00 Break 10.30-11.00 Break 11.00-11.30 Oral session 4 11.00-11.30 Wnt5a as a therapeutic target in cancer T. Andersson, MalmГ¶ (SE) 11.30-13.00 11.30-12.30 Oral session 2 Plenary session 4 Bladder and kidney tumours Chairs: J-E. Kurtz, Strasbourg (FR) Y. Allory, Creteil (FR) 12.30-14.00 Lunch 11.30-12.00 14.00-15.30 Plenary session 2 Molecular genetics and biomarkers Chairs: Z. Culig, Innsbruck (AT) N. Malats, Madrid (ES) Prognostic significance and therapeutic targeting of urothelial cancer stem cells K. Chan, Houston (US) 12.00-12.30 The role of Wnt signalling in prostate and bladder cancer I. Ahmad, Glasgow (GB) 12.30-13.00 Hedgehog signalling and cancer T. Massfelder, Strasbourg (FR) 13.00-14.00 Lunch 14.00-15.30 Oral session 5 15.30-16.00 Break 16.00-18.00 Poster session 3 18.00-18.30 Dominique Chopin Lecture Regulating the androgen receptor signalling cascade in prostate cancer: A journey into the unknown C. Robson, Newcastle-upon-Tyne (GB) 18.30-19.00 Dominique Chopin and ARTP Awards Chair: Z. Culig, Innsbruck (AT) 14.00-14.30 Androgen receptors in advanced prostate cancer M. Sadar, Vancouver (CA) 14.30-15.00 Break 15.00-15.30 Prostate stem cell antigen: A case study in translational research R. Reiter, Los Angeles (US) 14.00-14.30 Biomarkers in prostate cancer: What вЂ�s new? A. De la Taille, CrГ©teil (FR) 15.30-16.00 Molecular subtyping of prostate cancer using high-throughput technologies: From basic science to clinical translation S. Tomlins, Ann Arbor (US) 14.30-15.00 Genetic epidemiology of urinary bladder cancer L.A. Kiemeney, Nijmegen (NL) 16.00-17.15 Oral session 1 15.00-15.30 17.15-19.15 Poster session 1 Anti-oncogenic role of Gata3 in prostate cancer M. Bouchard, Montreal (CA) 19.30 Welcome reception 15.30-16.00 Break 16.00-17.00 Oral session 3 17.00-19.00 Poster session 2 European Association of Urology EAU 8th South Eastern European Meeting (SEEM) For more information please contact Congress Consultants at [email protected] or go to http://seem.uroweb.org Preliminary Programme 14.50 – 16.30 Poster sessions 4, 5 and 6 Saturday, 27 October 2012 Friday, 26 October 2012 16.30 – 17.50 Plenary session 2 Bladder cancer Chair: H.A. Г–zen, Ankara 08.00 – 09.20 Plenary sessions 3 Urolithiasis Chairs: D. Mladenov, Sofia F. Tartari, Tirana 09.00 – 09.10 Welcome and introduction D. Mladenov, Sofia B. Djavan, New York M. Marberger, Vienna 09.10 – 10.30 Plenary session 1 Infertility Chair: C. Alamanis, Athens 09.10 – 09.30 Male risk factors M.A. Sadighi Gilani, Tehran 09.30 – 09.50 Medical therapy of OAT syndrome N. Sofikitis, Ioannina 16.30 – 16.50 NMIBC: Predictive factors of progression M.A. Zargar, Tehran 16.50 – 17.10 NMIBC after BCG L.N. TГјrkeri, Istanbul 17.10 – 17.30 Re TURBT: Why, why not and when? T. Kalogeropoulos, Athens 17.30 – 17.50 Cystectomy above 75a N. Bojanic, Belgrade 17.50 – 18.30 Debate Biopsy of renal masses Chair: L.N. TГјrkeri, Istanbul 09.50 – 10.10 New aspects in IVF B. Alici, Istanbul Pro C. Г–bek, Istanbul 10.10 – 10.30 Vasovasostomy S. Micic, Belgrade Contra G.S. Marusic, Novi Sad 10.30 – 10.50 Coffee break and poster viewing 10.50 – 12.30 Poster sessions 1, 2 and 3 12.30 – 13.30 Lunch 13.30 – 14.30 State-of-the-art lectures 13.30 – 14.00 Urinary markers have replaced cytology D. Mitropoulos, Athens 14.00 – 14.30 Vesico-ureteral reflux; endoscopic management has rendered all other options obsolete? S. TekgГјl, Ankara 14.30 – 14.50 Coffee break and poster viewing European Faculty I. Ahmad, Glasgow (GB) P. Albers, Dusseldorf (DE) T. Andersson, MalmГ¶ (SE) A. Baniahmad, Jena (DE) C. Bevan, London (GB) M. Bouchard, Montreal (CA) K. Chan, Houston (US) F. Claessens, Leuven (BE) A. De la Taille, CrГ©teil (FR) J.T. Isaacs, Baltimore (US) L.A. Kiemeney, Nijmegen (NL) K. Knudsen, Philadelphia (US) T. Massfelder, Strasbourg (FR) R. Reiter, Los Angeles (US) C. Robson, Newcastle (GB) M. Sadar, Vancouver (CA) J. Shipley, Sutton (GB) S. Tomlins, Ann Arbor (US) EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations 26-27 October 2012, Sofia, Bulgaria 07.30 – 09.00 Registration ESUR Board A. Bjartell, MalmГ¶ (SE) Z. Culig, Innsbruck (AT) Chair F. Jankevicius, Vilnius (LT) G. Jenster, Rotterdam (NL) K.J. Junker, Jena (DE) M. Knowles, Leeds (GB) Vice-Chair N. Malats, Madrid (ES) M. Mancini, Padova (IT) Y. Allory, Creteil (FR) Associate Member 18.30-19.30 Symposium Berlin-Chemie 08.00 – 08.20 Is there still a role for SWL? A. Skolarikos, Athens 08.20 – 08.40 Do we need a flexible ureteroscope for modern stone management? H. Akpinar, Istanbul 08.40 – 09.00 Retrograde intrarenal surgery has replaced PCNL I. Saltirov, Sofia 09.00 – 09.20 Open stone surgery is dead TBC 09.20 – 09.40 Coffee breaks and poster viewing 09.40 – 11.20 Poster sessions 7, 8 and 9 11.20 – 12.10 State-of-the-art lecture Doing prospective trials the correct way A. Tubaro, Rome 12.10 Awards and closing remarks D. Mladenov, Sofia B. Djavan, New York M. Marberger, Vienna Awards for Best Poster Presentations are supported by an unrestricted educational grant from KARL STORZ GMBH & CO.KG and RICHARD WOLF Faculty H. Akpinar, Istanbul C. Alamanis, Athens B. Alici, Istanbul N. Bojanic, Belgrade B. Djavan, New York T. Kalogeropoulos, Athens M. Marberger, Vienna G.S. Marusic, Novi Sad S. Micic, Belgrade D. Mitropoulos, Athens D. Mladenov, Sofia C. Г–bek, Istanbul H.A. Г–zen, Ankara M.A. Sadighi Gilani, Tehran I. Saltirov, Sofia A. Skolarikos, Athens N. Sofikitis, Ioannina F. Tartari, Tirana S. TekgГјl, Ankara A. Tubaro, Rome L.N. TГјrkeri, Istanbul M.A. Zargar, Tehran Advisory Board C. Alamanis, Athens Y.M.Y. Al-Hallaq, Baghdad W. Artibani, Verona M. Bazardzanovic, Tuzla B. Djavan, New York M. Hiros, Sarajevo S.J. Hosseini, Teheran L. Lekovski, Skopje M. Marberger, Vienna S. Micic, Belgrade D. Mladenov, Sofia H.A. Г–zen, Ankara D. Perovic, Podgorica Z. Popov, Skopje I. Poulias, Athens S. Stavridis, Skopje F. Tartari, Tirana S. TekgГјl, Ankara A. Thanos, Athens D.V. Tomic, Mostar L.N. TГјrkeri, Istanbul M. Tzvetkov, Sofia A. Vuksanovic, Belgrade M. Xhani, Tirana Association of Urology August/September 2012 European Urology Today 27 Rules and Eligibility • All urologists and scientists are invited to send in papers. • The topic of the paper should deal with Minimally Invasive Surgery. • The paper must have been accepted for publication in a European Journal between 1 July 2011 and 30 June 2012. • All papers must be submitted in the English language. • All applicants have to be a member of the EAU. • The submitting author must be either the first or the corresponding senior last author. • Each author is allowed to submit no more than one paper. • Deadline for submission is 15 November 2012. • The award will be handed over at the 28th Annual EAU Congress in Milan, 15-19 March 2013 during the Opening Ceremony. A review committee, consisting of members of the EAU Scientific Congress Office, will select the winning paper. How to apply Please send your paper to the EAU Central Office at [email protected] and mention “EAU Hans Marberger Award 2013” in the subject line of your e-mail. The EAU Hans Marberger Award is supported by an unrestricted educational grant from KArl STorz GMbH & Co.KG. Win the EAU Hans Marberger Award 2013 Submit your paper on Minimally Invasive Surgery and you might be awarded the EAU Hans Marberger Award 2013 of € 5,000! EAU launches first EAU Prostate Cancer Research Award with support from the Fritz H. SchrГ¶der Foundation With the goal to encourage innovative, high-quality research in prostate cancer, the EAU has launched the first EAU Prostate Cancer Research Award 2013. Supported by an unrestricted educational grant from the Fritz H. SchrГ¶der Foundation, an expert jury will select the best paper dealing with clinical or experimental studies in prostate cancer and published or accepted by a renowned international scientific journal. Join this competitive search and help boost the quality of prostate cancer research in Europe! Be st r fi e th er! winn EAU Prostate Cancer Research Award 2013 28 European Urology Today Eligibility and Requirements • The topic of the paper should deal with clinical or experimental prostate cancer research. • The paper must have been published or accepted for publication in a highranking international journal between 1 July 2011 and 30 June 2012, and submitted in the English language. • Applicants must be a member of the EAU. • T he submitting author must be the first author of the paper or, by exception, the corresponding senior last author. • Applicant can only submit no more than one paper. • Deadline for submission by email is 15 November 2012. The award will be handed over at the 28th Annual EAU Congress in Milan, 15-19 March 2013 during the Opening Ceremony. A review committee will screen all entries and an independent jury will select the best paper based on quality and merits. How to apply Inquiries and correspondence should be addressed to the EAU Central Office, at [email protected], with the subject line: “Prostate Cancer Research Award 2013.” The award is supported by an unrestricted educational grant of € 5,000 from the Fritz H. SchrГ¶der Foundation. August/September 2012 Rome hosts laparoscopy and robotics meeting 9th annual meeting demonstrates new technologies, live surgeries Prof. Evangelos Liatsikos University Hospital of Patras Dept. of Urology Patras (GR) [email protected] With his extensive experience, Prof. Gill