European Urology Today

Official newsletter of the European Association of Urology

Quality registrations A passion for urology

Vol. 22 No.6/Vol. 23 No.1 - Dec. 2010/March 2011

Kidney donors

Prof. Hans-Gran Tiselius discusses the importance of quality database registries

Prof. Hans-Gran Tiselius

Fatherhood and a passion for urology top the agenda of Iranian expert Jalil Hosseini

21

Dr. Archil Chkhotua examines the issue of healthrelated QoL in both kidney donors and recipients
Dr. Archil Chkhotua

26th Annual EAU Congress

Vienna meeting affirms European urologys decisive role
Prof. Per-Anders Abrahamsson Secretary General EAU Malm (SE) per-anders. abrahamsson@ skane.se Judging by the way how European urology has responded to medical and healthcare issues, we can find comfort that our specialty stands on solid ground, thanks to the innovative spirit of our colleagues and the consolidation efforts we have relentlessly pursued. In Barcelona in 2010 this spirit of beating tough odds has been demonstrated by all, and reflected the advantage of collaborative ties and timely support in the face of a devastating natural calamity. This year our upcoming congress in Vienna not only aims to further deepen our goals to achieve progress in urology but also to continue and pursue excellence in order to deliver effective healthcare. We received a total of 3,779 abstracts for Vienna, out of which 1,161 were accepted for both poster and video presentations, or an overall acceptance rate of 31.4%. But beyond the value of statistics and figures, it is the quality of these abstracts that provide ample proof that both veteran and young urologists in this region are rising up to the challenges of science. And like other medical and scientific endeavours urology thrives on active professional exchanges which will be adequately served in our 26th Congress as we welcome the growing number of joint sessions organised and participated in by colleagues from across the globe. In Vienna, the Pan African Urological Surgeons Association (PAUSA) is formally joining us for the first time bringing Africa closer to the EAU! solutions we encounter in our daily practice. And providing the direction as collated and examined by some of our best experts are the most recent updates from the EAU Guidelines. Added to these are the various EAU Section Office meetings, sponsored symposia, live surgeries, courses and forums, to name a few. In this EUT edition, our editor-in-chief, Prof. Manfred Wirth, also remarked on the continuing accomplishments of our platinum journal, European Urology whose readership and reach has grown way beyond our expectations.

Our association is approaching the latter phase of its 30th year and beyond that we enter the fourth decade, a prospect that provides the twin challenges of seizing new opportunities whilst maintaining the gains our specialty has earned over the years.

The Scientific Programme not only provides focus and For yet another meeting that will highlight the best emphasis to the most current urological issues we not only of European urology but also its links to the face, but also aim, through the interactive sessions, to rest of the world, we hope to see you all in Vienna! gauge in real time the concerns, obstacles, and

The EAU Young Urologists Office

Supporting starting urologists beyond their years of residency
Prof. Christopher Chapple Adjunct Secretary General Member Education The mission statement for this Office is to create an optimal environment for young urologists in which they can expand and improve both their educational and practical skills. An EAU Young Urologists / Residents Corner will be developed in EUT. The first Corner can be found in this edition on page 10-12. A number of educational activities particularly pertinent to young urologists are presently occurring within the EAU. The YUO will have an important role in advising on how we can develop and tailor these activities to best serve the interests of our members. research training (in collaboration with the EAU Research Foundation) mentorship http://www.uroweb.org/education/scholarship/ Within the EAU Annual Congress The annual Residents Day organised by the Young Urologist Office in collaboration with the European Society of Residents in urology (E.S.R.U.) - an important and integral part of the EAU Scientific Committee programme. http://www.eauvienna2011.org Please contact us on yuo@uroweb.org This is an exciting time for the Association, as the future lies in the hands of our successors. This is our opportunity to ensure that we optimise the development of European urology by providing the most effective educational and training opportunities for the future. We would appreciate any feedback and suggestions on how to best develop and direct the activities of the YUO from YOU, whatever your career aspirations may be.

c.r.chapple@ sheffield.ac.uk A brainstorming meeting was held on 14 September 2010 at which there was unequivocal support for the foundation of the Young Urologists Office to build on the foundations of the highly successful EAU Residents Office. A committee was established to represent the major residents associations and young urologists, and it met on 3 November 2010. The participants included Dina Bedretdinova, Stefan Hruby, Jean Guillotreau, Emre Huri, Davide Arcaniolo, Michael Sedelaar, Stefan Larre, Tarik Esen (Chair YUO), Chris Chapple (Adjunct Secretary General), Jacqueline Roelofswaard (Executive Manager operational affairs). Other members of the committee could not attend, but many commented by e-mail, such as Nicola Von Ostau, Mary Garthwaite, Seluk Silay and Francesco Sanguedolce.

T. Esen (Chair YUO)

Within the European School of Urology (ESU) courses at the annual meeting e-learning programmes online laparoscopic training hands-on training at EUREP (European Urology Residents Education Programme) hands-on training at EAU Congress and EAU meetings (Winter Forum, Salzburg masterclass) hands-on training at a training centre in Cacares, Spain in the near future. The Young Urologists Academic programme (inaugural meeting in Milan, September 2010) It was agreed that the YUO should represent members http://www.uroweb.org/education/ in their first years as a urologist. The EAU is keen to continue working closely with the European Society of Within the Communications Office Residents in Urology (ESRU), with which it already EUT had a close and dynamic relationship when it was European Urology known as the Residents Office, but a Young Urologists European Urology supplements Office will interact with all the other residents EAU/EBU CME Publication series associations in Europe as well. It will act as the body eut@uroweb.org representing all EAU members who are either residents or young urologists. Within the EAU ACME programme CME programme Firstly, what is the definition of a young urologist? It Working with EBU to introduce the established EAU was agreed that he or she would be defined as an curriculum in urology EAU member younger than 40, or within 5 years of http://www.eu-acme.org/ finishing residency. Within the Guidelines Office The most comprehensive practice-based guidelines in the Urological World http://www.uroweb.org/guidelines/ Within the European Urology Scholarship Programme (EUSP) A comprehensive Scholarship programme: short and medium term clinical visits December 2010/March 2011

Apply now for the EAU-RF Basic Research Grant

For more details see page 19

26th Annual EAU Congress

Register Now! Online registration deadline: 1 March www.eauvienna2011.org

European Urology Today

History Office meets in Leuven

New projects call for collaboration
By Evgenia Starkova During its annual fall meeting History Office of the EAU discussed a number of issues related to Europes current historical research in urology and identified areas of prospective studies. The meeting took place on 12-14 October 2010 in Leuven, Belgium, and was organized by Prof. Guy Bogaert from Leuven and Dr. Johan Mattelaer from Kortrijk, who brought together many urologists and other specialists involved in the work of the EAU History Office. The working meeting of the office was accompanied by a symposium on the history of urology, which included a series of presentations dedicated to urology in various European countries, as well as research on the work of outstanding persons who - in various times and countries contributed to the development of this specialty. The role of some of these scientists and surgeons was discussed in the lecture Lithotomists at the Dawn of the United States by Prof. Rainer Engel, from Linthicum, USA, who included in his presentation the biographies of Dr. John Clark, Dr. Sylvester Gardiner, Dr. Robert Peter and others. The presentation gave insights into the working practices and customs of the time, and revealed some interesting precedents, such as a one of the earliest lawsuits for malpractice regarding a urological procedure. Continuing the subject, Dr. Dirk Mattelaer then presented his research on Lithotomists and their Ex Libris, uncovering the beautiful illustrations which crowed the library collections of many famous lithotomy practitioners of the 17th-18th centuries. Among other presentations are those given by Prof. Guy Bogaert (The History of Paediatric Urology in Europe), Prof. Frans Debruyne (The Greats Who Made the EAU), Dr. Amrith Rao (The History of the illustrated art of Uroscopy), Dr. Fritz Moll (The History of Vasectomy: a small urologic procedure but with remarkable aspects) as well as Dr. Johan Mattelaer (De Urinis tractatus duo by Henry Joseph Rega) and Erik Felderhof (The History of Syphilis). Some of these studies will be published as full-text articles in the 18th volume of De Historia Urologiae Europaeae. Two presentations received special attention and will be picked up by the EAU History Office as long-term projects. The first research, dedicated to Urology under National Socialism has to date been carried out by the research group of the German Urological Society, the DGU. Presented by Prof. Dirk Schultheiss, Chairman of the EAU History Office, the results of this research pointed to some interesting patterns, both in the way urology was practised during this difficult period and the fate of many German urologists with Jewish roots. The research is still in progress, but the preliminary results already point to the need to widen the scope of this undertaking and expand the investigation beyond the borders of Germany. According to the results of the research, 237 urologists (27%) practising in Germany before the onset of National Socialism were of Jewish origin and only 5 of them survived the regime while staying in the country. The rest either emigrated or were deported; several cases of suicide were also documented. To date the study has accumulated a large amount of biographical data and now moves to the next stage where collaboration from countries other than Germany is needed.
Historical Symposium in progress

Blandy, John Wickham, Richard Turner-Warwick and Sir David Innes Williams. We believe that it is vital to create similar initiatives in all European countries, commented Prof. Schultheiss. Certainly, we will need a standardized approach to this programme, in order to create a European library of such memoirs and to make sure that the quality of interviews remains high across the board of this initiative. The initiative will help to map the landscape of urological developments of the past, shedding light on the human factor behind these advances. The EAU History Office will be working to streamline, promote and integrate this programme into the activities of various national research groups interested in the history of urology, he added. We really hope that many enthusiastic urologists from all over Europe will join the Living Witness initiative. If you would like to take part in either of the running EAU History Office initiatives (Urology under National Socialism and The Living Witness Programme) please contact Prof. Dirk Schultheiss at dirk.schultheiss@urologie-giessen.de.

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. Dr. med. J. Rassweiler, Heilbronn (DE) PD Dr. med. O. Reich, Munich (DE) Dr. Th. Roumegure, Brussels (BE) Dr. M.S. Silay, Istanbul (TR) Mr. D. Summerton, Leicester (GB) Special Guest Editor Prof. F. Montorsi, Milan (IT) Advisory Board Prof. C. Abbou, Paris (FR) Prof. P. Abrams, Bristol (GB) Prof. W. Artibani, Verona (IT) Prof. T. Bjerklund-Johansen, Porsgrunn (NO) Prof. T. Esen, Istanbul (TR) Prof. F. Hamdy, Oxford (GB) Prof. D. Jacqmin, Strasbourg (FR) Prof. H. Madersbacher, Innsbruck (AT) Prof. M. Marberger, Vienna (AT) Prof. L. Martnez-Pieiro, Madrid (ES) Prof. V. Mirone, Naples (IT) Prof. F. Montorsi, Milan (IT) Prof. P.F.A. Mulders, Nijmegen (NL) Prof. J.M. Nijman, Groningen (NL) Mr. K.F. Parsons, Liverpool (GB) Prof. H. Van Poppel, Leuven (BE) Dr. H. Van Der Poel, Amsterdam (NL) Prof. J. Rassweiler, Heilbronn (DE) Prof. I. Romics, Budapest (HU) Prof. J. De la Rosette, Amsterdam (NL) Prof. J. Schalken, Nijmegen (NL) Prof. C. Schulman, Brussels (BE) Dr. D. Schultheiss, Gieen (DE) Prof. I. Sinescu, Bucharest (RO) Prof. C. Stief, Munich (DE) Prof. A. Tubaro, Rome (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 F +31 (0)26 389 0674 EUT@uroweb.org 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.

We are now in search for urologists and historians from various European countries, as well as the USA and the Middle East, who would be interested to take part in this study, and look into the fate of urologists who emigrated from Germany, said Prof. D. Schultheiss. We would also like to broaden the contexts of this search and examine the life and the working conditions of Jewish urologists in the 1930s-1940s, outside of Germany. The second project, which received an enthusiastic response from the working group of the History Office, was presented by Prof. Peter Thompson, UK. During his speech Prof. Thompson discussed the results of a project which was carried out by a group of British urologists Recording history- the living witness programme. This study is an initiative which aims to gather and publish extensive in-depth interviews with urologists who influenced the development of urology as a medical specialty four or five decades ago. In his update on the project, Prof. Thompson presented various details about the scientific approach used to document personal memoirs, interviewing techniques and the results of several interviews conducted to date with Profs. John

Prof. D. Schultheiss and Prof. I. Romic in discussion

Congratulations with your prize!!

1st prize: Dr. Melinda Siedler, Germany (Dell laptop Inspiron 11Z) 2nd prize: Dr. Abdullah Alessimi, France (Sony E-book reader) 3rd prize: Dr. Emilie Le Cornet, France (EAU Art Books collection)

Thank you for participating in our survey on underand postgraduate urological education in Europe
The EAU Strategy Planning Office

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European Urology Today

December 2010/March 2011

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Embracing new trends in science communication

Vienna website offers a new channel for knowledge-sharing
Prof. Manfred Wirth Editor-in-Chief European Urology Today Dresden (DE) Manfred.Wirth@ uniklinikumdresden.de Today, communication technology gives us numerous tools for disseminating and multiplying scientific knowledge. Speed of communication, innovation, relevance and interaction have become widelyaccepted if not to say expected features of information technology. Also in science. Urology has always been on the edge of innovation amongst the whole range of medical specialities in the development and application of new technologies e.g. endourology, ESWL, but also in creating a community of open dialogue in science and research. The EAU has contributed greatly to these developments, by giving voice to the international urological community through its numerous meetings and an extensive publication portfolio as well as by staying on top of the latest trends in communications. It is no surprise that the official journal of the EAU, European Urology, was one of the first in the world of urological science to embrace internet and offer digital publication and submission. At the occasion of last years congress, the official website of the EAU was launched, and this year we are happy to introduce you to the new official website of the 26th Annual EAU Congress: www.eauvienna2011.org. The website employs all the modern features of internet-publishing -with an emphasis on userfriendly navigation, and interaction and multimedia. We have made every effort to make this website contents-rich, with regular updates and highlights related to the scientific programme of the congress, but also opinion articles, overviews, highlights, news and interviews. Webcasts, again, will be offered on the website, with many more sessions being transmitted live this year. You will find more information about the interactive features of the new

website on the Vienna pages of this newsletter surely a treat for those urologists following the latest trends in technology. This newsletter, of course, is also an excellent opportunity to witness many of the developments in the field of scientific communication. We receive contributions from all over the world, and more than ever do they touch upon innovation and technology. In this issue, you will find articles on the newly formed Young Urologists Office of the EAU, several reports on ESU courses organised at the occasion of national meetings in various countries, as well as reviews and updates from the EAU Section Offices. I sincerely hope that you will enjoy reading this issue!

26th Annual EAU Congress . . . . . . . . . . . . . . . . 1 The EAU Young Urologists Office . . . . . . . . . . . 1 History Office meets in Leuven . . . . . . . . . . . .2 Embracing new trends in science communication. . . . . . . . . . . . . . . . . . . . . . . .3 Life of a urologist in Romania . . . . . . . . . . . . .3 EBU section: Comprehensive residents training as a central goal . . . . . . . . . . . . . . . .4 EBU Certified Training Centres . . . . . . . . . . . .4 Database quality registration . . . . . . . . . . . . .6 Urological Training in Europe A Survey . . . .7 Interview Jalil Hosseini . . . . . . . . . . . . . . . . . .8 1st Greek-Armenian Forum . . . . . . . . . . . . . . .8 Clinical challenge . . . . . . . . . . . . . . . . . . . . . .9 ESRU section: Welcome aboard! Vienna rings the bells for Urology. . . . . . . . . 10 From Resident to Young Urologist . . . . . . . . 10 ESRU booth and call for missing NCOs . . . . . 11 EAU 6th South Eastern European Meeting 2010 . 11 The 2010 European Urology Residents Education Programme . . . . . . . . . . . . . . . . . 11 Laparoscopic training in the Halle-School . 11 Memories of an addiction . . . . . . . . . . . . . . . 12 Unique opportunities in Budapest . . . . . . . . 12 Key articles from international medical journals . . . . . . . . . . . . . . . . . . . 14-15

Life of a urologist in Romania

Facing the challenges of the time through urology and determination
Prof. Dr. Viorel Bucuras Department of Urology Timisoara (RO) Romanian Association of Urology aims to make the EBU examination the official mandatory examination for the end of residency in the future. There are also a number of urologists who have already taken the EBU exams, and we hope that this number will grow significantly in the following years. There are 83 residents in urology at this moment, following their training in the following centers: Bucharest (six departments), Cluj-Napoca (two departments), Timisoara, Iasi, Targu Mures, Sibiu, Oradea, Craiova, Constanta, Brasov, and Arad.

vbucuras@ yahoo.com

Last year I had the pleasure and the honour to receive a letter from Prof. Manfred Wirth, the Editor-in-Chief Romanian urology today There are 290 registered urologists actually working of European Urology Today, inviting me to write in Romania, so there is one urologist per 76,000 about the activities of Romanian urologists. inhabitants, a figure that can be considered reasonable. There are still significant differences Many world-class urologists contributed to the some of the 41 counties of Romania have no development of this specialty in Romania. One of them deserves a special mention, Prof. Petru Dragan, urologists at all (especially in the eastern part), while in other regions the population coverage is very good. who was one of the outstanding personalities of Romanian urology, a great surgeon and a pioneer of endourology in our country. I had the pleasure of In Romania, university clinics starting my own urological training in Timisoara generally have the best equipment, under his supervision. The strong urological tradition in Timisoara has been upheld by the efforts of many specialists and urology enthusiasts - Prof. Florin Miclea, Assoc. Prof. Petru Boiborean, Drs. Mircea Botoca, Radu Minciu, Istvan Herman, Gheorghe Pupca, and the younger generation of urology talents - Drs. Alin Cumpanas, Adrian Muresan, Razvan Bardan, and Livius Daminescu. Our long-established tradition in endourology, has made our training centre for TUR/URS/PCNL/ laparoscopy very successful, helping several generations of young urologists from Romania to begin their experience in minimally invasive techniques. Training in urology After six years of medical school, our residents follow a training in urology which requires five years of residency, including three years of activity in a department of urology. The final exam gives the authorization to practise urology in Romania. In order to contribute to the European integration, the

Prof. Bucuras operating at the ESUT-organised live surgery session of the EAU Congress in Barcelona, 2010.

Adventures in Laparoscopy and Robotics continued . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 ESFFU section: 1st Joint ESFFU-ESGURS Meeting in Tbingen, Germany . . . . . . . . . . . 17 Become an associate of the ESFFU . . . . . . . . 17 EUVJ: Call for submissions . . . . . . . . . . . . . . 17 EAU-RFs strategic plans gain momentum . . 18 ESUT section: Training course in Laparoscopy in Timisoara . . . . . . . . . . . . . . . 19 Urology in Tunisia . . . . . . . . . . . . . . . . . . . . . 19 ESTU section: Health-related QoL: a vital issue in kidney transplantation . . . . . . 21 ESU section: European practices for Syrian urologists on PCa and BCa . . . . . . . . Manila hosts 2nd Joint ASU-ESU course . . . European School of Urology comes to Armenia . . . . . . . . . . . . . . . . . . . . . . . . . ESU Masterclass in Berlin . . . . . . . . . . . . . . Exceeding expectations. . . . . . . . . . . . . . . . Excellent format, top faculty . . . . . . . . . . . . ESU Courses on the edge of what is new in urology . . . . . . . . . . . . . . . . . . . . . . 23 24 25 26 26 26 27

laparoscopy and different type of lasers; there is also one centre with a Da Vinci robot (in Cluj-Napoca). Smaller urology departments generally have TUR and in some cases URS/PCNL devices, along the operating theatres for open surgery. Regarding the complexity of our surgical activity, it is the university clinics which perform the most difficult interventions, including currently radical/partial nephrectomy, radical prostatectomy, and laparoscopic surgery. There are four centres for renal transplantation (in Bucharest, Cluj-Napoca, Iasi, and Timisoara), performing renal transplants from living or cadaver donors. The Department of Urology of the Fundeni Hospital has also the most significant experience in the radical cystectomy with orthotopic neobladder. Problems and challenges In our activity we have to face a number of problems, most of them due to the economic difficulties of the actual recession period. These problems include the low level of funding for the hospitals, the reduction of all salaries in the state-run institutions (including the doctors in the public sector), and the high level of bureaucracy more and more papers must be submitted to obtain minimal funding. We are paid per working time, not per solved case, so the complexity of our activity doesnt count; the salary level is uniform, increasing proportionally only with the number of years of experience. Funding for new equipment is very hard to obtain, moreover in some situations it is difficult to cover the maintenance costs for the existing equipment. Finally, a significant problem in the last years is the migration of some of the young urologists to the Western European countries, where they look for better salaries and work conditions. Conclusion At the end of this short article about our activities, I want to stress that we, the Romanian urologists are making all the efforts to stay in line with European urology standards, struggling to have access to the latest scientific and technological achievements, and trying to provide the best possible care to patients. I am confident that the Romanian urological community will be dedicated to these goals in the years to come, too.

including TUR, URS, PCNL, ESWL, laparoscopy and different type of lasers...

The majority of Romanian urologists work in public hospitals, such as University Hospitals, County or Municipal Hospitals. The most recent regulations integrated the outpatient activities with urology clinics, so most of the urologists in the public sector also conduct outpatient consultations. A significant proportion of urologists consult patients in a private practice, in their own practice, or in medical centres, combining more specialties. A small number of urologists work exclusively in private practices, and there are even fewer private hospitals with urology operating theatres. An explanation for this situation is the fact that private practice is generally not reimbursed by the state health insurance, while private health insurance companies are only beginning to be present at this stage. All the members of the Romanian Association of Urology are automatically members of the European Association of Urology, due to the great integration efforts of our Associations President, Prof. Ioanel Sinescu. This situation is very convenient, giving to all our urologists the opportunity to stay in touch with the latest scientific achievements, published in European Urology, and facilitating our access to the European and regional congresses. Continuous Medical Education is regularly checked by the Romanian Physicians College, which recognises the CME points obtained at the EAU meetings. Technological level and everyday activity In Romania, university clinics generally have the best equipment, including TUR, URS, PCNL, ESWL,

MAGE-A3 MIBC Clinical Trial EAU-RF . . . . . 28 EVOLUTION: European LUTS/BPH Registry . 28 EULIS section: Tiselius to present 2011 Honorary EULIS lecture . . . . . . . . . . . . . . . . 32 Book reviews . . . . . . . . . . . . . . . . . . . . . . . 33 www.reviews . . . . . . . . . . . . . . . . . . . . . . . 33 EUSP: Four months in Leipzig . . . . . . . . . . . 34 Aussie moustache revival project attracts wide support . . . . . . . . . . . . . . . . . 36 NBI cystoscopy and bipolar plasma vaporisation . . . . . . . . . . . . . . . . . . . . . . . . 36 8th ESOU casts critical eye on medical, surgical issues . . . . . . . . . . . . . . . . . . . . . . 37 EU-ACME section: The 3rd European CME Forum . . . . . . . . . . 38 Congress calendar 2010/2011 . . . . . . . . .39-41 Successful andrology event in Athens attracts top specialists . . . . . . . . . . . . . . . . . 41 Urological scholarship in Leuven, Belgium . . 41 EAUN section: A message from the Chair of the EAUN - December 2010 . . . . . . High-level congress of the Association of Urological Nurses . . . . . . . . . . . . . . . . . . . . EAUN NZUNS cooperation . . . . . . . . . . . . EAUN Fellowship report . . . . . . . . . . . . . . . Hong Kong nurses gain valuable insights in the UK . . . . . . . . . . . . . . . . . . . . . . . . . . 42 42 42 43 44

Participants at the laparoscopy course in Timisoara, together with two of the instructors (Inv. Prof. Pilar Laguna and Prof. Viorel Bucuras), and with Mrs. Sybill Storz (President of Karl Storz)

December 2010/March 2011

European Urology Today

Comprehensive residents training as a central goal

Residency Training Programme in Urology at Clinica Universidad de Navarra, Spain
Dr. Juan Pascual Pidrola Dept. of Urology Clnica Universidad de Navarra Pamplona (ES) evaluations and gains experience in the laparoscopic procedures. Fourth-year residency training covers general urologic procedures such as endoscopic, open and laparoscopic surgery. Residents are trained to develop clinical and basic research projects. On the other hand, fifth-year residency training includes specific urological subspecialties such as oncologic surgery, renal transplantation and percutaneous procedures. Purpose and advantages of RTPU The Christian identity that the CUN shares with the University is reflected in healthcare such as the manner that healthcare professionals view their patients and the emphasis on human dignity. Each patient is considered unique and the activities of all the institutes workers are anchored in this principle, which in turn promotes commonly accepted values such as mutual respect, freedom of choice, spirit of co-existence without discrimination, justice and sensitivity in the treatment of and in dealings with others. super-specialisation complemented by a closer collaboration with other medical specialties, a development that will prompts us to rethink training programme for residents. On the other hand, urology retains its place in the frontiers of robotic surgery, with endourologic technology getting better every year. Certainly, we anticipate to be in the forefront of such progressive developments. In this way, the EBU RTPU certification

pascual@pulso.com The Clinica Universidad de Navarra (CUN) is a healthcare center of the University of Navarra. The CUNs original clinic was built in 1961, and since 2005 the total area has expanded to around 75,000 m2, with 400 beds and 254 consultation rooms. The CUNs credentials includes accreditation by the Spanish Health and Consumer Affairs Ministry and the Ministry of Education and Science to train medical, pharmaceutical and biological specialists in more than 30 specialties. Moreover, the CUN is one of the few European centers awarded with a Joint Commission International Accreditation since 2004.

is a commitment to improve the teaching and learning of our specialty, and allow residents following the programme at CUN to become highly professional, skilled, all-rounder urologists.

EBU Certified Training Centres

Residency Training Programmes in Urology
Country Austria Belgium Estonia Germany Medical University of Graz Landeskrankenhaus Leoben rankenhaus der Barmherzigen Brder Vienna Wilhelminenspital der Stadt Wien Landesklinikum Wiener Neustadt Algemeen Ziekenhuis Groeninge University Hospitals Leuven North Estonia Medical Centre Sozialstiftung Bamberg University of Bonn Heinrich Heine University Dsseldorf Universittsklinikum Essen Klinikum Garmisch-Partenkirchen Asklepios Klinik Barmbek Hamburg Hanover Medical School University Heidelberg Klinikum der Friedrich-Schiller-Universitt Jena Klinikum Kassel GmbH University of Kiel Klinikum Ludwigshafen Urologische Klinik Klinikum Mannheim Universittsklinik Wrzburg Sismanoglio Hospital Athens University of Crete Semmelweis University Budapest General Hospital of Bolzano City Graz Leoben Vienna Vienna Wiener Neustadt Kortrijk Leuven Tallinn Bamberg Bonn Dsseldorf Essen Hamburg Hanover Heidelberg Jena Kassel Kiel Ludwigshafen Mannheim Wrzburg Athens Heraklion Budapest Bolzano Amsterdam Rotterdam Programme Director Prof. Dr. K. Pummer Prof. Dr. T. Colombo Dr. P. Schramek Prof. Dr. O. Zechner Prof. J. Hofbauer Dr. I. Billiet Prof. H. Van Poppel Dr. L. Kukk Dr. K. Weingrtner Prof. Dr. S. Mller Prof. Dr. P. Albers Prof. H. Rbben Prof. Dr. A.J. Gross Prof. Dr. M.A. Kuczyk Prof. Dr. M. Hohenfellner Prof. Dr. J. Schubert Prof. Dr. B.G. Volkmer Prof. K.P. Jnemann Prof.Dr. M. Mller Prof. P. Alken Prof. Dr. H. Riedmiller Prof. C. Deliveliotis Prof. F. Sofras Prof. I. Romics Prof. Dr. A. Pycha Dr. T. de Reijke Prof. C.H. Bangma

Premier training The Residency Training Programme in Urology (RTPU) at Clinica Universidad de Navarra is committed to provide the finest urology training available. The RTPU began in 1974 under the direction of Prof. Jose M Berian, chairman of the Urology Department for 34 years. Dr. JI Pascual Piedrola succeeded Berian in 2008 and remains the current chairman. Clnica Universidad de Navarra and CIMA near Medical School,
Autumn 2009

The urology faculty consists of five academic and clinical urologists, including recognised leaders in urologic oncology, stone disease, laparoscopy, renal transplantation, urodynamics, incontinence and pelvic reconstruction. A well-rounded experience in general urology complements the training in the previously mentioned specialty areas. The result is a very balanced education in both office-based and surgical urology. Residents who complete their urology residency may choose careers in private practice, academic urology, or pursue specialised fellowship training. In 2009, the Urology Department carried out a total of 4,350 patient consultations and 717 hospital admissions. It also carried out 635 surgical operations, and recorded 3,355 hospital stays, with an average duration or stay of 4.7 days. The department also has the following sections: Andrology, Endoscopic and Laparoscopic Surgery; ESWL Unit, Kidney Transplant, Pelvic Floor Unit, Urodynamics and Functional Female Urology; and Urologic Oncology. Training programme The RTPU consists of five years of training, the first of which is spent in clinical general surgery at the same hospital. First-year rotations include general surgery, intensive care unit, radiology and nephrology. These rotations are under the direction of the urology residency programme tutor, Dr David Rosell. The four years of urology training take place at CUN. Second-year residency is focused to gain experience in common adult urologic diseases, to learn the appropriate selection and interpretation of urologic imaging tests, and practice in basic endoscopic and open surgical procedures. Third-year residency has the primary objectives to learn skills and standard practice in endoscopic, percutaneous and open surgical procedures. The resident assists the faculty in the outpatient

The residents are also committed to accomplish their work in the most professional and humane manner possible. This philosophy encourages each individual to work in a team in order to achieve the highest levels of excellence, serve others and to assume responsibility for their professional decisions and actions. The CUN maintains close ties with the CIMA, Centre of Applied Medical Research, the Faculty of Medicine and the University of Nursing, with which it shares teaching and research activities, and collaborates with the Science and Pharmacy faculties. This academic focus on the practical aspects of investigation aids the more successful treatment of patients, which further encourages the residents to participate in research projects, maintain contact with specialists from around the world and participate in courses and congresses. Thus, residents are motivated to update themselves with the latest advances in disease treatment. Interestingly, seven out of 10 residents have completed their doctorate degree. Clinical and theoretical training Conferences dealing with urological pathology, including morbidity and mortality, urological radiology, and journal club reviews are regularly scheduled, and covers the majority of the topics suggested in theoretical programmes. Residents are also constantly encouraged to write for clinical and basic research publications and participate as presenters in major urological congresses. Facilities to attend meetings and participate in specific courses are also provided. Additionally, final-year residents make use of the opportunity to attend the EAUs EUREP and actively take the option to participate in the written part of the EBU exam. Training portfolio Residents are required to maintain an electronic logbook as record of their training to contribute towards professional growth and concise planning during their residency. This also facilitates greater involvement in knowledge acquisition, basic skills development and enhances the trainees initiatives and ability to accept supervision. Moreover, this training strategy aims to identify how learning urology can be applied to a wide range of subjects and activities. Some of the goals in logbook-taking are: selfobservation/evaluation of ones own practice, identification of skills gaps, strategies for improving competence deficiencies, application of consolidated skills and improvement of evaluation system. Future The inevitable future of European urology will be

Greece Hungary Italy

Garmish-Partenkirchen Prof. Dr. H. Leyh

Netherlands Academic Medical Centre (AMC) Norway Poland Spain Sweden Erasmus Medical Centre Rotterdam Srlandet Sykehus HF Collegium Medicum Bydgoszcz Pomeranian Medical University Szczecin

Kristiansand & Arendal Dr. A. Andersen Bydgoszcz Szczecin Prof. Z. Wolski Prof. A. Sikorski Prof. A. Borwka Prof. H. Villavicencio Mavrich Dr. F.R. de Bethencourt Dr. J.I.P. Pidrola Dr. O. Andrn Prof. H.-P. Schmid Prof. Dr. U.E. Studer Prof. T. Sulser Prof. M.Y. Bedk Prof. H. zen Prof. Dr. S.E. Guntekin Prof. C.N. zsoy Ass. Prof. G. Aslan

Postgraduate Medical Educational Center Warsaw Warsaw Fundacio Puigvert Barcelona La Paz University Hospital Madrid Clinca Universidad de Navarra rebro University Hospital Barcelona Madrid Pamplona-Navarra rebro St. Gallen Bern Zrich Ankara Ankara Antalya Istanbul Izmir

Switzerland Kantonsspital St. Gallen Turkey Universitts Spital Bern University Hospital Zrich Ankara University Medical Faculty Hacettepe University School of Medicine Akdeniz University School of Medicine Istanbul University Faculty of Medicine Dokuz Eyll University Izmir

Post Graduate Sub Specialised Training Centres

Name & City Royal Hallamshire Hospital - Sheffield Saint Bartholomews Hospital - London Sub Specialisation Female & functional urology Stones in the upper urinary tract Programme Director Prof. C.R. Chapple Mr. J.P.Buchholz

The staff and residents of the Urology Department of CUN Pamplona, 2010
European Board of Urology (EBU)

European Urology Today

December 2010/March 2011

- 26th Annual EAU Congress -

EAU Congress: Abstract selection highlights diversity

The scientific programme of the 26th EAU Annual congress is taking its definitive shape with the completion of the abstract selection procedure which took place in mid-December. The EAU Scientific Congress Office, which is responsible for determining the scientific contents of the annual congresses, reviewed 3.779 abstract and video abstracts, which had been submitted this year. We are pleased with the quality of submitted abstracts, and this is reflected in a very reasonable acceptance ratio, said Prof. F. Hamdy, who chairs the EAU Scientific Congress Office. For the upcoming congress in March, 34.1% of all submissions were accepted. These will be divided into 92 poster sessions and 8 video sessions, representing 1,111 abstracts and 50 videos respectively. The selection meeting was productive and the results were again very encouraging, commented Prof. Hamdy. It is a positive confirmation for us to see the stability in the submission and selection processes it fosters a continuous growth in diversity and quality of the scientific contents. We have a very steady distribution of abstracts among the topics both in disease areas and approaches to treatment, underlined Prof. Hamdy. We are also very excited to see more and been among the most active groups, but this year we see that the interest in this abstract format has shifted to other countries, also beyond the EAU. He mentioned that while these shifts can be caused by better access to technology, better training or a general increase in interest these developments are very welcome, as they promise new insights, new creative and technological approached to presenting the surgical video material. This year, the video session will feature many of the actively developing trends in uro-technology, including a number of outstanding abstracts dedicated to LESS procedures in the management of renal and prostate diseases. NOTES procedures will also receive some exposure, promising to be one of the most prominent topics in the coming years. Of course, one of the hottest subjects this year is the robotically-assisted surgery, said Prof. Van Moorselaar. Surgeons across the globe have now gathered excellent expertise in performing such procedures, and they are able to share that experience with the congress audience. And you will be truly amazed at what can be performed with the help of a robot today it is not only the established radical prostatectomy, but also renal surgery, UPJ stenosis, and even paediatric surgery.

more submissions from non-European regions, including many South-American countries, USA, Canada and the Far East. This so-called geographical diversity of material gives our congress the breadth the scope which allows us to question, think outside of the box and to compare. Indeed, it seems like the whole world is coming to join the EAU this year, commented Prof. R.J.A.

