Technology, multidisciplinary collaboration drive the future of urology

25 February 2012

Advances in technology and tight coordination of efforts across various disciplines are visibly changing the landscape of urological science and education – this line of thought underpinned all of the presentations at yesterday’s EAU Press Event.

Speaking at the press event, EAU Executive Board Members Profs. P-A. Abrahamsson (SE), M. Wirth (DE), W. Artibani (IT) and C. Chapple (GB) – together with Prof. J. Barentzs (NL), one of the world’s top imagining experts,  described a futuristic picture of urological practice, where medical practitioners will make use of anatomical navigation systems, fast and sensitive MRI system for the diagnosis and grading of prostate cancer, surgical cockpits, double robotic consoles for efficient surgical training, as well as powerful, yet affordable agents which extend the life of patients with advanced PCa.

“To some this future may appear far-fetched,” said Prof. Per-Anders Abrahamsson in his commentary to the EUT. “But it is approaching fast, we are already dipping out toe in the water – for example, today’s ESUT Live Surgery session is a confident step in that direction.”

The press event covered a number of areas in urology, which see some of the most rapid developments today and also touched upon a whole range of controversial issues related to these advances.

Barentsz said imaging technique has definite advantages over TRUS-guided biopsy. “We are not there yet, and we are still missing Gleason 6 tumours,” he said. “However MRI imaging enables us to find most significant tumours and avoid complications associated with biopsy.”

“On the other hand, the question is – do we really want to find insignificant tumours?” said Barentsz during the Q&A. “When we say ‘insignificant cancer’, the patient only hears the last word.”

During the discussion, both Professors Abrahamsson and Manfred Wirth questioned whether this technique could really be applied by all radiologists and using ultrasound-guided biopsies, which is still the best tested approach.

Speaking at the press event, EAU Executive Board Members – Profs. P-A. Abrahamsson (SE), M. Wirth (DE), W. Artibani (IT) and C. Chapple (GB) – together with Prof. J. Barentzs (NL), one of the world’s top imagining experts painted a futuristic picture of urological practice, where medical practitioners will make use of anatomical navigation systems, fast and sensitive MRI system for the diagnosis and grading of prostate cancer, surgical cockpits, double robotic consoles for efficient surgical training, as well as powerful, yet affordable agents which extend the life of patients with advanced PCa.

“To some this future may appear far-fetched,” said Prof. Per-Anders Abrahamsson in his commentary to the EUT. “But it is approaching fast, we are already dipping out toe in the water – for example, today’s ESUT Live Surgery session is a confident step in that direction.”

The press event covered a number of areas in urology, which see some of the most rapid developments today and also touched upon a whole range of controversial issues related to these advances.

In his presentation on MRI, Prof. Barentsz expressed a conviction of that this imaging technique has definite advantages over TRUS-guided biopsy. He quoted four hot off-the-press studies that confirm his conviction.

“We are not there yet, and we are still missing Gleason 6 tumours,” he said.“However MRI imaging enables us to find most significant tumours and avoid complications associated with biopsy.”

“On the other hand, the question is – do we really want to find insignificant tumours?” said Barentsz in his round of Q&A.

“When we say ‘insignificant cancer’, the patient only hears the last word.”

Barents also talked about the challenges of a consistent approach to the procedure, qualified and accurate interpretation of data by specialists, quoting the recent consensus on these issues reached by radiologists on an international level.

The press-event also covered the subject of minimally-invasive surgery, with Prof. W. Artibani discussing some of the hottest developments and the effect it has on professional training of urologists. He also mentioned the recurrent challenge in the field of robotic surgery – the lack of robust data on the clinical outcomes.

Prof. C. Chapple followed, with his overview of the most recent developments in the management of overactive bladder, concluding with the current options: “Neuromodulation is being studied and is very trendy at the moment, Beta-3 agonists are being licensed as we speak, botulinum toxin is here to stay, whereas other modalities certainly require more evidence.”

Prof. Wirth concluded the press event, with his discussion of the current situation in medical treatment options for advanced prostate cancer patients. He mentioned that the last few years have seen the launch of many new agents and today the main challenges include the high cost of treatment, as well as the lack of data from randomised trials.

“At the EAU Research Foundation we are actively working to stimulate progress in this field, but we do need more support to attempt a more ambitious scope of activities.”

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