demonstrated the importance of partial nephrectomy in the current management of renal tumours and the role of new technical developments. The first day of live surgeries was dedicated to operations in the upper urinary tract, and began with a robotic partial nephrectomy performed by Alex Mottrie. This was followed by an extremely challenging laparoscopic retroperitoneal metastasectomy performed by Richard Gaston. Next, Sam Bhayani performed a robotic nephrouretectomy while Renaud Bollens performed a laparoscopic nephrectomy. Rome hosted the 9th Challenges in Laparoscopy and Robotics Congress (June 6-9, 2012), an annual meeting The day’s live surgeries closed with a robotic that has gained strength and prestige over the years. partial nephrectomy by Inderbir Gill, a retroperitoneal heminephrectomy by Xu Zhang, Returning to the city that was the meeting’s first and a robotic pyeloplasty by Tullio Sulser. All cases venue in 2004, this year’s congress was deemed a were successfully managed by the surgeons, and success for the attendance, quality of presentations the audience actively participated with questions and live surgeries. Organised under the auspices of and comments. The day’s session also ended with the EAU Section of Uro-Technology (ESUT), the a video clip presentation of possible complications meeting gathered some of the world’s renowned and their management, moderated by Sam Bhayani, laparoscopic and robotic surgeons who performed a Luis Martinez-PiГ±ero, Tullio Sulser and Carlo total of 22 live surgeries in three days. A total of 690 Terrone. participants from 40 countries joined the congress, along with 10 industry exhibitors. Bladder surgeries The second day opened with an interesting lecture by Ergife Hotel, located on the outskirts of Rome and the Prof. Thuroff regarding quality control of laparoscopic and robotic surgeries in Europe. Meanwhile, the day’s venue for the three-day congress, offered not only a live surgeries focused mainly on the bladder and pleasant venue but also a convenient location near urogynaecological operations. Ingolf Turk performed the Pio IX Clinic (Vincenzo Pansadoro Foundation) where the live surgeries took place. The hotel’s Leptis a robotic radical cystectomy, followed by the collaboration by Gill and Turk for an extended pelvic Magna Hall was equipped with the latest in 3D live lymphadenectomy. Gill also performed the transmission technology and two surgeries were construction of a total intracorporeal orthotopic ileal simultaneously observed and commented on by neobladder. participants [See photo]. Prof. Inderbir Gill delivers a lecture on partial nephrectomy approach through the Douglas Pouch (TransDouglas Baralp). Next, Richard Gaston performed a robotic monolateral nerve sparing radical prostatectomy. The final operation was a laparoscopic radical prostatectomy using Kymerax instruments by Gunther Janetschek. These novel instruments are motordriven, hand-held devices with a controllable articulation at the instrument tip. Beijing hosts 2013 congress Apart from the very high level of expertise demonstrated in the congress, attendees were treated to a lively social programme. The congress faculty members were welcomed to a gala dinner in a venue that has a breathtaking view of Rome. Moreover, all congress participants had a chance to take in the beautiful sites of the city and to enjoy Italian hospitality. The overall success of CIL & ROB 2012 was a testament to the organising committee’s outstanding efforts and the support from of all the participating experts. Next year’s congress will take place in Beijing, China as the Joint European-Chinese Meeting of Laparoscopy and Robotics. Profs. Xu Zhang and Yinghao Sun are the meeting directors along with Profs. Pansadoro and Disanto. The congress venue will be at the Convention Center of the Chinese PLA General Hospital and expectations are high for the 10th Annual CIL & ROB Meeting. The PLA General Hospital is one of China’s leading hospitals with a 3,300-bed capacity and state-of-theart equipment. With a full programme of presentations and live surgeries from worldrenowned experts, attendees will also have the opportunity to experience Beijing and witness the city’s rich cultural legacies. Visit http://www. challengesinlaparoscopy.it/ for further information. PLA General Hospital in Beijing, China – venue for CIL & ROB 2013 Table 1: Country of origin for attendees of CIL & ROB 2012 Simultaneous 3D live transmission of two surgeries On Wednesday, June 6, a laparoscopic course for beginners, organised by Karl Storz, was fully booked. The course was coordinated by the author, Francesco Curto and Alberto Breda. Live surgeries Thursday, the first day of congress sessions, opened with a welcome message from course directors Profs. Vito Pansadoro and Vincenzo Disanto. Introductory remarks were given by ESUT chairman Prof. Jens Rassweiler, EAU Robotics Section Dr. Alexander Mottrie, Italian Urological Society president Prof. Emanuele Belgrano, former SIU president Prof. Joachim Thuroff, EAU adjunct secretary general Prof. Walter Artibani, and next year’s (2013) congress director Prof. Xu Zhang. Prof. Inderbir Gill then gave the first lecture on partial nephrectomy. Richard Gaston was again tasked with an extremely challenging case, a bilateral laparoscopic ureterolysis, followed by the demonstration of a single-port laparoscopic sacrocolpopexy by this author and Alberto Breda. Next, Renaud Bollens and Gaston performed fistula repairs using laparoscopic and robotic techniques, respectively. The day’s live surgeries concluded with Turk performing a laparoscopic psoas hitch, and Vincenzo Pansadoro performing a transvesical diverticulectomy. Again, all cases demonstrated surgical expertise and prompted lively discussions and comments from the audience. The session closed with another video clip presentation of complications moderated by Renaud Bollens, Giuseppe Carrieri, Antonio Celia and Bernardo Rocco. Managing prostate cancer The focus of the final day was the surgical management of prostate cancer. Prof. Patel’s morning lecture was a thought-provoking retrospective on a decade-long experience in robotic radical prostatectomy. Theory complemented practice, with Patel expertly performing a bilateral nerve-sparing robotic radical prostatectomy. Course directors Profs. V. Pansadoro (left) and V. Disanto EAU Section of Uro-Technology August/September 2012 Jens-Uwe Stolzenburg performed an extraperitoneal laparoscopic radical prostatectomy on a very large prostate, and was followed by Jens Rassweiler performing a laparoscopic radical prostatectomy using the Ethos chair for increased ergonomic comfort. Aldo Bocciardi demonstrated a novel robotic radical prostatectomy technique with the use of an Argentina1 Australia6 Austria8 Belgium16 Brazil1 Bulgaria3 China37 Czech Republic 11 Denmark1 Egypt1 Finland2 France22 Georgia1 Germany33 Greece18 Hungary33 India1 Indonesia1 Italy235 Latvia4 Malaysia1 Mexico1 Morocco1 Netherlands26 Norway10 Poland14 Portugal18 Russian Federation 3 Saudi Arabia 6 Serbia4 Slovenia5 South Africa 3 Spain47 Sweden4 Switzerland24 Turkey57 Ukraine6 United Arab Emirates 2 United Kingdom 3 United States 17 ESUT-Winterforum Innovations and Classics in Endourology and Imaging Announcement 06-07 December 2012 Mannheim Germany Rosengarten Congress Center Further information: www.innovations-endourology.com European Urology Today 29 Congress calendar 2012/2013 September October 13-15: Broumana, Lebanon 3-5: Jena, Germany 7th Congress of the Lebanese Urology Society – Updates in Urology Contact: Infomed Tel.: + 961 1 510881-2-3 Fax: + 961 1 482116 E-mail:[email protected] Website: http://www.infomedweb.com European Course of Paediatric Radiology (ECPR) 2012 Contact: Conventus Congressmanagement & Marketing GmbH Tel.: +49 3641 311 63 58 E-mail:[email protected] Website:www.ecpr-course2012.de 14-15: Arezzo, Italy 3-7: Antalya, Turkey 2nd Conference on Failed Hypospadias Repair – 4th Surgical Workshop of CURGS - LIVE Contact: Center for Reconstructive Urethral Surgery Sava Perovic Foundation Tel.: +381 11 247 4918 Fax: +381 64 190 3736 E-mail:[email protected] Annual Meeting of the Society of Urological Surgery in Turkey Contact:UCD Tel.: +90 312 236 28 79 E-mail:[email protected] Website:www.urolojikcerrahikongresi.org 19-21: Valencia, Spain 32nd Congress of the European Society of Surgical Oncology (ESSO) Contact: ECCO – the European CanCer Organisation Tel.: +32 2 775 02 01 Fax: +32 2 775 02 00 E-mail:[email protected] Website:http://www.ecco-org.eu/Conferences/ Conferences/ESSO-32.aspx 20-22: Madrid, Spain 11th Congress of the European Federation of Sexology (EFS) Contact: AIM Group International Tel.: +39 06 330531 Fax: +39 06 33053229 E-mail:[email protected] Website:http://web.aimgroupinternational. com/2012/efs/ 26-28: London, United Kingdom EAU Robotic Urology Section Congress (ERUS) 2012 Contact: e-HIMS bvba Tel.: +32 3 491 87 46 Fax: +32 3 491 82 71 E-mail:[email protected] Website:http://erus2012.com/ 26-29: Leipzig, Germany 64th Congress of der German Society of Urology (DGU) Contact:DGU Tel.: +49 211 516 096 0 Fax: +49 211 516 096 60 E-mail:[email protected] Website:http://www.dgu-kongress.de/index. php?id=571&L=2 28-29: Yerevan, Armenia National congress of the Armenian Urological Society Contact: Ruben Hovhannisyan Tel.: +37 410 583 935 Fax: +37 