Van Moorselaar, who chairs EAUs Video Congress Committee, which is responsible for selecting the video abstracts for the congress. Van Moorselaar explained that while the quality of video abstract submissions is traditionally very high, the real shift this year is in the diversity of participating countries: There are some new trends associated with video submissions Italy and the Netherlands, for example, have always

For the latest programme update, please visit www.eauvienna2011.org

The EAU Congress a virtual experience

New website offers instant access to Europes largest urology meeting
The official website of the 26th Annual EAU Congress has now been redesigned to offer you a completely new online experience of the upcoming meeting. Here you will be able to navigate through the congress whether in search of an interesting lecture to plan into your agenda, information on the exhibition, accommodation or social events. Here are some of the must-visit features of the website check them out at www.eauvienna2011.org The Personal Congress Planner Make the most of your time at this years congress use your Personal Congress Planner. Log into the website, go to the Scientific Programme, select the sessions you want to attend and you will automatically see them in your Personal Congress Planner. If you are a speaker at the congress, the time and place of your presentation will also be scheduled for you. Add your personal appointments to the Planner, export your schedule into Outlook Express, Google Calendar, your smartphone, or simply print it out. Now you are set to go! EAU Exhibition Online A very exciting addition to the congress is a section dedicated to the EAU Exhibition. Here the delegates can find all the info they need about the exhibiting companies, but also check our the designated delegate zone. Interactive exhibition floorplans will help you to locate the company with ease and our searchable database of exhibitors will offer a insight into the scope of this major industrial trade show. EAU Congress App The EAU Congress App has arrived! If you cant imagine your life without a smartphone, very soon you will not be able to imagine the EAU Congress without this app. Scientific programme, abstracts, news all in the palm of your hand! With the new website we are ready to take on the virtual future of science! Are you?

Live Webcasts Just as in previous years, we will publish webcasts of most lectures online. Webcasts from four congress halls will be transmitted live, offering immediate access to the congress information for those not able to attend the meeting. Starting on the first day of the congress, this section of the website will host our daily webcast library and you will also be able to plan your viewing in your Personal Congress Planner.

European Urology Today

Database quality registration

A necessary tool for progress in the treatment of urological diseases
Prof. Hans-Gran Tiselius Karolinska University Hospital Dept. of Urology Stockholm (SE) Hans.Tiselius@ karolinska.se Co-authors: Paul Abrams, Maurizio Brausi, Stefan Buntrock, Thomas Ebert, Hashim Hashim, JeanJacques Wyndaele, Members of the Strategy Planning Office of the EAU. The development and improvement of effective urological treatment programmes - as well as all forms of treatment in the various fields of medicine require analysis of relevant patient data. Whether the recordings are made in paper or electronic form, extraction of the necessary information is both demanding and time-consuming. Moreover, when carried out at a later stage than at the time of information collection, it can be assumed that the recordings are less precise than desirable and in many cases probably incorrect. Experience has shown that in a substantial number of records, the information sought is difficult to find or completely missing. It stands to reason that under these conditions any quality control, treatment evaluation or statistical analysis will be invalid. patients record. Statistical analyses subsequently should be possible without extra repetitive work and without manual transferring of data to registries that are separate from the patients files. To write computer programmes for such a system concerning all urological pathologies is indeed a huge undertaking and of course a giant project for the whole medical field. Nevertheless is it a goal that most certainly needs to be achieved in the future and the question needs immediate and appropriate attention. Figure 2: Follow-up form for patients with prostate cancer
Date of followup PSA PSAquotient Potency Continence Adjuvant treatment Complications Alive, no evidence of cancer Alive, local recurrence Alive, lymph node involved Alive, with metastatic disease Dead Cause of death Prostate cancer; Non cancer cause; Unknown None; DXT; Hormones; Cystoscopy; Urethra dilatation None; UTI; Stricture; DVT; Testicular pain; Hernia; Other (specify) Impotent; Partially potent; Fully potent Complete; Minor stress leakage; Appliance

course of the disease, so that, at each point of time, it would be possible to get information on the current status of the patient. This preliminary proposed document for patients with prostate cancer is shown in Figures 1 and 2. The menus for each indicated field are provided in the forms. There is a great scientific value in central registration of urological conditions. Conclusions on treatment principles in various countries and how they affect the course of the disease are examples of information that otherwise would be difficult or impossible to achieve. Elucidation of etiological factors requires knowledge of epidemiological observations and in a long-term perspective a data registry might show the efficacy of prevention or prophylactic methods. From the perspective of politicians, central registries also will provide an invaluable tool for appropriate health care and economic considerations.

Figure 4

Needless to say such a system for all European countries cannot be In order to be successful, a first step is to find out what produced without solving a lot of Figure 1: Registration form for patients with kind of information is requested and how it should be problems. The example given here is prostate cancer recorded. As an attempt to approach the problem, we for patients with prostate cancer. Other similar registries need to be Figure 5 have looked at a number of databases used constructed for all other urological for follow-up and quality control of patients Date of biopsy / punction malignancies as well as for other with prostate cancer with the intention of Main initial symptom LUTS; No symptom; Screening; Other spec. common urological conditions, such constructing a generally acceptable form of PSA ng/ml [g/L] PSAquotient as, stone disease, LUTS, and urinary registry. Prostate volume (ml) tract infections, just to mention a few Date of examination The content of the following databases was examples. Today a wide array of TNMclassification T N M T0; T1a; T1b; T1c; T2; T3; T4; Tx considered: the Registry on Prostate Cancer national registries as well as local N0; N1; Nx M0; M1; Mx (cerified by the German Prostate Centers), the registries exists. None of them are PAD Gleason grade Gr1 Gr2 Italian Database for Prostate Cancer, the useful unless completed in a Sum 1,2,3,x Cytology WHOgrade G1; G2; G3;Gx; No information Radical Prostatectomy Database (BAUS) and meticulous way. When a central Sample obtained by Biopsy; TURP; Fine needle the Prostate Cancer Registry (Swedish registry of data for patients with Treatment decision date Oncologic Center) Several of these database various urological diseases is added Type of primary treatment Conservative; Curative; Noncurative registries contain numerous variables, and in to the working-load that already Type of conservative treatment this regard the extensive documentation in exists, long-term survival of any such Retropubic; Laparoscopic; Robot assisted the national German and Swedish cancer registry is unlikely. Moreover, double laparoscopic Nerve sparing Yes unilateral, Yes bilateral; No registries can be mentioned. Although all of or triple entry of patient data will pT pT0; pT2; pT3a; pT3b; pT4; No information these variables and even additional data are fail, if not immediately, then certainly Radical surgery? Yes; No; Undetermined highly interesting for various evaluation and in a longer time perspective, and the Gleason grade Gr1 Gr2 research purposes, it seems reasonable as accuracy is doubtful unless it is left in Figure 6 Sum a primary step to develop a registration the hands of devoted people. At the No; Yes form that fulfils minimum, though important end of the road we are therefore probably back to the pN pN0; pN1; pNx; No information requirements. A protocol is suggested that point where we started: manual extraction of data External; Brachytherapy; Combined Neoadjuvant hormones Yes; No accounts for all information that we believe is from record systems of variable quality. Nothing; External radiation; GnRHanalogue; important in order to draw conclusions on Antiandrogen; Cytostatic the course of the disease, relative to the It is therefore, in a long-term perspective, essential to Orchidectomy; GnRHanalogue; Antiandrogen; Estrogen; Other (specify) initial pathology and its treatment. As the store the necessary information in the patients local intention was to share all information records in a structured and standardised way. This electronically, each field in the protocol has to be means that all information that is required for the completed with choices from standardised menus central registry should be able to be transfer (disclosed in the form shown) or with numbers when During the past decades computers have been used electronically from the patients hospital record, for appropriate. A special part was added to document the each specific urological disease. increasingly in clinical administrative work and computerised medical record systems have been developed and widely implemented. It thereby was assumed or at least wishfully thought that this technical achievement would be the end of manual research work based on data collection for the purpose of quality control. In reality, however, very little changed because the way in which medical data were recorded in the computerised systems was identical to that done for decades (or even centuries). The superiority that computer technology offers regarding the problems mentioned has not been utilised at all. This means that for research purposes, as well as for simple quality analyses, it became necessary to develop disease specific registries. Such a registry is of fundamental importance for the necessary conclusions on therapeutic benefits and accordingly constitutes an inevitable tool in modern urology. So far registries must, however, be completed separate from the routine recordings in the patients file and seldom simultaneously with the primary collection of information. This kind of double-work is of course undesirable and not at all corresponding to other improvements in medicine. The modern long-term goal definitely should be a registration system that is structured and standardised in a way that allows all this information to be included in the
Strategy Planning Office

The bottom-line of all this is that each patient-record has to be organised as part of a database into which the information is fed from menus with standardised formulations. The possibility of such an approach has previously been impossible, but modern IT-technology opens the doors to a completely new way of documentation in patient records. Accordingly, it should be possible to find all the disease specific variables, for local registries, within the patients electronic record. Using such a system, relevant data can be transferred more or less automatically to national registries as well as to European or other central registries. A patient record of this kind was developed for Swedish patients with stone disease (1, 2) and experience showed that the system could be used for all purposes, in the treatment and follow-up of patients with stones, with great advantages. Unfortunately it was not possible to integrate this system into the general hospital patient information system, and at present, the data input into this standardised database has to be made in parallel with the old fashioned recordings. Most certainly there are several objections that will be raised against a registration system like this. It can be assumed that all information cannot be covered in a database. This is of course a reasonable objection. That problem is, however, easily solved by adding space for short text sections in addition to standardised expressions. Most people read patient files by quickly searching the text for key-words, ignoring most of the text body. If the word searched for is found it is good, if not the recording probably has been incomplete. Most of the important key-words whether organ or disease specific, will be found as standardised variables in the modern record system easy to find and easy to deal with.
Continued on page 7

Figure 3

European Urology Today

December 2010/March 2011

Urological training in Europe A Survey

Strategy Planning Office points to varying urology training standards and requirements in EU countries
Prof. Thomas Ebert Euromed Clinic Dept. of Urology Frth (DE) for further analysis in this report: 1. Is there a defined undergraduate curriculum detailing what should be taught? 2. Do students sit an examination in urology? 3. Is it possible for a medical student to graduate from your medical school and NOT receive any formal urology training? Results Altogether 2.935 junior members of the EAU in 44 countries were invited to participate in the web-based survey. 421 members answered the questionnaire. 356 from 37 countries stated in which country they had their undergraduate urology teaching. Table Table 2 1 displays those countries with more than 10 responders to the questionnaire. Included in the country-specific analysis were only countries (n=24) with more than two responders to each of the above mentioned questions (Table 2). Is there a defined undergraduate curriculum detailing what should be taught? According to the responses only in one out of 24 countries is a defined undergraduate curriculum available at all medical schools. In contrast, in 96% of the countries there are medical schools without a defined urological undergraduate curriculum (Table 2).

Thomas.Ebert@ euromed.de Co-authors: Paul Abrams, Maurizio Brausi, Stefan Buntrock, Hashim Hashim, Hans-Goran Tiselius, Jean-Jacques Wyndaele, Members of the Strategy Planning Office of the EAU. The Strategy Planning Office (SPO) of the European Association of Urology (EAU) conducted a survey on undergraduate and postgraduate urological training in European countries. The aim of this survey was to gather hard data on how urology is taught in 2010 throughout Europe at medical schools as well as in academic hospitals. The information of this survey should help to develop an EAU strategy for homogenisation of Urological Training in Europe. Method of collecting information The survey was conducted by a web-based questionnaire. All Junior Members of the EAU with valid e-mail addresses in the EAU member registry were invited for participation by an official EAU email (January 8th, 2010). The survey was open for responding to the invitation until June 2nd, 2010. The part of the questionnaire dealing particularly with undergraduate training (urology teaching for students at medical schools) comprised 10 questions. The answers were collected electronically and analysed on an EAU server. Three questions have been picked

Is it possible for a medical student to graduate from your medical school and NOT receive any formal urology training? 25% of all European medical students graduate from medical school without formal urology training (Figure 2). Only students from Belgium, Lithuania, Romania and Slovakia are unable to graduate without any formal urology training. In all other countries this situation is varying from university to university (Table 2).

are delivering urological care having never been educated in urology. When patients see a doctor with a urological problem, they would expect that doctor to have received at least some basic training in urology, and if not, the patients would expect to be sent to a doctor who was properly trained in urology. In order to maintain the high quality of urological care in Europe, the EAU should lead the way in defining the minimal standards for both undergraduate as well as postgraduate urological training (2). References
1. Navarrete RV, Le Duc A, Ackermann R, Boccon-Gibod L, Debruyne F, Ekman P, Jonas U, Abrahamsson P-A, Artibani W, Chapple C, Wirth M (2010) Medical students exposure to Urology in European schools: the European Association of Urology proposals for a convergence programme. Eur Urol 58: 528-531 2. Abrams P, Brausi M, Buntrock S, Ebert T, Hashim H, Tiselius H-G, Wyndaele J-J (2010) The Future of Urology (in press)

Table 1

Conclusion This current survey clearly demonstrates that urological training in European universities varies widely between and within countries. In 2010, with boundaries open within Europe it is becoming paramount that defined educational endpoints are imposed for all European medical students. This is Do students sit an examination in one of the priorities of the Bologna convergence urology? programme. The SPO supports the ideas of the Although most European medical European Academy of Urology and the Executive students have to pass some kind of Office of the EAU that the teaching of urology to medical students in Europe is compulsory and carries test in urology (Figure 1), this is minimum standards (1). not consistently required in each country. Only in 20% of all countries such a test is mandatory At present there are likely to be doctors, in many for all medical students (Table 2). countries, both in the community and hospitals that

Strategy Planning Office

Figure 1: Percentage of students in European medical schools who sit an examination in Urology

Figure 2: Percentage of students in European medical schools who graduate without any formal training in Urology

Continued from page 6

We are not saying that a record system of this kind can be constructed without problems and efforts, but the long-term benefits of a modern structured and standardised system are tremendous. What has been discussed above is a system for urological diseases. A similar approach should also be possible to implement for most other specialities. By combining such files it subsequently would be possible for each hospital or region to get a current update of the patients medical conditions and view treatment results and the course of disease. Although neither national nor European record networks probably can be established, a European central registry would be a good substitute. Figures 3-6 show a simplified example of the basic structure of an advanced recording system. Although the programming is considerable and initially expensive, the advantages are obvious. Figure 3 shows the simplified structure for recording data for a patient December 2010/March 2011

with a urological disease or with obvious or suspected urological symptoms. The work-up will result in a urological or a non-urological diagnosis. In the latter case, the patient is referred to another speciality or the relevant data are transferred to a record system adapted to that disease. When no diagnosis is obtained, the patient is re-entered into the examination plan and the protocol is later updated accordingly, to give a current view of the situation. From the data collected in the record system, relevant pre-identified variables are transferred to appropriate central registries. As shown in Figure 4 the central registry might be local, national or European (international) and a link between the different registries can easily be enabled.

Although a record system like this seems to be something for the remote future, we will only get there if we start thinking of medical documentation in modern terms. For urology such a goal should be reasonably easy to achieve. The first step of such a process is, however, to construct, agree upon and use disease specific quality registries and arrange so that all information for this registry is available in the patients records. Subsequently the record system needs to be adapted accordingly, but that second step is of course more demanding.

Since the treatment of each individual patient needs to also take into account other diseases, conditions and forms of therapy, it is essential that an updated general summary is always and easily accessible. A schedule for that is shown in Figure 5 and a very simplified out-line of the principles o such a summary The principles presented here, definitely represent a is given in Figure 6.

The manual work that accordingly will be necessary in the future is to complete the patients records at the time of patient visit, diagnosis, treatment and References follow-up. The data requested by the national quality 1. Tiselius H-G. Eriksson I, Karsk B, Lindgren L & registries can subsequently be transmitted Alexanderson C. Vra erfarenheter av ett datorbaserat automatically and in an anonymous form. Following a journalsystem. (Our experince with a computer based translation process, and in a similar way, data can patients record system) Med Mac 1994; 3: 13-16 (article automatically be exported to the European Central in Swedish) database registries. 2. Tiselius HG, Karlsson M, Thunblad K. Dynamisk
patientjournal r ovrderlig fr hgkvalitativ vrd. Lkartidningen 2002; 43: 4280-4282 (article in Swedish)

paradigm shift in the recording of patient data. It is a process that will take a long time to implement, but it nevertheless seems important and necessary from the perspectives of the health care providers and politicians, and not least the patients. The first step, however, is to define what we consider important to record as a minimum amount of data for the quality control registry (in urological diseases), then the process can be pushed further with adaptation of the local patient record systems. This process is indeed a real challenge to both the medical profession and the IT-experts, but every effort put into this project will pay off in a rich way.

European Urology Today

INTERVIEW
By Joel Vega Photography by Dick Brouwers

Jalil Hosseini
Collaboration between national associations and organisations like the EAU are significant in the sense that it conveys that we are part of a bigger endeavour that is urology. The discussions in annual meetings also show that we share common problems and experiences. Urologists from my part of the world are keen to exchange skills and experiences with our counterparts overseas. We believe that we can have input at the same time that we learn or receive insights from the work of scientists and researchers. Challenges for urology in Iran are quite a few and these include the number of well-trained urologists compared to the total population, the experience expansion requirements of the current crop of urologists and the need to respond to uro-oncological diseases, andrology- reconstructive urological surgeries, amongst others. Training and the education of young and potential urologists are and will continue to be one of the foremost concerns in the coming years in our country. There is a need to address training and education goals if we are to meet future challenges and excellence. International ties we have with other professional groups and associations in Europe, Asia and the Middle East are one of the strengths of Iranian urology. Quality medical education remains a chief priority and the fact that we have dedicated urologists in service is certainly an advantage. In reconstructive urology the challenge- not only in Iran but also in other countries- is the issue of training. Expertise in this sub-specialty will remain a tough question since there are few centres of expertise. In actual practice, the challenges are learning curves, expertise of a reconstructive surgeon, caseload, etc..

Jalil Hosseini, 55, is professor and director of the Reconstructive Urology Department at the Tajrish Hospital. He also heads the Infertility and Reproductive Health Research Center of the Shaheed Beheshti Medical Science University in Tehran, Iran. The current president of the Iranian Urological Association, Hosseini has authored more than 30 papers in peer-reviewed journals and textbooks. A passion for urology has dictated the career choices of Hosseini who has served as director or chaired several medical associations in Iran. Aside from reconstructive urology, his main interests cover infertility and onco-urology. He also serves as editorial board member in five medical journals. A father to two boys and two girls, the Isfahan-born Hosseini believes that international urology can only gain from collaborative projects and exchanges. Providing training and education to young urologists in areas that are often overlooked will be crucial to urologys advancement, said Hosseini.

Complications or poor outcomes and results in reconstructive urology can be largely avoided when there is depth of experience and if general urologists exercise adequate care during surgery. This issue cannot be overemphasised as we have seen cases of poor outcomes. I have a talent for new procedures needed in reconstructive surgery. I admire those who work for or dedicate themselves to achieving equality amongst various races and communities. Also people who are honest and show it in their deeds or actions. I enjoy swimming, reading holy verses, sports with my children and music.

1st Greek-Armenian Forum

Greek, Armenian University Medical Schools forge stronger ties through knowledge exchange
Prof. Constantinos Dimopoulos Ex. Rector of the Universities of Athens and Peloponnese Chairman of the National Ethics Committee of the Hellenic Ministry of Health Under the auspices of the medical schools of Athens and Yerevan Universities, the first Greek- Armenian Forum was held last September 16 to 19, 2010 in Yerevan, Armenia with the aim to boost the ties amongst the medical communities of both countries and for them to actively exchange ideas and experience. According to the organisers, the primary goal was for both Greek and Armenian doctors to join forces, present their knowledge or skills, and demonstrate their clinical approaches and treatment options for various medical problems, particularly those concerning or affecting urology. Prof. Gevorg Yaghjyan, Vice Dean of Yerevan State Medical School, inaugurated the event and cordially welcomed all the participants to the four-day meeting. In his opening remarks Yaghjyan stressed the importance of strengthening the centuries-old Hellenic and Armenian ties that have grown stronger over the years, especially those concerning medical issues. Representatives of the Athens Medical School included Professors Ch. Deliveliotis, Ch. Chrysofos, Ch. Alamanis, Rebelakos (University of Athens, GR), D. Radopoulos (University of Thessaloniki, GR), and N. Sofikitis (Universtity of Ioannina, GR). They were joined by Prof. Ruben Hoyhannisyan, who represented the Medical School of Yerevan and developed the discussion topics in urology, such as new prostate Participants from Greece, (from left): M. Chrysofos, A. Rebelakos, Ch. Alamanis, Ch. Deliveliotis, D. Radopoulos, N. Sofikitis cancer treatments, laparoscopic nephrectomy, MAGS nephrectomy, robotic surgery, MIOR prostatectomy, male urinary incontinence, partial nephrectomy, metastatic renal cell cancer treatment, laser ballistic lithotripsy, ureteroscopy, and laser TUMT-TUNA-TURP procedures for prostate cancer.
URO-IADV-BIGEUT-EN-201011

Logo of the Yerevan State Medical University

The Forum ended with the concluding lecture of the former Rector of the Universities of Athens and Peloponnese, Prof. Constantine Dimopoulos. C. Dimopoulos did not only welcome the Armenian medical community but also cited the close collaboration and strong collegial bonds between Armenian and Greek urologists. He also expressed his appreciation for the warm Armenian hospitality shown to all participants and noted the excellent organisation of the Forum. Dimopoulos added that as the first joint event prepared by both communities, Yerevan certainly made a lasting impression and posed a challenge to the organisers to repeat the same success in Athens, the planned venue for the next forum.

When bigger is better.

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BIGopsy

BACKLOADING BIOPSY FORCEPS

From left: Prof. C. Dimopoulos, Mr. P. Kasartzian and Prof. Gevorg Yaghjyan - Vice Dean of the Yerevan State Medical School

European Urology Today

December 2010/March 2011

COOK 2010

Clinical challenge
Prof. Oliver Hakenberg Section editor Rostock (DE)

The Clinical challenge section presents interesting or difficult clinical problems which in a subsequent issue of EUT will be discussed by experts from different European countries as to how they would manage the problem. Readers are encouraged to provide interesting and challenging cases for discussion at h.lurvink@uroweb.org

Case study No. 22

A 63-year-old female married patient presented in June 2004 with axillary discomfort and bloody discharge from the left nipple. The mammography showed irregular calcification with axillary lymph nodes enlargement (Figs. 1, 2). A left radical mastectomy with extended lymphadenectomy was performed. The histopathology showed infiltrating ductal carcinoma G2 and 15/20 lymph nodes were involved. The patient received tamoxifen one tablet every day as adjuvant therapy in addition to 23 session of radiotherapy. 3 years later she complained of menorrhagia. In December 2007 she underwent total hysterectomy and salpingo-ovarectomy. The histopathology revealed endometerial adenocarcinoma G1, invading of the myometrium. Cervix and adnexia were free of tumour and the surgical margins were free of tumour as well. No adjuvant treatment was given. One year later and during a routine follow up by ultrasound a 4 cm suspicious cystic mass in the left kidney was found. The CT showed a 47 mm low density mass in the posterior-inferior position in the median portion of the left kidney (Fig. 3).

Oliver.Hakenberg@ med.uni-rostock.de

Case study No. 21

A 45-year-old man was referred by an office urologist doing the follow-up care for this patient. The patient had undergone right tumour nephrectomy for renal cancer in 2002 (pT1pNxM0G1). He is asymptomatic but has some mild comorbidity with obesity, hypertension, hypercholinesteremia and hyperuricemia, all of which are medically treated and controlled. Serum urea and creatinine are normal, the calculated glomerular filtration rate is 112 ml/min (normal limit: > 80 ml/min). Routine follow-up imaging by ultrasound had shown a cystic lesion within the left kidney, the consecutively done CT scan is shown in figure 1. The radiologist did not assign a Bosniak class. The patient is referred for further management. This patient is in good physical condition except for gross obesity (BMI 41).

Fig. 1: CT scan of the patient with central cystic formation in left kidney

Discussion points 1. What should be done? 2. Are further investigations needed and helpful? 3. Which management options are available and appropriate?

Case provided by Oliver Hakenberg, Dept. of Urology, Rostock University, Germany oliver.hakenberg@med.uni-rostock.de

Systematic follow-up required

Comments by Mr. Peter Whelan Leeds (UK)
What should be done? This case illustrates the shifting paradigm of following up patients with renal malignancy. With increasing numbers of patients having nephronsparing surgery, they will already be conditioned to expect very long term follow-up with the possibility of imaging anomalies occurring, and that these will need to be investigated rigorously. In this case, a definitive procedure for confined disease with every expectation of cure was carried out in 2002.The ultrasound was for the rare chance of a sequential lesion occurring in the contralateral kidney. The patients youth at the time of the nephrectomy should have prepared him for an extended period of follow-up but, nevertheless, the finding of a space occupying lesion ( SOL) will have caused a significant psychological blow, and both the patient , himself, and the lesion will need careful handling. The patient is obese and already has co morbidities which will impact on the long term function of the solitary kidney. It is essential that he be induced to lose weight, and keeps it off. Careful review of his medication, as well as stabilising of his weight at an optimal level should be discussed with an internist. This endeavour cannot be emphasised enough. The lesion itself is awkwardly placed, and has not been assigned a Bosniak number by the radiologist. On the limited views shown it would seem to be between a Bosniak 2 and 3, and it needs further definition by at least an interval CT scan. The cyst, itself, is likely to enlarge and to expand outwards; however, possibilities exist that some part of the draining calyceal system could suffer obstruction. What further investigations are needed and helpful? The patient needs a planned, systematic follow-up, preferably by ultrasound, initially 6 monthly for a couple of years and then annually together with monitoring of his renal function, the frequency of which is dependent on his general medical condition. Variations in cyst size will need further CT scanning. Ideally at this stage, percutaneous aspiration of the cyst should occur for reassurance, baseline knowledge of the cytology, and to monitor the reaccumulation rate of the fluid. This patients size and the cysts situation make this difficult and can possibly be deferred until a longer sequence of images is obtained, so that the rate of change and consistency can be shown. Following any aspiration, the nature and image of the cyst will change due to the chances of bleeding at aspiration. What management options are available and appropriate? The patients weight loss must be sustained, and his general condition must be monitored. If enlargement of the cyst occurs and percutaneus aspiration is still problematical, then laparoscopic aspiration will be necessary. If the cytology becomes positive, or the Bosniak score changes to a 4, then nephron-sparing surgery will be necessary. The ability of the patient to safely undergo this surgery needs discussing on an ongoing basis. If the patients lesion is not amenable to local surgery, a positive diagnosis of malignancy must be obtained and nephrectomy and subsequent dialysis will be necessary. The opportunity for transplantation will only come 2 further years down the line. This last measure should be a rare expedient nowadays.

Fig. 1 and 2: Irregular calcification with axillary lymph nodes enlargement

Fig. 3: A low density mass in posterior lower part of the left kidney

Possibility of a partial nephrectomy

Comments by Dr. Michael Staehler Berlin/Munich (DE)
Ad 1.; In this patient, several risk factors hint towards a malignant tumour in the left kidney: obesity, history of a renal tumour and a new lesion. The renal disease might be hereditary. Thus one would like to know the histology of the renal tumour that was removed in 2002. In case of a clear cell carcinoma, von-Hippel-Lindau (VHL) mutation might show a predisposition for renal tumours, but intervention should only be done with tumours larger than 4cm. A reevaluation of the CT-scan would be necessary in order to determine the contrast uptake of the lesion. Bosniak classification should be obtained. Hypertension needs to be controlled to protect the remaining renal function. Ad 2., Urine analysis should be done to detect hematuria. If hematuria is present, transitional cell carcinoma of the kidney should be excluded endoscopically. If the nature of the lesion can not be clarified with the available CT-scans, a contrastenhanced ultrasonography could reveal contrast uptake and further classify the lesion. Usually magnetic resonance imaging could help with the classification of the cystic lesions, but this is not superior in classifying renal cysts compared to contrast enhanced ultrasonography. Ad 3., If the lesions do show contrast uptake, partial nephrectomy should be the treatment of choice at a specialized centre. If the lesion remains unclear, a control MRI or CT could be done 3 months later to gather more information on the growth tendency. Biopsy in cystic lesions may be false negative in up to 60% of the patients. With hereditary VHL-mutation or papillary renal cell carcinoma, the risk of metastases is below 1%, and therefore watchful waiting, with an early control after 3 months might be a choice for this patient. In the rare case of transitional cell carcinoma, laser therapy might be feasible after securing that the lesion is not invasive.

Case study No. 21 continued

The patient underwent open partial nephrectomy of the remaining left kidney with complete excision of the central cystic lesion. Histology confirmed cystic clear-cell carcinoma (Fuhrmann grade 2) pT1aG2R0L0V0. Surgical margins were tumour-free with a narrow margin width. The postoperative course was uncomplicated. Serum creatinine was 170 mol/l at discharge on day 7.

Discussion points 1. Is CT- guided biopsy necessary? 2. If positive for renal cell carcinoma (RCC), what is appropriate? Minimally invasive therapy (Cryotherapy or RFA) or surgical ablative treatment? 3. For surgical ablation, should partial or radical nephrectomy be preffered in view of the fact that the patient has already been treated for two other malignancies? 4. If RCC is present, might the adjuvant treatment with tamoxifene and radiotherapy have contributed to the pathogenesis of an RCC? 5. Is there are relationship between an extended pelvic operation and a possible RCC development?

Case provided by Abdou Khair Chamssuddin, Ibrahim Bargouth, Naji Abdouch and Mouhannad Sleiman, Al-Bairouni University Hospital, Damascus, Syria dr.chamssuddin@gmail.com
Readers are encouraged to provide interesting and challenging cases for discussion at h.lurvink@uroweb.org.

