Uniting urology: EAU-JUA Exchange Programme 2024

Our first stop was the Department of Urology at Niigata University. Chairman and Executive Director, Prof. Yoshihiko Tomita, showcased the department’s pioneering techniques in robotic surgery. We observed a high-risk robot-assisted prostatectomy enhanced by the innovative use of intraoperative transrectal ultrasound (TRUS) to precisely delineate the prostate from the bladder.

Beyond their methodical approach to robot-assisted radical prostatectomy (RARP), the department also demonstrated a profound commitment to education. Medical students were actively involved in all activities, highlighting the university's dedication to nurturing the next generation of medical professionals. Moreover, the department boasts an impressive innovation and research centre conducting 120 global trials, with about 40 focused on urological topics, underscoring the university’s leadership in medical research and treatment advancements.

The journey continued at the Tokyo Medical and Dental University, Japan’s top dental university and 4^th Medical University. Prof. Yasuhisa Fujii and Dr. Hajime Tanaka introduced the visitors to a unique tetramodal bladder-sparing protocol that integrates transurethral resection of bladder tumour (TURBT) with a combination of radiotherapy and chemotherapy, followed by open partial cystectomy. Their positive results were presented during a conference where we presented our home centres and our areas of interest. Furthermore, the recent fusion with the Tokyo Institute of Technology led to the creation of the Institute of Science Tokyo, where the development of a new robotic system named Saroa was discussed. This represents the future of collaborative medical and technological advancements.

During their morning briefing at the Jikei University School of Medicine, Prof. Takahiro Kimura, along with coordinator Dr. Takafumi Yanagisawa, illustrated how their institution manages complex clinical cases with a collaborative approach. They also observed a laparoscopic radical nephroureterectomy with the interesting retroperitoneal approach. The department’s specialization in brachytherapy provided insights into the precise treatment of prostate cancer using internal radiation.

Additionally, the extensive availability and utilisation of MRI across all three centers was particularly striking, illustrating an interesting approach to diagnostics driven by their MRI capacity.

The visit culminated at the 111^th Annual Meeting of the JUA in Yokohama which was attended by over 6,000 participants from around the globe. Themed "Beyond Boundary," the meeting served as a vibrant hub of knowledge exchange, with sessions largely conducted in English to promote international inclusivity.

We had the honour of presenting our research at the Scholarship Forum. We discussed the efficacy of self-expanding stents in treating ureteral strictures, and shared insights on Calcium Electroporation as a novel treatment for bladder tumours. The meeting also provided an excellent opportunity for networking, allowing us to meet fellows from the American Urological Association (AUA) who were participating in a similar exchange programme.

An additional highlight of the meeting was the "URO FUN RUN," a three-kilometre run that brought together participants in a lighter, more social setting. Together with our Japanese colleagues, we joined this event, where many runners wore humorous and creative costumes. This activity was not only a chance to foster camaraderie among the attendees but also an opportunity to enjoy a casual, engaging activity that contrasted with the formal proceedings of the meeting.

During our exchange programme with the Japan Urological Association, we were treated to memorable cultural experiences that enriched our scientific journey. One standout event was a traditional dinner in Niigata hosted by Prof. Yoshihiko Tomita which featured an evening with geishas. This immersive experience showcased intricate dances and classical music, highlighting the elegant artistry that geishas represent.

In addition to this cultural display, we explored the local cuisine by visiting various Izakayas —Japanese gastropubs where they enjoyed dishes such as yakitori and sashimi. These casual eateries, pivotal to Japanese social life, offered us a slice of everyday joy and relaxation. The culinary adventure was complemented by tasting different varieties of sake, each reflecting the unique flavours of their regions of origin.

This blend of traditional entertainment and gastronomic exploration provided us with a deeper understanding of Japan's rich heritage, beautifully juxtaposing their medical and scientific engagements. Such experiences underscored the profound connection between Japan's historical traditions and its contemporary practices, offering us a comprehensive view of the country's cultural and professional landscape.

Reflecting our time in Japan, we found the exchange programme to be an illuminating blend of cutting-edge urological practices and deep cultural insights. The programme not only provided a front-row seat to the latest advancements in urology but also offered a unique perspective on how cultural elements influence medical practices in Japan. The exceptional hospitality and willingness of our Japanese hosts to share knowledge were particularly striking, as was the meticulous care observed in surgical procedures.

As strong proponents of international collaboration, we believe that the future of global healthcare relies heavily on the exchange of knowledge, mutual respect, and a continuous drive for innovation. Our experiences underscore the importance of unity within the medical community, showing how breaking down geographical and cultural barriers can significantly enhance patient care across the globe. This journey highlighted the vital role of collaborative programmes in fostering a more interconnected and harmonious global medical landscape.

We would like to express our utmost gratitude once again to Prof. Yoshihiko Tomita and the Niigata Medical and Dental University; Prof. Yasuhisa Fujii, Dr. Hajime Tanaka, and the Tokyo Medical and Dental University; Prof. Takahiro Kimura, Dr. Takafumi Yanagisawa, and the Jikei University School of Medicine for providing us with eye-opening insights and best practices, as well as, for welcoming us to their institutions.