410 580 449 E-mail:[email protected] 28: ESU organised course on What’s new in Prostate cancer and female urology at the time of the national congress of the Armenian Urological Society Contact:ESU 28-2 Oct: Vienna, Austria 37th ESMO Congress Contact: ESMO Head Office Tel.: +41 91 973 19 26 Fax: +41 91 973 19 18 E-mail:[email protected] Website:http://www.esmo.org/events/vienna2012-congress.html 30-4 Oct: Fukuoka, Japan 32nd Congress of the SociГ©tГ© Internationale d’Urologie (SIU) Contact:SIU Tel.: +1 514 875 5665 Fax: +1 514 875 0205 E-mail:[email protected] Website:http://www.siucongress.org/ 30 European Urology Today 4-6: Oxford, United Kingdom International Cancer Imaging Society 12th Annual Teaching Course Contact:ICIS Tel.: +44 207 036 8805 E-mail:liz.appleyard@cancerimagingsociety. org.uk Website:www.icimagingsociety.org.uk 11-12: Pisa, Italy Urology in 2012: What’s in and What’s New Contact: Congress Lab Tel.: +39 055 5539746 Fax: +39 055 5539741 E-mail:[email protected] 11-14: Athens, Greece 21st Pan-Hellenic Urological Congress Contact: Hellenic Urological Association (HUA) Tel.: +30 2107223126 Fax: +30 2107245959 E-mail:[email protected] Website:www.huanet.gr 13: ESU organised course on Urothelial cell carcinoma: Radical surgery in bladder cancer and infertility at the time of the National congress of the Hellenic Urological Association Contact:ESU 12-13: Dresden, Germany EAU 12th Central European Meeting (CEM) Contact: Congress Consultants B.V. Tel.: +31 26 389 1751 Fax: +31 26 389 1752 E-mail:[email protected] Website:http://cem.uroweb.org 15-19: Beijing, China Annual Congress of the International Continence Society (ICS) Contact:ICS Tel.: +44 117 9444881 Fax: +44 117 9444882 E-mail:[email protected] Website:http://www.icsoffice.org/Events/ ViewEvent.aspx?EventID=134 17-19: Barcelona, Spain 53rd Course on Urology Contact: FundaciГі Puigvert Tel.: +34 93 416 9732 Fax: +34 93 416 9730 E-mail:[email protected] Website:http://www.fundacio-puigvert.es/es/ 53_Curso_de_urologia 18-21: Tunis, Tunisia 3rd Maghreb urological congress at the time of the 12th national congress of the Tunisian Urological Association Tel.: +216 98 33 91 63 E-mail:[email protected] 19: ESU organised course on Female and functional reconstructive urology at the time of the national congress of the Tunisian Urological Society Contact:ESU Worldwide, continually updated urological meeting calendar at www.uroweb.org 19-20: Berlin, Germany 9-10: Linz, Austria 2nd International Meeting of the EAU Section of Urological Imaging (ESUI) Contact: Congress Consultants B.V. Tel.: +31 26 389 1751 Fax: +31 26 389 1752 E-mail:[email protected] Website:http://esui2012.uroweb.org/ Annual educational meeting of the Austrian Society of Urology Contact: Prof. Mesut Remzi Tel.: +43 2262/7805740 Fax: +43 2262/7802850 E-mail:[email protected] 19-20: Barcelona, Spain Advanced video based interactive ERUS-ESU Masterclass on Robotic-Assisted Radical Cystoprostatectomy Contact: e-HIMS bvba Tel.: +32 3 491 87 46 Fax: +32 3 491 82 71 E-mail: [email protected] Website: www.erusmasterclass.com 21-24: Venice, Italy 85th Annual Meeting of the SocietГ Italiana di Urologia (SIU) Contact: SocietГ Italiana di Urologia (SIU) Tel.: +39 0686202637 Fax: +39 0686325073 E-mail:[email protected] Website:www.siu.it 22-23: Dundee, United Kingdom Fundamentals of Transurethral Resection and Ureteroscopy Course Contact: University of Dundee Tel.: +44 1382 383400 Fax: +44 1382 646042 E-mail:[email protected] Website:www.dundee.ac.uk/surgicalskills/ 25-27: Strasbourg, France 20th Meeting of the EAU Section of Urological Research (ESUR) Contact: Congress Consultants B.V. Tel.: +31 26 389 1751 Fax: +31 26 389 1752 E-mail:[email protected] Website:http://esur2012.uroweb.org/ 26-27: Sofia, Bulgaria EAU 8th South Eastern European Meeting (SEEM) Contact: Congress Consultants B.V. Tel.: +31 26 389 1751 Fax: +31 26 389 1752 E-mail:[email protected] Website:http://seem.uroweb.org 31-2 Nov: Ostrava, Czech Republic National congress of the Czech Urological Society Contact: AleЕЎ Petrik, MD, PhD Tel.: +420 387 875 201 E-mail:[email protected] Website:www.hanzo.cz/cusen November 1: Ostrava, Czech Republic ESU organised course on Bladder cancer at the time of the National congress of the Czech Urological Society Contact:ESU 2-4: Troia, Portugal National meeting of the Portuguese Association of Urology Contact: Rogeria Sinigali Tel.: +351 21 324 3590 Fax: +351 21 324 3599 E-mail:[email protected] Website:www.apurologia.pt 3: ESU organised course on UPJ stenosis and reconstructive surgery at the time of the national meeting of the Portuguese Association of Urology Contact:ESU 7-8: Dundee, United Kingdom 2nd Advanced Laparoscopic Renal Resection Course Using Thiel’s Cadavers Contact: University of Dundee Tel.: +44 1382 383400 Fax: +44 1382 646042 E-mail:[email protected] Website:www.dundee.ac.uk/surgicalskills/ 9: ESU organised course on Role and limits of endoscopy/laparoscopy in urology at the time of the Annual educational meeting of the Austrian Society of Urology Contact:ESU 9-11: Berlin, Germany 5th ESU Masterclass on Female and functional reconstructive urology Contact:ESU 13-18: MazatlГЎn, Mexico 62nd National Congress of the Sociedad Mexicana de Urologia Contact:SMU Tel.: +55 9000 33 85 Fax: +55 9000 33 86 Website:http://www.wix.com/congresosmu/ mazatlan2012#!the-place 14-15: Guangzhou, China Chinese Urology Education Programme (CUEP II) Contact: European School of Uorology (ESU) and Chinese School of Urology (CSU) Tel.: +31 26 389 0680 and +86 10 59805003 Fax: +31 26 389 0684 and +86 10 59805003 E-mail:[email protected] Website:www.uroweb.org 15-16: Seville, Spain CDC Course on Andrology - Reconstructive Surgery and Sexual Medicine Contact: VEYSA Event Management Tel.: +34 954 51 76 06 E-mail:[email protected] Website:http://www.cdcandrologia.com 15-18: Guangzhou, China 19th Annual Meeting of the Chinese Urological Association (CUA) Contact:CUA E-mail:[email protected] Website:http://www.cuan.cn/engcua/Index.aspx 15: Barcelona, Spain ESU Medical Oncology course on Genitourinary Cancer on the occasion of the 4th EMUC (MOGUC) Contact:ESU 16-18: Barcelona, Spain 4th Multidisciplinary Meeting on Urological Cancers Embracing Excellence in Prostate, Bladder and Kidney Cancer Contact: EAU, ESMO and ESTRO Tel.: +31 26 389 0680 Fax: +31 26 389 0674 E-mail:emuc-meeting2012@ congressconsultants.com Website:www.emucbarcelona2012.org/ 21-24: Paris, France 106th National Congress of the French Association of Urology (AFU) Contact: Colloquium-AFU 2012 Tel.: +33 1 44 64 15 15 Fax: +33 1 44 64 15 16 E-mail:[email protected] Website:http://www.urofrance.org/congres-etformations.html 23: ESU organised course on Female urinary incontinence at the time of the national congress of the French Association of Urology Contact:ESU 22-25: Kuala Lumpur, Malaysia 21st Malaysian - Scottish Urological Conference Contact: Conference Secretariat Tel.: +603 4025 1251 Fax: +603 4025 1252 E-mail:[email protected] Website:www.muc2012.com 24-25: 4th ESU-ASU Teaching course at the time of the 21st Malaysian-Scottish Urological Conference Contact:ESU August/September 2012 Congress calendar 2012/2013 26-30: Cairo, Egypt National meeting of the Egyptian Association of Urology Contact: Prof. Mohammed Eissa Tel.: +202 225 776717 Fax: +202 257 80588 E-mail:[email protected] Website:http://uro-egypt.com 28: ESU organised course on Endourology and stones at the time of the national meeting of the Egyptian Association of Urology Contact:ESU 28-1 Dec: Berlin, Germany 7th European Congress of Andrology (ECA) organised by European Academy of Andrology (EAA) EAU Section of Andrological Urology (ESAU) German Society of Andrology (DGA) Contact: Conventus Congress management & Marketing GmbH Tel.: +49 3641 311 6346 Fax: +49 3641 311 6241 E-mail:[email protected] Website:www.andrology2012.de 29-30: ESU Teaching courses on Operative andrology Contact:ESU December 3-4: Cambridge, United Kingdom Ureteroscopy Workshop Contact: Nimish Shah and Oliver Wiseman Tel.: +44 1223 217444 E-mail:[email protected] Website:www.camurology.org.uk 6 -7: Mannheim, Germany August 2013 10th Meeting of the EAU Section of Oncological Urology (ESOU) Contact: Congress Consultants B.V. Tel.: +31 26 389 1751 Fax: +31 26 389 17512 E-mail:[email protected] Website:www.uroweb.org/events/ 4-8: San Diego, CA, USA 26-30: Barcelona, Spain Annual AUA Meeting 2013 Contact:AUA Tel.: +1 410 689 3700 Fax: +1 410 689 3800 E-mail:[email protected] Website:http://www.aua2013.org/ 25-26: Heidelberg, Germany 18-21: Istanbul, Turkey Translations in Urologic Oncology Contact: German Cancer Research Center (DKFZ) Tel.: +49 611 20480921 Fax: +49 611 20480910 E-mail:[email protected] Website: www.uro-oncology2013.com 50th ERA-EDTA Congress Contact: ERA-EDTA Congress Office Tel.: +39 052 198 9078 Fax: +39 052 195 9242 E-mail:[email protected] Website:http://www.era-edta2013.org/ Annual Meeting of the International Continence Society Contact: ICS Office Tel.: +44 117 944 4881 Fax: +44 117 944 4882 E-mail:[email protected] Web:http://www.icsoffice.org/Events/ ViewEvent.aspx?EventID=180 18-20: Rome, Italy February 2013 2-5: Davos, Switzerland European Urology Forum 2013 – Challenge the experts Contact:ESU 7-9: Yas Island, UAE 9th Pan Arab Continence Society Meeting in collaboration with the International Continence Society (ICS) and & International