December 2010/March 2011

European Urology Today

Young Urologists/Residents Corner Welcome aboard! Vienna rings the bells for Urology
A celebration of ESRUs 20th anniversary in the worlds music capital
Dr. Selcuk Silay YUO Section Editor Chairman ESRU Istanbul (TR) The EAU Congress is a time for European urologists, senior doctors and residents to meet and exchange ideas, evaluate the results of last years projects and to make plans for the coming year. Hopefully, if time allows, they can also get a chance to relax in Viennas cafes and restaurants for a taste of the delicious apple pies with coffee. session some of the very well-known, legendary role-models in urology will show up and tell us their life stories, including ups and downs in their career. Frankly, Residents Day will be one of the must attend activities of the congress once again. For those of you with more practical concerns, lunch will be available during the session, and we are going to distribute invitations to the popular ESRU dinner and party. After the long Residents Day, the very interesting presentations, attendance in plenary sessions, courses and visits to the ESRU booth (dont miss it!), I wish you all a nice stay in lovely Vienna. About Vienna The venue for the congress is the Austria Centre Vienna (ACV), a modern conference complex located between the Danube City district and the Vienna International Centre (U.N.). The ACV has a large exhibition space with spacious conference halls, an internal computer network and a digital signage system amongst its facilities. The social programme will certainly be memorable in a city where art and culture have a long tradition. Our Austrian NCOs have already started preparations for the ESRU Dinner. I am sure that we will have a lot of fun during the dinner, and take the opportunity to come together once again. Vienna, the last great capital of the 19th century ball, is renowned not only for its Opera Ball, but also for the excellent events in theatre, opera, classical music and fine arts. Ranging from classic, baroque and modern, the citys architecture is unique for having Europes finest examples of art nouveau. Good public transportation also brings visitors to major attractions such as the imperial palaces of Hofburg and Schnbrunn with its 18th century Tiergarten Schnbrunn park, home of the worlds oldest zoo.

It is exactly this relaxed and friendly atmosphere that we plan to create in the ESRU booth during the congress. It will serve as a place where all residents can meet, discuss the various aspects of European urological training and get a chance to learn more It was in 2006 that I first fell in love with the beautiful about the upcoming advantages of the ESRU city of Vienna. The film The Illusionist with Edward activities. We also intend to exchange ideas, Norton was more effective than any promotional participate in competitions to win prizes, and most of movie in providing delightful views of Viennas all to get in touch with people of various cultural and historical places. social backgrounds but with one common interest: urology. This lovely city in the heart of Central Europe is now preparing for the third time for the 26th Annual EAU The ESRU has many surprises in store for you in Congress. With its extensive scientific programme, Vienna. Our NCOs have the best tips for dining and and the citys favourable location within Europe, the clubbing in Vienna, with our scouts checking the top congress is expected to attract one of the highest places for you to visit. We will also have tips for numbers of visitors in its history. In addition to the museums, operas and tourist attractions. Lets all programme, we are also very happy to celebrate the contribute by actively making this booth the most 20th year of ESRU. We believe that ESRU has always lively place during the exhibit, and by making it been an ideal forum for residents to express represent the most lively and energetic residents themselves and to be heard. Furthermore, ESRU has group in Europe! Furthermore, we will again have our been a valuable tool of the EAU and EBU to achieve biggest rendezvous and annual scientific meeting, the standardisation of education around Europe for about Residents Day. It will take place on the second day of 20 years. the congress, which is 19 March. We are expecting all residents to participate in this wonderful meeting in The ESRU family has raised the residents awareness Hall F2, from 10:15 to 17:00. of their position by pushing the envelope many times with the activities it has prepared. Most importantly, a During the Residents Day, you will have the chance to friendly atmosphere has been established between be the first to know about the latest changes from the the residents, which will directly affect their relations EUSP, regarding scholarship opportunities available to and keep the urologists together in the future. For the European residents. You can also get information above reasons, I, as the new chairman of this unique about EBU projects across Europe. You can also win a society, once again applaud the 20th anniversary of Campbell book if you correctly answer all the ESRU. I will try my best to earn this position, and questions on the multiple choice quiz. Most work as much as I can in collaboration with the importantly, the EAU Young Urologists Office, the National Communication Officers (NCOs), EAU, EBU new body for young urologists and residents inside and other independent urological organisations to the EAU, will show up on the podium for the first time help to improve the standardisation of education with some great projects. Another interesting topic across Europe. will be the How to make it in Urology session. In this selcuksilay@ gmail.com

chairman of ESRU. Thanks to Tamas for sharing his experience in a laparoscopy course in which he participated while in Germany. He is highlighting that the laparoscopy courses are ideal forums for the residents and young urologists before starting their laparoscopic live surgery. After reading these articles by Maksudhan Rashidov (Uzbekistan) and Tamas Zober (Hungary) I am sure that you will once again consider applying for a fellowship. Another article comes to us from an Iranian resident, covering his impressions during the South Eastern European Meeting, held in Istanbul. He underlines the importance of the regional meetings once again with his honest criticism. Zafer from Istanbul wrote his impressions in the EUREP course. It seems like this course is a favourite for the residents training in Europe (mine as well!). Dina from Russia summarises the activities of ESRU at the EAU congress and invites missing residents who do not have representation inside the ESRU to join. Francesco, a legendary name of the ESRU and a former secretary has shared his experience in this society with his Mediterranean honesty. We will never forget his contributions to ESRU. I greatly appreciate those who contributed for this issue, and kindly invite all of you to write articles on subjects that you are interested in.

Introduction of this issue In these pages, you will read the great experiences of a resident from Uzbekistan while performing his fellowship in Budapest. It provides a good example for us to demonstrate the benefits of the EUSP grants. One other fellowship report is from the former I wish all of you a great congress in Vienna!

From Resident to Young Urologist

EAU Young Urologists Office announces plans for supporting this important transitional period
Ass. Prof. Emre Huri EAU YU Office Member Ankara (TR) Urology (ESRU) have made clear that there is a need to create an environment for young urologists in which they can learn and improve their educational and practical skills. Definition The YUO will target residents, as well as urologists who have finished their training no more than 5 years ago or who are less than 40 years of age. In practice, many of the EAUs other offices provide activities dedicated to residents, and the YUO will promote further the access by young urologists to EUSP programmes such as scholarships, fellowships and short term visits, to educational activities such as courses and meetings providing relevant content for this particular group (for example, the annual congress of the EAU or the EUREP). A new link within the EAU webpage will be created to summarise activities dedicated to that population. E-learning facilities currently under development within the EAU are also an axis of development for this new office. These include web-based teaching programmes and the development of applications for smartphones. The YUO will not only focus on promoting state-of-the-art complementary education, but it will also create a favourable environment for future European academic leaders to develop research, and for collaboration like the innovation meeting that was organised earlier on this year in Milan. At this point, there is an opportunity for any young urologist to improve the service provided by the YUO by providing feedback on the current activities and addressing their needs and difficulties to achieve the highest quality training through the variety of training programmes in different centres of Europe. The initiative that was run by the ESRU in asking residents to assess their own training centre through questionnaires over the last years is providing useful information which we will be supporting further. We encourage all young urologists to participate in such evaluations, thereby identifying what makes a department better, or how to improve training. Young urologists needs will also be better characterised using a questionnaire that will be sent to them from EAU database. This work, in collaboration with the ESRU will also provide useful information for the establishment of European training guidelines. This new office will increase educational opportunities and academic collaboration among the residents and young urologists in Europe. We invite all of you to contact us for your demands and comments on young urology activities. We hope to see you in Vienna!

dremrehuri@ yahoo.com

Co-authors: Dr. Stephane Larr (Young Urologist) and Prof. Tarik Esen (Chair YUO) In the global urological community, the definition of a urology resident is clear. Many national and international urology residents organisations exist that aim to support and harmonise urology training programmes, to encourage participation at scientific activities and to finally create well-trained residents. However, at the end of the residency, even if a core and basic training is achieved, young urologists are lacking experience and practice compared to senior urologists, as they are moving from a supervised position to a non-supervised one. This is a vulnerable transition period in urology career during which major decisions will be made such as pursuing an academic, a public or a private practice career. The EAU has modified the EAU Residents Office which has now become the EAU Young Urologists Office (YUO) to address these concerns. It offers support not only during the residency, but also in the following years. The experience from the former office and the feedback from the European Society of Residents in 10 European Urology Today

Young Urologists Office

Mission The Young Urologists Office aims to promote the relationship between the EAU and all young urologists/ residents in urology by developing and implementing scientific research and activities dedicated to them all. Activities Promoting training and research possibilities for residents and young urologists throughout Europe. Composition The office is composed of a Chairman, three ESRU representatives, six Chairmen of residents organisations from France, Spain, Germany, UK, Italy and Turkey and in addition three young urologists. Chair YUO Chair Spanish Resident Organisation Chair Italian Resident Organisation ESRU Secretary Chair Turkish Resident Organisation Young Urologist Young Urologist Young Urologist Chair French Resident Organisation Chair UK Resident Organisation ESRU Chair Elect Chair German Resident Organisation ESRU Chair T. Esen A. Vilaseca Cabo D. Arcaniolo D. Bedretdinova E. Huri F. Sanguedolce J.P.M. Sedelaar S. Larr J.L. Guillotreau M. Garthwaite M.S. Silay N.E. Von Ostau S. Hruby Istanbul (TR) Barcelona (ES) Napoli (IT) Moscow (RU) Ankara (TR) Bologna (IT) Nijmegen (NL) Oxford (UK) Toulouse (FR) Leeds (UK) Istanbul (TR) Essen (DE) Salzburg (AT)

December 2010/March 2011

Young Urologists/Residents Corner

ESRU booth and call for missing NCOs
Dr. Dina Bedretdinova ESRU Secretary Research Institute of Urology Dept. of Innovations Moscow (RU) dina.dinova@gmail. com Dear residents, We are going to have our own place to meet in Vienna at the ESRU booth, booth no. Z50. You can come and join this wonderful world of ESRU! During the congress, you can meet your National Communication Officers at this booth and ask them any questions. You can meet your colleagues from other countries face-to-face, and exchange stories! ESRU invites you to come and share your experience in urological education. We will organise some surprises for you, so dont forget to put visit the ESRU booth in your agenda. You can learn more about ESRU projects and participate in them. And even more you can bring us your project or idea and together we can make it happen. It would be great if you could contact us before the congress so well be able to prepare, but if you prefer to talk only in person, you are also welcome. Of course, our ESRU Hospitality Club project is the one to check out first, so come around to fill in the form to travel or to host. Weve already received invitation letters from different countries and we are grateful to these active participants who are ready to host residents! Also, we invite residents from the following countries to come to the ESRU booth, as you are greatly missed! Let your country be represented in ESRU, and have your own voice to change your future in urology. From EU states: Cyprus, Finland, Luxembourg, Malta and Slovakia. From other European countries: Albania, Andorra, Azerbaijan, Bosnia and Herzegovina, Iceland, Liechtenstein, Monaco, Montenegro, San Marino and Serbia.

ESRU Booth

ESRU is extending its collaboration with other urological bodies in Europe, and we believe that our interaction can help to increase the level of residents knowledge and skills. We welcome all new ideas and projects to work on.

EAU 6th South Eastern European Meeting 2010

A visitors experience at the EAU 6th SEEM in Istanbul
Dr. Reza Aghelnezhad Resident in Urology Hasheminejad Kidney Center Dept. of Urology Tehran (IR) reza_aghel@ yahoo.com SEEM 2010 took place in the very nice city of Istanbul, the most South-Eastern point of continental Europe. It was amazing, and I am so grateful to have had the chance to attend this meeting. It helped me to improve my knowledge of current urological issues, and to get to know some experts from neighbouring countries to whom I can refer my patients when there is not enough experience for their case in my own country. I have made some good friends during the meeting, I ate some very delicious cookies in the coffee breaks and I have seen a very nice historical city. It was a highly enjoyable experience. very nice lectures. Two case discussion sessions stand out in my mind: those on high-risk prostate cancer and small-solid renal masses by Profs. Esen and Marberger respectively were my favorite sessions and particularly informative.

It is difficult to write about the advantages and disadvantages of a regional meeting like SEEM 2010. Here, I wish to thank all the people who have a role in Of course, one of the major advantages is the greater the meeting, especially Monique Oosterwijk who chance of authors from the regional countries helped me in a kindly manner. Again I wish to say presenting their abstracts, but at the same time I special thanks to Prof. Marberger who had a very think that this lowers the quality of the accepted active role in all aspects of the meeting. There were abstracts. In the mentioned meeting, nearly 240 some informative lectures and panels with both articles were accepted from a limited number of regional experts and some authorities from other countries and they were all presented (divided in parts of Europe. Here I want to appreciate those from groups and occurring simultaneously) during a total non-regional countries (including Prof. Chapple, Prof. of 300 minutes. This seems like too many to me. Fitzpatrick and Prof. Marberger) and also to Probably a smaller number of more sophisticated congratulate those from regional countries for their articles could work better -even if it results in my own

Richard Wolf 2nd prize winner for best abstract Dr. S. Silay (right) receives the award from Prof. M. Marberger (left), Richard Wolf representative and Prof. T. Esen (second from right)

articles not being accepted. In conclusion, I wish to say that overall the SEEM was a very good programme, and like any other programme it will continue to improve with time. I hope to have the chance to attend the meeting in 2011 as well.

The 2010 European Urology Residents Education Programme

Where tomorrows urologists meet and learn
Dr. Zafer Tandogdu ESRU Database Manager Istanbul (TR) During the busy days of residency, it is usually very difficult to find serious time to study the theoretical part of urology. Even though we all try our best to learn as much as we can, it is simply not always possible. I have attended a lot of educational programs in my time, and they all contributed to my education. However, it must be said that the European Urology Residents Education Programme (EUREP) in Prague was by far the best. The October 2010 EUREP course fulfilled the aim of theoretical training of final year residents. Within the six-day course, a broad spectrum of urology was covered by experts in their fields. In my opinion, the course was a success in several ways. Even though there are many reasons to explain this success, I think that there are three major reasons which should be mentioned in detail. The first is the friendly environment created by the faculty members and EAU staff. The friendly environment provoked learning, attendance to the lessons and created a free environment where people could ask questions to the faculty without any hesitation. Secondly, it should be mentioned that all the travel and accommodation costs were covered by the EAU, which allowed a lot of people to attend the course without any financial concerns. Finally, the European Board of Urology fellowship examination was held at the end of the course, and the attendance fee was reduced for EUREP course participants. Having the examination at the end of the course was an important motivational factor for the residents. All in all, the EUREP course was a success, and one of a kind in the world for getting all residents of Europe together in a friendly environment. Such a course is not just an educational tool, but also a place where the urologists of tomorrow meet each other.

drzafer@gmail.com

Laparoscopic training in the Halle-School

Three educational days of hands-on courses in Eastern Germany
Dr. Tams Zber, PhD ESRU Past Chairman Peterfy Hospital Dept. of Urology Budapest (HU) clinic of the Martin-Luther University of HalleWittenberg. procedures. First we started in pelvic trainers, where fresh organs (kidneys and closed structures) were prepared. Later we moved to real surgery. We Usually, their courses are organised six to eight times a rotated during different procedures, so everybody had year, and limited to ten participants at a time. After the the chance to insert the trocars, prepare the kidney and warm welcome from Prof. Paolo Fornara, on the first the hilum, perform nephropexy or kidney resection day, the program started with live surgery. Several and so on. The two tutors, Dr. Francesco Greco and Dr. laparoscopic procedures were presented concurrently in Felix Kawan were very supportive to everybody and helped a lot in improving our surgical skills. two surgical theaters. Prof. Fornara and Dr. Greco performed laparoscopic radical nephrectomy, nerve-sparing radical prostatectomy and kidney cyst The group was accommodated in a very nice hotel resection. Some of the participants were given the with a spa. After dinner, the participants were invited opportunity to scrub in and assist in these operations. to the Hotels bar, where one of the students, Dr. Domenico Veneziano, from Italy, was playing popular Finishing the surgeries in the late afternoon, we moved songs on the piano. It was a big success, as even to Bad Saarow, where a brand new laparoscopic other guests from the hotel were singing with him. training center has recently opened. (Fig. 1) During the The participating young urologists were mostly from following two days, the participants had the Germany and Austria, but visitors from Egypt, opportunity to learn and practice laparoscopic Hungary, Italy and Russia were also in attendance.

In many urological departments, laparoscopic surgery has already been introduced, or will be shortly. Young colleagues are searching for courses and workshops to get ready for the new challenge. During my three-month long fellowship in Germany, I had the opportunity to participate in one of the well-known laparoscopic courses of the university December 2010/March 2011

Fig. 1: Divided into small groups, everybody had a chance to practice different parts of laparoscopic surgery

Having spoken to other colleagues, I can say that this training has been really helpful for those just starting laparoscopic surgery, like us. We had a very useful and relaxed time with the Halle-school. European Urology Today 11

Young Urologists/Residents Corner Memories of an addiction

An ESRU Secretarys experiences, and his thoughts on the organisation
Dr. Francesco Sanguedolce Former ESRU Secretary and YUO member Barcelona (ES) Bologna (IT) fsangue@ hotmail.com resident disciplines, including urology. I joined the European Society of Residents in Urology (ESRU) in 2004, starting off by collaborating with the former Italian National Communication Officers (NCO) for ESRU. After a competitive election, Paolo Verze from Naples and myself were named the new Italian NCOs in 2005, and a new era started. Among the many activities realised, we launched a very attractive web page; we constantly updated a database of all the Italian residents in urology; several forms of didactic support (CDs, DVDs, textbooks, etc) were published for residents, dealing with the different monothematic topics we debated during our meetings; and a running course on laparoscopic surgery passed through the majority of the urologist residency centres. At the same time, the relationships with the other NCOs increased, in the shape of association activities as well as social ones. Member, but of course this was possible thanks to the efforts of the group of friends I had worked with in the previous years. My experience as secretary has been particularly exciting: during the two years in this position, I had the privilege to work with a group of excellent professionals who grew to be very close friends of mine. The list is very long but among them I would like to mention the former chairmen Stina Erikson and Andreas Petrolekas. We faced several new projects and challenges. For instance, we organised the ESRU booth at the exhibition area during the EAU annual meeting, which served as a meeting point for all the European (but also non European ones) residents. Another project was the first (and the last) ESRU autumn meeting, set up in Slovenia in 2009 during the Central European Meeting, which was attended by almost 100 European residents. We renovated the ESRU statute, extending the area of influence to the community of young urologists, and the relationships between ESRU, EAU and EBU were taken in a new direction. Among the personal recognition I would like to mention the invitation from the Polish Residents Association to represent ESRU during their annual meeting: the warm reception I received from the local representatives of residents and the chairman of the Polish Association in Urology in Bydgoszcz in November 2009 is one of my most treasured memories. The answer was always the same: the enthusiasm I put in all these activities was the same I received from my friends from ESRU. Everybody influenced the others with their own propositions, ideas, projects, seasoned with their own experience, cultures and disposition. Moreover, it was funny to characterise people according to their origins; in my case I was always labelled as being in possession of a Mediterranean character, for the warm way I used to interact with the others. This attitude is probably a common feeling of those addicted people who like the challenges and have a strong desire to open their mind beyond their own borders. Over these years, I have come to realise that in most cases people are not aware of such a disposition of their souls, and that they need to be pushed to become an active part of an organisation. The most notable characteristic of ESRU, which makes it a fundamental part of the urological world, is to recognise these people and to give them the opportunity to offer their talent to the urologist community. That is why I am pretty sure that one of the friends I already met or that I will be meeting in these years will once be the future EAU General Secretary: shall we bet on it?

When I was a young medical student, some of my colleagues got me involved in a medical students association, the Segretariato Italiano Studenti in Medicina (Italian Secretariat of Students in Medicine), one of the several national organisations that make up the International Federation of Medical Students Associations (IFMSA). From the second to the last year of my education, being part of this association felt like a part-time job to me, even though I was doing it for free! It was like a drug: to meet new people from all over the world, exchange with them experiences, ideas and projects dealing with medicine topics and humanitarian aids made me love more the medical subjects and at the same time, opened my mind to new cultures and to different ways to see the world. When I graduated in medicine, I thought that my experience in the world of non-lucrative organisations was at an end toobut I was mistaken! I was surprised to find that many similar organisations already existed in almost all of the

The most notable characteristic of ESRU, which makes it a fundamental part of the urological world, is to recognise these people and to give them the opportunity to offer their talent to the urologist community.

Unique opportunities in Budapest

Reporting on a ten-week clinical fellowship at the Semmelweis University, Budapest
Dr. Maksudhon Rashidov NCO of ESRU Republic Research Center for Emergency Medical Aid Tashkent (UZ) maksutrashidov@ yahoo.com The Department of Urology at Semmelweis University was established in 1920 as one of the first independent urological clinics in Europe. It is a big building with four floors. There are five operating theatres and about 50 beds. The department deals with unusual and complicated urological cases, and the beds are always occupied because of the high rate of admissions and operations. The departments library was wonderful; its collection included a wide variety of urological magazines, and many books in several languages that reflect all historical periods of modern urology. The Department of Urology has a guestbook that starts in 1922 with a contribution by the founder of the department, Professor Illys. It is a real mirror of international contacts and represents the last few decades of a countrys history. The staff of the department was friendly, cooperative, and supportive of my ambitions. Success is not an individual effort; it requires teamwork. I learned from the whole team at Budapest, especially from their work ethic, which was geared toward hard work, success, and prosperity. Every day, I attended urological surgeries as an assistant or observer, especially in uro-oncology and reconstructive surgery under the supervision of Professor I. Romics. I regularly attended meetings and discussions of controversial issues, trying to broaden my mind. On Tuesdays and Fridays, there was a major round with the Professor, which included thorough reviews and discussions of each patients clinical history, physical examination, preoperative investigations, and planned operations and further management. I was fortunate enough to have my fellowship during the summer, as residents and half of the staff were on vacation and I had a real chance to attend almost all of the operations that had my interest. In addition to this good fortune, my fellowship also coincided with the 90th Anniversary of the Urology Department, with a great number of guests from around the world. Training in urology in Budapest was a memorable experience. The Urology Department of Semmelweis University is a good place for further training and the exchanging of experiences, as a significant number of uro-oncologic, reconstructive and endourologic surgeries are performed there daily. Ten weeks is a relatively short time to get good hands-on training in advanced urological surgery, and I therefore look forward to spending a longer period of time in one of the subspecialties of urology in the future. The EUSP provides an excellent environment for learning, and in many instances, hands-on experience, so that scholars may acquire knowledge and skills that they will then be able to transfer to their own practice. I would like to express my deep gratitude to Prof. I. Romics and his friendly staff for their hospitality and support, and the EAU and EUSP scholarship committee for the wonderful opportunity to spend some time as a part of a clinic of excellence that this scholarship provides. My special thanks also go to Tessa Schraven and all colleagues without whom my visits would not be so fruitful.

Budapest must rank highly among the most attractive cities of the world. It successfully combines a centuries-old architectural and cultural heritage with the latest features of modern life. The whole city is packed with fortifications and buildings from Roman times, Turkish baths still in use today, the heritage of the Gothic and Baroque eras, and the incredibly rich architecture of the Art Nouveau. As part of the European Urological Scholarship Programme (EUSP), I spent a fruitful ten weeks doing a fellowship at the Urology department of Semmelweis University in Budapest, Hungary. This experience greatly affected my knowledge of specialised urology, and also my career.

Guidelines Quiz
1) In former cigarette smokers, a significant decline in the risk of developing bladder cancer does not occur until smoking has been discontinued for how long? a) 1 year b) 2 to 4 years c) 5 to 9 years d) 10 to 20 years e) 21 to 30 years 2) Aberrations of which chromosome or chromosome segment are associated most closely with papillary low-grade, superficial bladder cancer? a) 17 p b) 13 q c) 9 q d) 9 p e) 7 3) The risk of progression to muscle invasive disease for patients with untreated CIS of the bladder is approximately: a) 5-15% b) 15-25% c) 25-35 % d) 35-45 % e) > 45 % 4) Cancer occurring in urinary intestinal diversion is most likely to occur in: a) Augmentations b) Colon conduits c) Ileal conduits d) Ureterosigmoidostomies 5) What is the next step for a man with a post void residual of 300 ml? a) Repeat the PVR assay b) Upper urinary tract imaging c) Urodynamic testing d) TURP

The correct answers of this Guidelines Quiz can be found elsewhere on this page.
European Association of Urology

From: Campbell-Walsh Urology 9th Edition Review, 3rd edition, by Alan J. Wein, MD, PhD(hon), Louis R. Kavoussi, MD, Andrew C. Novick, MD, Alan W. Partin, MD, PhD and Craig A. Peters, MD (eds). Copyright Saunders/ Elsevier (Philadelphia) (2007). Reprinted with permission.

Prof. Romics in the midst of an operation

12

European Urology Today

The correct answers of this issues Guidelines Quiz are: 1d, 2c, 3e, 4d, 5a
Guidelines
2011 edition

As a consequence of the good results of our jobs, in 2007 it was proposed that I become the new secretary for ESRU, a position that started officially in the spring Of course, all of these activities took up much of my of 2008. This was the first time that an Italian free time; sometimes to the extent that my colleagues representative had become an Executive Committee would question why I persevered.

Quiz answers

December 2010/March 2011

EAU Guidelines Office

in Vienna during the EAU Annual Congress
Guidelines training session Evidence-Based Guidelines: A Workshop for Guideline Developers
Friday, 18 March: 14.00-17.00 hrs Room J565
Faculty Workshop
Mr. K.F. Parsons Chairman EAU Guidelines Office Prof.Dr. J. NDow Board member EAU Guidelines Office Prof.Dr. S.E. Canfield Drs. J. Krabshuis Research librarian

Join the activities organised by the

European Association of Urology

Plenary session 2 Trauma and reconstruction EAU Guidelines Office report: Single port laparoscopy and robotic surgery Speaker: Prof. Dr. Axel Merseburger Monday, 21 March: 10.00-10.30 hrs. eURO Auditorium Subplenary session 5 EAU Guidelines Office presentations Sunday, 20 March: 11.00-12.00 hrs. Hall E2 Speakers: Mr. Keith F. Parsons (chairman Guidelines Office) Introduction

Guidelines
2011 edition

INVITATION

Workshops objectives Target audience All those involved and interested in the production of clinical guidelines. Aim To familiarise workshop participants with a number of crucial steps in the guidelines production process. Focus of this years training session will be: Guidelines scope How to find data. The session will consist of a mix of plenary presentations and exercises (in smaller groups) where all are invited to actively participate. There will be ample opportunity to quiz the panel and discuss anything considered of relevance.

11.00 11.20 Prof.Dr. C. DeAngelis (EiC JAMA) Conflict of interest, guidelines and industry involvement 11.20 11.40 Prof.Dr. D. Mitropoulos Complications of urological procedures 11.40 12.00 Prof.Dr. M. Rouprt European guidelines for the diagnosis and management of upper urinary tract urothelial cell carcinomas

Strengthening outcomes for patients receiving ADT*

Prolia the rst and only RANK Ligand inhibitor for the treatment of bone loss1

*ADT = androgen-deprivation therapy.

Reference: 1. Prolia (denosumab), Summary of Product Characteristics, 2010. Prolia (denosumab) Brief Prescribing Information
Please refer to the SmPC (Summary of Product Characteristics) before prescribing Prolia. Pharmaceutical Form: 1 ml solution for injection presented in pre-lled syringe containing 60 mg of denosumab. Contains sorbitol (E420). Indications: Treatment of osteoporosis in postmenopausal women at increased risk of fractures. Prolia signicantly reduces the risk of vertebral, non-vertebral and hip fractures. Treatment of bone loss associated with hormone ablation in men with prostate cancer at increased risk of fractures. Dosage and Administration: Single subcutaneous injection of Prolia 60 mg is given once every 6 months. No dose adjustment for renal impaired patients. Patients must be supplemented with calcium and vitamin D. Prolia is not recommended in paediatric patients (age < 18). Contraindications: Hypocalcaemia. Hypersensitivity to the active substance or any of the excipients. Special warnings and precautions for use: Hypocalcaemia must be corrected by adequate intake of calcium and vitamin D before initiating therapy. Patients with severe renal impairment or receiving dialysis are at greater risk of hypocalcaemia. Clinical monitoring of calcium levels is recommended for patients predisposed to hypocalcaemia. Patients receiving Prolia may develop skin infections (predominantly cellulitis) leading to hospitalisation and should contact a healthcare professional immediately if they develop signs or symptoms of cellulitis. Osteonecrosis of the jaw (ONJ) has been reported with denosumab and with bisphosphonates. ONJ has been reported rarely with Prolia 60 mg every 6 months. A dental examination should be considered prior to treatment with Prolia in patients with concomitant risk factors (refer to SmPC). While on treatment, these patients should avoid invasive dental procedures if possible. Good oral hygiene practices should be maintained during treatment with Prolia. The needle cover of the syringe contains dry natural rubber (latex derivative), which may cause allergic reactions. Patients with rare hereditary problems of fructose intolerance should not use Prolia. Interactions: No interaction studies have been performed. The potential for pharmacodynamic interactions with hormone replacement therapy (HRT) is considered to be low. Pregnancy and lactation: Prolia is not recommended for use in pregnant women. A risk/benet decision should be made in patients who are breast feeding. It is unknown whether Prolia is excreted in human milk. No data are available on the effect of Prolia on human fertility. Undesirable effects: Adverse reactions reported in placebocontrolled clinical studies in women with postmenopausal osteoporosis and breast or prostate cancer patients receiving hormone ablation: Common (> 1/100, < 1/10) Urinary tract infection, Upper respiratory tract infection, Sciatica, Cataracts, Constipation, Rash, Pain in extremity; Uncommon (> 1/1,000, < 1/100) Diverticulitis, Cellulitis, Ear infection, Eczema; Very Rare (< 1/10,000) Hypocalcaemia. In the osteoporosis clinical program ONJ has been reported rarely with Prolia. Please consult the SmPC for a full description of side effects. Pharmaceutical Precautions: Do not mix with other medicinal products. Store in a refrigerator (2C8C). Do not freeze. Keep the pre-lled syringe in the outer carton in order to protect from light. Do not shake excessively. Prolia may be stored at room temperature (up to 25C) for up to 30 days in the original container. Once removed from the refrigerator use within these 30 days. Marketing authorisation holder: Amgen Europe B.V., Minervum 7061, NL-4817 ZK Breda, The Netherlands. Further information is available from the SmPC. Date of PI preparation: May 2010. Adverse events should be reported. Legal Category: Medicinal product subject to medical prescription. Marketing authorisation number: EU/1/10/618/003.

2011 Amgen, Zug, Switzerland. All rights reserved.

DMO-IHQ-AMG-220-2011 01.2011

December 2010/March 2011

AMG05J11001_EAU_EUT_news_ad.indd 1

European Urology Today

21/01/2011 17:10

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Key articles from international medical journals

Prof. Oliver Reich Section editor Munich (DE) had excellent results that were equivalent to results for kidneys from heart-beating brain-death donors. Clearly long-term follow-up to 10 years will be important. The only modifiable variable associated with a potential risk of graft failure was cold ischaemic time. The data also suggest that these kidneys should be managed by the national matching scheme to minimize HLA mismatch in the way that brain-death donations are co-ordinated. progressed whilst on docetaxel and that suggests Cabazitaxel might be a more effective choice as first line chemotherapy. However post docetaxel abiraterone has produced similar results with less side-effects. contexts and to explore their potential clinical applications. A total of 101subjects were enrolled in 2008 from urologic oncology clinics to form three study groups: 44 PCa free, 46 confirmed PCa, and 11 negative prostate biopsies. Urine was collected after attentive digital rectal exam and coded to blind group allocation for laboratory test.

Oliver.Reich@ klinikummuenchen.de

Transplanted kidneys following cardiac death do just as well as those donated after brain death
The demand for kidney transplantation far exceeds the supply of donor organs. Most decreased-donor kidneys are from donors with brain-stem death whose heart was beating (brain-death donors). However, in the UK the last decade has seen a fall in the number of brain-death donors. In contrast, use of kidneys from non-heart-beating donors (cardiacdeath donors) has risen steeply from 3% of all deceased donors in 2000 to 32% in 2009. In the UK these largely come from donors who have suffered massive irreversible brain injury but do not fulfil the criteria for brain-stem death; death is instead certified by cessation of cardiopulmonary function after a decision to withdraw life-supporting treatment (Maastricht category 3). This is unavoidable associated with a variable period of warm ischaemia which increases the incidence of delayed graft function. Little information is available about long-term function or the factors that affect graft survival.

