From February 1 to 4, 2014, Davos will once more be the venue for the European Urology Forum, one of the EAU’s oldest and most established scientific and educational initiatives. This meeting seeks to encourage professionals to challenge the current thinking about the latest concepts, treatments and clinical evidence. A highlight of the event, eagerly awaited by oncologists, is designed precisely for that purpose.
The “Challenge the Experts” programme specifically seeks to open discussion on all areas of urological practice, encouraging out-of-the-box thinking to identify possible developments. Dr. Bogdan Geavlete is one of the challengers, and he shares his experience on preparing for the challenge, along with the subjects that he hopes will open discussion.
Preparing for the challenge – The experience
“Personally speaking, actually preparing to face the very best experts in various endourological fields of interest proved to be both exciting and difficult. While enjoying the honor of a substantial scientific involvement in such a prestigious international event, the responsibility of being up to the task weighted rather heavily. The dominant idea in my mind while putting together the lectures was not to disappoint such an impressive gathering of well-known urological personalities. Moreover, my ultimate goal was to pass along a correct as well as attractive message to the audience that could perhaps become of some use for their daily medical practice.”
Endoscopic treatment- The challenge
Dr. Geavlete will “Challenge the Experts” in three different topics, all related to endoscopic treatment. His first challenge deals with endoscopic vaporization in lower urinary tract pathology. Titled Endoscopic vaporization in lower urinary tract pathology – From monopolar to plasma, Dr. Geavlete further explains:
“The subject of retrograde vaporization is and has always been a quite intriguing area of discussion for modern endourology. While the monopolar current failed to provide this method with enough tissue ablation capabilities, plasma vaporization offered bipolar electrosurgery a quite attractive perspective. Consequently, this approach was described over the past 6 years as a valuable tool in BPH endoscopic treatment, characterized by satisfactory surgical efficacy, reduced bleeding risks, fewer intra- and immediate postoperative complications and shorter convalescence. Plasma-button enucleation was confirmed as a good solution in large prostate’ patients while the NBI assisted plasma vaporization displayed safety superiority over classical TURBT in large NMIBT formations, together with a better oncologic evolution.
A second area in which he will seek to convince the experts, is new technologies for BPH endoscopic treatment. He contributes to the discussion by presenting an overview of minimally invasive therapeutic approaches. In his words:
“During the last decade, various minimally invasive therapeutic approaches fiercely competed for a place in BPH treatment armamentarium. The main principles of prostatic tissue ablation, respectively resection, vaporization and enucleation, materialized into an important number of procedures, of which only a few were really sustained by reliable clinical studies: monopolar/bipolar resection, GreenLight laser and plasma vaporization, Holmium and Thulium laser and plasma-button enucleation. While the urodynamic and symptom score outcomes appear to remain somewhat similar, conventional TURP and open adenomectomy look increasingly surpassed by newer methods in terms of reduced perioperative morbidity and faster postoperative recovery. The discussion remains open and future research is likely to shed further light as to the ideal BPH therapeutic modality.”
Dr. Geavlete seeks to close his challenge with a discussion on Narrow Band Imaging (NBI), weighing in on the benefits of it on urothelial cancer. His presentation, with the provocative title NBI vision in urothelial cancer – What difference does it really make? deals with the following:
“Narrow band imaging opened the door for a better endoscopic vision in urothelial cancer diagnostic while not seriously expanding equipment requirements, training necessities and overall costs. During the past few years, NBI cystoscopy gained an increasing acknowledgement as a useful additional bladder cancer diagnostic modality, capable of bringing significant improvements in the NMIBT detection rates. An overview of the available literature, combined with personal experience supported by prospective, published data, were intended to underline one main idea: NBI technology represents a remarkably effective tool in bladder tumors’ imaging, apparently able to challenge the gold-standard status of conventional white light cystoscopy. So far, the substantially higher number of tumors/cases found in NBI mode seems to lead the way towards better postoperative instillation therapy and fewer short-term recurrences.”