Children Continence Society (ICCS) Contact:PACS Tel.: +202 24553443 Fax: +202 24553443 E-mail:[email protected] Website:www.pacsoffice.com/PACS/ ESUT Winter Meeting - Innovations and Classics in Endourology and Imaging Contact: Dr. Heike Diekmann Congress Communication Consulting Tel: +49 221 8014990 Fax: +49 221В 80149929 E-mail:[email protected] Website:www.innovations-endourology.com 7-8: Algiers, Algeria 26-2 Mar: Las Vegas, NV, USA National Congress of the Algerian Association of Liberal Contact: National Congress of the Algerian Association of Liberal Urologists Tel.: +213 21 65 82 19 Fax: +213 21 65 82 19 E-mail:[email protected] Website:www.aaul-dz.com/manifestation.html Society for Urodynamics and Female Urology (SUFU) 2013 Winter Meeting Contact:SUFU Tel.: +1 847 517 7225 Fax: +1 847 517 7229 E-mail:[email protected] Web:http://sufuorg.com/meetings/ 12th Annual Congress of the Belgian Association of Urology (BAU) Contact: Mrs Femke Arnouts – e-HIMS Tel.: +32 3 800 06 54 Website:http://bau2012.be/ 13-15: Dubai, United Arab Emirates 1st Conference Experts in Stone Disease Contact: Erasmus Conferences Tel.: +30 210 7414700 Fax: +30 210 7257532 E-mail:[email protected] Website:www.esd2012.org Downloads:http://www.uroweb.org/uploads/ tx_calendar/29312_flyer_vol3.pdf 14-15: Istanbul, Turkey 3rd Meeting of the EAU Section of Genito-Urinary Surgeons (ESGURS) Contact: Congress Consultants B.V. Tel.: +31 26 389 1751 Fax: +31 26 389 1752 E-mail:[email protected] Website:http://esgurs.uroweb.org/ January 2013 18-19: Helsinki, Finland 28th Bi-Annual Meeting of the Nordic Urogynecological Association (NUGA) Contact:NUGA E-mail:[email protected] Website:https://www.ics-online.com/EI/ cm.esp?id=387&pageid=_2IY0V7USO August/September 2012 www.uroweb.org May 2013 23-26: Melbourne, Australia 7-8: Brussels, Belgium Worldwide, continually updated urological meeting calendar at 10th International Congress of Andrology Contact: ICA 2013 Congress Office Tel.: +61 3 9645 6311 Fax: +61 3 9645 6322 E-mail:[email protected] Website:www.ica2013.com March 2013 15-19: Milan, Italy 28th Annual EAU Congress Contact: Congress Consultants B.V. Tel.: +31 26 389 1751 Fax: +31 26 389 1752 E-mail:[email protected] Website:www.eaumilan2013.org April 2013 3-6: New Orleans, LA, USA Annual meeting of the American Association of Genitourinary Surgeons (AAGUS) Contact:AAGUS Tel.: +1 734 232 4943 Fax: +1 734 936 8037 E-mail:[email protected] Website:www.aagus.org/AAGUS_Meeting.htm 13-16: San Antonio, TX, USA 38th Annual Conference of the American Society of Andrology Contact:ASA Tel.: +1 847 619 4909 Fax: +1 847 517 7229 E-mail:[email protected] Website:http://andrologysociety.org/meetings/ default.aspx 19-23: Milan, Italy Symposium on biomarkers of prostate cancer Contact: Dr Cathie Sturgeon Tel.: +44 131 242 6885 E-mail:[email protected] Website:www.milan2013.org/index.php 28-1 Jun: Dublin, Ireland 38th Annual Meeting of the International Urogynecological Association Contact: IUGA Office Tel.: +1 954 933 1728 Fax: +1 954 933 1648 E-mail:[email protected] Website:http://www.iuga.org/ 30-1 Jun: Amsterdam, The Netherlands 1st World Congress on Pelvic Pain Contact: Congress Consultants B.V. Tel.: +31 26 389 1751 Fax: +31 26 389 1752 Website:www.pelvicpain-meeting.com E-mail:[email protected] 31-4 Jun: Hong Kong, China World Congress of Nephrology ISN, HKSN and APSN Contact:ISN Tel.: +32 280 804 20 Fax: +32 280 844 54 E-mail:[email protected] Website:http://www.wcn2013.org/ June 2013 5-8: Murnau, Germany 26th Annual Meeting of the German-speaking medical Society for Paraplegia (DMGP) 2013 Contact: Conventus Congressmanagement & Marketing GmbH Tel.: +49 3641 311 63 11/15 Fax: +49 3641 311 62 41 E-mail:[email protected] Website:www.dmgp-kongress.de 17-20: Manchester, United Kingdom Annual Meeting of The British Association of Urological Surgeons (BAUS) Contact:BAUS Tel.: +44 20 7869 6950 E-mail:[email protected] Website:www.baus.org.uk 22-25: Niagara Falls, ON, Canada 68th Annual meeting of the Canadian Urological Association Contact:CUA Tel.: +1 514 392 7703 Fax: +1 514 227 5083 E-mail:[email protected] Website:www.cua.org/ July 2013 7-13: Salzburg, Austria ESU – Weill Cornell Masterclass in General urology Contact:ESU September 2013 5-7: Copenhagen, Denmark 2nd Meeting of the EAU Section of Urolithiasis (EULIS) Contact: Congress Consultants B.V. Tel.: +31 26 389 1751 Fax: +31 26 389 1752 E-mail:[email protected] Website:www.uroweb.org/events/ 8-12: Vancouver, Canada 33rd Congress of the SociГ©tГ© Internationale d’Urologie (SIU) Contact: SIU Central Office Tel.: +1 514 875-5665 Fax: +1 514 875-5205 E-mail:[email protected] Website:www.siu-urology.org/ 25-28: Dresden, Germany 65th Congress of der German Society of Urology (DGU) Contact:DGU Tel.: +49 211 516 0960 Fax: +49 211 516 096 60 E-mail:[email protected] Website:www.dgu-kongress.de/index. php?id=571&L=2 25-27: Dresden, Germany 21th Meeting of the EAU Section of Urological Research (ESUR) Contact: Congress Consultants B.V. Tel.: +31 26 389 1751 Fax: +32 26 389 1752 E-mail:[email protected] October 2013 2-5: Lima, Peru Congreso CAU Peru 2013 Contact: Sociedad Peruana de UrologГa Tel.: +51 1 4606809 Email: [email protected] Website: www.cauperu2013.com 4-5: Prague, Czech Republic 13th Central European Meeting (CEM) Contact: Congress Consultants B.V. Tel.: +31 26 389 0680 Fax: +31 26 389 0674 E-mail:[email protected] Website:www.cem2013.uroweb.org For more elaborate information on all EAU meetings please contact Congress Consultants or consult the EAU website: Phone: +31 (0)26 389 1751 Fax: +31 (0)26 389 1752 Website:www.uroweb.org For more elaborate information on all ESU courses please contact the European School of Urology or consult the EAU website: Phone: +31 (0)26 389 0680 Fax: +31 (0)26 389 0684 E-mail:[email protected] Website:www.uroweb.org European Urology Today 31 Canadian Urological Association (CUA) Canadian Tour 2012 Academic Exchange Programme New links and insights from the CUA-EAU Exchange Dr. A. Erdem Canda Ankara AtatГјrk Training and Research Hospital Ankara (TR) erdemcanda@ yahoo.com Dr. Roman Sosnowski Institute of Oncology Dept. of UroOncology Warsaw (PL) roman.sosnowski@ gmail.com Dr. Peter NyirГЎdy Semmelweis University Dept. of Urology Budapest (HU) nyiradyp@ hotmail.com During one of the department’s research meetings, we had the chance to talk about our institutions respective achievements, our countries and the EAU as one of the biggest urological associations. Following academic tradition, a faculty dinner was arranged for us. And despite our tight schedule we have seen historical landmarks such as the Old Fisherman’s Village in Lunenburg. In other words, our academic excursion could not start any better. We are more than thankful to our hosts for providing us with an exceptional tour and a memorable welcome. services at the Victoria General Hospital and the New Halifax Infirmary. Additionally, there are outpatient clinics with the whole service spectrum needed for diagnostic workup, non-surgical treatment and follow-up of patients with urological complaints. Our two-day programme has shown that surgical oncology is an essential part of the services provided by the department. We have seen during the visit radical prostatectomies that use various technologies. One elegantly performed intervention was by Prof. Bell who convincingly showed that open radical prostatectomy remains a treatment option for localised carcinoma of the prostate despite the entry of new technologies. We also observed a highly sophisticated laparoscopic technique used for a nephron-sparing management of a centrally located small renal tumour. The postoperative analgesic management was also interesting, using an epidural-like catheter introduced above the 11th rib of the flank incision. It became evident to us that functional urology is a central focus of the clinical and research activities of the department which offers full spectrum rehabilitation programme. Research projects and clinical studies of the Functional Urology Research Group presented by Prof. Gajewski gave insight into a structure which allows translational research with high efficacy. Our meeting with his group took place at the Royal Nova Scotia Yacht Squadron, which not only has an exceptional ambience but is also distinguished by its history (Photo 1). Photo 3: Prof. Gajewski, The Dalhousie University Campus, Halifax (from left: Dr. Erdem Canda, Dr. Roman Sosnowski, Dr. Jerzy Gajewski and Dr. Peter Nyirady). To learn about the department’s way of closely following the development of the manual surgical skills of residents and fellows, as structured and organised by Dr. Greg Baily was another highlight of our visit. We were invited to actively participate in the annual testing of the surgical skills of the residents and fellows (Photo 4). Each resident had to demonstrate practical skills by conducting five different surgical manoeuvres such as closure of a bowel injury using a fresh bowel segment, reanastomosis of a transected ureter or closure of a vascular injury under persisting outflow etc. Each step had to be completed within eight minutes under supervision of staff members. It was not only a challenge to the residents and fellows but also for us. New impressions in Montreal Leaving Halifax for Montreal meant that we did not only say goodbye to wonderful hosts and