Source: Analysis of factors that affect outcome after transplantation of kidneys donated after cardiac death in the UK: a cohort study. Summers DM, Johnson RJ, Allen J, Fuggle SV, Collett D, Watson CJ and Bradley JA.
Lancet 2010; 376: 1303-11.

Source: Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. De Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels J-P, Kocak I, Gravis G, Bodrogi I, Mackenzie ML, Shen L, Roessner M, Gupta S, Sartor AO, for the TROPIC investigators.
Lancet 2010; 376: 1147-54.

A novel panel of TMPRSS2:ERG fusion markers can provide a very specific and sensitive tool for urinebased detection of PCa
The authors have developed a new panel of TMPRSS2:ERG fusion markers for a urine-based qPCR test. Using these new markers, they demonstrated a lack of fusion-positive samples in PCa-free subjects and a clinical sensitivity of 45.4% in PCa patients prior to treatments. The fusion markers were detected in 2 of 11 (18.2%) biopsy-negative patients, suggesting potentially false negative biopsies. The authors conclude that their novel panel of TMPRSS2:ERG fusion markers can provide a very specific and sensitive tool for urine-based detection of PCa. Theses markers can potentially be used to diagnose patients with PCa who have negative biopsies. The findings should be confirmed by prospective studies and in higher sample size.

Second-line chemotherapy for CRPC

Following the publication of TAX 327 and the SWOG trial in 2004, docetaxel in combination with prednisone has become established as standard first-line chemotherapy for men with metastatic castration-resistant prostate cancer, which remain the second most common cause of cancer death amongst men in the developed world. Unfortunately although docetaxel improves survival in this group of men progression is inevitable. Currently there is no approved treatment for men who have progressed after docetaxel treatment. This study compares Cabazitaxel a tubuli-binding taxane shown to have antitumor activity in models resistant to paclitaxel and docetaxel with Mitoxantrone which has been shown to improve quality of life but not improve overall survival

Heterogeneity between surgeons in cancer control and functional outcomes after radical prostatectomy
While previous studies have shown that complications and biochemical recurrence rates after radical prostatectomy (RP) vary between different surgeons, data on functional outcomes are rare. In this study, Vickers and colleagues evaluated whether there is heterogeneity between surgeons for urinary and erectile function following RP, adjusting for case mix and year of surgery on the basis of a cohort accrued at a single academic centre. The study consisted of 1910 RP patients who were treated by 1 of 11 surgeons between January 1999 and July 2007 at Memorial Sloan-Kettering Cancer Center. Patients were evaluated for functional outcome 1 year after surgery.

Source: A Panel of TMPRSS2:ERG Fusion Transcript Markers for Urine-Based Prostate Cancer Detection with High Specificity and Sensitivity. Phuong-Nam Nguyen, Philippe Violette, Sam Chan, Simon Tanguay, Wassim Kassouf, Armen Aprikian, Junjian Z. Chen.
European Urology, 2010 Nov 17. [Epub ahead of print]

This randomised open-label phase 3 study was The 23 UK adult renal transplant centres provide funded by the drugs developer Sanofi-Aventis. mandatory data to the UK transplant registry. This was Undertaken in 146 centres across 26 countries men used to identify all renal transplantations from with pathologically proven prostate cancer and decreased donors between 1 January 2000 and 31 documented disease progression during or after December 2007. Transplants of kidneys from completion of docetaxel treatment and an ECOG controlled cardiac death donors of Maastricht category performance of 0-2 were recruited. Men who had 3 were compared to transplants of kidneys from previous mitoxantrone therapy or radiotherapy to brain-death donors. Recipients were excluded if they >40% of the bone marrow were excluded. All men were younger than 18 years at transplantation or had received oral prednisone 10mg o.d. and were received a non-renal organ transplant. randomly assigned to receive mitoxantrone 12 mg/m2 i.v or cabazitaxel 25 mg/m2 on day 1 of each 21-day The multivariate analysis included donor and cycle. (Interestingly this was the maximum tolerable recipient age, sex, ethnic group, blood group, medical dose due to neutropenia in previous studies). co-morbidities warm ischaemic time, HLA mismatch Premedication of dexamthasone 8 mg i.v. and intra level and recipient sensitisation, outcomes included venous histamine H2-antagonist was administered 30 all-cause graft failure, patient survival, primary min or more before Cabazitaxel. Antiemetic non-function, delayed graft function, acute rejection prophylaxis and GCSF following significant and graft function as measured by the eGFR. neutropenia was also allowed. The primary endpoint was overall survival. Secondary endpoints included progression-free survival and safety

Rates of urinary incontinence and erectile dysfunction vary widely between surgeons
The authors found significant heterogeneity in functional outcomes after RP (p < 0.001 for both urinary and erectile function).

Dihydrotestosterone tested for a possible prevention of prostate growth

For recipients of kidneys from cardiac-death donors, increasing age of donor and recipient, repeat transplantation [] were associated with worse graft survival

8289 kidneys donated after brain death and 845 after controlled cardiac death were identified. Cardiacdeath donors were younger, more prominently male and white and less likely to smoke, whilst recipients of these kidneys were older less likely to have received a previous transplant (1401 [17%] vs 97 [11%], p<0.0001), and received kidneys that were less well matched for HLA. First-time recipients of kidneys from cardiac-death donors (n=739) or braindeath donors (n=6759) showed no difference in graft survival up to 5 years (HR 1.01, [CI0.83-1.19, p=0.97]), or in eGFR at 1-5 years after transplantation. In the small group of recipients receiving a kidney from a cardiac-death donor following a previous failed transplant, graft survival was significantly worse perhaps because they were much less well matched for HLA than were second grafts in recipients of kidneys from braindeath donors in an HLA-sensitised recipient population. For recipients of kidneys from cardiacdeath donors, increasing age of donor and recipient, repeat transplantation and cold ischaemic time of more than 12 hours were associated with worse graft survival. Delayed graft function and warm ischaemic time had no effect on outcome. This study confirms that for recipients of their first grafts, kidneys from controlled cardiac-death donors
Key articles EAU EU-ACME Office

Cabazitaxel improved survival in patients with metastatic castrationresistant PCa with progressive disease after docetaxel-based chemotherapy but with significant side-effects
Between 2 January 2007 and 23 October 2008, 755 patients were enrolled; 378 to receive Cabazitaxel and 377 mitoxantrone. Approximately 50% of men had measurable soft-tissue disease and 25% had visceral disease. About 70% of patients had progressed either during or within 3 months of completing docetaxel treatment, including 30% who progressed during treatment. The Kaplan-Meier analysis showed an overall survival benefit in favour of carbazitaxel. Median overall survival was 15.1 months versus 12.7 months (HR 0.70 [CI 0.59-0.83, p<0.0001]). Patients treated with carbazitaxel also showed a higher rate of tumour response (14.4% vs 4.4%, p=0.0005) and PSA response (39.2% vs 17.8% p=0.0002). This was associated with increased risk of significant neutropenia (82% vs 58%) and febrile neutropenia (8% vs 1%). Cabazitaxel has been shown to improve survival in patients with metastatic castration-resistant prostate cancer with progressive disease after docetaxel-based chemotherapy but with significant side-effects. It is interesting to note that 30% of the group had

The complex endocrine interactions in prostate growth have been extensively researched, but not every aspect is fully understood, especially in view of Four surgeons had adjusted rates of full continence benign enlargement. It has been hypothesised that <75%, whereas three had rates >85%. For erectile long-term administration of a nonamplifiable pure function, two surgeons in the series had adjusted androgen might decrease prostate growth, thereby rates <20%; another two had rates >45%. They found decreasing or delaying the need for surgical some evidence suggesting that surgeons erectile and intervention. This hypothesis, that dihydrotestosterone urinary outcomes were correlated. Contrary to the (DHT), a nonamplifiable and nonaromatisable pure hypothesis that surgeons trade off functional androgen might be able to reduce prostate growth in outcomes and cancer control, better rates of middle-aged men, was examined in a clinical functional preservation were associated with lower industry-sponsored trial (BHR Pharma). biochemical recurrence rates. In a randomised, placebo-controlled, parallel-group trial (Australian New Zealand Clinical Trials Registry The authors conclude that strong correlations number: ACTRN12605000358640) in an outpatient between functional and oncologic outcomes indicate setting, 114 healthy men older than 50 years without that this variation results from differences in known prostate disease were recruited and treated technique, rather than from differences in how surgeons trade off functional preservation and cancer with transdermal DHT (70 mg) or placebo gel daily for 2 years. Prostate volume was measured by control. ultrasonography; bone mineral density (BMD) and Source: Cancer Control and Functional Outcomes body composition were measured by dual-energy x-ray absorptiometry; and blood samples and questionnaires After Radical Prostatectomy as Markers of were collected every 6 months, with data analysed by Surgical Quality: Analysis of Heterogeneity mixed-model analysis for repeated measures. Between Surgeons at a Single Cancer Center.

Andrew Vickers, Caroline Savage, Fernando Bianco, John Mulhall, Jaspreet Sandhu, Bertrand Guillonneau, Angel Cronin, Peter Scardino.

This is a negative study but such European Urology, 2010 Nov 10. [Epub ahead of print] findings are of importance if they successfully test a hypothesis which TMPRSS2:ERG fusion transcript has been discussed for years markers for urine-based PCa In the analysis, over 24 months there was an increase detection in total (29% [95% CI, 23% to 34%]) and central (75%
A common TMPRSS2:ERG fusion isoform has been shown to be detectable in the urine of men with prostate cancer (PCa) and has been coupled with other molecular markers in urine-based cancer detection. However, critical evaluations remain scarce on the utility of one or multiple fusion markers in urine-based detection. In this study, Nguyen and colleagues aim to evaluate the specificity and sensitivity of multiple TMPRSS2:ERG fusion isoforms in diverse clinical [CI, 64% to 86%]; p < 0.01) prostate volume and serum prostate-specific antigen level (15% [CI, 6% to 24%]) with time on study but DHT had no significant effect on prostate volume. DHT treatment decreased spinal BMD slightly (1.4% [CI, 0.6% to 2.3%]; p < 0.001) at 24 months but not decrease hip BMD. DHT increased serum aminoterminal propeptide of type I procollagen in the second year of the study (compared to placebo) and increased serum DHT levels and its metabolites (5-androstane-3,17-diol and 5-androstane-3,17-diol). Serum levels of testosterone, estradiol, luteinising hormone, and

14

European Urology Today

December 2010/March 2011

Mr Philip Cornford Section editor Liverpool (GB)

Philip.Cornford@ rlbuht.nhs.uk

follicle-stimulating hormone levels were suppressed under DHT treatment while hemoglobin (7% [CI, 5% to 9%]) and serum creatinine levels were increased (9% [CI, 5% to 11%]). The effects on body mass were an increase in lean mass (2.4% [CI, 1.6% to 3.1%) but a reduction in fat mass (5.2% [CI, 2.6% to 7.7%]) (p < 0.001 for all). In the DHT group there were only 3 patients with an increase in prostate-specific antigen levels (none with prostate cancer). Serious adverse events were not seen. This is a negative study but such findings are of importance if they successfully test a hypothesis which has been discussed for years. Thus, DHT treatment for 24 months has no effect on prostate growth or PSA, neither beneficial nor adverse.

setting. In a double-blind, placebo-controlled, multicentre phase 3 trial this therapeutic principle was investigated in an industry-sponsored investigation (funded by Dendreon; ClinicalTrials.gov number NCT00065442). 512 patients were randomly assigned in a 2:1 ratio to receive either sipuleucel-T (341 patients) or placebo (171 patients) administered intravenously every 2 weeks, for a total of three infusions. The primary endpoint was overall survival (analysed by means of a regression model adjusted for baseline levels of serum prostate-specific antigen (PSA)) and lactate dehydrogenase (LDH)).

seen; as no effect on the time to disease progression was observed, further studies will be needed.

Source: Sipuleucel-T immunotherapy for castration-resistant prostate cancer. Kantoff PW, Higano CS, Shore ND, Berger ER, Small EJ, Penson DF, Redfern CH, Ferrari AC, Dreicer R, Sims RB, Xu Y, Frohlich MW, Schellhammer PF; IMPACT Study Investigators.
N Engl J Med 2010; 363:411-22.

Prof. Oliver Hakenberg Section editor Rostock (DE)

Oliver.Hakenberg@ med.uni-rostock.de

This studys immunising strategy might have definite effects in the last phase of prostate cancer, in addition to chemotherapy

In the sipuleucel-T group, there was a relative reduction of 22% in the risk of death as compared with the placebo group (hazard ratio, 0.78; 95% confidence interval [CI], 0.61 to 0.98; p = 0.03) during the observation period. This represented an improved median survival by 4 months (25.8 months in the sipuleucel-T group vs. 21.7 months in the placebo Source: Long-term effects of dihydrotestosterone group). The 36-month survival probability was 31.7% treatment on prostate growth in healthy, in the sipuleucel-T group versus 23.0% in the placebo middle-aged men without prostate disease: a group. As many patients received docetaxel later on, randomised, placebo-controlled trial. Idan A, further analysis was needed: the effects were also Griffiths KA, Harwood DT, Seibel MJ, Turner L, observed with the use of an unadjusted Cox model Conway AJ, Handelsman DJ. and a log-rank test (hazard ratio, 0.77; 95% CI, 0.61 to Ann Intern Med. 2010; 153: 621-32. 0.97; p = 0.02) and after adjustment for use of docetaxel after the study therapy (hazard ratio, 0.78; 95% CI, 0.62 to 0.98; p = 0.03). However, the time to Vaccine for hormone-resistant objective disease progression was similar in the two study groups.

colorectal cancer during a median follow-up of 18.3 years. The daily use of aspirin significantly reduced the 20-year-risk of colon (20-year risk of colon cancer (incidence hazard ratio [HR] 0.76, 0.60-0.96, p = 0.02; Aspirin remains a surprising drug, with many mortality HR 0.65, 0.48-0.88, p = 0.005). This effect beneficial effects on humans. It has been shown that did not, however, show for rectal cancer (0.90, it can be effective in the prevention of cardiovascular 0.63-1.30, p = 0.58; 0.80, 0.50-1.28, p = 0.35). In morbidity, and it is widely used for this purpose. subsets of patients, the effect on colon cancer Several long-term studies have been conducted with seemed to be most pronounced for the proximal this endpoint. This study evaluated the long-term rather than the distal colon (for incidence difference effects of lower doses of aspirin (75-300 mg daily) on p=0.04, for mortality difference p = 0.01). colorectal cancer, specifically the effects of aspirin on Significantly, the benefit was related to the duration incidence and mortality due to colorectal cancer in of regular medication with aspirin. The allocation to randomised trials of aspirin in cardiovascular aspirin of 5 years or longer reduced the risk of medicine. proximal colon cancer by about 70% (0.35, 0.20-0.63; 0.24, 0.11-0.52; both p < 0.0001) and also reduced the For this purpose, four randomised trials of aspirin risk of rectal cancer (0.58, 0.36-0.92, p=0.02; 0.47, versus control in primary (Thrombosis Prevention Trial, 0.26-0.87, p = 0.01). British Doctors Aspirin Trial) and secondary (Swedish Aspirin Low Dose Trial, UK-TIA Aspirin Trial) prevention This analysis definitely suggests that aspirin taken for several years at doses of at least 75 mg daily can of vascular events and one trial of different doses of aspirin (Dutch TIA Aspirin Trial) were followed-up and significantly reduce the individual risk of colorectal evaluated for the effect of aspirin on the risk of cancer, both for incidence and mortality. Thus, taking colorectal cancer over 20 years during and after the a cheap medication regularly may be much more trials by analysis of pooled individual patient data. effective than screening for colorectal cancer. Further studies will be needed and effects on other tumour entities searched for.

Might aspirin be better than screening?

prostate cancer?

The search for effective treatments for castrationresistant prostate cancer continues, and immunotherapeutic modalities have long been in focus. Sipuleucel-T is an autologous active cellular immunotherapy with some reported efficacy in this
Key articles EAU EU-ACME Office

An immunising strategy, as used in this study, might have definite effects in the last phase of prostate cancer in addition to chemotherapy. In this trial, the use of sipuleucel-T prolonged overall survival among men The authors found that in these four trials of aspirin versus control (mean duration of scheduled treatment with metastatic castration-resistant prostate cancer. Whether this will be clinically relevant remains to be 6.0 years), 391 (2.8%) of 14,033 patients had

A cheap medication taken regularly may be much more effective than screening for colorectal cancer

Source: Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Rothwell PM, Wilson M, Elwin CE, Norrving B, Algra A, Warlow CP, Meade TW.
Lancet 2010; 376 :1741-50.

http://esffu-esgurs.uroweb.org

1st Joint Meeting of the EAU Section of Female and Functional Urology (ESFFU) and the EAU Section of GenitoUrinary Surgeons (ESGURS)
6-8 October 2011, Tbingen, Germany
EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations

31st CONGRESS OF THE SOCIT INTERNATIONALE DUROLOGIE

ICC BERLIN October 16-20 2011

WITH THE

5th Conference of the World Urological Oncology Federation October 15-16, 2011 www.wuof.org

Featuring the ICUD CONSULTATION ON PROSTATE CANCER

ABSTRACT SUBMISSION DEADLINE: APRIL 1, 2011

European Association of Urology

www.siucongress.org

December 2010/March 2011

1090_SIU2011_EUT_BerlinAD_NOV.indd 1

Client: Description:

SIU 2011 BERLIN

Docket number: 20-1090

File Size: Trim Size:

100 % 133,4 mm X 194,3 mm

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Adventures in Laparoscopy & Robotics continued

Meeting enjoys success, prepares to make another leap forward
Jens-Uwe Stolzenburg University of Leipzig Dept. of Urology Leipzig (DE) knowledge and experience with the rest of the urologic community. The above described concept was the initial objective of the annual international meeting entitled Challenges in Laparoscopy and Robotics. participants. Several debatable issues arose and the majority of the hot topics were discussed. Diagnostic markers, prostatic fascial anatomy, intraoperative ergonomics, indications for renal biopsy, warm ischemia time during laparoscopic partial nephrectomy and many more were among the sessions that attracted significant interest. Not all sessions were driven to a consensus but many new ideas were conceived. Thus, the participants witnessed according to the tradition of the previous meetings the evolution of laparoscopy in the making. The social programme was also very impressive. Vito and his colleagues expressed their warm friendliness to all of us. The faculty will never forget the memorable dinner at the Vatican gardens as well as the entire hospitality. Prof. Dr. med. Jens Rassweiler Section editor Heilbronn (DE)

The 7th European Meeting on Laparoscopy and Robotics which took place this summer, once again served its main purpose: to bring together stolj@medizin. technological advances, education and uni-leipzig.de communication in order to ameliorate the knowledge of on-going research and clinical activities. Several live surgeries were performed by experts in the field. Evangelos Liatsikos Challenging laparoscopic procedures such as University Hospital of cystectomy, intracorporeal neobladder, partial Patras nephrectomy were presented live with every step of Dept. of Urology the procedure commented by the performing Patras (GR) surgeon, moderators and audience. The real-time commentary on the procedures provided a wider perspective for the participants while the experts could exchange their experience. The state-of-the-art nature of the performed live surgeries represents a liatsikos@yahoo.com mystery for the attending urologists and certainly provides an interactive method for laparoscopic and/ Urologic surgery has undergone significant changes or robotic training. Technical issues were extensively during the last two decades. Open surgical approaches discussed and refinements of laparoscopic and have been replaced by laparoscopy which rapidly robotic methods were proposed by the attending achieved the appropriate efficiency and improved experts. In addition, the audience was able to witness several aspects of patient care. In addition, the the most recent developments in laparoscopic surgery science fiction of robots operating on patients such as laparoendoscopic single site surgery (LESS) to became reality with the introduction of robotic-assisted be performed live. surgery. The continuous dispute between open, laparoscopic and robotic surgeons has thus begun. LESS has been proposed as the next evolutional step of laparoscopic surgery. The performance of Nevertheless, the questions remain the same. How laparoscopic procedure by instruments inserted will patient care be improved? The answer to this through a multi-lumen single port is associated with question is the training and accumulation of high technical challenge. Only high laparoscopic skill experience in the new fields of urologic laparoscopy and experience can overcome these issues. LESS is by practising urologists as well as urology residents. performed by a very limited number of surgeons Moreover, experienced urologists in the laparoscopic worldwide and the live transmission of this procedure and robotic field should be able to exchange is surely of interest.
Uro-Technology

jens.rassweiler@ slk-kliniken.de In an attempt to continue and if possible to surpass the success of previous meetings, the 8th European Meeting on Laparoscopic and Robotic Urologic Surgery- Challenges in Laparoscopy and Robotics will take place in June 2011 in the city of Leipzig, Germany. The meeting is expected to keep the tradition as a key international event for laparoscopy and robotics where innovations in new techniques and technologies are revealed for the first time. The intriguing scientific programme will include a large number of live laparoscopic and robotic surgeries performed by the worlds most renowned surgeons. Interesting presentations and debates pertinent to laparoscopy and robotics will enrich the programme and guarantee a scientific level of utmost standard and highest expectations. The selection of Leipzig as the hosting city is not random. Leipzig is a historical city with a rich cultural and commercial profile. Major classical music composers have lived and flourished here. The peaceful German revolution initiated in Leipzig. In addition, major car industries (Porsche and BMW) are producing several of their lines in Leipzig. Clearly, music action and speed are the major characteristics of this city. This is the perfect city to host Challenges in Laparoscopy and Robotics. The combination of music, action and speed of the organized programme will render the meeting as a memorable event for all participants from a scientific as well as a social standpoint. Welcome in Leipzig!

Prof. Vito Pansadoro

The scientific sessions of the meeting gave motivation for fruitful discussions and debates among the

Challenges in Laparoscopy & Robotics

The European Congress of Laparoscopy 2011

2011

Nevertheless, it is not easy to distinguish why along with all the previous editions, the 7th meeting of Challenges in Laparoscopy and Robotics was such a success. Probably, the success could be attributed to the significant figures in the fields of laparoscopy and robotics which provided an intriguing and more advanced perspective of urologic surgery while a huge number of participants ready to receive the tricks of the trade attended. The above combination of experts presenting their natural talent and ambitious urologists ready to gain as much as possible - was probably the key to the success of Challenges in Laparoscopy and Robotics series. A fulfilling sensation was present after the conclusion of the meeting and this represents its most prestigious asset which has led to the yearly re-appointment for the meeting. Needless to say, that the participants of the meeting are usually returning to one of the following meetings to experience once again the thrill of the evolution of laparoscopic and robotic urology.

Several live surgeries were performed by experts in the field.

Leipzig
9-10-11 June 2011 Leipzig, Germany The Westin Hotel
Course Directors Vincenzo Disanto Bari, Italy Evangelos Liatsikos Patras, Greece Vito Pansadoro Rome, Italy Jens Uwe Stolzenburg Leipzig, Germany Surgeons Alberto Breda Renaud Bollens Vincenzo Disanto Richard Gaston Inderbir Gill Gnter Janetschek Jihad Kaouk Evangelos Liatsikos Alex Mottrie Vito Pansadoro Vipul Patel Thierry Pichaud Peter Rimington Jrg Rassler Jens Rassweiler Stefan Siemer Jens U. Stolzenburg Holger Till Ingolf Trk Roland Van Velthoven Peter Wiklund

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! 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!

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European Urology Today

December 2010/March 2011

www.uroweb.org

Some of the most prominent Laparoscopic Urological Surgeons will perform innovative live surgery demonstrating the full spectrum of urological procedures.

Apply for your EAU membership online!

1st Joint ESFFU-ESGURS Meeting in Tbingen, Germany

Live surgeries on reconstructive and functional urology to highlight skills refinement
By Joel Vega Live simultaneous surgeries and practical demonstrations on how to refine and master skills needed for the latest procedures in reconstructive surgery and functional urology will be the focus of the first joint meeting between the EAU Section of Female and Functional Urology (ESFFU) and the EAU Section of Genitourinary Reconstructive Surgeons (ESGURS). To be held from October 6 to 8 this year at the University Hospital of Tbingen in Germany, the two-and-a-half day meeting will highlight surgical procedures in both reconstructive and functional urology, with topics ranging from urethral strictures, stress incontinence, male incontinence, OAB procedures, neobladders to troubleshooting issues, to name a few. We want to show how the newest surgical procedures are done that can be backed up with published results. There are many new developments in functional urology and this requires that practitioners know how to master these procedures. We will discuss them in a technical way with the aim that participants learn how to execute these procedures themselves, said Dr. John Heesakkers, ESFFU chairperson. The collaboration with the ESGURS is important since we try to cover the whole spectrum of surgical
ESFFU and ESGURS

http://esffu-esgurs.uroweb.org

1st Joint Meeting of the EAU Section of Female and Functional Urology (ESFFU) and the EAU Section of GenitoUrinary Surgeons (ESGURS)
6-8 October 2011, Tbingen, Germany
EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations

minor procedures in reconstructive and functional urology will be demonstrated, with expert participants in the live surgeries actively interacting with the audience throughout the surgical sessions. Under the auspices and coordination of Sievert of the Urology Department in Tbingen, Heesakkers said the university hospital has one of the finest facilities suited for the live surgeries and cadaver-anatomy demonstrations. Not only is the hospital and laboratory centre well-equipped, but the communication facilities allow simultaneous surgeries with direct transmission into a lecture hall. For urological residents with interest in this field and even for junior practitioners the Tbingen meeting will be just the right occasion to refine and update their skills since the emphasis is on the practical know-how, explained Heesakkers.
European Association of Urology

organised in collaboration with the EAUs European School of Urology and the affiliated section offices who are specialised in reconstructive, functional and female urology. Complementing the annual masterclass on functional Dr. J. Heesakkers and female urology held in Berlin, participants to the Tbingen meeting can also advance to observation fellowships or hands-on scholarship training in experts centres. If there are participants who really want to go deeper into practise then they can apply for or register for training in specialised centres. This field of urology is rapidly evolving and we can see that there is not only heightened interest amongst young urologists but also the need to back up or boost our skills in this specialised field, according to Heesakkers. Organisers hope to attract around 250 participants to the meeting which marks one of the first of such joint or collaborative activities amongst the EAU section offices. Aside from providing specialised training, the event is also a platform for the section offices to recruit new members who can actively participate.

procedures. The live surgeries will provide insights into how these procedures impact our daily practice and how we can best deal with the various technical and procedural challenges, he added. Together with co-chairmen Professors Dr. KarlDietrich Sievert and Serdar Deger, Heesakkers said the two groups have planned a programme that will include live simultaneous surgeries and cadaveranatomical demonstrations, workshops and state-of-the-art lectures. Around 25 to 30 major and

Urologists and especially young urologists are invited to submit case abstracts for the meeting. The presentation of abstracts will be based on technical surgical issues like new techniques, peculiar cases, handling of complications, troubleshooting etcetera. The presentations should not focus on basic science, huge patient series or theoretical topics. The aim is to have a very practical session with discussions about how to handle issues like preoperative bleeding, troubleshooting in prosthetic surgery or standard surgery in non-standard patients. A selection of the best abstracts will be presented during the meeting. Skills gap Heesakkers noted that at the moment, technical developments have swept the field of functional urology with industry-driven devices and technologies that a gap exists between actual surgical know-how and how this growth can impact existing surgical treatment and medical therapies. There is a need for us to examine these procedures, for them to be appreciated and learned, and we want to fill that gap in skills knowledge. We have to catch up with the developments that are going on in this field if we really want to deliver optimal treatment and care to our patients, Heesakkers said.

EUVJ: Call for submissions

Share your experience - contribute to the European Urology Video Journal
Today, the scientific know-how and research findings receive exposure in various dedicated publications and across the board of urology. Sharing experience and new approaches in urological surgery is more of a challenge, as often this knowledge is based on the skill and innovation, rather than research data. European Urology Video Journal offers a perfect platform for sharing this knowledge with a large international audience as, indeed, one picture says more than a thousand words. This digital publication currently in its 16th volume offers a collection of surgical videos with detailed commentary from the operating surgeons. EUVJ covers a large spectrum of subjects both in terms of urological subspecialisation, as well as applied technology. The EUVJ is now entering a new era, with all of its videos being made available to the members online at the official website of the EAU. This initiative does not only offer immediate access to the EAUs collection of surgical videos, but also brings about a new change a more flexible submission of videos for publication. All members of the EAU are encouraged to submit DVDs and videos to be included on the EUVJ. In this way high-quality material will be widely diffused and become readily available to all EAU members. Submission (preferably digital files): 1. Digital files (miniDV, DV, DVD, DVCAM, DVCPRO) 2. Betacam Digital 8 3. MPEG2, MPEG4, Quicktime files The material, 10-15 min in duration should be sent for application together with a short comment and a concise but detailed description of the technique, if applicable, accompanied by schematic drawings and the most important references. A portrait photograph of the main/submitting author is welcome. All material is to be sent to: EAU Central Office, Attn. DVD Library PO Box 30016 6803 AA Arnhem, The Netherlands.

The Tbingen meeting is also the latest addition to the The laboratory of the Anatomy Institute at the University Hospital of Tbingen, Germany education and training activities launched or

Become an associate of the EAU Section of Female and Functional Urology!

The EAU Section of Female and Functional Urology (ESFFU) aims to recruit highly motivated professionals who dedicate a significant part of their urological career to female and functional urology, a field of expertise that has recently been gaining renewed interest amongst young urologists. With the challenges and manifold developments in this field, one of the ESFFUs goals is to organise a group of experts with thorough and highly specialised knowledge regarding the clinical practice of female and functional urology. Achieving this will help boost or further advanced the gains made in recent years. Moreover, the ESFFU believes that by strengthening the ranks of urologists specialised in this area, the issues they face today will be given more careful attention, enabling them to identify solutions that will improve treatment procedures. Equally important, the ESFFU recognises the central role played by specialists to rightly identify and address on a pan-European level what is lacking or should be developed in the current practice of female and functional urology. In this respect, the ESFFU has exerted efforts to represent urological specialists dealing with female and functional urology. With the urgent need to provide better healthcare, the ESFFU consider it crucial to have the active support of a group of associates that would ably assist the ESFFU Board achieve its long-term objectives. The ESFFU associates have the following responsibilities: Suggest or nominate candidates for ESFFU Board membership Elect members of the ESFFU Board Attend the ESFFU business meetings and collaborate in designing future activities Help define new areas to be developed by the ESFFU Associates also have to meet the following qualifications: They have to devote most of their working hours to female and/or functional urology; They work in a teaching environment wherein the clinic they are working for is a recognised urological training centre; They have authored or at least have-co-authored a peer-reviewed publication; They are willing to accept responsibilities or perform tasks for the ESFFU whenever requested. Interested urologists and potential candidates can contact Astrid Venhorst of the Section Office of the EAU for further information at a.venhorst@uroweb. org. Candidates will receive a standard application form that needs to be properly filled out and returned. The ESFFU Board will select the successful candidates. John Heesakkers Chairman EAU Section of Female and Functional Urology

Members of the Video Committee at a recent meeting. Standing from left: Dr. Robert Rabenault, Prof. Petrisor Geavlete, Ass. Prof. Igle Jan De Jong Sitting from left: Dr. Aurel Messas, Dr. Jeroen Van Moorselaar (Chairman)

December 2010/March 2011

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EAU-RFs strategic plans gain momentum

Foundation looks back to a year of sustained and visible growth
By Joel Vega Now on its fifth year, the EAU Research Foundation (EAU-RF) has gained the needed impetus in its efforts to actively contribute to urological research and act as bridge between urological centres, research organisations and the EAU. The achievements we have in the last year are clear. We have initiated clinical trials of interest for new developments that will advance urological treatments. We have also initiated registries on urological diseases to see how treatments are done throughout Europe, said EAU-RF Chairman Prof. Peter Mulders. Mulders, EAU-RF chairman since 2008, added that the EAU-RF has finally gained the momentum to focus on its long-term plans and provide a reliable platform for urology research. We have set up a framework that cater to the needs of European urology. The EAU-RF is now recognised by various stakeholders for fulfilling a crucial role, and that it can act accordingly, said Mulders. The mandate that we have is clear and, more importantly, our efforts to fulfil these tasks are being acknowledged within and outside the EAU. Tasked to promote, facilitate and stimulate clinical and basic research in European urology, the EAU-RF has earned its stripes in the last few years since its creation in 2007. Mulders noted that that for instance, ZEUS (Zometa European Study) is a landmark study and one of the fastest-recruiting success story of the EAU-RF and its Central Research Office (EAU CRO). A randomised, open-label, multi-centre study, ZEUS harnessed the collaboration of the EAU with the Scandinavian Prostate Cancer Group (SPCG) and the Arbeitsgemeinschaft fur Urologische Onkologie (AUO). ZEUSs interim analysis results were made available early in 2010 with the preliminary outcomes showing that, according to the protocol specifications, there was no statistically significant difference between patients who use Zometa and those who do not use it. The study, which runs up to this year, is awaited to come up in its final report with the compounds added value. MAGE A3 Mulders said another notable EAU-RF study involves patients who need to undergo a cystectomy for their muscle invasive bladder cancer. The project is a randomised, double blind, placebo controlled phase II trial to evaluate the safety and efficacy of recMAGE-A3 + AS15 Antigen Specific Cancer Immunotherapy (ASCI) in patients with MAGE-A3 positive muscle invasive bladder cancer after cystectomy. The trial known as MAGE A3, a product of GSK Biologicals, will run this year with Mulders as principal investigator. The aim is to assess whether adjuvant treatment with recMAGE-A3 + AS 15 ASCI after cystectomy is safe and effective and improves the outcome of patients who are clinically tumourfree after cystectomy and who had a transitional cell carcinoma with expression of the MAGE-A3 antigen.
Basic Research Committee Chair Prof. W. Watson Clinical Studies Committee Chair Prof. A. Patel

support from Amgen. The grant will be awarded to a young urologist who will join the Bone Oncology Group based in Oxford University. Young urologists who can invest two to three years of research work are particularly encouraged to apply (See announcement for details). The Bone Oncology Group is working on the role of micro RNA in the development of bone metastasis at the Nuffield Department of Surgical Sciences. The group, headed by Prof. Freddie C. Hamdy, is based at the Botnar Institute, Oxford University. Crisis as opportunity Asked on the impact of the lingering financial crisis that has affected the industry and the state of medical research in particular, Mulders said the crisis can actually be a blessing disguise. In my view due to the financial crisis the EAU-RF has become more important for sponsors since they have become more selective and are prompted to better communicate with experts in the field before new programmes are actually initiated, he said. We have the experts with the EAU and the EAU-RF and we see that industry partners are gradually shifting to collaborative strategies. Not only that, other independent groups as well, such as the EORTC, are tracking the same joint and collaborative projects. With the EAU-RFs long-term strategies in mind, Mulders said the momentum that the foundation has built in recent years will hopefully spur similar coordinated moves from its partners in the urological community and the industry. A lot of energy has been invested to the EAU-RF. What is significant, perhaps, is that everybody is aware of the EAU-RFs activities and how various stakeholders can exert concerted efforts through our platform. It is definitely an achievement if the EAURF is viewed as an organisation where research efforts are effectively pooled together to completion, said Mulders.

