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. Böhle,
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)
m.porena@unipg.it
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
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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 �Jack’ Thomas Grayhack, 1923-2012
Surgeon, scientist and loving father
The European Association of
Urology conveys its condolences
to the family of Dr. John �Jack�
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
Königsberg. 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:
matthew.hebdon@atriumhealth.com
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
esou2013@congressconsultants.com 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
ESOU2013@congressconsultants.com
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, Göteborg (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
Société 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
m.smink@uroweb.org.
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
Vladimír Boroviˇcka, Czech Republic
Pradeep Bose, United Kingdom
Stefanie Böttcher, 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 Cˇapoun, 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
Jörg 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 Kavˇciˇc, 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 Syvänen, Finland
Monika SzakГЎcsovГЎ, Czech Republic
Volkmar Tauber, Austria
Hasan Hüseyin Tavukçu, Turkey
Antonella Tocco, Italy
Mahmoud Toma, Germany
Armin Töpfer, 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 Ylönen, 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, mohammadaliagamy@yahoo.com
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.
oliver.hakenberg@med.uni-rostock.de
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 h.lurvink@uroweb.org.
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 �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
esgurs@congressconsultants.com 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 �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 �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
�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
guidelines@uroweb.org
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
esui2012@congressconsultants.com 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
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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 m.smink@uroweb.org, 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 m.smink@uroweb.org,
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
website�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
Société Internationale d’Urologie
September 30 -October 4, 2012
Fukuoka International Congress Center
a_cestari@yahoo.it
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 �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
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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: m.smink@uroweb.org
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
mcberlin2012@congressconsultants.com 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, Mönchengladbach (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
• Peyronie�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 esu@uroweb.org 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. Guzmán 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
cem2012@congressconsultants.com 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. Szendröi, 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. Szendröi, 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 �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: a.terberg@uroweb.org.
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 �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 EUT@uroweb.org 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
esur@congressconsultants.com 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, Malmö (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, Malmö (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 �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
seem2012@congressconsultants.com 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, Malmö (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, Malmö (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 m.smink@uroweb.org
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. Schröder
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.
Schröder 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
m.smink@uroweb.org, 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.
Schröder 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)
liatsikos@yahoo.com
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:nancyhatem@infomedweb.com
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:marlen.schiller@conventus.de
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:info@dafneservizi.it
Annual Meeting of the Society of Urological Surgery
in Turkey
Contact:UCD
Tel.:
+90 312 236 28 79
E-mail:info@urolojikcerrahikongresi.org
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:esso32@ecco-org.eu
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:efs2012@aimgroup.eu
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:info@erus2012.com
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:info@dgu.de
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:ruben_hovhannisyan@yahoo.com
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:congress@esmo.org
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:central.office@siu-urology.org
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:info@congresslab.it
11-14: Athens, Greece
21st Pan-Hellenic Urological Congress
Contact: Hellenic Urological Association (HUA)
Tel.:
+30 2107223126
Fax:
+30 2107245959
E-mail:hua@huanet.gr
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:cem2012@congressconsultants.com
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:info@icsoffice.org
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:53cursourologia@fundacio-puigvert.es
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:amine_derouiche@yahoo.fr
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:esui2012@congressconsultants.com
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:mRemzi@gmx.at
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: liesbeth.voets@e-hims.com
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:educational@siu.it
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:s.z.young@dundee.ac.uk
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:esur@congressconsultants.com
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:seem2012@congressconsultants.com
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:petrik@nemcb.cz
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:apurologia@mail.telepac.pt
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:s.z.young@dundee.ac.uk
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:esu@uroweb.org
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:veysaevent@veysaevent.com
Website:http://www.cdcandrologia.com
15-18: Guangzhou, China
19th Annual Meeting of the Chinese Urological
Association (CUA)
Contact:CUA
E-mail:editor@cuan.cn
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:afu@a-supprimer.clq-group.com
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:21stmuc@gmail.com
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:info@uro-egypt.com
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:jana.radoi@conventus.de
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:stephanie.taylor@addenbrookes.nhs.uk
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:esou2013@congressconsultants.com
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:aua@AUAnet.org
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:webmaster@dkfz.de
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:congress@era-edta.org
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:info@icsoffice.org
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:info@pacsoffice.com
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:info@heikediekmann.de
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:karim.hachi@aaul-dz.com
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:info@sufuorg.com
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:info@esd2012.org
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:esgurs@congressconsultants.com
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:yngvild.hannestad@isf.uib.no
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:ica2013@wsm.com.au
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:info@eaumilan2013.org
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:sheskett@umich.edu
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:info@andrologysociety.org
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:cs@csturgeon.net
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:office@iuga.org
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:s.debruin@congressconsultants.com
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:wnieuwenweg@theisn.org
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:justus.appelt@conventus.de
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:events@baus.org.uk
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:info@cuameeting.org
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:eulis2013@congressconsultants.com
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:congress@a-supprimer.siucongress.org
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:info@dgu.de
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:esur@congressconsultants.com
October 2013
2-5: Lima, Peru
Congreso CAU Peru 2013
Contact: Sociedad Peruana de UrologГ­a
Tel.: +51 1 4606809
Email: spu_urologia@yahoo.es
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:cem2013@congressconsultants.com
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:esu@uroweb.org
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 Malmö (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 suffering from pelvic pain
to join us for this meeting! Please visit the website for information about
the scientific 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 different 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 �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, Tübingen (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. Fütterer, 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)
k4anix@xtra.co.nz
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
�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 k.fitzpatrick@eaun.org
For more information please check www.eaumilan2013.org or
contact Congress Consultants at info@congressconsultants.com
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 eaun@uroweb.org
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/
• FormoreinformationyoucancontacttheEAUNOfficeateaun@uroweb.org
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

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