excellent institutions but we have also transitioned from an English-speaking region into another culture and environment- the Franco-Canadian life style. A group of young ladies welcomed us at our hotel in Montreal, and who, as CUA representatives, also efficiently organised our visit and were responsible for making our Canadian tour so efficient. When Prof. Luc Valiquette, former SIU Secretary General and Surgical Director of the University of MontrГ©al and on behalf of Prof. Fred Saad (Photo 5), chairman of the Department of Urology, joined us at the enjoyable lunch, we already had had a sightseeing tour in downtown Montreal. Having the city sightseeing tour at the start of our visit was probably well-thought by our hosts considering the busy programme that the Department of Urology of the University of Montreal had prepared for us. Prof. Rolf Ackermann Heinrich-HeineUniversity DГјsseldorf (DE) ackermann-urol@ t-online.de The Canadian Urologic Association (CUA) and the European Association of Urology (EAU) has created the Academic Exchange Programme with the goal to offer promising young urologists the chance to link up with their colleagues in Canada and Europe and with representatives of leading institutions. The programme started last year with the visit of three young urologists and a senior prominent Canadian academic urologist: Ben Chew (Vancouver), Anthony J. Bella (Ottawa), Armando Lorenzo (Toronto), and Jerzy Gajewski (Halifax) who visited academic centres in MalmГ¶ (SE), Sheffield (UK), Barcelona (ES), Milan (IT) and Vienna (AT). This year three European urologists visited six academic institutions in Canada. In a series of reports to appear in this newsletter, the participants will share their observations and experience. Reports were written by A. Erdem Canda, associate professor of the Department of Urology at Ankara Ataturk Training and Research Hospital in Turkey; Peter NyirГЎdy associate professor and deputy head of the Department of Urology at Semmelweis University Budapest, Hungary; Roman Sosnowski associate professor of the Uro-oncology Department at Oncology Centre in Warsaw, Poland; and Prof. Rolf Ackermann, former chief and professor emeritus of the Urology Department at the Heinrich-HeineUniversity in DГјsseldorf. What a start in Halifax! The European group met on June 3 in Halifax to visit the Department of Urology at The Dalhousie University which was founded in 1818 by the Governor General Lord Dalhousie. The main university in Nova Scotia province, it consists of 11 faculties providing academic education to almost 20,000 students. During the campus tour we were briefed on the history of the Dalhousie University and learned about its academic legacy (Photo 3). Prof. Jerzy Gajewski organised our programme. The department, chaired by Prof. David Bell, runs clinical 32 European Urology Today Photo 6: Prof. Luc Valiquette, Department of Urology, HГґpital St Luc, The University of Montreal (from left: Dr. Peter Nyirady, Prof. Rolf Ackermann, Dr. Roman Sosnowski, Dr. Luc Valiquette and Dr. Erdem Canda) Photo 1: Meeting with the faculty members of the Department of Urology, The Dalhousie University at the Royal Nova Scotia Yacht Squadron (from left: Dr. Dawn MacLellan, Dr. Roman Sosnowski, Dr. Peter Anderson, Dr. David Bell, Dr. Jerzy Gajewski, Prof. Rolf Ackermann, Dr. Peter Nyirady, Dr. Erdem Canda, Dr. Greg Baily, Dr. Sakher Tahaineh). Research in paediatric urology Our visit to the paediatric urology division acquainted us with the highly sophisticated research project directed by Dr. MacLellan (Photo 2). This project examines the effects of stretch on the urothelium in vitro at the protein level, applying proteomic tools and looking at the impact by studying metabolomics. Using a small animal model with partial obstruction of the kidney and complete urinary obstruction, the project was expanded to an in vivo situation. Studies in paediatric cases are not only conceivable but already under consideration. We were deeply impressed by Dr. MacLellan’s knowledge and involvement in this basic research. Photo 2: Visiting the Division of Pediatric Urology, The Dalhousie University, Halifax guided by Dr. Dawn MacLellan (from left: Dr. Dawn MacLellan, Dr. Roman Sosnowski, Prof. Rolf Ackermann). A tour of the facilities of the department and a glimpse at the enormous new clinical centre still under construction gave us a good impression of the importance of this institution, which is also equipped Photo 4: Annual testing of residents’ surgical skills, Department with modern technology (Photo 6). Since one of the of Urology, The Dalhousie University, Halifax. A resident tour members is highly interested in robotic surgery, attempts to close a vascular injury under persisting outflow on the experience in robotic surgery presented by Dr. a model in the lab. Zorn was very valuable. “We noted that a lot of emphasis is given to the collaboration between professional scientists and clinicians, allowing efficient teamwork” The department’s prestigious reputation is obviously due to its competent and comprehensive services plus the very efficient teamwork among its members. With regards to the structure of the services, we noted the separation of the outpatient from the clinical department, and its impact on the weekly timetable of staff physicians. Providing outpatient services in between surgery does not seem to be possible in this system. Photo 5: City tour in Montreal with Prof. Luc Valiquette and colleagues from the Department of Urology, The University of Montreal (from left: Dr. Peter Nyirady, Dr. Roman Sosnowski, Dr. Diego Barrieras, Dr. Jean-Paul Perreault, Dr. Luc Valiquette and Prof. Rolf Ackermann). Photo 7: Visiting the Research Department with Prof. Anne-Marie MesMasson, The University of Montreal (from left: Dr. Roman Sosnowski, Dr. Erdem Canda, Dr. Anne-Marie MesMasson, Prof. Rolf Ackermann, Dr. Peter Nyirady and Dr. Jean-Baptise Latouf). Continued next page August/September 2012 Amsterdam to host 1st World Congress on Pelvic Pain 1ST WORLD CONGRESS ON Pelvic Pain 2013 Consensus meeting for pain specialists By Joel Vega For the first time three international leading organisations active in the treatment and management of pelvic pain are collaborating to organise the first multi-disciplinary meeting on pelvic pain issues from May 30 to June 1 next year in Amsterdam, the Netherlands. “This is a unique and historical collaboration between three leading organisations- Pain of UroGenital Origin (PUGO), the International Pelvic Pain Society (IPPS) and ConvergencesPP (ConPP). These groups have joined forces to closely examine the Dr. Bert Messelink prospects and challenges in the management of pelvic pain, and that makes this meeting particularly exciting,“ said Dr. Bert Messelink, urologist and 2013 PUGO chairman. Messelink said the three-day conference will present a comprehensive scientific programme that will cover all aspects of pelvic pain, from anatomy, clinical aspects to treatment options, guidelines and prospects in research. Gathering experts from various disciplines, and with the support of caregivers and patients groups, the meeting not only aims to inform healthcare professionals but also serve as a consensus meeting. “Since the organising groups include various disciplines, this event becomes all the more relevant. We expect attendance by gynaecologists, urologists, surgeons, general practitioners and pain doctors as well as physiotherapists and sexologists,“ added Messelink. Six plenary sessions will be presented with experts tackling a range of topics. Updates, state-of-the-art lectures and symposia will look into issues such as organ dysfunctions and pain, societal impact of pelvic pain, myofascial pain, the role of patient organisations, psychological/sexological aspects of pelvic pain, interdisciplinary and multispecialty investigations and management in specialised Pelvic Pain Centres, and the future of pelvic pain management, to name a few. Organisers are also inviting pain specialists to actively contribute to the meeting sending in abstracts. “With this initiative we aim to contribute to further raising the awareness and increase knowledge about pelvic pain. Moreover, we hope that researchers and specialists will share the insights from their studies and clinical work regarding this debilitating condition,“ added Messelink. For further details and information on registration, hotel arrangements and other conference activities, visit the congress website at www.pelvicpain-meeting.com Dates to remember 1 September 2012 Start abstract submission The п¬Ѓrst World Congress on Pelvic Pain is a truly multidisciplinary congress, of relevance for all caregivers working in the п¬Ѓeld of pelvic pain. Pain of UroGenital Origin (PUGO), the International Pelvic Pain Society (IPPS) and ConvergencesPP (ConPP) have joined forces to organise this unique meeting. Aside from sharing high quality information, the organisers hope, and trust, that this initiative will contribute to raising further awareness and increase knowledge about this debilitating condition. ›› C A LL FO R A B ST RY A20C13TS DEADLINE: 15 JANUAR 30 MAY - 1 JUNE 2013 BEURS VAN BERLAGE AMSTERDAM, THE NETHERLANDS We invite everyone involved in treating patients suп¬Ђering from pelvic pain to join us for this meeting! Please visit the website for information about the scientiп¬Ѓc programme and to submit your abstract. 