EAU Research Foundation Chair Prof. P. Mulders

EAU Registries Chair Prof. A. Tubaro

Central Research Office Director Dr. W. Witjes

access to a lot of tissue samples from cystectomy specimens, explained Mulders. Appropriate molecular studies can be done with the specimens and with the complementary studies we can examine whether we can individualise treatment for this specific group of bladder cancer patients. Aside from the MIBC cystectomy project, a trial on non-muscle invasive bladder cancer (NMIBC) will be initiated by the EAU-RF this year. The trial will look into the number of Bacillus Calmette-Guerin (BCG) cycles in NMIBC. Six participating countries will be involved in the randomised, prospective study, and Mulders said side studies will be performed such as the detection of NMIBC with various light sources and detection markers. Together with the Basic Research Committee these side studies will be evaluated based on their relevance, he explained. Mulders also noted that more clinical trials are under development in both oncology and non-oncology areas in urology such as neuromodulation in overactive bladder (OAB) and imaging studies in renal cell carcinoma, amongst others. He also mentioned that the Clinical Studies Committee (chaired by Anup Patel) will also have meetings during the 26th EAU Annual Congress in Vienna with urological experts and interested industry partners..

In collaboration with partners in the industry, the registry on focal therapy aims, amongst other goals, to provide answers as to what constitutes the best patient profile in the treatment of localised PCa. For the EAU-RF, however, a much awaited breakthrough was the first research grant to be coordinated by the Basic Research Committee, headed by Prof. William Watson. The Basic Research Committee is one of the cornerstones in the EAU-RF and serves a crucial role within the organisation as it aims to boost the development of urological research throughout Europe. And since the committee has a role in identifying research laboratories in Europe that are known for their high-level medical research activities, the committee exerts efforts to attract researchers or non-clinicians involved in urology research. For the Basic Research Committee, 2011 may yet prove to be a crucial year with the new developments or advances in prostate cancer, bone management and other key areas, according to Mulders. This is why we are happy to announce the first research grant to be coordinated by the committee and with

And since the committee has a role in identifying research laboratories in Europe that are known for their high-level medical research activities, the committee exerts efforts to attract researchers or non-clinicians involved in urology research.

Application for EAU Research Investigators from basic urology research laboratories
The Research Foundation of the European Association of Urology (EAURF) has the central mission to stimulate, facilitate, organise and popularise high quality clinical and scientific urological research in Europe. In building the infrastructure to deliver this mission, the EAURF have committed themselves to support and develop research networks and links with clinical and basic research organisations across the European research community. To accommodate this, the EAURF wants to compile a database of all European Urology Basic Science researchers and their groups which can be used to inform network development. This database will allow established and emerging basic science researchers to identify groups with research synergies, it will facilitate clinical teams to identify complimentary basic science groups for translational research efforts and accommodate large and small pharmaceutical and biomarker companies, to identify groups for collaboration and project development. If you lead a basic science research group in the field of Urology and have an interest in being involved in collaborative networks, we would strongly encourage you to visit the website and complete the short questionnaire. Thank you very much for your interest. Bill Watson Chair EAURF Basic Research Committee

Breakthrough research grant Another key section of the EAU-RF is the EAU Registries, and Mulders underscored the gains made by the committee which is chaired by Prof. Andrea Tubaro. An example was the BPH registry, considered A total of eight to 10 European countries will participate as one of the largest registries in BPH with support with an anticipated average of six to eight centres each. coming from GSK. This registry has been efficiently Patients will be recruited over approximately 24 months recruiting in several European countries and the results will be presented in future EAU meetings, and the trial will be terminated once the last patient is Mulders said. followed-up for 36 months. It is also important to mention that the Basic Research Committee is involved to perform adequate side studies since this (MAGE A3) trial will provide Also during the upcoming congress in Vienna, the EAU-RF expects to finalise a proposed project examining the role of focal therapy in prostate cancer.

Resear Foundation
EAU Research Foundation is looking for investigators from basic urology research laboratories Interested? http://eaurfbslist.uroweb.org/

For any questions please contact: researchfoundation@uroweb.org

EAU Research Foundation

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European Urology Today

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Training course in Laparoscopy in Timisoara

Popular and useful training in Romania for those interested in specialising in Laparoscopy
Dr. Alin Cumpanas Urology Clinic Timisoara (RO) overall usefulness of the course and exercises, not just everyones individual performance. The differences between the mean times before and after the course were statistically significant, demonstrating the benefits of courses like these. It remains true that, as Prof. Pilar Laguna concluded during the diploma handling ceremony, this course does not offer anyone all the skills which will make him able to operate by himself. Neither does the second, advanced course on living tissues (that took place 28-30 October, 2010). They only open the mind and help the hands of those who want the practise. A lot of further, hard practice, both in the lab and in the surgical theatre, is needed to become laparoscopic urologic surgeons.

alincumpanas@ hotmail.com

Fig. 3: Setup for exercises in pelvi-trainer

Co-authors: Prof. Viorel Bucuras, Timisoara (RO), Prof. Jens Rassweiler, Heilbronn (DE), Prof. Maria Pilar Laguna, Amsterdam (NL) The Fourth International Training Course in Laparoscopy (Part 1 Basic Skills) took place between 30 July and 1 August 2010. It was organised by the Department of Urology of the Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, under the auspices of the EAU Section of Uro-Technology (ESUT), and sponsored by the Romanian branch of Karl Storz Endoskope. The two-and-a-half-day course was devised to offer participants both the basic knowledge and skills required for those interested in urological laparoscopy. As in the previous editions, all the available places (11 for this year) were filled one

Fig. 2: Preparation of pin-table trainer

We are grateful to all of those involved in organising the course, and anyone interested in its further development is welcome.

month in advance, as the course has a good reputation among the Romanian urologists keen to begin in this field (Figure 1). Each day started with a theoretical presentation about the essentials of urologic laparoscopy, such as instruments, handling, access, incidents and complications, ergonomy in laparoscopy, and the creation of a pneumoperitoneum. Using the excellent facilities offered by the Pius Brinzeu Centre of Microsurgery, Experimental Surgery and Laparoscopy from the host institution, the three Course Directors (Profs. Pilar Laguna, Jens Rassweiler and Viorel Bucuras) gave the trainees outstanding lessons about the handling of laparoscopic instruments, sections and sutures in this case through practising on chicken legs and pig bladders. After an initial evaluation regarding their skills in laparoscopy, the participants practised on a pin-table pelvi-trainer. Simple knots, left and right hand sutures and running sutures were learned and practised until exhaustion. While initially difficult, and very time-consuming, the exercises got easier with every hour of practice (Figure 2-3).

Urology in Tunisia
A successful first Tunisian-Spanish meeting
Prof. Ali Horchani President of TUS Tunis (TN) Hendaoui, Tunis (TU), C. Hernndez Fernndez, Madrid (ES), N. Kchir, Tunis (TU). These speakers gave interesting lectures on hospital infections, ablative techniques in renal cancer, LESS and Notes in Laparoscopic surgery, the organisation of kidney transplants in Spain and in Tunisia, the use of MRI in urooncology, premature ejaculation and a urologists versus pathologists debate. As usual, the European School of Urology was present, with a course accredited within EU-ACME by EBU on Retropubic radical prostatectomy tips, tricks and pitfalls managed by the doctors N. Mottet, Saint Etienne (FR) and C. Barr of Nantes (FR). A special interest was noted for this course, with 150 Tunisian, Algerian and Mauritanian participants. Around 250 participants took part in this congress. We hope to continue our cooperation with the EAU and ESU to make strides in improving urology in Tunisia.

ali.horchani@rns.tn The 10th National Urology Congress and first Tunisian Spanish meeting, STU2010, was held on 23-25 September 2010 in Tunis, in a cordial atmosphere of fruitful international exchanges. This congress was organised by the Tunisian Urological Society and featured many speakers of international fame: A. Alcaraz Asensio, Barcelona (ES), D. Azria, Montpelier (FR), P. Camparo, Suresnes (FR), A. Cherif, Tunis (TU), B. Cuzin, Lyons (FR), L.

Fig. 1: Group picture of participants with course directors at the training centre
EAU Section of Uro-Technology

On the last day, the trainees performed urethrovesical anastomosis on pig bladders, using the continuous running suture technique. After that, the trainees took part in a final evaluation, which aimed to assess the

Announcement

The EAU Research Foundations (EAU-RF) announces the official call for applications to the first EAU-RF Basic Research Grant to a young urologist who will focus in the next two to three years on basic research work in urological oncology. In a milestone development of the EAU-RFs efforts to advance urological research training a unique collaboration between the EAU-RF and Amgen has resulted in a fellowship position been created, supported by Amgen, at the Bone Oncology Group, Nuffield Department of Surgical Sciences at Botnar Institute, University of Oxford (UK). The appointment to this position will be administered by the EAU-RF Basic Research Committee. The Bone Oncology Group, Nuffield Department of Surgical Sciences at Botnar Institute, University of Oxford (UK), headed by Prof. Freddie C. Hamdy, has a proven track record in achieving significant outcomes and offers the project the Role of microRNA in the development of bone metastasis. The successful candidate will join the distinguished research team in Oxford starting this year. We consider this research grant a breakthrough development particularly with regards to Basic Research since this kind of work embodies the EAURFs mission and objectives. We can only bring the state of urological research to the next level if we actively support crucial work being done in basic science, says EAU-RF Chairman Prof. Peter Mulders.

EAU-RF Basic Research Grant

Conditions for application Young urologist In last-year residency Recommendation letter Motivation letter Detailed CV Applications in English Deadline for application 1 April 2011 How to apply Potential candidates, who are in their last-year residency, are required to submit a recommendation letter, a motivation letter and their detailed CVs to the EAU-RF at the following address: EAU Research Foundation European Association of Urology, PO Box 30016, 6803 AA Arnhem, The Netherlands Fax: + 31 (0)26 389 06 74 The EAU-RF will also welcome interested applicants at their booth Z50 at the forthcoming 26th Annual EAU Congress in Vienna, Austria from 18 to 22 March 2011. The EAU-RF Basic Research Grant is supported by an unrestricted educational grant from AMGEN

Call for applications for the first Basic Research Grant

December 2010/March 2011

European Urology Today

19

Changing the urological landscape

Introducing MISA 2011 the award for surgeons in the eld of minimally invasive surgery. Excellence, persistence and patience are the true drivers of innovation. Find out who will receive this prestigious award at the EAU Awards Corner! Topic 2011: Advances in LESS Surgery in Urology For the rst time, this scientic award on the advances in minimally invasive surgery will be supported by Olympus Europa Holding GmbH with a European Travel Grant.
SE 025-10

Visit t EAU A he wa Corner rds at

www.olympus-europa.com

EAU Guidelines Office training session repeated in Vienna

Friday, 18 March 2011 14.00 - 17.00 hrs
Mark this date in your calendar!
European Association of Urology

http://esusalzburg.uroweb.org

Guidelines
2011 edition

Priority will be given to EAU Guidelines Office panel members. Please register and send an e-mail to: e.robijn@uroweb.org

ESU - Weill Cornell Masterclass in General urology

10-16 July 2011, Salzburg, Austria
EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations

ERUS11

www.erus2011.com

8 edition 05-07 October 2011

th

Hotel Grand Elyse, Hamburg, Germany

European Robotic urology Symposium

latest Developments in Robotic Surgery
live case transmissions in Full High Definition all day training on the da Vinci Si update lectures & video presentations Meet the Expert sessions Poster and Video contest Congress exhibition
Congress organization by Ismar Healthcare For more information please contact: T +32 3 491 87 46 / F +32 3 491 82 71 Duwijckstraat 17, 2500 Lier, Belgium info@erus2011.com

Alex Mottrie, Belgium Magnus Annerstedt, Denmark Walter Artibani, Italy Ali Riza Kural, Turkey Thierry Pichaud, France Charles-Henry Rochat, Switzerland Peter Wiklund, Sweden

HOST FaCulTy
Felix Chun, Germany Margit Fisch, Germany Markus Graefen, Germany Alexander Haese, Germany

Local congress organization by TCB-Technology Consult Berlin GmbH T +49 30 40 50 45 30 / F +49 30 40 50 45 319 Chodowieckistr. 22, 10405 Berlin, Germany erus@tcberlin.net

SaVE THE DaTE

Courses in robotic surgery

SCIENTIFIC COMMITTEE

European Association of Urology

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European Urology Today

December 2010/March 2011

Health-related QoL: a vital issue in kidney transplantation

Donors as well as the recipients should be monitored for physical and psychosocial outcomes
Dr. Archil Chkhotua National Centre of Urology Transplantation Team Tbilisi (GE) recipients and dialysis patients by their nephrologists. The following socio-demographic and clinical factors have been analysed and compared in the dialysis patients: age; gender; duration of dialysis; educational level (low - secondary school graduate or less; medium - high school undergraduate or graduate; high post-graduate education, or scientific degree); socio-economic level (net family income low or high); serum haemoglobin (Hb); presence of diabetes and heart failure. The exclusion criteria for the dialysis patients were concomitant acute illnesses that may have acutely influenced their HRQoL. The control group has been generated by using probability-based methods to ensure representativeness of the general population of the country. The subjects from other psychological surveys have been provided by the national psychological association for this purpose. The mean age in this group was 519 years (18-70 years). Exclusion criteria were chronic diseases, with the exception of controlled systemic hypertension and previous non-major surgical interventions.
Table 2: Comparison of the mean GBB-24 scores between the groups

achkhotua@ gmail.com Health-related quality of life (HRQoL) concept is well-known in clinical medicine and is frequently applied for the assessment of surgical or other treatment modalities to determine their therapeutic success. It has become a leading criteria in many outcome studies alongside with somatic and economic factors and is frequently listed as a parameter in many medical societies guidelines. Despite methodological difficulties in making HRQoL measurable, there are numerous surveys and questionnaires used for this purpose. The Short Form-36 (SF-36), Giessen Subjective Complaints List-24 (GBB-24) and Zerssens Mood-Scale (Bf-S) are internationally validated and frequently used questionnaires for the assessment of HRQoL [1, 2, 3].

The groups were matched on the basis of: age, sex, race and other major covariates. At the time of the study, 97.8% of the recipients were alive and 89% of these had a functioning graft. For the following SF-36 results with references validated for another cultural The HRQoL analysis is especially important in the items: Social function, Bodily pain and Vitality, background; too few participants or low response donors as they are healthy persons voluntarily donors scored significantly better than the controls and rates. Nonetheless, they suggest hypotheses that donating an organ. Postoperative health of the kidney RCC patients. Bodily pain and Vitality indexes of require evaluation in a well-designed prospective donors has been studied on several studies showing the controls were significantly higher than that of the manner. that the organ donation does not cause serious RCC (Fig. 1). In all five GBB-24 items the donors scored medical problems like: deterioration of kidney higher than the controls and the patients. For the Despite the numerous reports analysing the HRQoL of function, arterial hypertension or proteinuria. Although gastric complaints the difference was significant. In dialysis patients and renal transplant recipients, an advocated in the literature, psychosocial assessment this item the RCC patients scored worse than controls important question: which RRT can be expected to and monitoring of living kidney donors is not yet and donors (Fig. 2). The mood analyses have shown provide the better quality of life? remains routinely performed and there are only limited reports that Bf-S scores of the donors were significantly higher unanswered. Results of these studies are inconclusive examining the HRQoL issues in the donors. than that of the controls (p = 0.0007) and patients (p < and somewhat controversial. 0.0001). The controls scored better than the patients (p The same is true for kidney recipients and dialysis = 0.0183). The better scores of the donors in somatic parameters patients. Results of studies comparing HRQoL of shown by our study can be explained by the fact that hemodialysis (HD) and peritoneal dialysis (PD) patients In all eight SF-36 domains the dialysis patients had they are selected group of individuals, well-evaluated with renal transplant recipients (T) are controversial. better scores than the transplant recipients and the and with better general health than representatives of Considerable uncertainty exists as to the differences in controls. The mean SF-36 scores were not significantly the common population. The better scores in HRQoL of: a) HD and PD patients; and b) dialysis different between: a) control group and transplant psycho-social parameters is caused by the fact that patients and transplant recipients, when adjusted for recipients; and b) hemo- and peritoneal dialysis donating an organ is associated with giving a second covariates (age, diabetes etc.). To date, only few studies patients including previously transplanted recipients life to the family member and/or close relative, from different countries have addressed this issue. (table 1). In all GBB-24 components the transplant psycho-social mobilization of the donor and There are no publications analysing HRQoL changes in recipients scored significantly higher than HD and PD consequently, the better mood. kidney transplant recipients who lost their grafts and patients. In the following components: Fatigue went back to dialysis. tendency, Limb pain and Cardiac complaints, Prospective design and high response rate are the recipients scored better than the controls and PT most important advantages of this study. The response We decided to analyse the importance of the HRQoL patients. There was no difference in GBB-24 scores rate of 93% is the highest reported in the literature issues in living donor kidney transplantation. Our study between the dialysis patients including the PT using these questionnaires. Another advantage is a population consisted of the following groups: 1) the recipients (table 2). According to the mood analysis comparison of pairs of subjects and controls matched kidney donors operated at our institution from January (Bf-S) scores of the transplant recipients and controls for gender and age. Only few studies have evaluated 2005 to December 2008 (n = 57); 2) 52 patients who did not differ and were significantly higher than that of the matched pairs whereas others have compared their underwent nephrectomy due to the renal tumour the dialysis patients. findings with the scores of general population. The (RCC); 3) 48 renal transplant recipients (T); 4) 120 present analysis is also the first to include postpatients on hemodialysis (HD); 5) 43 patients on The studies on the donors psychological well-being nephrectomy patients, and apply the Bf-S peritoneal dialysis (PD); 6) 9 recipients who lost their and HRQoL have been conducted since the early years questionnaire to the study groups. grafts and went back to dialysis (PT); and 7) 120 age- of kidney transplantation. However, most of the and sex matched healthy individuals (Controls). existing studies have limitations like: retrospective On the basis of this pilot study we can conclude that design; unmatched groups; use of non-standardised the HRQoL of living kidney donors is not different from The kidney donors and all the patients have been and validated questionnaires; comparison of the that of the healthy subjects and significantly better followed-up prospectively. The mean donor age was 499 years. The mean follow-up was 32 months Table 1: Comparison of the mean SF-36 scores between the groups (range: 4-57 months). All the transplants were performed from genetically related donors. The donor recipient relationship was following: parent 86.5%; sibling 2.7%; cousin and uncle 5.4% each. All the donors are alive.

Figure 1: Comparison of the mean SF-36 scores between the groups

PF physical function; PR physical role; SF social function; BP bodily pain; MH mental health; ER emotional role; V - vitality; GH general health perception. * p = 0.0001 vs. Controls and p = 0.0209 vs. RCC; p = 0.0357 vs. Donors and p = 0.0375 vs. Controls; p = 0.0478 vs. Controls and p = 0.0006 vs. RCC; p = 0.0128 vs. RCC.

Figure 2: Comparison of the mean GBB-24 scores between the groups

* p = 0.0080 vs. Controls and p = 0.0293 vs. RCC

Ninety eight patients have been operated at our institution for renal tumours. The mean follow-up was 28 months (range: 4-35 months). None of the patients had clinical signs of renal insufficiency or other substantial co-morbidities (diabetes etc). Radical or partial nephrectomy without adjuvant immunotherapy was performed in all patients. Three questionnaires (SF-36, GBB-24 and Bf-S) have been mailed, e-mailed, or handed out to all the donors and the patients with a follow-up of at least 3 months. The evaluation procedure was completely anonymous and all the respondents were free of any charges related to the filling or sending the questionnaires. Weve received the completed questionnaires from 57 donors (93%) and 52 patients RCC (53%). The response rates in other groups were: 97% in HD; 95% in PD; 90% in PT; and 84% in T. The high response rates have been ensured by the fact that the questionnaires have been handed out personally to almost all the donors,
EAU Section of Transplantation Urology (ESTU)

than the HRQoL of the patients operated due to the medical indications. The HRQoL of patients on hemo- and peritoneal dialysis is similar and lower than that of the general population. Renal transplantation significantly improves the HRQoL at least to the level of the healthy individuals whereas the graft loss is associated with significant worsening of the HRQoL. The donors should be monitored for both physical and psychosocial outcomes of the donation. The future prospective studies with higher number of participants will enhance our knowledge of the factors influencing the HRQoL of the living kidney donors and their recipients. References
1. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473-483. 2. Giessing M, Reuter S, Schonberger B, et al. Quality of Life of Living Kidney Donors in Germany: A Survey with the Validated Short Form-36 and Giessen Subjective Complaints List-24 Questionnaires. Transplantation 2004; 78: 864-872. 3. Zerssen D: Die Befindlichkeitsskala. Beltz-Test GmbH; 1976.

December 2010/March 2011

European Urology Today

21

9 th European Urology Residents Education Programme (EUREP)

2-7 September 2011, Prague, Czech Republic http://eurep.uroweb.org

Exclusive training opportunity

General information
Participation and contribution This teaching programme has been developed and created exclusively for all European urological residents. The EUREP provides an almost complete update and overview of modern urological practice presented by a distinguished European faculty. The EUREP is an initiative of the European School of Urology in collaboration with the European Board of Urology. The participants have the possibility to do the written part of the FEBU exam (Fellow of the European Board of Urology) on the last day of the programme. EUREP participants will also be evaluated by means of MCQs during the sessions. Format The format is a full six-day course comprising five modules. Each day is made up of two sessions that last around seven hours. Morning sessions feature state-of-the-art lectures, while afternoon sessions offer interactive case discussions, video, and test-your-knowledge sessions. The laparoscopy hands-on-training sessions will take place at the beginning and end of the day. The training which is sponsored by Olympus helps the participants sharpen their skills and offers hands-on interaction with state-of-the-art equipment. Venue of the EUREP Meeting The EUREP will be organised in Prague, Czech Republic. The venue at the Clarion Congress Hotel provides excellent facilities and the four-star hotel has all the necessary facilities needed for both the scientific programme and social activities. Travel Arrival date: Thursday evening, 1 September 2011 Departure date: Wednesday afternoon, 7 September 2011

Preliminary programme 2011

Module 1 Urological cancer
Chair: M. Babjuk, Prague (CZ) Faculty: G. Ahlgren, Malm (SE) A. Heidenreich, Aachen (DE) J. Palou, Barcelona (ES) Testis cancer and penile cancer Diagnosis and treatment of stage 1 disease Management of metastatic disease Treatment of primary lesion Management of inguinal lymph nodes Non-muscle invasive bladder cancer Diagnosis, staging and risk stratification Management of low, intermediate and high risk disease Muscle invasive bladder cancer Surgical and non-surgical options and techniques Neo and adjuvant chemotherapy and the management of metastatic disease Renal cancer Diagnosis and management of T1-2 disease Management of locally advanced and metastatic disease

Registration information
Important dates Online registration will open on 3 January 2011. The selection process will be made after the close of registration on 29 April 2011. A total of 360 participants will be selected. Participants will be notified by email if they have been selected. If selected, the deadline for cancellation is 1 August 2011 after this time a cancellation fee of 500 will be charged. Selection criteria Registrations can only be submitted through the online registration system. The registration will only be considered complete if the registration is accompanied by: A letter from the head of department indicating the date that the participants training will end A copy of passport or National ID Card Additional criteria 1. EAU membership. Priority is given to those who are or become a member before the registration deadline 2. Year of training. Priority is given to residents in their final year of training (i.e. training should be finished before September of the following year based on the information received from the proof of status) 3. First come first served 4. English skills 5. Target per country 6. It is only allowed to attend the EUREP course once For further detailed information regarding the registration rules for the 9th EUREP course we strongly recommend that you visit http://eurep.uroweb.org. Registration non-European residents If you are a non-European resident that is interested in taking part in the 9th EUREP course please go to http://eurep.uroweb.org for the rules and regulations regarding participation.

Module 2

Prostate cancer and BPH

Chair: P. Hammerer, Braunschweig (DE) Faculty: A. Govorov, Moscow (RU) V. Ramani, Manchester (GB) L. Turkeri, Istanbul (TR) Prostate cancer Screening, early detection and staging Treatment for localised disease Surgical treatment, radiation, focal therapy, active surveillance Locally advanced prostate cancer Systemic treatment BPH Medical treatment BPH BPH: Surgical treatment

Module 3

Andrology, stones and upper tract endourology

Chair: A. Tasca, Vicenza (IT) Faculty: G. Dohle, Rotterdam (NL) A. Patel, London (GB) E. Wespes, Brussels (BE) Andrology Structured approach to the management of male infertility Varicocele Pathophysiology, diagnosis and management Male contraception and microsurgical refertilization The ageing male Evaluation and treatment Disorders of erectile function Peyronies disease: New physiopathology concept Stones Aetiology, management and prophylaxis of urolithiasis ESWL treatment of urolithiasis Percutaneous and open surgery Upper tract endourology Stents in the urinary tract Ureteroscopic stone manipulation Endourology in UPJ obstruction

If you meet the criteria we would encourage you to register for this opportunity, Prof. Van Poppel, course director

For more comprehensive information we strongly recommend you visit the website http://eurep.uroweb.org
Workshops on laparoscopy hands-on-training
06.45 08.20 Morning session 19.00 21.00 Evening session Extra Hands on Training workshops: 13.45 15.15 Sunday afternoon session 15.30 17.00 Sunday afternoon session Participants can only participate in 1 session The European Urology Residents Education Programme (EUREP) offers during the EUREP course in Prague an intensive hands-on laparoscopy training sponsored by Olympus. The workshops gives everyone the opportunity to train in basic techniques with lap trainers and suturing under expert supervision. Thanks to the intense tutoring by one trainer to two students we expect a fast learning curve. Training modules: Insertion of the trocars: Insertion in working direction Distance of the trocars Angle between the trocars 3/5 trocar approach Use of all instruments in the LapTrainer under 2D vision: Handling and manipulation 0 field of view Working in a team cameraman surgeon Handling of the instruments bimanual Coordination of left and right hand Learn the third dimension Move beans and rings in the LapTrainer on a nailboard Suturing techniques with suture & different skin pads: Interrupted suturing Continuous suturing Advanced suturing (optional): Circular suturing Anastomosis

Module 4

Functional urology

Chair: F. Cruz, Porto (PT) Faculty: E. Chartier-Kastler, Paris (FR) M. Drake, Bristol (GB) P. Radziszewski, Warsaw (PL) Lower urinary tract dysfunction Terminology and essential urodynamics Overactive bladder: Idiopathic and neurogenic Painful bladder syndrome: Essential issues Assessing the neuropathic patient Everyday neurourological treatment Female urology Management of stress urinary incontinence in female patients Pelvic organ prolapse: Philosophy and reality Mesh complications and urogenital fistulas Male urology Male incontinence: Main aspects

Module 5

Paediatric urology, trauma and infection

Chair: R. Kocvara, Prague (CZ) Faculty: T-E. Bjerklund Johansen, Arhus (DK) D. Bogaert, Leuven (BE) K. OFlynn, Manchester (GB) Paediatric urology Essentials of obstructive uropathy Congenital malformations of the external genitalia Infections Urinary tract infections Trauma Diagnosis and management of kidney, bladder and urethral trauma

EUREP is supported by an unrestricted educational grant from

Scientific secretariat ESU Office PO Box 30016 6803 AA Arnhem, The Netherlands T +31 (0)26 389 0680 F +31 (0)26 389 0674 eurep@uroweb.org 22 European Urology Today

December 2010/March 2011

European practices for Syrian urologists on PCa and BCa

Report on the ESU Course at the time of the 28th Annual Congress of the Syrian Urological Society
Dr. Ghanem AlSibai Al Razi Urology Dept. Tartous (SY) He summarised the current status of robot-assisted radical cystectomy as follows: In experienced hands estimated blood loss is < 500 cc, and hospital discharge on postoperative day 4-5; Complications appear similar to open surgery and decrease with experience. The greatest area of concern was the adequacy of lymph node dissection in the higher regions common iliac to peri-caval-aortic; Experienced surgeons have demonstrated the possibility of reduced blood loss, no need for opiates and reduced hospital stay; Prof. Wirth then presented his take-home messages regarding complications and results of radical cystectomy as follows: Radical cystectomy with extended lymphadenectomy is optimal curative treatment of muscle invasive bladder cancer; There is an acceptable rate of morbidity and mortality in high volume centres; Radical cystectomy is a safe and effective treatment also for elderly patients; Consideration of individual co-morbidity is important. European association of Urology (EAU) advises men who consider screening by PSA and biopsy to obtain information on the risks and benefits of screening and individual risk assessment. It also became apparent that the issue is not the problem of over-diagnosis, but over-treatment. Then, Prof. Marberger raised another issue: the cutoff value of PSA that indicates biopsy. He asks why the cut-off value is not at 2, 1.5, or 1. The dilemma is that PSA at low levels mainly reflected BPH, not prostate cancer (with PSA < 2.5 ng/ml). PCa are still pT3, but many more clinically insignificant cancers are there. Then he concluded these issues by saying that at this time, PSA cutoff values (> 2.5, 3 or 4 ng/ml) provide a reasonable balance between excessive detection rates and the risk of missing relevant PCa. Men presenting with PSA values of 2-3 ng/ml should be re-examined more frequently. Available nomograms applying risk modifiers should be used specifically in this category of men. All the five drugs proved effective in prospective controlled randomized studies. For immunotherapy he gave insight on a new approach for treatment of hormone refractory prostate cancer through a dendritic, cell-based vaccine called sipuleucel-T (Provenge). This novel drug was approved by FDA in USA in April 2010. Sipuleucel-T (Provenge) is the first successful immunotherapy for treatment of metastatic prostate cancer. Prof. Wirth then addressed two new medications, MDV3100 and abirateron. MDV 3100 is a second generation antiandrogen with improved characteristics over currently available antiandrogens. Abiraterone acetate (CB 7630) is a novel pan-inhibitor of androgen synthesis. It inhibits testosterone production produced by the testis, adrenals and the prostate tumour. For prevention of bone loss, he shed light on a new drug called denosumab which is proven to increase bone mineral density and reduce cumulative occurrence of vertebral fractures after duration up to three years. Denosumab is the first substance that effectively reduces bone loss during androgen suppression therapy. Radical prostatectomy The last lecture was on open versus laparoscopic versus robot-assisted radical prostatectomy by Prof. Bob Djavan, who offered an extensive discussion regarding the merits and disadvantages of the three main approaches currently used for radical prostatectomy.

dr.sibai-mg@ scs-net.org The continuation of series of courses organised yearly by the ESU makes a great difference to the urological community of Syria. For this whole-day course, a number of topics are requested by the Syrian Urological Society (SUS). The ESU takes care of the contents and the financial support of the course. Syrian urologists consider the ESU course one of the most important scientific events at their national congress and every year different topics are thoroughly discussed by well-known European urologists. The results have always been beyond expectations, and with the number of attendants increasing continuously, we can say that these events prove to be a success year after year. Much of this success comes from the fact that the courses are always presented in a well-structured, practicable manner, providing a clear guidance and most updated recommendations from on each topic.

