Urology Beyond Europe

24 February 2012

Eleven Urology Beyond Europe (UBE) joint sessions marked the first day of the 27th Annual EAU Congress, with the Maghreb Union countries joining the annual congress for the first time.

The sessions enabled the EAU and overseas national or regional societies to jointly address crucial urological issues through presentations, debates and lectures that cover key issues and emerging trends. Prof. Didier Jacqmin (FR), EAU International Relations chairman characterised the sessions as “an important part of the congress, which stresses the worldwide scope of the EAU and international cooperation.” 

Prostate cancer and BPH

Jacqmin also co-chaired the Joint Session of the EAU and the Arab Association of Urology (AAU), together with Profs. Hassan Abol-Enein (EG) and Saad Kayal (SY). The session was split into two themed blocks: Prostate cancer and urinary stones”, and “Reconstructive surgery and how do I do it?” The latter provided practical advice to the participants, who took part in discussions. Many questions came from the inquisitive audience.

The session featured speakers from both associations, starting with this year’s winner of the Willy Gregoir Medal, Prof. Michael Marberger (AT), who offered insights from his experiences in European practice.

Marberger spoke about the continued necessity for Trans-Urethral Resection of the Prostate (TURP) in treating Benign Prostatic Hypertrophy (BPH). He stated that although TURP had been written off 10 and even 20 years ago, the low morbidity, continual improvement and the effective and durable solution that it provides are some of the positive aspects compared to laser treatment. HoLEP laser surgeryalso has a steep learning curve, taking up to 50 cases for urologists to master it.

In his concluding remarks Marberger said TURP remained a reference standard in the EAU Guidelines, and that its use is increasing compared to other surgical approaches for BPH in Austrian hospitals, the procedure having been used in 76% of cases in 2010. Prof. Bertrand Tombal (BE) spoke in favour of a conservative approach to prostate cancer. His presentation stressed the Hippocratic oath of a surgeon’s responsibility to not only do good, but also to do no harm, giving examples of refusing treatment when the patient’s quality of life is severely affected, or if treatment would be ineffectual. Co-chair and AAU president Prof. Kayal refl ected on what the EAU could learn from the AAU. “We actually learn more from the EAU! But each association deals with specific urological conditions problems that we can learn from,” he said. Tombal specifically mentioned stone disease as an example of knowledge exchange. “The high occurrence of stone formation in the Arab countries means that the EAU-AAU Joint Session is the place to be for the latest developments in this field.”

Future prospects
Former EAU Secretary General Frans Debruyne (NL) started the EAU- Confederaçion Americana de Urologica (CAU) session by giving the audience a glimpse of the future of urology. In an enthusiastic speech, Debruyne pointed to molecular diagnosis, (molecular) imaging and technical novelties in urology as key areas for future development. Techniques like 3D vision for laparoscopic surgeons, augmented reality and long-distance surgery are also among the exciting prospects that he expects to further develop.

Bladder cancer
At the joint session with the Urological Society of India (USI) bladder cancer was examined by Professors Manfred Wirth (DE) and Marko Babjuk (CZ). “Treatment with Bacillus Calmette Guerin (BCG) risks progression and metastases but may preserve the bladder,” said Wirth in his closing remarks regarding T1G3 bladder cancer. He added: “Cystectomy with neobladder may offer the best opportunity for cure but is associated with morbidity and it may lead to potential overtreatment in many cases of T1G3.”

Photo: The Co-chairs of the Joint EAU-AAU Session

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