15 January 2013 Deadline abstract submission 15 February 2013 Outcome abstract selection available 1 March 2013 Preregistration deadline 20 May 2013 Registration closed Make sure to book your hotel room well in advance Rooms in diп¬Ђerent hotel categories and within easy reach of the congress can be reserved online through our website W W W. P E LV I C PA I N - M E E T I N G .C O M Canadian Tour...continued from previous page A visit to the research and oncological multidisciplinary outpatient facilities at the HГґpital Notre Dame also impressed us in many ways. We were introduced to sophisticated projects headed by Prof. Anne-Marie MesMasson, which aim to identify new biomarkers for prostate and kidney cancer by applying tissue micro arrays. Again we noted that a lot of emphasis is given to the collaboration between professional scientists and clinicians, allowing efficient teamwork. The close link between the clinical oncologists with a wellstructured clinical research leads to an effective translation of research findings (Photo 7). 28th Annual EAU Congress EAU Best Paper Awards 2013 For the two Best Papers published in Urological Literature on Clinical and Fundamental Research. These papers have to be prepared, published or accepted for publication between 1 July 2011 and 30 June 2012. EAU Hans Marberger Award 2013 For the Best Paper published on Minimally Invasive Surgery. This paper has to be prepared, published or accepted for publication between 1 July 2011 and 30 June 2012. Being a sub-specialty, paediatric urology services are offered outside the adult urology facilities at the HГґpital Sainte-Justine which is located near the impressive main campus of the university. The department’s exciting and very special childrenoriented new interior is fascinating (Photo 8). A short visit to the operative facilities and observing the doctors at work gave us a good impression. New links and insights Our team also actively participated in clinical case discussions presented by the fellows and residents of the department (Photo 9). At the end of the session, each of us gave a brief presentation about the EAU, its structure, goals, achievements and collaboration with our national urological associations. Photo 8: Visiting the main campus of The University of Montreal with Dr. Barrieras (from left: Dr. Peter Nyirady, Dr. Diego Barrieras and Dr. Roman Sosnowski). Thanks to the structured programme of our visit as organised by the Department of Urology of the University of Montreal, through Dr. Diego Barrieras, we visited the clinical and outpatient facilities, and the units for translational as well as clinical research, giving us useful insights into the department’s delivery of healthcare services. Invited by Dr. Barrieras, we also enjoyed the wonderful show of MontrealВґs world famous Cirque Du Soleil. At the end of our visit, we also met residents and staff members for dinner at a typical restaurant in Montreal’s old town, and that evening we learned that 15 of the 17 participants came from different countries. Indeed it was a вЂ�global evening’! Photo 9: Participating in the residents’ clinical case presentations, Department of Urology, The University of Montreal. August/September 2012 Will you be an EAU Award Winner in Milan? Apply Deadline: 15 November 2012 n For more information, rules and regulations: www.eaumilan2013/the-congress/awards ow an d win! EAU Crystal Matula Award 2013 For a young promising urologist under the age of 40 who has the potential to become one of the future leaders in academic European urology. National Societies can nominate a candidate for this award or eligible candidates can apply by contacting their national urological society directly. EAU Prostate Cancer Research Award 2013 For the Best Paper on Clinical or Experimental Prostate Cancer Research. The paper must have been accepted for publication in a high-ranking international journal between 1 July 2011 and 30 June 2012. As we left our hosts and expressed our heart-felt thanks for the exceptional programme that they had carefully prepared, we were all convinced that we have not only benefitted from new connections but have also gained valuable impressions about the urological and academic life in Canada. European Urology Today 33 Embracing Excellence in Prostate, Bladder and Kidney Cancer 4th European Multidisciplinary Meeting on Urological Cancers 16-18 November 2012, Barcelona, Spain Dear colleagues, The concept of multidisciplinary cooperation in the management of urological cancers is no longer a novelty concept. It is being integrated into clinical practice by hospital departments and it is now openly discussed on various strategic and scientific levels. This trend is now well-established and yet only a few years ago, when we convened for the 1st EMUC in 2007, many of these developments were only starting to crystalise into a consistent approach. We believe that the European Multidisciplinary Meeting on Urological Cancers has led Walter Artibani Steven Joniau the induction process of the multidisciplinary approach in onco-urology. Today, we are facing new challenges. The established multidisciplinary framework is branching out, opening new doors and identifying new areas of cooperation. To match the intensity at which new developments occur, the EMUC will now be organised annually. We hope that you will join us in 2012 for the 4th edition of this event, because EMUC is more than an opportunity for professional development, it is a chance to engage with onco-urological science on an entirely new level. Johann de Bono Hans Joachim Schmoll Alberto Bossi The 4th European Multidisciplinary Meeting on Urological Cancers will bring together professionals from three fields: urology, medical oncology and radiology. Our main objective will remain, as we will continue to stimulate discussion and cooperation across disciplines and formulate optimal treatment strategies for onco-urological patients. At the same time, we will be zooming in on translational and basic science as well as technology, giving extra attention to some of the most forward-looking findings in the field. 08.15 – 08.30 Welcome and introduction Urologist – W. Artibani, Verona (IT) Medical oncologist – K. Fizazi, Villejuif (FR) Radiation oncologist – D. Hollywood, Dublin (IE) 08.30 – 10.00 Session 1: Treatment of oligo-metastatic prostate cancer Chairs: Urologist – A. Alcaraz, Barcelona (ES) Radiation oncologist – D. Rades, Lubeck (DE) Medical oncologist – D. Berthold, Lausanne (CH) 08.30 – 08.45 Case presentation including voting Urologist – A. Alcaraz, Barcelona (ES) 08.45 – 09.00 What is the optimal diagnostic assessment of bone metastases? Radiologist – F. Lecouvet, Brussels (BE) 09.00 – 09.15 09.15 – 09.30 Limitation of hormone therapy as single systemic modality Urologist – N. Mottet, Saint Etienne (FR) Is there a role for local treatment in metastatic disease? Radiation oncologist – V. Khoo, London (GB) 09.30 – 10.00 Voting and discussion 10.00 – 10.30 Coffee break and poster viewing 10.30 – 12.00 Session 2: Multimodality treatment of early CRPC Chairs: Urologist – M. Spahn, Bern (CH) Radiologist – N. De Sousa, Surrey (GB) Medical oncologist – J. Bellmunt, Barcelona (ES) David Dearnaley Bertrand Tombal Gertraud Heinz-Peer 10.30 – 10.45 10.45 – 11.00 11.00 – 11.15 11.15 – 11.30 Case presentation including voting Urologist – M. Spahn, Bern (CH) Optimal staging of early CRPC: Should we move away from bone scan and CT Scan? Radiologist – A. Padhani, Northwood (GB) Role of salvage prostatectomy and LND in patients with non-metastatic CRPC Urologist – S. Joniau, Leuven (BE) 13.30 – 13.45 Case presentation including voting Urologist – N. Clarke, Manchester (GB) 13.45 – 14.00 Chemotherapy Medical oncologist – TBC 14.00 – 14.15 Hormonal therapy Urologist – B. Tombal, Brussels (BE) 14.15 – 14.30 Radionuclide therapy Radiation oncologist – C. Parker, London (GB) 14.30 – 15.00 15.00 – 15.30 Role of cytoreductive nephrectomy Medical oncologist – T. Powles, London (GB) 11.00 – 11.15 Immunotherapy and vaccines Urologist – P. Mulders, Nijmegen (NL) Voting and discussion 11.15 – 11.30 Targeted therapies Medical oncologist – T. Eisen, Cambridge (GB) Coffee break and poster viewing 11.30 – 12.00 Voting and discussion 12.00 – 13.30 12.30 - 13.30 The future of imaging Radiologist – G. Villeirs, Ghent (BE) 15.45 – 16.00 The future of biomarkers Pathologist – M. Rubin, New York (US) 16.00 – 16.15 The future of surgery Urologist – A. Briganti, Milan (IT) 16.15 – 16.30 The future of external beam radiotherapy and brachytherapy Radiation oncologist – M. Van Vulpen, Utrecht (NL) The future of medical therapies Medical oncologist - J. De Bono, Sutton (GB) Saturday, 17 November 2012 Session 5: Treatment of oligo-metastastic RCC Chairs: Urologist – H. Van Poppel, Leuven (BE) Radiologist – G. Villeirs, Ghent (BE) Medical oncologist – T. Powles, London (GB) 08.30 – 08.45 Case discussion and voting Medical oncologist – T. Powles, London (GB) 08.45 – 09.00 The role of metastasectomy in the era of targeted therapies Urologist – P. Mulders, Nijmegen (NL) Medical treatment in the non-metastatic CRPC setting, where do we stand? Medical oncologist – C. Sternberg, Rome (IT) 11.30 – 12.00 Voting and discussion 12.00 – 13.30 Lunch and poster viewing Optimal initial strategy in oligo-metastatic RCC