Prof. Marberger then described the proper standard technique of taking a biopsy as already exists in the Orthotopic neobladder literature. Then he provided evidence that the higher The last talk in this session covered the orthotopic the PCA3 score, the greater the likelihood of a positive neobladder. Presented by Prof. Bob Djavan this review repeat biopsy. touched upon the history, evolution and current status of orthotopic neobladder. Here he raised the following Prof. Marberger addressed another important issue issues: regarding identifying focal PCa for the purpose of focal The bowel segment to be used; therapy. He stated that endorectal MRI/Dynamic MRI Whether to perform an anti-reflux mechanism; reliably identifies CA >1 cm3 and with refinement It is wonderful that the ESU stimulates the Continence; (MRSI) >0.5 cm3. development of urology in various countries all over Metabolic consequences; the world, and we highly appreciate it. On behalf of Risk of urethral recurrence in men and women. Treating metastatic PCa SUS, I would like to thank the ESU Board and the ESU After this lecture, Prof. M. Wirth gave his talk on the staff, and express our hope that such successful ESU He summarised the WHO consensus 2007 regarding treatment of metastatic prostate cancer. He presented courses will continue to be organised in Syria for urinary diversion and stated that in over 7,000 an excellent lecture that highlighted the most recent decades to come. patients, orthotopic neobladder was carried out in and up-to-date advances in the treatment of 47%, while ileal conduit in 33%, anal diversion in 10% metastatic prostate cancer. He classified the strategy of The 28th Annual Congress of the Syrian Urological and continent cutaneous diversion in 10%. The treatment into two large categories. Society was held on 7-9 October 2010 in Damascus, recommended pouch is ileal neobladder (Kock Pouch). Hormonal sensitive prostate cancer. Syria. Friday, 8 October was fully devoted to the ESU The ureter must be implanted end-to-side free Hormone insensitive prostate cancer. course which was dedicated to prostate and bladder refluxing to afferent loop. He also mentioned that the cancer. need for anti-reflux incontinent cutaneous pouch is For hormone-sensitive prostate cancer, he addressed still not well-studied. two new gonadotrophin-releasing hormone We have had the honour of welcoming Prof. Michael antagonists, namely: Abarelix and Degarelix. Both Marberger, Vienna (AT), Prof. Manfred Wirth, Dresden After each presentation, enough time was given to drugs proved to be effective in the treatment of (DE), as well as Prof. Bob Djavan, New York (US) as answer all questions which offered an excellent hormone sensitive prostate cancer through multiple Chairman of the ESU Course. The full-day course opportunity for a discussion between the audience randomised, open-label, phase 3 studies. attracted high numbers of attendees. and the faculty. These question sessions and the case discussion at the end of the morning session offered a The main problem with these new drugs is the After a welcoming word by me as the Secretary structured discussion of clinical cases covering history possibility of an allergic reaction occurring in 1.1% of General of the SUS, an introduction was made by Prof. and physical examination, proper diagnosis, and patients. Bob Djavan about the European School of Urology as therapeutic options. This format resulted in a lively a unique education opportunity for urologists. debate and an excellent interaction with the faculty. Based on randomised phase 3 study Prof. Wirth recommended intermittent rather than continuous BCa diagnosis PCa screening hormonal therapy in advanced prostate cancer. He The morning session was devoted to bladder cancer After the break, the second part of the day began concluded that intermittent therapy is at least as beginning with a presentation by by Prof. Marberger which was devoted to prostate cancer. The first effective as continuous androgen deprivation and is a entitled Streamlining the diagnosis of Cancer of the speaker in this session, Prof. M. Marberger, presented safe and reasonable standard in hormone-responsive Bladder. During his lecture, he discussed three on prostate cancer screening and diagnosis. prostate cancer. challenges which are crucial in the management of Here he raised an important issue regarding the non-muscle invasive bladder cancer, namely, logical approaches to reducing prostate cancer For the treatment of hormone insensitive metastatic detection of carcinoma in situ and flat bladder mortality. He suggested two main approaches, prostate cancer, he addressed four important aspects: cancers, obtaining reliable histology, avoiding early namely: prevention or slowing of oncogenesis and chemotherapy, immunotherapy, new concepts of recurrence. earlier diagnosis with better curative therapy. hormone therapy, prevention of bone loss. These approaches could be reached through screening For the first challenge, Prof. Marberger suggested a of prostate cancer, as was seen in the European For chemotherapy he stated that the following drugs combination of routine cytology and white light and Randomised Study of Screening of Prostate Cancer are effective chemotherapeutic agents against fluorescence cystoscopy. Moreover, in one of his (ERSPC) which proved that systematic screening hormone insensitive prostate cancer: mitoxantrone, take-home messages he mentioned that the reduces Prostate Cancer mortality but at considerable docetaxel, docetaxel+dstramustine, satraplatin, combination of fluoroscopic cystoscopy and optical expense of over-diagnosis and over-treatment. So the cabazitaxel. coherence tomography can improve detection of CIS and flat bladder lesions dramatically, and hence reduce the number of unnecessary biopsies. For the second challenge, he suggested the use of the new WHO 2004 grading system for obtaining reliable histology. For the third challenge, he recommended doing a second TURBT four to six weeks after the first resection. Radical cystectomy The second presentation was dedicated to the results and complications of radical cystectomy. Prof. M. Wirth started his talk by comparing laparoscopic and robotic radical cystectomy, versus open radical cystectomy. He then addressed the issue of the results and complications of radical cystectomy, the different techniques of urinary diversion and their consequences. December 2010/March 2011

Profs. Al Sibai and Marberger

He demonstrated the evolution of the three techniques over the past two decades and stated that laparoscopic radical prostatectomy is losing the round and is no longer carried out in most centres in the USA. On the other hand, robot-assisted prostatectomy is getting much popularity and about 80% - 90 % of radical prostatectomy is currently carried out robotically in USA. However, he mentioned that open prostatectomy is still the technique that gives the best results regarding the oncological outcome, continence and erectile function. Prof. Djavan advised the Syrian urologists to keep on training in open radical prostatectomy as it is the most cost-effective modality. As during the morning sessions, the audience participated very actively with questions and discussion following each presentation. The day went to its end with closing remarks. As usual the attendees enjoyed tremendously the ESU day. Praise We are very grateful to the ESU Board for organising these courses annually, and we have to thank again Prof. M. Marberger, Prof. M. Wirth, and Prof. B. Djavan for joining us at the 28th Annual Congress of the SUS. I should thank the manager of the European School of Urology (ESU) Mrs. Jacobijn Sedelaar-Maaskant for her cooperation and collaboration in organising these courses. Definitely, I will never forget the young lady from the ESU office, Monique Oosterwijk, who exchanged with me a lot of e-mails discussing all details for preparing the ESU Course, for her enthusiasm and the great job that she did. The 29th Annual Urological Congress of the SUS will be held in the autumn of 2011. We have been promised to have a wonderful ESU full-day course and you are cordially invited to participate in this congress. European Urology Today 23

From right to left: G. AlSibai, M. Al Om, I. Barghouth, A. Al-Dayel, A. Al-Sayyed, Z. Ayash, A. Shehab

Manila hosts 2nd Joint ASU-ESU course

Paediatric topics and uro-oncology top meeting agenda
By Joel Vega The 2nd Joint Course of the Asian School of Urology (ASU) and the European School of Urology (ESU) held in Manila, Philippines last December 2 to 3, 2010 tackled current issues in paediatric urology, prostate cancer and upper and lower urinary tract transitional cell carcinoma (TCC), with topics ranging from hypospadias repair, radical cystectomy to castration refractory prostate cancer. A lot of work has been exerted by the members of the Education Office of the European Association of Urology (the European School of Urology) and the Asian Society of Urology, and we are indebted to Prof. Rainy Umbas and his colleagues for the efficient and fruitful interaction, said ESU Chairman Prof. Hein van Poppel. strengthen worldwide international collaboration in urological education and training between Asia and Europe. The topics were selected by the national association in response to frequently encountered issues faced by local urologists. The teaching faculty in Manila included Dante Dator (Philippines), Sim Hong Gee (Singapore), Manish Patel (Australia), Rien Nijman (the Netherlands), Hideyuki Akaza (Japan) and Noel Clarke (UK). Topics discussed included distal hypospadias surgery, medical and surgical management of vesico-ureteral reflux (VUR), radical prostatectomy outcomes and complications, radical cystectomy outcomes, management of Non Muscle Invasive Bladder Cancer and urinary diversions and orthotopic bladder replacement. Amongst the selected take-home messages were:
The 2nd Joint ASU-ESU course held in Manila, Philippines

In the cost-effective detection of prostate cancer, PSA remains a valuable test whilst current risk calculators have inherent pitfalls due to the extrapolation of European/American data to the Asian population.

In VUR, medical treatment is a primary option whilst surgery is considered for specific indications. However renal scars may occur following successful treatment and surgery does not prevent urinary tract infections (UTI) (Nijman);

Held at the occasion of the 53rd Philippine Urological According to Umbas the collaboration with the ESU Association (PUA) Annual Convention in Mandaluyong has been well received in Southeast Asia. Participants Regarding treatment options for castration refractory prostate cancer, denosumab is the City, Metro Manila, the ESU-ASU course aims to value the exchange of knowledge and skills newcomer after zoledronic acid in preventing/ particularly with recent delaying first and multiple Skeletal Related Events. advances made in Europe Notable adverse events occurring in both treatment regarding surgical techniques groups included hypocalcemia and osteonecrosis of and medical treatment the jaw (Patel); strategies, Umbas said as he noted the first successful joint On risk-stratified management of NMIBC, a ASU-ESU course in Bali, randomised controlled trial (conducted by Japanese Indonesia during the 32nd researchers) of prophylactic intravesical instillation Annual Scientific Meeting of chemotherapy in combination with the oral the Indonesian Urological administration of a Lactobacillus casei preparation Association. versus intravesical instillation chemotherapy alone has shown that Lactobacillus casei preparation or a We bring together experts fermented milk drink decreases the bladder cancer from both regions and respond risk and prevents tumour recurrence after to the concerns faced by local TransUrethral Resection of a Bladder Tumor urologists. We try to be flexible (Akaza). and by covering issues of current interest makes the In the cost-effective detection of prostate cancer, course more relevant and Prof. R. Nijman lectures at the 2nd ASU-ESU course PSA remains a valuable test whilst current risk interesting, Umbas said.

calculators have inherent pitfalls due to the extrapolation of European/American data to the Asian population. Regarding initial prostate biopsy, it involves transrectal 10-12 cores laterally directed biopsy under local anesthesia. More cores can also be considered in cases of very large prostates (Hong Gee); Radical cystectomy is still considered the gold standard procedure for invasive bladder cancer and post operative mortality at 30- and 60-days has decreased progressively over the decades, and with it, a concomitant and significant decline in reoperation rates. The very popular simple urinary diversions are more and more replaced by orthotopic neobladders (Clarke).

Participants value the exchange of knowledge and skills particularly with recent advances made in Europe regarding surgical techniques and medical treatment strategies.

http://seem.uroweb.org

http://esubarcelona.uroweb.org

EAU 7th South Eastern European Meeting (SEEM)

14-15 October 2011, Skopje, Macedonia
EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations

6th ESU Masterclass on Medical treatment for urological cancer

2526 June 2011, Barcelona, Spain
EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations

European Association of Urology

European Association of Urology

24

European Urology Today

December 2010/March 2011

European School of Urology comes to Armenia

The arrival of world-class urological laparoscopy
Armenian urologists do realise the need to speak the same language with the colleagues around the world and the language we must speak today is called minimally-invasive approach. The learning pathway set up by the European Association of Urology which leads to the high standards of urologic education and care is hard, but Armenian urologists are eager to take on the challenge. The results of the ESU course held at the very first day of the Annual Meeting of the Armenian Association of Urology (4 October 2010) confirmed that we are in indeed in the process of learning the language. This event was the first ever professional educational event in Armenia dedicated to laparoscopy in urology and we want to reassure the organisers and participants that it has opened a new era and that the new beginnings will rapidly develop. a justification for the existing situation. On the other hand, the understanding of the surgeons responsibility to offer the patient the optimal treatment leads to seeking the ways of introducing laparoscopy in urology throughout Armenia and creating the chances for the local urologists to master in the concepts and skills of that. The leadership of the Armenian Urological Association, headed by the recently elected President Prof. Armen Muradyan, has been doing its best to use each and every opportunity to install and run more of this minimally-invasive approach.

Usually, expectations are in the best case only met, especially, when both the faculty and audience consist of urologists. Still, the most exquisite and lofty professional satisfaction comes at those rare moments when the expectations are being exceeded. This has been definitely the case with the recent ESU course in It is truly impossible to underestimate the importance Yerevan, Armenia. Undoubtedly, the faculty members of this ESU course, as for the first time, we, Armenian are the world-class professionals, the topics, lectures urologists, hosted world-class laparoscopic urologists. and the content were chosen very meticulously, the With this event came the realisation of the inevitability educational process and methodology were and necessity of a widespread introduction of elaborately tuned to allow the audience to get the laparoscopic urological techniques in Armenia, and most out the course. Still, these are the technical this was one of the two major achievements of the characteristics of any ESU course that always course. Once again, the course has demonstrated that correspond to the highest standards. It is not possible ESU faculty together with local organisers. Left to right: A. Grabsky, Yerevan (AM), R. Autorino, Cleveland (US), A. McNeill, the educational format chosen by the EAU is a to expect anything less than that from an ESU course. Edinburgh (GB), A. Avoyan, Yerevan (AM), B. Van Cleynenbreugel, Leuven (BE) universally common denominator for virtually any This was expected and it became a reality. professional mentality, background, ideology and In this report we should touch on highlights, like through a series of rich and sophisticated capacity. The explanation of why the expectations of the presentations and lectures, most immediate perfect attendance and most active participation of Armenian urological community were exceeded lies We have to confess that the development of urological in a completely different sphere in the most elusive interaction with the audience, sincerest interest in the the audience, very smart manner of conducting the laparoscopy lags behind in our country compared to sphere of human emotions, feelings and sympathy. It professional growth of the Armenian urologists and a course by the faculty, the organisation of the course by Ms. Susan Heeren, whose considerate attitude most scrupulous organisation of the course. other fields in urological surgery and it is not as is very easy for an educated person to share even to the smallest detail made this event a bright widespread as it should be. There are several reasons professional information. But one can share and - by Thus, we can state that two principal goals of course, success. We want to thank the leadership of the EAU for that, objective and subjective, still, none of them is doing that - touch the feelings of the audience, and ESU for the organisation of this wonderful set by the local organisers and ESU have brilliantly creating an emotional matrix which helps turn that information into knowledge and mentality. This is the been achieved. Firstly, we made sure that laparoscopy professional event, thank the ESU staff and faculty, time when you get the most refined contentment and is one of the highest roads of urology and mastering it thank all those, who spent their precious time for and invested their mind and soul in the development of your expectations are exceeded. The old Greek saying is the requirement of today, if we intend to secure urology in Armenia, all those who contributed to harmonic development of our specialty according to about the student, who is not a vessel to be filled, bringing the standards of urological service to the the accepted standards. Secondly, the Armenian but a torch to be lit is an absolutely precise same level throughout Europe. urological flywheel has picked the strongest possible description of what has happened in the Ballroom of impulse and it will drive us in the right direction and the Yerevan State Medical University. The team of Dr. never let us go astray from the path so beautifully Dr. Armen Avoyan Van Cleynenbreugel from Belgium has entirely described by Dr. Van Cleynenbreugel, Dr. McNeill and Yerevan (AM) reached its goal: they managed to enkindle the Dr. Autorino. Crowning this was the most delicate and Armenian urologists, to arouse in them a deep and Dr. Arthur Grabsky subtle accomplishment - we, Armenian urologists, inextinguishable interest toward the beautiful and Yerevan (AM) realised that there exists a totally new, previously exciting world of laparoscopy, to instil them with under- or even unexplored source of professional sufficient fuel to further quest for the place of satisfaction for a urological surgeon, a source that Dr. Ruben Hovhannisyan laparoscopy in ones professional life, to pass on to Yerevan (AM) ESU speaker R. Autorino, Cleveland (US) them the valuable knowledge. This has been achieved does reward to the highest standards.

European School of Urology

Activities 2011
March
18-22 ESU Courses, HOT, Education and Innovation at the time of the 26th Annual EAU Congress Vienna (AT)

Organised courses at National Urological Society meetings

Masterclasses
June
25-26 6th ESU Masterclass on Medical treatment for urological cancer Barcelona (ES)

April
22 ESU organised course on Prostate cancer at the time of the national congress of the Serbian Association of Urology Belgrade (RS)

July
10-16 ESU Weill Cornell Masterclass in General urology Salzburg (AT)

November
11-13 4th ESU Masterclass on Female and functional reconstructive urology Berlin (DE)

June
3 ESU organised course on Stones, laparoscopy, non-muscle invasive bladder cancer and prostate advanced cancer at the time of the national congress of the Moldavian Urological Association Chisinau (MD) ESU organised course on Urological trauma at the time of the annual meeting of the Austrian-Bavarian Society of Urology Klagenfurt (AT) ESU organised course at the time of the national congress of the Latvian Urological Association Liepaja (LV)

Residents course
September
2-7 9th European Urology Residents Education Programme (EUREP) Prague (CZ)

4 9

September
9 26 ESU organised course at the time of the national congress of the Polish Urological Association ESU organised course on Update in female urology and reconstruction at the time of the national congress of the Scientific Society of Urologists of Uzbekistan Gdansk (PL)

Combined EAU/ESU meetings

July
7-8 Chinese Urology Education Programme (CUEP I) Beijing (CN)

October
Tashkent (UZ) 26-27 Chinese Urology Education Programme (CUEP II) Nanjing (CN)

November
11 ESU organised course on Urolithiasis, BPH, overactive bladder, laparoscopy and erectile dysfunction at the time of the national congress of the Bulgarian Association of Urology ESU courses are accredited within Sofia (BG) programme by EBU with 1 credit per hour ESU Office T +31 (0)26 389 0680 F +31 (0)26 389 0684 esu@uroweb.org www.uroweb.org

December 2010/March 2011

European Urology Today

25

ESU Masterclass in Berlin

Evidence-based updates bolstered by expertise and experience
Dr. Lara Gerbrandy Schreuders Alant Vrouw Dept of Urology Amsterdam (NL) have such a wonderful faculty to guide us through the whole spectrum of this urological field. The whole spectrum indeed because what a diversity of subjects did the masterclass have to offer: from the anatomy of the pelvic floor (always more difficult than you think, but with the amazing videos of faculty member Dr. Vase from Mumbai - an easy 3D insight) to surgical management of detrusor overactivity, from bowel and anorectal physiology to pelvic organ prolapse It was a three-day rollercoaster-experience of presentations and discussions and I think it covered all aspects of this field. We had many discussions which were quite entertaining at most times. For instance, what do you think the faculty members prefer for a surgical intervention for stress urinary incontinence? Dirk De Ridder, Leuven, likes the MiniArc, John Heesakkers, Nijmegen, the TVT, Chris Chapple, Sheffield, admitted he preferred the Monarc (or a pubovaginal sling in a secondary procedure or in cases of clear ISD and/or fixed urethra), David Castro-Diaz, Tenerife, the Monarc or MiniArc, Walter Artibani, Verona, the TVT-O and Dmitry Pushkar, Moscow, the TVT-O or TOT (or a Burch for teaching purposes). In this, also quite a diversity! In conclusion, it was great to be part of this Master Class. I learned a lot and made new friends as well. And the small group of participants made it very easy to ask questions and to join the discussion. Many thanks to the organising committee!

http://esuberlin.uroweb.org

4th ESU Masterclass on Female and functional reconstructive urology

11-13 November 2011, Berlin, Germany
EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations

laraschreuders@ hotmail.com This year the ESU Masterclass on Female and functional reconstructive urology was organised for the third time and I was very happy to be one of the participants who could join in. In the Netherlands I work as a urologist in a public clinic specialised in pelvic floor disorders so this masterclass was especially made for me! I hoped to learn more about the pros and cons of the different treatment options and to hear more of treatments coming up in the near-time future. The near 30 participants who joined this masterclass came from all over Europe, mainly from Belgium and Southern European countries, but also from Latvia and Belarus. The modern and spacious Hotel Berlin-Berlin was our home for three days and it is conveniently situated in the centre of Berlin and very close to the Gedchtniskirche and the famous shopping area of the Kurfstendamm. Our focus however was on urology and we were very happy to

Exceeding expectations
Masterclass offers insights, updates, interaction
Dr. Zane Pilsetniece Riga Paula Stradina Clinical University Hospital Riga (LV) impressions than I expected, I would like to tell you shortly about this time. At the beginning, I would like to give thanks for this time in Berlin to all who organised this course and shared their knowledge and opinions. The main reason why I decided to attend this course was my interest in female and functional urology and pelvic dysfunctions. This course was really interesting and fruitful, led by Europes best experts in this field of all. All presentations were made to remind and stress main points to remember in female urology and pelvic dysfunction: starting from anatomy, physiology, different kind of dysfunction and finishing with smart neurogenic things and reconstructive surgery. The main expectation from this course was to gain new insights, to meet colleagues who work in this field, and to get experience and ideas on how to improve my clinical practice and skills. I truly enjoyed in attending these highly professional lectures and discussions of leading experts in this field. All participants could were given an opportunity to take part in the discussions too and also solve very specific clinical cases. The masterclass format meant that the course was mainly oriented to very practical and clinical problems. I can evaluate this course very highly and I would recommend it to all colleagues who are interested in female and functional reconstructive urology. It is important to gain new experience and share your own, because we can always look at developments from different sides, and we never know when we will meet a patient with a complicated condition, similar to those discussed in presentations. Finally, I would like once again thank ESU for this investment in me and other doctors, because, to my mind, it is very important to talk one language in medicine because we all have the same goal: efficiently help our patients. My greetings to everyone I met in Berlin!

zpilsetniece@ apollo.lv On 5-7 November I had an opportunity to visit 3rd Masterclass on Female and functional reconstructive urology in Berlin which was held within the framework of the ESU. As I appreciated these three days a lot and received much more knowledge and

Excellent format, top faculty

Update on female and functional reconstructive urology with a focus on clinical application
Dr. Frank Van Der Aa UZ Gasthuisberg Leuven Dept. of Urology Leuven (BE) observership in one of the selected and recognized centers, the day started with an interview by two of the faculty members. Besides current practice and expertise of the participant, the interview dealt with expectations regarding the masterclass and the observership following this masterclass. In general the masterclass was a positive experience both at the theoretical level and at the social level. It was a great occasion to participate in interactive sessions in a rather small group of participants with an excellent faculty.

In the afternoon the actual class started. During the sessions the entire faculty was always present and both participants and experts could ask questions, give remarks, ask for further explanations. Some discussions could continue during lunch, where we On 5-7 November 2010 the 3rd ESU Masterclass on had the occasion to interact with colleagues from female and functional reconstructive urology was held abroad and with the faculty. In general, sessions were in Berlin. I went to the masterclass with the interactive and the threshold for interaction was low. expectation to receive up to date theoretical and practical guidelines regarding several functional and On Saturday evening there was a faculty dinner at reconstructive topics. I hoped to meet some Einstein Caf, a traditional Wiener Kaffeehaus with international colleagues with similar interest and good local kitchen, wine and beer. With some drinks finally I hoped to be able to discuss some issues with and speeches, the evening set off in a good tone. It the renowned faculty of the masterclass. was well after midnight before we realised it. The day after, 8 oclock sharp the last half day started. Every I arrived in Berlin on a rainy Thursday evening. The faculty member summarised his key points/take home venue was Hotel Berlin Berlin, a large but messages. We ended with some cases of the atmospheric four star hotel. On 5 November, for those participants to test our newly acquired or updated Faculty and participants of the 3rd ESU Masterclass on Female and functional urology in Berlin, November 2010. who wanted to pursue the masterclass with an knowledge. frank.vanderaa@ uz.kuleuven.ac.be 26 European Urology Today December 2010/March 2011

ESU Courses on the edge of what is new in urology

Progamme 2011: Reinforcing success, exploring new trends in science and practice
On the occasion of the Annual EAU Congress, the European School of Urology organises courses for continuous medical education. Every year, these courses are revised and new members of faculty take part in the programme all to make sure that course participants receive top-quality, clinically-oriented information that can be of immediate use in their clinical practice. This year, the ESU offers 40 specialised courses covering a wide spectrum of topics. All of these courses are aimed at narrow target groups, allowing for a highly individualised teaching approach. Just as in previous years, experts subspecialising in prostate cancer management have the opportunity to update their knowledge in courses dedicated to this subject matter from screening, diagnosing and staging to surgical treatment. One can also enroll in courses which present the most essential information on the management of other urological diseases as well as courses dedicated to new technologies in urology as well as research and scientific publication methodology. meet the needs of urologists with varied levels of by J-U. Stolzenburg (Germany) and Laparoscopy for beginners, chaired by A.D. Joyce, UK to list just a few. expertise and experience. Furthermore, our teaching programme accommodates for a highly interactive Following up on the feedback from the participants of and individualised approach to continuous medical previous congresses, we are repeating our most education. It is also an excellent opportunity to engage and to be taught by worlds leading experts in successful courses, including Update on stone disease, chaired by Prof. M. Marberger (Austria), the field. Laparoscopic and robot-assisted laparoscopic radical cystectomy, chaired by P. Wiklund (Sweden) and HOT sessions: Making laparoscopy training accessible hendrik.vanpoppel@ Radical cystectomy and orthotopic bladder substitution Hands-on training sessions, organised by the ESU and uzleuven.be the EAU Section of Uro-Technology (ESUT) are a surgical tricks and management of complications, unique feature of the congress. Sponsored by KARL chaired by Prof. U. Studer (Switzerland). STORZ these sessions offer the participants a unique opportunity to be introduced or to advance their skills Amongst the new courses this year are Safe This years programme features many courses using some of the best technology in laparoscopy outpatient operations: how and where? chaired by dedicated to minimally invasive approaches to the training available today. H. Haas (Germany) and How to practice evidencemanagement of urological diseases. These courses are always and without exception a great success, and based urology, chaired by P. Dahm (USA). These new Guided by several instructors on the floor, the additions offer insights into the global trends in at the 26th Annual EAU Congress, we will be delegates perform a series of exercises, taking turn at urology and set them into the context of ever-day presenting updated information on these subjects. various training stations for a maximum exposure to urological practice. different technologies. These sessions are a Here are some of the best-attended courses of the It is worth mentioning that the courses offered by the fascinating and truly hands-on experience and a programme -Advanced course on laparoscopic chance to get tips and tricks from some of Europes European School of Urology are not only tailored to nephrectomy, chaired by V. Pansadoro (Italy), best experts in the field. Robot-assisted laparoscopic prostatectomy, chaired address narrowly delineated subjects, but also to Prof. Hein Van Poppel Chairman European School of Urology

ESU Courses
Saturday, 19 March 2011
ESU Course 1 Prostate cancer screening, diagnosis and staging Chair: F.C. Hamdy, Oxford (GB) Faculty: I. Romics, Budapest (HU) A.R. Zlotta, Toronto (CA) ESU Course 2 Evaluation and management of female pelvic floor disorders Chair: E.J. Messelink, Groningen (NL) Faculty: S. Morkved, Trondheim (NO) F.C. Burkhard, Berne (CH) J. Deprest, Leuven (BE) ESU Course 3 Update on stone disease Chair: M. Marberger, Vienna (AT) Faculty: M.P. Laguna, Amsterdam (NL) A. Patel, London (GB) ESU Course 4 Retropubic radical prostatectomy tips, tricks and pitfalls Chair: H. Van Poppel, Leuven (BE) Faculty: O.W. Hakenberg, Rostock (DE) ESU Course 5 Office management of male sexual dysfunction Chair: C. Stief, Munich (DE) Faculty: I. Eardley, Leeds (GB) D. Ralph, London (GB) ESU Course 6 Renal transplantation: Technical aspects, diagnosis and management of early and late urological complications Chair: F.J. Burgos Revilla, Madrid (ES) Faculty: A.J. Figueiredo, Coimbra (PT)

Sunday, 20 March 2011

ESU Course 7 Management of small renal tumours Chair: D. Jacqmin, Strasbourg (FR) Faculty: P. Gontero, Turin (IT) J. De La Rosette, Amsterdam (NL) ESU Course 8 Laparoscopic and robot-assisted laparoscopic radical cystectomy Chair: P. Wiklund, Stockholm (SE) Faculty: R.F. Van Velthoven, Brussels (BE) J. Rassweiler, Heilbronn (DE) ESU Course 9 Advanced management of urethral stricture disease Chair: C.R. Chapple, Sheffield (GB) Faculty: P. Nyirady, Budapest (HU) G. Barbagli, Arezzo (IT) December 2010/March 2011

ESU Course 20 How to write a manuscript and get it published in European Urology Chair: F. Montorsi, Milan (IT) Faculty: S.F. Shariat, New York (US) G. Novara, Padua (IT) ESU Course 10 C.J. Gratzke, Munich (DE) Paediatric urology for the adult urologist: A practical D. Murphy, Melbourne (AU) update Chair: J.M. Nijman, Groningen (NL) ESU Course 21 Faculty: G.A. Bogaert, Leuven (BE) Vaginal surgery for urologists S. Tekgl, Ankara (TR) Chair: D. Pushkar, Moscow (RU) Faculty: D.J.M.K. De Ridder, Leuven (BE) ESU Course 11 Robot surgery in urology how to start ESU Course 22 Chair: H.G. Van Der Poel, Amsterdam (NL) Radical cystectomy and orthotopic bladder Faculty: B.S.E.P. Van Cleynenbreugel, Leuven (BE) substitution surgical tricks and management of M. Stckle, Homburg (DE) complications Chair: U.E. Studer, Berne (CH) ESU Course 12 Faculty: J.E. Gschwend, Munich (DE) Lower urinary tract dysfunction and urodynamics A. Stenzl, Tbingen (DE) Chair: P. Abrams, Bristol (GB) Faculty: P. Radziszewski, Warsaw (PL) ESU Course 23 S. Madersbacher, Vienna (AT) Surgery or radiotherapy for localised and locally advanced prostate cancer ESU Course 13 Chair: B. Djavan, New York (US) Chronic Pelvic Pain Syndromes (CPPS) with special Faculty: T. Wiegel, Ulm (DE) focus on Chronic Prostatitis (CP) and Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC) Chair: J-J. Wyndaele, Antwerp (BE) Faculty: J.C. Nickel, Kingston (CA) Monday, 21 March 2011 J. Nordling, Herlev (DK) ESU Course 24 ESU Course 14 The infertile couple urological aspects Surgical management of locally advanced & Chair: W. Aulitzky, Vienna (AT) metastatic renal cancer Faculty: W. Weidner, Giessen (DE) Chair: Z. Kirkali, Bethesa (US) Faculty: M. Kuczyk, Hanover (DE) ESU Course 25 Safe outpatient operations: How and where? ESU Course 15 Chair: H. Haas, Heppenheim (DE) Laparoscopy for beginners Faculty: M.S. Michel, Mannheim (DE) Chair: A.D. Joyce, Leeds (GB) R. Miller, London (GB) Faculty: X. Cathelineau, Paris (FR) ESU Course 26 ESU Course 16 Diagnosis and management of non-muscle invasive Management and outcome in invasive and locally bladder cancer (NMIBC) advanced bladder cancer Chair: J.A. Witjes, Nijmegen (NL) Chair: A. Alcaraz, Barcelona (ES) Faculty: J. Palou, Barcelona (ES) Faculty: B. Malavaud, Toulouse (FR) M. Babjuk, Prague (CZ) ESU Course 17 Minimally invasive treatment for localised prostate cancer Chair: G. Morgia, Catania (IT) Faculty: S. Machtens, Bergisch Gladbach (DE) S. Throff, Munich (DE) ESU Course 18 Metastatic prostate cancer Chair: K. Pummer, Graz (AT) Faculty: K. Miller, Berlin (DE) ESU Course 19 Robot renal surgery Chair: A. Mottrie, Aalst (BE) Faculty: G. Guazzoni, Milan (IT) J. Hubert, Nancy (FR) ESU Course 27 Advanced course on upper tract laparoscopy (UPJ, adrenal and stones) Chair: G. Janetschek, Salzburg (AT) Faculty: F. Porpiglia, Turin (IT) H. Baumert, Paris (FR) ESU Course 28 Interventional therapies for BPH Chair: K.M. Anson, London (GB) Faculty: R. Kuntz, Berlin (DE) T.E. Bjerklund Johansen, rhus (DK) ESU Course 29 Advanced course on laparoscopic nephrectomy Chair: V. Pansadoro, Rome (IT) Faculty: H.P. Beerlage, s-Hertogenbosch (NL)