Oncologist – T. Eisen, Cambridge (GB) 12.30 - 13.30 Astellas symposium 09.30 – 10.00 Voting and discussion 09.00 – 09.15 09.15 – 09.30 10.30 – 12.00 Session 6: Metastatic RCC: The debate… Chairs: Urologist – N. Clarke, Manchester (GB) Radiation oncologist – A. Morganti, Rome (IT) Medical oncologist – T. Eisen, Cambridge (GB) 10.45 – 11.00 15.30 – 15.45 Coffee break and poster viewing Case presentation including voting Radiation oncologist – A. Morganti, Rome (IT) Session 4: What does the future hold in prostate cancer? Chairs: Urologist – B. Tombal, Brussels (BE) Radiation oncologist – A. Bossi, Villejuif (FR) Medical oncologist – J. Bellmunt, Barcelona (ES) 08.30 – 10.00 10.00 – 10.30 10.30 – 10.45 15.30 – 17.00 16.30 – 17.00 EMUC Scientific Committee EAU: Walter Artibani, Verona (IT) EAU: Steven Joniau, Leuven (BE) ESMO: Johann de Bono, Sutton (GB) ESMO: Hans Joachim Schmoll, Halle (DE) ESTRO: Alberto Bossi, Villejuif (FR) ESTRO: David Dearnaley, Sutton (GB) EORTC: Bertrand Tombal, Brussels (BE) ESUR: Gertraud Heinz-Peer, Vienna (AT) www.emucbarcelona2012.org 13.30 – 15.00 Session 3: Metastatic CPRC: the debate… Chairs: Urologist – N. Clarke, Manchester (GB) Radiation oncologist – M. Mason, Cardiff (GB) Medical oncologist – S. Osanto, Leiden (NL) See you in Barcelona! The format of this meeting will feature state-of-the art lectures, practice-oriented case discussions and Scientific Programme Friday, 16 November 2012 exciting debates – generating top-class international multidisciplinary knowledge. At the same time, there will be plenty of opportunity for the delegates to talk to world’s leading experts and build interdisciplinary networks. Stereotactic radiotherapy for a radioresistant tumor: Breaking the dogma Radiation oncologist – G. De Meerleer, Ghent (BE) 14.00 – 14.30 Voting and discussion 10.00 – 10.30 Coffee break and poster viewing 10.30 – 12.00 Session 10: Oligometastatic bladder cancer Chairs: Urologist – J. Palou, Barcelona (ES) Radiation oncologist – N. James, Birmingham (GB) Medical oncologist – S. Osanto, Leiden (NL) 10.30 – 10.45 Case presentation including voting Urologist – J. Palou, Barcelona (ES) 10.45 – 11.00 Role of surgery in oligometastatic TCC Urologist – J. Catto, Sheffield (GB) 11.00 – 11.15 Role of radiotherapy in advanced TCC Radiation oncologist – N. James, Birmingham (GB) Lunch and poster viewing 11.15 – 11.30 Astellas symposium Update on medical treatment of advanced TCC Medical oncologist – D. Berthold, Lausanne (CH) 13.30 – 14.30 Session 7: Testis cancer – Penile cancer Chairs: Urologist – N. Clarke, Manchester (GB) Radiation oncologist – N. James, Birmingham (GB) Medical oncologist – K. Fizazi, Villejuif (FR) 13.30 – 14.00 09.30 – 10.00 Testicular cancer: Changing epidemiology during the cisplatin era Medical oncologist – S. Fossa, Oslo (NO) What’s new in penile cancer management? Urologist – S. Horenblas, Amsterdam (NL) 14.30 – 15.00 Coffee break and poster viewing Session 8: Oral presentations of the best abstracts – Award session Chairs: Urologist – L. Turkeri, Istanbul (TR) Radiation oncologist – A. Bossi, Villejuif (FR) Medical oncologist – C. Sternberg, Rome (IT) 11.30 – 12.00 12.00 – 13.30 Session 11: The role of focal treatment for prostate cancer Chairs: Urologist – F. Montorsi, Milan (IT) Radiologist – J. Barentsz, Nijmegen (NL) Radiation oncologist – V. Khoo, London (GB) 12.00 – 12.15 The point of view of the pathologist Pathologist – F. Algaba, Barcelona (ES) 12.15 – 12.30 The point of view of the surgeon Urologist – H. Ahmed, London (GB) 12.30 – 12.45 The point of view of the radiation oncologist Radiation oncologist – N. Van As, London (GB) 15.00 – 17.00 Sunday, 18 November 2012 08.30 – 10.00 Session 9: Locally advanced bladder cancer Chairs: Urologist – M. Brausi, Modena (IT) Radiation oncologist – M. Mason, Cardiff (GB) Medical oncologist – M. De Santis, Vienna (AT) 08.30 – 08.45 Case presentation including voting Urologist – M. Brausi, Modena (IT) 08.45 – 09.00 Role and extent of LND in bladder cancer Urologist – A. Stenzl, TГјbingen (DE) 09.00 – 09.15 Radio-chemotherapy as alternative to surgery, ready to go? Radiation oncologist – N. James, Birmingham (GB) 09.15 – 09.30 Voting and discussion 12.45 – 13.00 The point of view of the interventional radiologist Radiologist – J. FГјtterer, Nijmegen (NL) 13.00 – 13.30 Voting and discussion 13.30 – 14.00 Take home messages Urologist – R. Karnes, Rochester (US) Radiation oncologist – A. Bossi, Villejuif (FR) Medical oncologist – M. De Santis, Vienna (AT) 14.00 – 14.10 Closing remarks Urologist – W. Artibani, Verona (IT) Medical oncologist – K. Fizazi, Villejuif (FR) Radiation oncologist – D. Hollywood, Dublin (IE) Neo-adjuvant vs. adjuvant chemo Medical oncologist – J. Bellmunt, Barcelona (ES) 4th European Multidisciplinary Meeting on Urological Cancers organised by: 34 European Urology Today August/September 2012 Delivering urology services in New Zealand Nurse-manager writes on the challenges of working for a remote community in northern New Zealand Andrea Nixon Vice-Chair NZUNS Nurse/manager Northland Urology Whangarei (NZ) [email protected] Whangarei Hospital is the Northland District Health Board (NDHB) “base” hospital with three further regional hospitals in Kaitaia, Dargaville and the Bay of Islands. We have six operating theatres and one endoscopy suite in Whangarei, and two smaller operating theatres in Kaitaia where only day-stay procedures are performed. All urological procedures are carried out here in Whangarei. We do not have a designated urology ward, but instead we have two surgical wards with a total of 58 beds. EAUN Board Chair Vice-chair Secretary Board member Board member Board member Board member www.eaun.uroweb.org Our clinics are housed in a specially-modified house I am a nurse/manager for Northland Urology in Whangarei, New Zealand, (approximately 200 km north of Auckland). At present I am the only member of the NZ Urological Nurses Society from Northland, and currently hold the position of the vicechairperson. My husband, Tony Nixon is a urologist and since we both wished to live by the sea and work in a smaller community-focussed centre, this brought us 15 years ago to Whangarei. Northland, with a population of almost 160,000 is New Zealand’s least urbanised region and half of the population live in rural areas. About 32% of the population is the indigenous Maori, and the region is considered as one of the country’s most socioeconomically-deprived areas. It is not uncommon for our patients to arrange clinic appointments around the tides – yes the beach at low tide is the only way out from some of the most remote areas. They then face a six-hour journey for a 15-minute appointment. The two urologists who provide the service to this region can be described as “general urologists” since they do everything from trauma, paediatrics, incontinence, stone management to radical cystectomies. NZ citizens get free secondary (hospital) care and subsidised primary health care. Few people in Northland have private medical insurance. You will not find “robot” equipment in our hospital since the budget is tight and our needs are great. European Association of Urology Nurses Although the urologists provide various types of urological surgery, they do at times transfer some of the more complex cases, such as those requiring major vascular reconstruction during surgery, to Auckland. We have an excellent paramedic helicopter service, which is a necessity considering our large geographical area and remote access. A welcoming place As nurse/manage, I run both the public urology outpatients and our private practice. Shortly after moving to Whangarei we set up the company вЂ�Northland Urology’ and contracted to the local district health board to provide all urology outpatient services. Our clinics are housed in a specially-modified house, with a beautiful garden where families often gather while waiting for the appointments of their relatives. The rooms were opened and blessed by our local Kaumatua (Maori elder). This not only recognises the spiritual well-being of our Maori patients but all of our patients. We believe clinics need to be welcoming places since the people who come are often anxious and concerned, particularly when the news they receive about their health is not good. It is a very beautiful and peaceful place to work and not a day goes by that a patient fails to compliment us about this. There are three nurses in our team, though I am the only one who works full time. We run six public outpatient clinics between the two urologists, and three are also attended by our registrar. The clinics attend to various patients and include minor room-based procedures such as prostate biopsies, flexible cystoscopies, stent removals, urodynamics, BCG instillations and catheterisations. We also undertake urology research that usually involves phase III and open label trials. Recently, I have been joined by a second study coordinator who is also a pharmacist and whose expertise is invaluable. Is your National Society organising a meeting and would you like the EAUN to be present? Contact our chair at [email protected] For more information please check www.eaumilan2013.org or contact Congress Consultants at [email protected] 15.00-16.00 Panel discussion Bladder cancer Welcome reception 16.00-16.45 Lecture Who takes care of the caretakers Sunday, 17 March 2013 17.00-18.00 Sponsored sessions Sponsored session Saturday, 16 March 2013 17.00-18.00 08.15-08.30 EAUN Opening 08.30-09.45 EAUN Workshop Catheterisation - Intermittent catheters 08.00-10.00 EAUN Market Place Workshop Shopping for tools Embarrassing issues in urology 08.30-09.15 Lecture AIURO 09.30-10.30 EAUN Workshop Nursing solutions in difficult cases: Case studies 08.30-09.30 EAU-ESU Course - 2 Bladder Session Part 1 - Benign 09.45-10.45 EAU-ESU Course - 2 Bladder Session Part 2 - Oncological 11.00-11.45 State-of-the-art lecture Palliative care in urology 11.45-12.15 Lecture Transition from childhood to adult urology 12.15-12.45 EAUN General Meeting (AGM) 13.15-13.45 State-of-the-art lecture Brachytherapy in urological cancer 13.45-14.30 State-of-the-art lecture Urological disorders and surgical problems State-of-the-art lecture Complimentary medicine in oncology 11.00-12.00 Research Competition 10.45-12.30 EAUN Workshop Bladder instillation for interstitial cystitis/radiation cystitis 11.00-12.00 Panel discussion Overactive bladder syndrome/ nocturia/pelvic floor issues 10.45-12.30 EAUN Workshop Implementation of healthy lifestyles in urology pathways 12.00-13.00 Debate & panel discussion PCa Screening 13.15-13.45 13.45-15.00 Poster viewing Poster Abstract Session 12.00-12.30 State-of-the-art lecture The gender aspect 13.15-14.15 EAU-ESU Course - 1 Prostate Session Part 1 - Benign 12.30-13.00 14.45-15.45 EAU-ESU Course - 1 Prostate Session Part 2 – Oncological 13.45-14.45 Operating Room Nurses Session 14.45-15.00 Award session 13.45-14.45 State-of-the-art lecture Pre-operative interventions/ nutritional aspects 15.00-15.45 State-of-the-art lecture Penile carcinoma Poster viewing 16.00-17.00 Sponsored session 15.00-15.30 Lecture The online diary for patients communication tool EAUN Board members Kate Fitzpatrick, Dublin (IE) Bente Thoft Jensen, Г…rhus (DK) Willem De Blok, Amsterdam (NL) Lawrence Drudge-Coates, London (UK) Veronika Geng, Lobbach (DE) Susanne Hieronymi, Frankfurt (DE) Susanne Vahr, Copenhagen (DK) Monday, 27 February 2012 10.00-10.30 European Association of Urology Nurses August/September 2012 September 2012 Irish Society of Urology Annual Meeting, Belfast, Ireland September 2012 ERUS Congress, London, United Kingdom October 2012 AEEU Annual Meeting, Madrid, Spain Poster Abstract Session 16.00-17.00 EAUN Workshop Writing evidence-based guidelines Followed by panel discussion on Clinical development in practice The EAUN Board have been involved in or attended the following activities throughout the world recently: 15.30-16.45 State-of-the-art lecture Health economics 08.30-10.30 EAUN around the world www.eaumilan2013.org 15.00-15.45 Friday (pre-congress) Hospital visits* E Hara taku toa I te toa taki tahi My success is not as a result of me alone. E ngari taku toa he toa taki tini However, my success is as a result of many. Te tumanako kia tau nga tini manaakitanga o te Atua ki runga I a koutou katoa May the blessings of almighty be bestowed upon one and all. Our phones are always on and our team accessible. Patients, be they public or private, are provided the services as the need arises. Our fellow consultants and general practitioners have direct access to a urologist or nurse, and they say that the urology service provided here in Northland is second to none. 16-18 March 2013, Milan, Italy 13.00-15.00 I would like to acknowledge the assistance of Patrick Whiu as my Maori advisor as I end this article with some Maori sayings: Our newest team member is a nurse specialist in prostate cancer. We evaluated our service and felt this was an area where we could make some improvements. Prostate cancer is an increasing part of our work load with our patients getting younger. Our local cancer society is also very pro-active and felt that they too could use someone with specific training. The position is a job share between our two organisations and is working really well with positive feedback from our patients. in conjunction with the 28th Annual EAU Congress Preliminary Programme We are truly blessed with the community in which we live, and a vocation that has immeasurable rewards. Tony and I undertake a number of medical study days and community information evenings each year. These activities range from an audience of 1,000 men in the local sports stadium to a “chat” over dinner with a dozen members of an isolated rural community in their local hall. We get to see Northland’s most beautiful areas that are off the beaten track and meet the most wonderful people. 14th International Meeting of the European Association of Urology Nurses (EAUN) Kate Fitzpatrick (IE) Bente Thoft Jensen (DK) Willem De Blok (NL) Lawrence DrudgeCoates (UK) Veronika Geng (DE) Susanne Hieronymi (DE) Susanne Vahr (DK) Call for Abstracts, Difficult Cases and Research Plans Deadline: 1 December 2012 * Limited places are available and registration will be on a first-come, first served basis through the online system. European Urology Today 35 Join our search for Nursing Solutions in Difficult Cases If you are among those who encounter atypical cases in daily practice and have found your own solutions, we would like to invite you to take a few photos and write a standard protocol. You can download a form with a list of standard questions. The form should include a description of the problem, the nursing intervention provided, the material you have chosen to help the patient and the final results. Please note: Difficult Cases that have not been (completely) solved may also be submitted! Call for Cases Share your expertise Together with the EAUN you will share and pass on this knowledge to other nurses. The cases will be evaluated by an international expert jury. The 10 most interesting cases are presented by the authors and discussed with the audience in a special session at the 14th International EAUN Meeting in Milan. The EAUN will place the material on their website as a unique opportunity to learn from each other. All submissions that meet the criteria will be published on the EAUN website and in European Urology Today. Some of the Submission Criteria and Rules • TheauthorsandpresenterofthisDifficultCasemustberegisterednurses • Thetopicselectedmustbeofrelevancetourologynursinginterventionsin Difficult Cases • Thecaseisillustratedwithphotosoftheproblemandthesolution(ifany), preferably 2-5 photos • ThesolutiondescribedinthisDifficultCaseisyourownsolutionanda nursing intervention • Thecaseispresentedinacompletedsubmissionformaccompaniedbya written patient consent • WheninvitedtopresenttheDifficultCaseinMilanyouwillpresentthecase using the EAUN Difficult Cases slides All criteria can be found at the Milan website: www.eaumilan2013.org/14th-eaun-meeting How to apply • PleasecheckthespecialpageonDifficultCasesubmissionatthecongress website for full details. • For more information you can contact the EAUN Office at [email protected] Submission deadline: 1 December 2012 Nursing Solutions in Difficult Cases Join our search for the best nursing solutions! We are looking forward to your contributions! European Association of Urology Nurses Do you have an idea for a project that will…….. • Improvethequalityofyourdailyworkinurologycare • Turnaneworuniqueaspectofnursingcareintoaresearchproject • Evaluatedevelopmentswhichhavetakenplaceinyoururologicalfield • Turnpracticalclinicalissuesinnursingintoaresearchprojecttohelpresolve them • Ordoyouhaveasmallpracticalprojectwhichyouwouldliketodevelopinto aresearchproject …thenweinviteyoutosubmitaresearchprojectproposalfortheEAUNNursing ResearchCompetition. The 10 best cases will be granted a free registration for the 14th International EAUN Meeting in Milan, 16-18 March 2013 Call for Research Projects Youcanfindthefulldetailsofthesubmissionprocessanddetailsofpreviously submittedresearchprojectplansonourwebsite.Thewinnerin2012, H.Cobussen,forexample,submittedtheproject:“Whichfactorsmakeclean intermittent(self)catheterisationsuccessful”. Duringthe14thInternationalEAUNMeetinginMilan(March2013),allprojects ofthenomineeswillbediscussedinascientificsession,enablingallparticipants tolearnthroughfeedbackanddiscussions.IfEnglishisnotyourfirstlanguage donotletthisdeteryoufromsubmittingaresearchproposal;thejuryarewell awarethatitismuchmoredifficulttowritesuchaproposalinaforeign language,andyourproposalwillbejudgedonitsmerits. Awinnerchosenfromthefinalsixnomineesselectedbyajury,willreceive €2,500to(partly)fundtheresearchproject. Tobeeligibleparticipantsmustcomplywiththefollowing: • Bearegisterednurse • Theprojectmustnothavestartedatthetimeofsubmission • Theproposal,thepresentationandtheprojectmustbeundertakenbythe submittingnurse • Thetopicselectedmustbeofrelevancetourologicalnursing • Theresultsoftheprize-winningresearchprojectwillbepublishedinEuropean UrologyTodayandontheEAUNwebsiteandthewinnerisinvitedtopresent theresultsorpartsoftheresultatthenextInternationalEAUNMeeting. Alldetailsregardingparticipationandcriteriaforsubmissioncanbefoundatthe Milanwebsite:www.eaumilan2013.org/14th-eaun-meeting/ • [email protected] Submission deadline: 1 December 2012 Wehopethatyouwillnotmissthisopportunity.Remember,nursingresearch smallorlargecanstillchangetheurologicalworld! 36 European Urology Today EAUN Nursing Research Competition € 2,500 grant to be awarded at the 14th International EAUN Meeting in Milan, 16-18 March 2013 August/September 2012
© Copyright 2024 Paperzz