ESU Course 30 Robot-assisted laparoscopic prostatectomy Chair: P.T. Piechaud, Bordeaux (FR) Faculty: W. Artibani, Verona (IT) P. Dasgupta, London (GB) ESU Course 31 Palliative treatment of advanced genito urinary cancer Chair: A. Heidenreich, Aachen (DE) Faculty: B. Tombal, Brussels (BE) ESU Course 32 Advanced course on laparoscopic prostatectomy Chair: J-U. Stolzenburg, Leipzig (DE) Faculty: K. Touijer, New York (US) ESU Course 33 Testicular cancer Chair: P. Albers, Dsseldorf (DE) Faculty: N.W. Clarke, Manchester (GB) ESU Course 34 Urinary tract and genital trauma Chair: L. Martnez-Pieiro, Madrid (ES) Faculty: H. Abol-Enein, Mansoura (ET) ESU Course 35 Ultrasound for the urologist - TRUS and TRUS guided biopsies Chair: P. Hammerer, Braunschweig (DE) Faculty: V. Scattoni, Milan (IT) ESU Course 36 Medical uro-oncology Chair: G.H.J. Mickisch, Bremen (DE) Faculty: C.N. Sternberg, Rome (IT) ESU Course 37 Post-surgical urinary incontinence in males Chair: M.M. Fisch, Hamburg (DE) Faculty: V. Nitti, New York (US) ESU Course 38 General neuro-urology Chair: F.R. Cruz, Porto (PT) Faculty: M. Drake, Bristol (GB) ESU Course 39 How to become the best reviewer for European Urology Chair: F. Montorsi, Milan (IT) Faculty: S. Madersbacher, Vienna (AT) R. Sylvester, Brussels (BE) G. Giannarini, Bern (CH) V. Ficarra, Padua (IT) ESU Course 40 How to practice evidence based urology Chair: P. Dahm, Gainesville, (US) Faculty: J.W. Mazel, Hoofddorp (NL)

European Urology Today

27

MAGE-A3 MIBC Clinical Trial EAU-RF

The EAU Research Foundations new trial for patients undergoing cystectomy
Dr. Wim Witjes EAU Research Foundation Arnhem (NL) MAGE-A3 ASCI has been shown to be well tolerated and only associated with mild local injection site or systemic reactions of similar nature to those commonly experienced with routine preventative vaccinations. GSK is currently evaluating the efficacy and safety of MAGE-A3 ASCI in Phase III clinical studies for NSCLC and melanoma: The MAGRIT trial is evaluating MAGE-A3 ASCI in patients who have a tumour staged IB, II or IIIA NSCLC which has been surgically removed and tested positive for MAGE-A3 The DERMA trial is evaluating MAGE-A3 ASCI in patients who have Stage IIIB or IIIC melanoma with gross involvement of the lymph nodes and tested positive for MAGE-A3 The immunotherapy with MAGE-A3 ASCI appears to be tolerated well. Since MAGE-A3 tumour antigen is expressed in approximately 40% of patients with bladder cancer, the possibility that recMAGE-A3 + AS 15 ASCI may also be an efficient therapy in patients with bladder cancer needs to be explored. MAGE-A3 ASCI is an investigational compound and it is not approved for use in any indication in any country at this time. Rationale: Currently, the standard treatment for localised muscle invasive bladder cancer is radical cystectomy. Many patients with muscle invasive bladder cancer will relapse after cystectomy The 10-year disease-specific and overall survival of patients with organ-confined disease (defined as < pT3a) is 72.9% and 49.1%, rapidly decreasing to 33.3% and 22.8% for non-organ- confined disease (Gschwend et al, Eur. Urol. 2002). There is thus a clear medical need for an additional anti-tumoural treatment in this population. There is not enough evidence in favour of the routine use of adjuvant chemotherapy From scientific evidence so far available, it is unclear whether immediate adjuvant chemotherapy or chemotherapy at the time of relapse is superior or if the two approaches are equivalent with respect to the end-point overall survival. MAGE-A3 is a factor of poor prognosis The interest in recMAGE-A3 ASCI treatment is further reinforced by the possible link between MAGE-A3 expression and shorter survival (Gure et al, JCO 2005) MAGE-A3 is tumour-specific, recMAGE-A3 ASCI treatment is highly tolerated and shows promising Phase II results Taking into account the tumour-specificity of MAGE-A3, the high tolerability of recMAGE-A3 + AS15 and the promising results from the Phase II clinical trials in melanoma and lung cancer, this study has been initiated in bladder cancer by the EAU-RF. Study design This is a multicentre, prospective, randomised, placebo-controlled, parallel group, double-blind, trial to compare the efficacy and safety of recMAGE-A3 + AS15 ASCI intramuscular injections with placebo intramuscular injections. The initial target in this Phase II study will be to enrol 273 patients to be assigned randomly to 2 treatment schedules in a 2:1 ratio, 2 patients randomised for recMAGE-A3 + AS15 ASCI versus 1 patient randomised for placebo. The treatment scheme consists of 5 doses administered at 3-week intervals, followed by 8 doses administered at 3-month intervals for a total maximum duration of study treatment administration of 27 months. Data collection will be organised by Remote Date Entry on Electronic Case Report Forms (eCRF). A total of 8-10 European countries will participate with an anticipated average of 6-8 centres each. Patients will be recruited over approximately 24 months and the trial will be terminated once the last patient is followed-up for 36 months. Study population A total of 273 patients with histologically confirmed transitional cell carcinoma of bladder urothelium (T2,3 N0 or N1 or N2 and M0 disease or Stage T4 N0 M0 disease after cystectomy) with expression of the MAGE-A3 antigen, and who are free of residual disease and free of metastases, will be randomised a few days before first study treatment administration. We anticipate that we need to screen 4 or 5 patients for each eligible patient who can be randomised. Hence, we need approximately 1,229 patients (range 1,092 1,365 patients) who undergo radical cystectomy and are willing to participate to end up with 273 patients randomised. Main endpoint The primary endpoint of this trial is disease-free survival at the end of the study. The EAU-RF is the sponsor of this study. Chiltern Contract Research Organisation has subsidiaries in each of the participating countries and will help in the selection of sites. They will take care of the local study start up, initiation and monitoring of the sites. GSK Biologicals Belgium will partially support the trail and provide the study medication. Participating countries are The Netherlands, Germany, United Kingdom, Poland, Spain, Italy, France, Switzerland, and possibly Denmark and Sweden. The study is currently in its start-up phase, and the plan is to have the first patients enrolled in or before the second quarter, 2011. An investigators meeting will be planned at the occasion of the Annual EAU Congress, March 2011 in Vienna.

w.witjes@ curatrial.com The EAU Research Foundation is starting up a study in patients who need to undergo a cystectomy for their muscle invasive bladder cancer entitled: A randomised, double blind, placebo-controlled phase II trial to evaluate the safety and efficacy of recMAGE-A3 + AS15 Antigen Specific Cancer Immunotherapy (ASCI) in patients with MAGE-A3 positive muscle invasive bladder cancer after cystectomy. A European Association of Urology Research Foundation Randomised Phase II Clinical Trial. This trial will assess whether adjuvant treatment with recMAGE-A3 + AS 15 ASCI after cystectomy is safe and effective and improves the outcome of patients who are clinically tumour-free after cystectomy and who had a transitional cell carcinoma with expression of the MAGE-A3 antigen. MAGE-A3 ASCI MAGE-A3 ASCI combines the cancer-specific antigen, MAGE-A3, and a combination of substances, called AS15, to boost the immune systems reaction to the antigen. It aims to increase the bodys immune response to the cancer. In clinical studies to date,

EAU Research Foundation

EVOLUTION: European LUTS/BPH Registry

EAU-RF announces successful enrolment of patients for the Evolution Registry
The EAU Research Foundation is conducting a European Registry on patients with LUTS associated with BPH entitled European registry evaluating management practices of general practitioners and urologists, and pharmacological treatment outcomes in patients with Lower Urinary Tract Symptoms associated with Benign Prostatic Hyperplasia (LUTS/ BPH). observational registry conducted in 5 European countries within a sample of GP outpatient clinics and urologists hospital or office-based clinics. The participating EU countries are; France, Germany, Italy, Spain and the United Kingdom.

requested for face to face support with data entry with the web-based data entry system (Inform)- by means of on-site visits by the CRAs in stead of remote support, as was initially planned for this registry. The means in favour of this purpose are now in place, and involved sites have been visited by PRN Services staff to provide support on database training and patient data entry early January 2011.
Register The Evolution hasbeen registered onto the Dutch Nederlands Trial Register(NTR). The NTR is recognised by the WHO and ICMJE.

Two populations of patients will be studied in this registry: Patients presently/recently untreated with LUTS/ BPH pharmacological agents (defined as patients This registry is currently being conducted in all five participating European countries, and the enrolment of who are newly diagnosed, or previously managed with watchful waiting, or discontinued LUTS/BPH patients is in full swing and making good progress. At pharmacological treatment prior to the baseline the moment (November 2010) 740 patients have been visit [with -blockers or phytotherapy or enrolled, and the targeted number of 2,000 patients is anticholinergics for 1 month, with 5 -reductase expected to be achieved by the first quarter of 2011. inhibitors either as monotherapy or in combination Rationale for 6 months, with other LUTS/BPH medical therapy 1 months]), and with IPSS 8 who for The diagnosis and management of LUTS/BPH have start LUTS/BPH pharmacological treatment at or undergone considerable development in the last directly after the baseline visit; decade, and results of landmark studies have become available. Recent information from prospective studies Patients presently/recently treated with LUTS/BPH on the management of LUTS/BPH and patient pharmacological treatment prior to the baseline visit (with -blockers or phytotherapy or outcomes across European countries is sparse in the anticholinergics for 1 month, with 5 -reductase actual clinical practice setting. inhibitors either as monotherapy or in combination Aim for 6 months, with other LUTS/BPH medical To collect data in a real-life setting across different EU therapy for 1 months) and continue LUTS/BPH pharmacological treatment. countries on: The usual management of Lower Urinary Tract The total number of patients enrolled to the registry Symptoms associated with Benign Prostatic will be 2,000. The target is 200 presently/recently Hyperplasia (LUTS/BPH); The effect of LUTS/BPH and its pharmacological untreated 200 presently/recently treated and patients treatment outcomes on LUTS/BPH-related health per country. status, general quality of life (QoL), and sexual function. Status and timelines

Fig. 2: The total number of recruited patients per country

Primary objective To evaluate symptom persistence in patients with LUTS/BPH under LUTS/BPH pharmacological treatment. Symptom persistence is defined as International Prostate Symptom Score [IPSS] of 8 points or more. Registry design and patient population This is a two-year, multicentre, prospective,
EAU Research Foundation

Fig. 1: The number of participating sites of urologist and general practitioners per country

Evolution Team and contact details Prof. Dr. Andrea Tubaro Principal Investigator Sant Andrea Hospital Rome (IT) Tel: +39 063 377 5760 Dr. Wim Witjes Scientific and Clinical Research Director EAU CRO Arnhem (NL) Tel: +31 (0) 263 890 677 Hassan Mkadmi, MSc Fig. 3: Patient recruitment progress per month as of Clinical Project Manager EAU CRO February 2010 Arnhem (NL) Tel: +31 (0) 263 890 677 Paula Read Lead Clinical Research Associate, Prn +44 (0) 1256 316551 (+44 (0) 1364 631401) Tel: E-mail: pread@prnservices.co.uk Marian Ritchie CRA Italy & Project Coordinator UK, Prn Tel: +44 (0) 1908 666166 (+44 (0) 1256 316551) E-mail: mritchie@prnservices.co.uk Sheila Innes Lead Clinical Trial Administrator UK, Prn Tel: +44 (0) 1256 316 551 Fig. 4: Patient recruitment planning to end Q1 2011 Laure Cathala (CRA France), Prn Tel: +33 (0) 4 90 07 77 60 The acceleration of patient recruitment is necessary in E-mail: laure.brocard@thevarc.com Anna Garca (CRA Spain), Prn the coming period in order to achieve the targeted Tel: +34 (0) 934 368 269 number of 2,000 patients by the first quarter of 2011. E-mail: anna.garciacra@yahoo.es The needs and demands of the participating sites to Karin Schroeder (CRA Germany), Prn contribute to the realization of this challenge were Tel: +49 (0) 8121 980 28 28 assessed, and the main outcome is that a E-mail: k.schroeder@cro-service.com considerable number of the participating sites

For more information or participation please visit our website or contact the Evolution Team (details below). http://www.trialregister.nl/trialreg/admin/ rctsearch.asp?Term=2013

28

European Urology Today

December 2010/March 2011

http://historyandrology2011.uroweb.org

5 th International Congress on the History of Urology in conjunction with the Andrology Update 2011
3-4 June 2011, Budapest, Hungary
Organised by the European Association of Urology, European Section of Andrological Urology (ESAU) and the Semmelweis University Dept. of Urology, Budapest

GHENT LIVE SURGERY DAYS

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FACULTY Andrich D, London, UK Barbagli G, Arezzo, Italy Hoebeke P, Ghent, Belgium Lumen N, Ghent, Belgium Martinez-Pineiro L, Madrid, Spain Mundy A, London, UK Oosterlinck W, Ghent, Belgium Van Laecke E, Ghent, Belgium REGISTRATION Early registration until the 10th of March, 2011. www.ghentlivesurgery.com

ORGANISATION Prof. Dr. Willem Oosterlinck and Dr. Nicolaas Lumen Ghent University Hospital De Pintelaan 185 9000 Gent, Belgium CONTACT US The congress organisation can be reached (secretary Mrs. Ilse Maes) by email: poli.urologie@uzgent.be by telephone: +32 - 9 - 332 22 79 by fax: +32 - 9 - 332 38 89

European Association of Urology

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December 2010/March 2011

European Urology Today

29

- ADVERTORIAL -

- ADVERTORIAL -

- ADVERTORIAL -

Vardenafil ODT: A new solution to an old problem?

Frans M.J. Debruyne MD, PhD Professor of Urology Andros Mens Health Institute Arnhem (NL) f.debruyne@ urologicconsultancy. com baseline ED severity or the presence of underlying conditions (all p<0.0001). In the intent-to-treat (ITT) population (n=686), least squares (LS) mean IIEF-EF scores for vardenafil ODT versus placebo at week 12/ last observation carried forward (LOCF) were 21.1 and 14.1, with corresponding baseline scores being 12.3 and 12.8, respectively (indicative of moderate ED). LS mean overall SEP3 success rates were 62.7% and 26.0%, with corresponding baseline values being 13.1% and 15.0%, for men taking vardenafil ODT and placebo, respectively. Similar significant improvements associated with vardenafil ODT, compared with placebo, were seen when the ITT population was split by age (<65 years or 65 years) or the presence of underlying conditions (Figure 1). A separate retrospective evaluation of data from the POTENT integrated analysis, and data from a pooled analysis of studies of the vardenafil film-coated tablet, showed that both formulations had comparable efficacy.

Vardenafil orodispersible tablet (ODT), the first and only orodispersible phosphodiesterase type 5 (PDE-5) inhibitor, was recently launched in a 90-minute talkshow-style symposium at the Mens Health World Congress in Nice, France. A faculty of urologists and sexual health specialists introduced delegates to vardenafil ODT, highlighting the advantages of this innovative new formulation, which does not require water for administration. Benefits include improved bioavailability compared with the vardenafil film-coated tablet, dosing simplicity via the single 10 mg dose, and a favourable efficacy and safety profile that makes vardenafil ODT suitable for men with erectile dysfunction (ED), irrespective of age or underlying conditions. In addition, the product comes in a novel, sleek packaging to meet the needs of todays man. Erectile dysfunction: where are we now? In his introduction, Chairman Prof. Vincenzo Mirone reflected on the field of ED therapy in the twelve years since the introduction of PDE-5 inhibitors. The benefits of seeking treatment for ED are broad, and include not only improved sexual function and quality of life, but also increased opportunities for the diagnosis of other health problems; however, ED is under-diagnosed and under-treated.[1] Less than one third of affected men seek treatment,[2] and many barriers exist to treatment seeking (Table 1). Furthermore, rates of adherence with therapy are low, and over half of all PDE-5 inhibitor users discontinue therapy.[3] It is clear that greater ED treatment seeking is needed. Efficacy and safety of vardenafil ODT Dr. Marc Gittelman provided an overview of the efficacy, safety and pharmacokinetic characteristics of vardenafil ODT. Two pivotal phase III trials have assessed the efficacy and safety of vardenafil ODT in men of varying age and health status, with ED. POTENT I and II were double-blind, randomised, parallel-group, placebo-controlled clinical trials of identical design, carried out at 75 study centres throughout Australia, Europe, Mexico, North America and South Africa.[9,10] Primary efficacy measures were the erectile function domain of the International Index of Erectile Function (IIEF-EF), Sexual Encounter Profile question 2 (SEP2) Were you able to insert your penis into your partners vagina? and SEP3 Did your erection last long enough for you to have successful intercourse?.

Figure 2: Geometric mean plasma concentrations of vardenafil after a single dose of vardenafil ODT, or 10 mg vardenafil film-coated tablet, in fasting men with ED aged <65 years and 65 years (Reproduced from Heinig R et al. Clin Drug Investig 2011; 31: 2741 with permission from Adis, a Wolters Kluwer business. Adis Data Information BV 2011. All rights reserved)

83.6%), easiest to take (14.5% vs 85.5%) and most convenient therapy (13.9% vs 86.1%).[14] Market research showed that acceptance of an ODT formulation of a PDE-5 inhibitor is high among both patients and physicians. A quantitative, questionnaire-based survey was conducted in Brazil, Germany and Italy among patients (n=300) who were current, previous and non-users of PDE-5 inhibitor therapy and physicians (general practitioners and urologists; n=240) to explore their perceptions of ED therapy and assess acceptance of a placebo ODT formulation of vardenafil. Over 90% of current, previous and non-users of PDE-5 inhibitors had a positive impression of the placebo ODT vardenafil formulation and levels of interest in trying this novel formulation were high. Similarly, over 95% of physicians had a positive overall impression of vardenafil ODT, with 76% stating that they would be likely to prescribe this drug to their patients. The convenience aspects of the ODT formulation were particularly liked by both patients and physicians. In the latter part of his presentation, Dr. Edwards discussed the vardenafil ODT galenic formulation and innovative drug packaging. Vardenafil ODT is manufactured using patented co-processed polyol excipient technology for optimal stability, and dissolves within seconds when placed in the mouth. The novel vardenafil ODT packaging is stylish and discreet, fitting easily into the pocket. In response to the widespread, growing problem of drug counterfeiting,[16] the pack also incorporates twelve anti-counterfeiting measures. *p<0.0001, **not significant (p>0.05)
Figure 1: LS mean IIEF-EF scores at week 12/LOCF, and overall SEP3 success rates, following treatment with vardenafil ODT versus placebo for the ITT population (n=686), split by presence of underlying conditions (Figure 2011 Wiley. Used with permission from Sperling et al. J Sex Med 2011; 8: 26171)

In the POTENT studies, adverse events (AEs) were transient and mostly mild to moderate in severity. Following a 4-week unmedicated run-in period, The most frequently reported drug-related AEs in the subjects were randomised to either vardenafil ODT or vardenafil ODT group were headache, flushing, nasal placebo, taken without water, but with food if desired. congestion, dizziness and dyspepsia, consistent with Over half of the study population was aged 65 years, the known safety profile of PDE-5 inhibitors. most of the subjects were long-term sufferers of ED (mean time since onset of more than 5 years) and a Vardenafil ODT shows attractive pharmacokinetic large proportion had underlying conditions, such as characteristics diabetes mellitus, dyslipidemia and hypertension. An In men with ED, vardenafil ODT has 2127% greater integrated analysis of data from both POTENT I and II bioavailability compared with the film-coated tablet was performed to examine the effects of age, formulation (Figure 2). This is likely due to partial baseline ED severity and the presence of diabetes, absorption of the drug through the oral mucosa, dyslipidemia and hypertension on the efficacy and which avoids first-pass metabolism. safety of vardenafil ODT.[11] All other pharmacokinetic parameters are similar Vardenafil ODT is efficacious and well tolerated in a between the two formulations. The bioavailability of broad population of men with ED vardenafil ODT is not significantly affected by even a Vardenafil ODT was significantly superior to placebo high-fat, high-calorie meal, thus there is no restriction for all primary efficacy measures, regardless of age, on its intake with food.[12] Table 1: Barriers to ED treatment seeking and reasons for non-adherence with ED therapy (in no particular order) Barriers to ED treatment seeking Social stigma surrounding the condition[5] Embarrassment among patients about discussing their condition[6] Attitudes and beliefs about ED treatment[7] Cultural and psychosocial factors[7] Reluctance among healthcare professionals to enquire about mens sexual health[8] European Urology Today Reasons for non-adherence with ED therapy[4] Lack of effectiveness Side effects Lack of opportunity/desire for sexual intercourse Lack of partner interest in resuming sexual activity Cost

Vardenafil ODT: tailored to todays ED patient Dr. David Edwards followed by highlighting the many advantages of ODT formulations compared with other solid or liquid formulations, including ease of handling and administration, a favourable mouth feel and taste that promotes acceptability, increased bioavailability, and improved compliance and convenience.[13] Research shows that ODT drug formulations are popular with patients.[14,15] A study conducted in patients with migraine (n=218) found that compared with the film-coated tablet, the ODT was perceived to be the least disruptive (16.4% vs

The patients experience of vardenafil ODT In the final presentation, Prof. Frans Debruyne reminded delegates that the final choice of ED treatment lies with the patient, and only they, and their partner, can judge which is the best treatment for them.[17] The patients perception of a particular ED treatment is also important in determining uptake and continuation with therapy. To assess patients perceptions of vardenafil ODT, eligible patients (n=28) who participated in the POTENT I study at Andros Mens Health Clinics, Arnhem, Netherlands were re-contacted and interviewed using a predefined questionnaire. Prof. Debruyne presented a series of patient cases describing their experiences of using vardenafil ODT. Overall, perceptions of vardenafil ODT were very positive. Patients found this to be a very convenient

Chairman Prof. Vincenzo Mirone introduces the panel of experts (from left) Dr. Marc Gittelman, Dr. David Edwards, Prof. Frans Debruyne, Prof. Ridwan Shabsigh and Dr. Michael Perelman

30

December 2010/March 2011

Prof. Frans Debruyne relates the patients experience of vardenafil ODT using filmed interviews of patients from the POTENT I study

Dr. David Edwards looks on as a short film illustrating the novel vardenafil ODT packaging is played to the audience dysfunction: a comparison of six countries. BJU Int 2004; 94:1055-1065. 9. Gittelman M, McMahon CG, Rodriguez-Rivera JA, Beneke M, Ulbrich E, Ewald S. The POTENT II randomised trial: efficacy and safety of an orodispersible vardenafil formulation for the treatment of erectile dysfunction. Int J Clin Pract 2010; 64:594-603. 10. Sperling H, Debruyne F, Boermans A, Beneke M, Ulbrich

formulation that offers an easy, discreet way to take References ED medication. Among the main product attributes 1. Mulhall JP, King R, Brimmer DJ, Harnett J, Hvidsten K, cited by patients were the rapid onset and duration of Kennedy SS, Reddy P, Denevich S, Pashos CL. Attitudes, action, and favourable side effect profile. Patients also beliefs, and values regarding the sexual experience in frequently reported that vardenafil ODT works first men: development of the Sexual Experience time, and provides flexibility and spontaneity. Questionnaire. J Mens Health 2010; 7:20-30. The changing ED world The symposium concluded with an interactive discussion between the audience and faculty, moderated by Prof. Ridwan Shabsigh, on current challenges in ED therapy and the role that vardenafil ODT can play in addressing these. This lively discourse explored the reasons why ED is a taboo topic, the impact of ED on the couples relationship, limitations of current ED therapies and younger men with ED. What does vardenafil ODT offer? Prof. Mirone concluded that vardenafil ODT is an efficacious therapy for men with ED, regardless of age or underlying conditions. It offers a multitude of benefits, including the convenience of use anytime, anywhere, without the need for water or other liquids, the simplicity of a single dose, and an excellent efficacy and safety profile. This new PDE-5 inhibitor formulation is perceived very positively by patients and may help to overcome barriers to ED diagnosis and treatment seeking.
2. Mulhall J, King R, Glina S, Hvidsten K. Importance of and satisfaction with sex among men and women worldwide: results of the Global Better Sex Survey. J Sex Med 2008; 5:788-795. 3. Althof SE. When an erection alone is not enough: biopsychosocial obstacles to lovemaking. Int J Impot Res 2002; 14 Suppl 1:S99-S104. 4. Klotz T, Mathers M, Klotz R, Sommer F. Why do patients with erectile dysfunction abandon effective therapy with sildenafil (Viagra)? Int J Impot Res 2005; 17:518-523. 5. Tomlinson J, Wright D. Impact of erectile dysfunction and its subsequent treatment with sildenafil: qualitative study. BMJ 2004; 328:1037. 6. Baldwin K, Ginsberg P, Harkaway RC. Under-reporting of erectile dysfunction among men with unrelated urologic conditions. Int J Impot Res 2003; 15:87-89. 7. Byrne M, Doherty S, McGee HM, Murphy AW. General practitioner views about discussing sexual issues with patients with coronary heart disease: a national survey in Ireland. BMC Fam Pract 2010; 11:40. 8. Shabsigh R, Perelman MA, Laumann EO, Lockhart DC. Drivers and barriers to seeking treatment for erectile

E, Ewald S. The POTENT I randomized trial: efficacy and safety of an orodispersible vardenafil formulation for the treatment of erectile dysfunction. J Sex Med 2010; 7:1497-1507. 11. Sperling H, Gittelman M, Norenberg C, Ulbrich E, Ewald S. Efficacy and safety of an orodispersible vardenafil formulation for the treatment of erectile dysfunction in elderly men and those with underlying conditions: an integrated analysis of two pivotal trials. J Sex Med 2011; 8:261-271. 12. Heinig R, Weimann B, Dietrich H, Bottcher MF. Pharmacokinetics of a new orodispersible tablet formulation of vardenafil: results of three clinical trials. Clin Drug Investig 2011; 31:27-41. 13. Bandari S, Mittapalli RK, Gannu R, Rao YM. Orodispersible tablets: An overview. Asian J Pharm 2008; 2:2-11. 14. Dowson AJ, Charlesworth BR. Patients with migraine prefer zolmitriptan orally disintegrating tablet to sumatriptan conventional oral tablet. Int J Clin Pract 2003; 57:573-576. 15. Marquez-Contreras E, Gil V, Lopez J, Plazas MJ, Heras J, Galvan J, Porcel J. Pharmacological compliance and acceptability of lansoprazole orally disintegrating tablets in primary care. Curr Med Res Opin 2008; 24:569-576. 16. Shepherd M. Beef up international cooperation on counterfeits. Nat Med 2010; 16:366. 17. Heaton JPW, Hackett G, Savage D, Padley RJ. Patient choice is critical in managing erectile dysfunction. Eur Urol Suppl 2002; 1:33-37.

An enthusiastic audience keen to participate in the interactive discussion

The first and only ED tablet to dissolve on the tongue without water

Where next, darling?

The car

The garden The beach

Levitra 10mg Orodispersible Tablets EU Essential Information Levitra 10mg orodispersible tablets (Levitra 10mg ODT). Refer to SmPC before prescribing. Composition: Active ingredient: 10mg vardenafil (as hydrochloride). Excipients: aspartame (E951), peppermint flavour, magnesium stearate, crospovidone, mannitol (E421), silica colloidal hydrated, sorbitol (E420). Indications: Treatment of erectile dysfunction in adult men. Not for use in women. Contraindications: Hypersensitivity to the active substance or to any of the excipients; coadministration with nitrates or nitric oxide donors (such as amyl nitrite) in any form; patients who have loss of vision in one eye because of non-arteritic anterior ischaemic optic neuropathy (NAION); men for whom sexual activity is inadvisable (e.g. severe cardiovascular disorders); severe hepatic impairment; endstage renal disease requiring dialysis; hypotension; recent stroke or myocardial infarction; unstable angina; known hereditary retinal degenerative disorders; concomitant use with potent CYP3A4 inhibitors (ketoconazole and itraconazole (oral form)) in men older than 75 years; concomitant use with HIV protease inhibitors such as ritonavir and indinavir (very potent inhibitors of CYP3A4). Warnings and precautions: Cardiovascular status should be considered. Vardenafil has vasodilator properties, resulting in mild and transient decreases in blood pressure.

Patients with anatomical deformation of the penis or conditions which predispose to priapism (such as sickle cell anaemia, multiple myeloma or leukaemia) should be treated with caution. Combination with other treatments for erectile dysfunction is not recommended. Patients on stable alpha-blocker therapy: initiate vardenafil therapy at a starting dose of 5mg film-coated tablets and consider a time separation of dosing. Patients treated with alpha-blockers should not use Levitra 10mg ODT as a starting dose. Concomitant use with potent CYP3A4 inhibitors (itraconazole and ketoconazole (oral form)) should be avoided. Vardenafil dose adjustment might be necessary if moderate CYP3A4 inhibitors such as erythromycin and clarithromycin are given concomitantly. Avoid grapefruit juice. Prolongation of QTc interval avoid use in patients with relevant risk factors. Advise patients that in the case of sudden visual defect to stop taking Levitra ODT and consult a physician. Administration to patients with bleeding disorders or active peptic ulceration only after careful benefit-risk assessment. Levitra 10mg ODT contains aspartame, a source of phenylalanine which may be harmful for people with phenylketonuria. Patients with rare hereditary problems of fructose intolerance should not take Levitra 10mg ODT as they contain sorbitol. Undesirable effects: Most common: Headache. Common: Dizziness, flushing, nasal congestion, dyspepsia. Other adverse drug reactions: Conjunctivitis, allergic oedema and angioedema, allergic reaction, sleep disorder, anxiety, somnolence, paraesthesia and dysaesthesia, syncope, seizure, amnesia, visual disturbance, ocular hyperaemia, visual

colour distortions, eye pain and eye discomfort, photophobia, increase in intraocular pressure, lacrimation increased, non-arteritic anterior ischaemic optic neuropathy, visual defects, tinnitus, vertigo, sudden deafness, palpitation, tachycardia, myocardial infarction, ventricular tachyarrhythmias, angina pectoris, hypotension, hypertension, dyspnoea, sinus congestion, epistaxis, gastrooesophageal reflux disease, gastritis, gastrointestinal and abdominal pain, diarrhoea, vomiting, nausea, dry mouth, increase in transaminases, increase in gamma-glutamyl-transferase, erythema, rash, photosensitivity reaction, back pain, increase in creatine phosphokinase, myalgia, increased muscle tone and cramping, increase in erection, priapism, feeling unwell, chest pain. Serious cardiovascular reactions, including cerebrovascular haemorrhage, sudden cardiac death, transient ischaemic attack, unstable angina and ventricular arrhythmia reported postmarketing with another medicinal product in this class. Posology and method of administration: The maximum dose for Levitra ODT is 10mg/day. Patients with mild hepatic impairment should start with Levitra 5mg film-coated tablets. The maximum dose recommended in patients with moderate hepatic impairment is Levitra 10mg as film-coated tablets. Levitra 10mg ODT is not for use in patients with moderate and severe hepatic impairment. Legal Category: Medicinal product subject to medical prescription. Marketing Authorisation holder: Bayer Schering Pharma AG, 13353 Berlin, Germany. For further details contact your local Bayer Schering Pharma organisation. Version: 10 September 2010.

Introducing Levitra orodispersible tablet the only treatment for erectile dysfunction that comes in a playful, discreet, pocket-friendly pack to meet the needs of todays man anytime, anywhere.

First-line ED therapy he can take anytime, anywhere

Date of preparation: January 2011

G.GM.MH.08.2010.0050

BSP01J11001_Half_Pg_Ad_FAW.indd 1

December 2010/March 2011

European Urology Today

18/01/2011 15:01

31

Tiselius to present 2011 Honorary EULIS lecture

EULIS meeting in Vienna to honour distinguished Swedish expert
Prof. Palle J.S. Osther Chairman EAU Section of Urolithiasis (EULIS) Fredericia (DK)

http://eulis.uroweb.org

book contributions and has given more than 240 oral presentations.

Despite his busy medical career, Tiselius has supported and guided young researchers who eventually received their doctoral degrees. Aside from his academic work, Palle.Joern. Tiselius has been one of the main contributors to the Osther@slb. EAU guidelines on urolithiasis. He was the first to regionsyddanmark.dk perform Extracorporeal Shock Wave Lithotripsy (ESWL) in Scandinavia, and is known to have significantly Prof. Hans-Gran Tiselius, considered one of the contributed to developing and refining ESWL to a high worlds opinion leader in the field of urolithiasis, will level of excellence. His outstanding research and present the honorary lecture during the EAU Section theories on crystallisation processes in the renal of Urolithiasis (EULIS) scientific meeting at the forth- nephron have bridged our understanding of the stone coming 26th Annual EAU Congress in Vienna, Austria. forming process from earlier data mainly based on research performed in whole urine, whilst his recent In his honorary EULIS lecture, Prof. Tiselius will speak research also describes stone disease more as a on Studies on the role of calcium phosphate in the micro-environmental disorder. process of calcium oxalate crystallization and calcium oxalate stone formation. The lecture will highlight When he is not into the stone business, Hans-Gran new pathophysiological aspects of stone disease, Tiselius is a skilful and respected artist, painting in oil which will potentially guide doctors into new ways of his impressions of the magnificent Swedish natural treatment. landscapes. Tiselius, who officially retired in 2009 from his clinical work at the Renal Stone Unit of Karolinska University Hospital, received his medical degree in 1972 and only two years later completed his doctoral dissertation (Ph.D). His has dedicated his professional life to the study and treatment of kidney stone disease and is widely known to be at the forefront in both basic and clinical stone research. Tiselius has published 187 original peer-reviewed papers, 114
EAU Section of Urolithiasis (EULIS)

1st Meeting of the EAU Section of Urolithiasis (EULIS)

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European Urology Today

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Book reviews
Prof.Dr. Paul Meria Section Editor Paris (FR) paul.meria@sls. aphp.fr

a separate paragraph. Ablative procedures in onco-urology such as HIFU and cryotherapy of prostate and kidney tumours are described in the third chapter. Recent advances in BPH management are considered in a dedicated chapter, describing various laser technologies and bipolar transurethral resection. The last chapter deals with new developments in laparoscopy including image-guided systems, training problems and flexible instruments. This well-illustrated textbook assembles useful information for urologists anxious to update their knowledge in the abovementioned topics.

ISBN Editors

: 978-3-13-150641-2 : C. Chaussy, G. Haupt, D. Jochan, K.U. Khrmann Publisher : Thieme Verlag Publication : 2011 Edition : 1st Price : 69,95 Euro Pages : 208 Illustrations : 95 illustrations Binding : softcover Website : www.thieme.de

Therapeutic Energy Applications in Urology

Minimally invasive procedures have progressively replaced open surgery in the field of urology. New developments in various technologies provide urologists with very efficient devices, available for less invasive operations with direct patients benefit. Chaussy and co-editors wrote this textbook with the help of more than 30 contributors from Germany, Switzerland and the Netherlands who participated in the consensus meeting of the German Society for Shock Wave Lithotripsy. Five topics were discussed by the committees before plenary sessions were organized with the aim of establishing consensual answers to the questions. Thus, urolithiasis, lithotripter technology, ablative onco-urology, BPH and laparoscopy were exhaustively addressed. Five groups were set up to assess current progress within the chosen topic and discuss direct
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impact on patients health. Future developments were also discussed. Five chapters of this book report on the committees works. Each of them begins with a consensus survey. The chapter dedicated to urolithiasis assembles various paragraphs dedicated to diagnostic methods and therapeutic procedures including ESWL and endourology. The following chapter deals with lithotripter technology: various devices available at present are described in specific paragraphs, since shock waves effects on pain memory are discussed in

The European School of Urology is committed to provide continuing medical education (CME) that is readily accessible to urological professionals. Besides our various learning events, the ESU now offers online CME to fit the often hectic working schedule of many urologists.

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Dr. Andrea Cestari Section Editor Milan (IT) OpenCME, gives you an opportunity to: Watch video presentations on your iPad, iPhone or laptop/desktop computer Participate in interactive activities, or simply read text-based courses Take post-tests and earn credits, right from your device Select CME on the basis of conditions addressed or therapies discussed Review all activities available on OpenCME from any society, university or faculty member, as well as from top peer-reviewed journals and major conferences Send activities of interest to your inbox for later viewing Share activities with colleagues using e-mail, Facebook or Twitter Search for CME activities that match one or more keywords you specify, including signs, symptoms, diagnoses, therapies, etc. Keep track of your activity history Add CME activities you feel would benefit other OpenCME users

SIU-ASTELLAS
Award 2011
Since 1994, the Socit Internationale dUrologie and the Astellas European Foundation (AEF, formerly Yamanouchi European Foundation) have sponsored a $30,000 USD award granted to a scientist of notable professional and ethical standing. In preparation for the 31st SIU Congress, to be held October 16-20, 2011 in Berlin, the SIU and the AEF solicit nominations for this prestigious award. Nominations should include a detailed curriculum vitae and a letter with a full explanation of the candidates merit, and must be submitted to the coordinates below no later than March 1, 2011. The Selection Committee, appointed by the SIUs Board of Chairmen, will review all applications and announce the SIU-Astellas Award 2011 laureate at the 2011 SIU Congress in Berlin. Previous laureates were Dr. Donald S. Coffey (1994), Dr. Nils Kock (1997), Dr. Emil Tanagho (2000), Dr. Alvaro Morales (2002), Dr. Michael Marberger (2004), Dr. Frans Debruyne (2006), Dr. Andrew Novick (2007), and Dr. Peter Alken (2009). Selection Committee, SIU-Astellas Award 2011 c/o SIU Central Ofce 1155 University Street, Suite 1155, Montral, Qubec, Canada H3B 3A7 Telephone +1 514 875 5665 Fax: +1 514 875 0205 central.ofce@siu-urology.org

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OpenCME is a service that provides physicians with an unparalleled, always-at-hand choice of medical education from the worlds most highly regarded academic institutions, medical societies and thought-leading educators. Thanks to OpenCME, medical doctors can now take continuing medical education courses wherever and whenever your schedule permits, using your iPad, iPhone or iPod Touch. Trusted OpenCME Urology Sources include American College of Emergency Physicians, American College of Obstetricians and Gynecologists, American Urological Association, Cleveland Clinic Center for Continuing Education, Harvard Medical School, Johns Hopkins University School of Medicine and others. Topics of interest within OpenCME Urology include bladder cancer, urinary incontinence, urinary tract infections, SDTs amongst others.

www.medical-jokes.com
Stressed by being on call in a weekend or during a holiday period? Need to relax a little bit after a long day in the OR? This website offers quite a few good jokes related to medicine (urology included) and perhaps they will help you to ease the tension of your busy schedule. A visit is worthwile!

Research Fellowship
The California Urological Foundation, in association with the Socit Internationale dUrologie, announces the availability of a Research Fellowship for a fully-trained Urologist from Africa to do research for one year in a medical laboratory of the University of California in San Francisco (UCSF). This award is intended to prepare the candidate for an academic career in his or her home country; a rm commitment to return will be a material consideration in the evaluation of candidates. This fellowship carries a stipend of $50,000 USD, of which $14,000 is used to cover medical insurance and administrative fees. Applications for this fellowship will be evaluated by a joint SIU/UCSF Committee and should include a proposed area of study, a detailed CV, and professional references. The deadline for the 2011 Fellowship will be March 30, 2011. Application forms are available on the SIU website www.siu-urology.org under the Training Scholarships tab. Applications can be submitted by mail, fax or e-mail to: UCSF-SIU Research Fellowship c/o SIU Central Ofce 1155 University Street, Suite 1155, Montral, Qubec, Canada H3B 3A7 Telephone +1 514 875 5665 Fax: +1 514 875 0205 central.ofce@siu-urology.org

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EUSP: Four months in Leipzig

Gaining insights into subspecialty training
Dr. Rowan Casey Dublin (IE) prostatectomy. This technique was pioneered by Prof. Stolzenburg and has been extensively published in the world literature (1). The daily routine started with a team meeting at 7.30 am where the residents delivered their reports from the night duty and from the ward rounds which start at 6.45. The operating list starts at 8am and consisted of one or two laparoscopic radical prostatectomies per day in one theatre and all other major cases in the other theatre. Laparoscopic cases ranged from EERPE, diverticulectomy, nephrectomy, mesh hernia repair and varicocoelectomy. The theatre list finished at 3-4pm and there was then a staff meeting every day to discuss difficult cases, histology and imaging. I had acquired a basic level of knowledge of spoken German prior to and during my time there but the majority of staff spoke English so the language barrier was not an issue. There was plenty of opportunity for clinical research and feedback. The experimental dry lab course (either LESS or laparoscopic) is run twice to three times per year and it is possible to partake in this. Also the Challenges in Urology meeting will be held in One of the main theatres of the Urology Unit in the University Leipzig at the end of June 2011 and so will be a good Hospital time to be present there. Leipzig is a fantastic city to live in and is famous for a number of artists (Bach, Goethe). The weather is cold in winter but Leipzig enjoys a warm dry summer. Transport to Leipzig was slightly problematic and involved an internal flight (Frankfurt or Berlin) or train from Berlin to get to Leipzig. Access to sports facilities and shopping is easy. The incidence of organ confined prostate cancer is increasing in Ireland and is expected to double in the next ten years. There are currently a minimal number of centres in Ireland performing laparoscopic radical prostatectomy (LRP). LRP has been demonstrated to be equivalent to open surgery in cancer outcomes, continence and potency, and superior in terms of analgesia requirements, cosmesis, hospital stay and catheter duration. These benefits are clearly important in health economic terms with an ageing population and higher rates of prostate cancer. EERPE is a challenging technique to acquire and requires much time training and keeping skills up-to-date. My intention is complete my sub-specialisation training in laparoscopic radical prostatectomy and return to Ireland with the skills necessary for appointment to a Consultant Urological Surgical post if and when one becomes vacant or available. In order to introduce EERPE into my practice I intend to refresh my skills on a dry laparoscopic trainer, send my urological team (anaesthetist, theatre nurses and

rowcasey@rcsi.ie The post I was accepted on by Professor Stolzenburg was an unfunded laparoscopic radical prostatectomy Fellowship and consisted of purely clinical operative and research commitments. The hospital programme Universittsklinikum Leipzig is a 600-bed University teaching hospital with the all the major surgical sub-specialties represented on the University campus. The Urology Unit consists of two main theatres for major open and laparoscopic cases, two endoscopic units (for endoscopic procedures (TURs, ureteroscopy, PNCL etc.), a complete radiological unit (IVU, Cystogram, ultrasound) and two wards (35 and 25 beds) with one- and two-bedroom accommodation. The department performs 350 radical prostatectomies per year, as well as 60-70 open and laparoscopic/LESS nephrectomies, 25 cystectomies and all other urological procedures.

My training involved 15 hours on a dry model trainer to become proficient in needle holding and pelvic suturing techniques. I then assisted either Professor Stolzenburg or one of his two consultant colleagues who perform EERPE and who collectively have experience of greater than 3000 cases. All cases were performed with consultant assistance in a modular or staged training model (2,3) until I was able to carry out the cases independently. At the end of the first month training I had finished my first phase of training (port insertion and camera holder). By the end of month two my time was spent as first assistant with gradually increasing periods as main operator until the two months when I gradually completed the pelvic lymphadenectomy, urethral dissection, nerve-sparing intrafascial prostatectomy and the There is one chief (Prof. posterior sutures of the urethrovesical anastomosis. I Stolzenburg), four completed a log book of cases performed and was consultants, four junior exposed to a standard range of complications and consultants and eight their management. residents. Currently three surgeons are We are in the final stages of editing a surgical text performing book Atlas of laparoscopic and robot-assisted laparoscopic radical urological surgery due to be published in three prostatectomies or months by Springer. I have contributed to EERPEs endoscopic approximately 50% of the chapters since my time in extraperitoneal radical the unit.

surgical assistants) to Leipzig to observe the procedure and its set-up. For my first cases I will get mentoring/supervision from a colleague from Leipzig in order to introduce the procedure safely in carefully selected patients for improved clinical outcomes. I am very grateful to the European Urology Scholarship Programme (EUSP) for making the Fellowship in Leipzig possible. I learned much in terms of practical skills and operative confidence. I also learnt about a different health system and culture than the one I trained and live in and I highly recommend Prof. Stolzenburgs unit in Leipzig for further training. References
1. Endoscopic extraperitoneal radical prostatectomy: evolution of the technique and experience with 2400 cases. Stolzenburg JU, Kallidonis P, Minh D, Dietel A, Hafner T, Dimitriou D, Al-Aown A, Kyriazis I, Liatsikos EN. J Endourol 2009;23:1467-72. 2. Evaluation of complications in endoscopic extraperitoneal radical prostatectomy in a modular training programme:a multicentre experience. Ganzer R, Rabenalt R, Truss MC, et al. World J Urol 2008;26:587-93 3. Modular training for residents with no prior experience with open pelvic surgery in endoscopic extraperitoneal radical prostatectomy. Stolzenburg JU, Rabenalt R, Do M et al. Eur Urol 2006;49:491-8.

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December 2010/March 2011

European Urological Scholarship Programme (EUSP) Session

Monday 21 March 2011; 14.00 17.00 hrs.
Room: Chairs: 14.00 14.10 14.10 14.20 14.20 15.30 14.20 14.30 14.30 14.40 Hall H C-C. Abbou, Creteil (FR) C.R. Chapple, Sheffield (GB) Introduction C-C. Abbou, Creteil (FR) Outcome of one year of EUSP programme: Poll from the hosts and applicants C-C. Abbou, Creteil (FR) Final report of five EUSP scholars Impact of aberrant promoter methylation on urothelial carcinoma behaviour S. Larr, Paris (FR) Indications and realisation of a partial or complete treatment in localized prostate cancer. Use of dynamic MRI and targeted prostatic biopsies E. Lecornet, Lille (FR) Biomarkers for prostatic inflammation diagnosis in benign prostatic hyperplasia R. Grgoire, Bordeaux (FR) New targets for molecular diagnostic of prostate cancer M. Salagierski, Lodz (PL) Identification, propagation and differentiation of putative stem cells in normal human urothelial (NHU) cells in vitro. F. Wezel, Mannheim (DE) Award presentation Best Scholar C-C. Abbou, Creteil (FR) Promotion Clinical Research Fellowship projects J.A. Schalken, Nijmegen (NL) 2 Fellows facing the Jury Presentation S. Dyakov, Varna (BG) Presentation A. Mogorovich, Pisa (IT) Questions Award presentation Best Fellow C-C. Abbou, Creteil (FR) Presentation Accreditation of the EUSP Centres (example of the ESUT) R. Muschter, Rotenburg (DE) EUSP Session on How to train Endourology J. De La Rosette, Amsterdam (NL) EUSP Cocktail for all scholars & hosts In front of Hall H

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35

Aussie moustache revival project attracts wide support

Funky Movember campaign brings back fun in mens health issues
By Joel Vega Call it a combination of Aussie-styled doggedness and humour, but the Movember project that originated Down Under and which aims to attract public support and funds to mens health issues is picking up steam across the Western world. The Movember Foundation, a non-profit, charitable organisation which runs the annual mens health initiative Movember across the globe is responsible for the sprouting of moustaches on thousands of mens faces around the world every November since 2003. With the sole aim of raising vital funds and awareness for mens health, specifically prostate cancer, testicular cancer and depression in men, Movember raises funds by seeking out sponsorship for their Mo growing efforts. The rules are simple- register online at Movember.com and start the month of Movember clean shaven and then grow a moustache for 30 days. Sounds fun and simple. But that basically is the success recipe of this initiative which now reaches Europe first via the UK and Ireland in 2007 and just last year in the Netherlands, Finland, Spain and the Czech Republic. Meanwhile, South Africa has attracted close to 10,000 people taking part, according to organisers. just 6,000 people in the UK, and 1,500 in Ireland, there are now more than 110,000 taking part in the UK in 2010 and more than 12,000 in Ireland, said Bill McIntyre, one of the lead campaigners and spokesman for Movember Europe. McIntyre said there were numerous enquiries from across Europe received last year for the 2011 campaign. So there should be plenty of opportunities to bring the moustache back, whilst raising funds for prostate cancer in more European countries in the next few years, he added. The funds raised as a result of Movember is channelled by the Foundation to mens health partners and into a number of world class and innovative education, research and awareness initiatives. For instance Movember Australia collaborates with two mens health partners the Prostate Cancer Foundation of Australia (PCFA) and beyondblue, which provides support to victims of depression. In its official website the group said the total cost of administration and fundraising at 6% of donations is low by global fundraising standards. This reflects our goal of continually reaching for the best possible campaign outcome while carefully monitoring costs, according to the Movember Foundation. and Ireland. A total of 20 campaigns have been launched since 2003 in all six participating countries as of 2010, and in the US the number of participants have exceeded 60,000 people. To have a durable impact on mens health issues and research, the group has recently announced the creation of the Movember Global Action Plan (GAP) which will work with a team of prostate cancer experts to identify key beneficiaries and outcomes in prostate cancer research. And as part of the Movember GAP, the Movember Foundation Board has established an independent Global Scientific Committee (GSC) composed of the best prostate cancer experts from around the world. The GSC will act as an advisory board on what research programme should be funded and how they should be implemented.
Prof. Jack Schalken of Nijmegen, the Netherlands supports the Movember project by sporting a real moustache for the month of November last year

In the Netherlands, Prof. Jack Schalken of the UMC St Radboud in Nijmegen, has provided active support to the Movember campaign. Fun activities included celebrating the weekend with drinks and distributing vintage t-shirts to participating Mo Bros who proudly sport their newly-grown moustache, said Schalken. A gala party was also held in the last weekend of November in Amsterdam with proceeds from the ticket sales going to Movember funds. McIntyre said there is interest from non-Western countries such as Singapore and Hong Kong. If there is enough significant support for Movember in a country, we will certainly investigate bringing the campaign there, he said adding that Movembers vision and values are the elements that drives the campaign to achieve its goals. There is a determination to achieve the vision of changing the face of mens health, and this will be delivered by ensuring Movember keeps to its values of making sure the campaign is fun and simple, said McIntyre.

The response has been great in Europe. The campaign Aside from Australia, the Movember Foundation runs official campaigns in New Zealand, US, Canada, the UK first started in the UK and Ireland in 2007, and from

NBI cystoscopy and bipolar plasma vaporisation

Advantages of a new diagnostic and treatment approach in large non-muscle invasive bladder tumours
Dr. Bogdan Geavlete Saint John Emergency Clinical Hospital Dept. of Urology Bucharest (RO) bogdan_geavlete@ yahoo.com Co-authors: Dr. Florin Stanescu, Spitalul Clinic de Urgenta Sf. Loan, Dept. of Urology, Bucharest, Prof. Petrisor Geavlete, Saint John Emergency Clinical Hospital, Head of Urology Dept., Bucharest Bladder cancer remains an important and difficult to treat pathology in modern urology, as it is considered the most expensive tumour with regard to both costs per patient per year as well as lifetime costs per patient. Subsequently, non-muscle invasive bladder cancer (NMIBC) accounts for the highest share of the overall costs involved by this malignancy. [1] Technically speaking, the tissue surface is visualised using light of a narrow bandwidth, obtained due to a narrow band filter placed in front of the white light source which provides centre wavelengths in the blue (415 nm) and green (540 nm). These specific wavelengths are strongly absorbed by hemoglobin and only penetrate the tissue surface. Therefore, the vascular structures appear dark brown (capillary vessels) or green (veins), thus contrasting with the pink or white mucosal background. [5] The specifically vascular nature of the urothelial carcinoma may constitute the basis for substantial benefits related to this new method. Subjectively speaking, NBIC offers a visual impression of the abnormal mucosal areas, thus creating a threedimensional perspective of bladder tumours and distinctively emphasising their capillary architecture. (Fig. 1) On the other hand, an important issue related to NMIBC treatment is represented by difficulties concerning the resection of large tumours, which often implies important bleeding rates, prolonged resection time, poor visibility and an increased complication rate. A new treatment approach for large non-muscle invasive bladder tumours was introduced in our Clinical Department in 2009 as an international premiere: the bipolar plasma vaporisation (BPV) using the Olympus SurgMaster UES-40 bipolar generator (Olympus, Tokyo, Japan) and the button shaped electrode. white light, followed by NBIC, emphasising a specific bladder map of all tumours found using NBI. Bipolar resection biopsy followed by plasma vaporisation and tumoural bed resection were applied for all tumours larger than 1 cm, followed by NBI control, searching for eventual residual lesions. Standard Re-TUR was performed 4 weeks after the initial procedure. In our initial experience of 77 consecutive patients (53 men and 24 women), the overall, CIS, pTa and pT1 tumour detection rates for WLC and NBIC were 81.9% versus 92.6%, 64% versus 96%, 79.5% versus 90.6% and 90.5% versus 95.2%, respectively. Ten patients presented muscle-invasive bladder tumours diagnosed by both methods and were subsequently excluded from the study and referred for radical cystectomy. Pathologically confirmed positive tumoural margins were found using NBI in 11.7% of the cases. The superior diagnostic accuracy of NBIC compared to standard WLC was confirmed by the literature data. A trial by Cauberg et al. determined an overall detection rate of 94.7 % for NBIC and 79.2 % for WLC. [5] These results can be considered quite promising, since the published studies underlined the significant obturator nerve stimulation, bladder wall perforation and bleeding rates specific to standard monopolar transurethral resection of bladder tumours (15.7%, 7.8% [6] and 2.8% [7], respectively). In this initial series, the residual tumours rate established during Re-TUR was 8.9%. From this perspective, the advantages provided by NBIC and BPV appear to be significant when compared to the literature data, which found a Re-TUR recurrence rate of 37% in cases of large and multiple tumours [8]. Progress in the form of short-term follow-up obtained using this hybrid technique may be explained by the improved cystoscopic examination using NBI, as well as by the superior local endoscopic treatment achieved by plasma vaporisation.

We may conclude that the combined diagnostic and treatment modality consisting of NBIC and BPV seems to represent a promising alternative in cases of large non-muscle invasive bladder tumours, thereby creating the premises for an increased diagnostic accuracy, an efficient tumoural tissue ablation and a As far as the actual endoscopic treatment was According to literature data, 50% to 70% of the reduced rate of residual tumours at Re-TUR. Certainly, concerned, the plasma vaporisation proved to NMIBC patients display recurrence after the initial represent both a safe and effective technique. The rate longer follow-up periods and more extensive trials treatment. Numerous cases of early recurrences are will be required in order to establish the long-term of obturator nerve stimulation was 3.9%, the mean determined by the incomplete removal of tumours hemoglobin drop was 0.3 g/dl, the mean advantages and general viability of this approach. during transurethral resection [2]. During the last catheterisation period was 2.5 days and the mean decades, many methods of improving bladder cancer The references of this article can be requested from hospital stay was 3.5 days. A single case of diagnostic and treatment were evaluated. Quite often, postoperative bleeding was encountered, and none of the EUT Editorial Office by sending an a-mail to: small papillary tumours and flat lesions of carcinoma In our experience, the most important benefits of BPV the patients presented bladder wall perforation. eut@uroweb.org. in situ (CIS) are not visualised by the standard white are represented by the rapid vaporisation of large light cystoscopy (WLC), thus leading to a significant quantities of tumoural tissue with minimal blood loss, increase in the short-term recurrence rate. the excellent visibility throughout the procedure, and consequently, the reduced complication rate. This type The photodynamic diagnostic using of vaporisation does not alter the visual characteristics hexaminolevulinate blue light cystoscopy provided of the anatomical layers, thus enabling the surgeon to satisfactory progresses in terms of diagnostic accuracy differentiate the tumoural tissue and the muscular [3] and recurrence rates [4], as it significantly fibres of the bladder wall with increased accuracy. improved the detection of CIS lesions, [3] as well as of (Fig. 2) pTa and pT1 tumours [4]. However, questions have been raised concerning the cost-effectiveness of this Since large bladder tumours are often associated with approach. In this regard, the narrow-band imaging Fig. 1: pTa tumour overlooked in white light, and only visible when using NBI extended margins as well as small satellite tumours cystoscopy (NBIC) appeared as a promising which may not be distinguished during the standard alternative, as it described improved detection rates WLC, in such cases NBIC may represent a useful without the need for the intravesical instillation of a additional diagnostic technique. Consequently, this contrast medium. Subsequently, the overall cost of the combined diagnostic and treatment approach, procedure appeared to be substantially lower by consisting of NBIC and BPV for patients presenting comparison to the photodynamic diagnostic. large bladder tumours, was introduced as an absolute premiere. NBI represents an optical diagnostic technique which enhances the contrast between the mucosal surfaces Cases of tumours over 3 cm were selected based on and the microvascular structures, based on the abdominal ultrasonography, computer tomography wavelength-dependent increase of the depth of the and flexible cystoscopy. WLC was initially performed, light penetration into the mucosa. resulting in a bladder diagram of all lesions visible in Fig. 2: Plasma vaporisation of a large pT1 tumour and the clean muscular layer of the bladder wall after the procedure 36 European Urology Today December 2010/March 2011

8th ESOU casts critical eye on medical, surgical issues

London meeting attracts more than 900 international participants
By Joel Vega The 8th EAU Section of Oncological Urology (ESOU) Meeting held in London, the United Kingdom, from January 21 to 23 this year surpassed previous attendance records with more than 900 participants flocking to the British capital for a three-day assessment of controversial and emerging issues in oncological urology. Not only are we delighted by the high attendance but we also are encouraged by the interactive character of the sessions. With international expert speakers, we are fulfilling the ESOUs goal to look deeply into onco-urological issues and encouraging our members and associates to do their part by closely re-examining research or clinical work, said ESOU Chairman Vincent Ravery. Barentsz (Nijmegen, the Netherlands) described the fundamentals of multiparametic MRI and provided an overview of various MRI techniques. Multiparametic MR imaging may potentially increase prostate cancer detection accuracy in comparispon to T2-weighted MR imaging only. However, future research is needed to confirm initial results, said Barentsz. In a debate, Theo De Reijke (Amsterdam, the Netherlands) took the critical viewpoint on the EAU Guidelines that says margin-positive patients, after radical prostatectomy, should be given adjuvant radiotherapy. Michel Bolla (Grenoble, France) defended the guidelines and said that within the context of a multidisciplinary approach, adjuvant radiotherapy has to be a part of the tacit contract established between surgeon and the patient, each time the likelihood of a local relapse seems important after radical or conservative procedures He however stressed the strategy should be evidencebased, and that for pT2R1pNo patients, post-operative irradiation has not provided a gain yet. Selected key messages in PCa are: George Thalmann (Berne, Switzerland) discussed G3pT1 disease or poorly differentiated (G3) cancers which are known to have a worse prognosis than other superficial bladder tumours. In his conclusions, Thalmann noted that immediate cystectomy for all primary T1G3 bladder cancers may result in overtreatment, and that even with an immediate radical cystectopmy for all patients with T1G3 bladder cancers, five-year survival is only around 80%. In the debate on EAU Guidelines regarding early Re-TUR in NMIBC, Maurizio Brausi (Modena, Italy) challenged the guidelines whilst Marko Babjuk (Prague, Czech Republic) forwarded pro arguments. Babjuk conceded that guidelines recommendations should be focused and critically discussed, and that the idea of a second TUR emanated from unsuccessful initial procedures. Brausi countered that there should be more focus on improving surgery (TUR) rather than collecting old data and re-doing TUR, and that TUR teaching programme should be a part of the standard urological training.

Marberger (left photo) and Laurent Boccon-Gibod receive the ESOUs Achievement Awards from Maurizio Brausi and Bob Djavan

we have to be careful not to overestimate LESS/ NOTES, said Alcaraz as he noted that technical issues require further refinement. Tim OBrien (London) gave several practical tips regarding caval surgery such as a careful review of up to date imaging, working with the same team, honesty with patients about outcomes, learning how to mobilise the liver and replace the IVC, amongst others. Gerald Mickisch (Bremen, Germany), made a critique on targeted therapies in metastatic renal cell carcinoma (mRCC) within the context of efficacy, patient tolerability and cost effectiveness. A lot of hype has accompanied the entry of so-called targeted therapies in mRCC, said Mickisch. He stressed these drugs remain palliative and not curative. Although lifespan in good/intermediate patients has now reached from around three to four years, he said there is still no change in the natural behaviour of tumour growth. Since progression-free survival (PFS) was the primary end point of all registration studies, OS-data are only hypothesis-generating. Due to the cross-over design of sunitinib, bevacizumab + IFN-alpha, or pazopanib pivotal studies there was no statistical significant difference. Both, the Cochran analysis and modern computer simulation models, suggest equivalent efficacy, added Mickisch. In his summary overview on ASMO/ESMO news, Tim Eisen (Cambridge, UK) said there are now good agents available and new agents are expected. But he said the key questions include the order in which these agents should be used and how physicians select the right agent for the patient. He added there is a need to gain regulatory or funding agency approval for analyses compensating for cross-over. Stepping up This programme is certainly a most welcome and stimulating way to touch base with young urologists. Having a discussion with these young urologists allows us to have a sense of the future or the possibilities in urology, said Richard Hautmann (Ulm, Germany) who chaired the discussions on bladder, renal and prostate cancers with Boccon-Gibod and Marberger.

Sir Mike Richards (at podium) opens the 8th ESOU Meeting, looking on are Vincent Ravery (left) and local organiser Simon Brewster

Simon Brewster, local organiser and ESOU board member, said holding the annual ESOU meeting in London not only introduces the ESOUs programme to a wider audience but also continues the ESOUs tradition of providing a dynamic platform for European oncological urologists. With most participants coming from Germany, Spain and the host country, the meeting featured debates, state-ofthe-art lectures and Q&A sessions. With unrestricted grant from Ipsen, the ESOU launched this year the STEPS (Sessions To Evaluate Progress) Meet the Expert, a by-invitation only discussion amongst 15 young urologists and three senior experts. Professors Michael Marberger and Laurent BocconGibod received Lifetime Achievement Awards for their contributions to urology. The ESOU recognises the significant contributions of these distinguished urologists to urological training and education, said Bob Djavan at the close of the meeting. Also honoured during the meeting were Jonas Hugosson and colleagues. The Swedish group won the ESOUs Best Abstract Award for their study Mortality results from the Gteborg randomised population-based prostate-cancer screening trial, published in The Lancet Oncology in August 2010. Challenges in PCa In cancer prevention, patients need to be more aware of lifestyle improvements such as proper diet and regular exercise, and the ill-effects of smoking. But equally important is the crucial role that early diagnosis can contribute to the prospect of long-term survival amongst patients, said Sir Mike Richards, the UK Department of Healths National Cancer director, in his keynote address. According to Richards, urological malignancies today constitute the commonest tumour group. He mentioned a UK survey which showed that British cancer patients noted an improvement in cancer care compared to a decade ago. But he added that a great deal still needs to be done to further boost the quality of healthcare. In the prostate cancer sessions, Peter Hammerer (Braunschweig, Germany) lectured on the role of 5 alpha-reductase inhibitors (5ARIs) in chemoprevention, saying there is a rationale for the use of dietary factors and 5ARIs in prostatic disease. 5ARIs reduce the risk of being diagnosed with prostate cancer among men who are screened regularly for prostate cancer, Hammerer said. The overlap between BPH and prostate cancer may allow a more unified approach to managing these conditions, with 5ARIs having a central role, he said. Although conclusive evidence is still limited, the current data indicate that a low-fat, high fibre diet, complemented with dietary habits that avoid high energy intake, excessive meats and dairy products, may contribute in reducing PCa incidence. Regarding the role of Magnetic Resonance Imaging (MRI) in PCa detection, localisation and staging, Jelle December 2010/March 2011

RCC: treatment prospects The renal cancer session assessed minimal invasive procedures such as laparoscopic radical nephrectomy Markus Graefen: Radical prostatectomy (RP) for (LRN), amongst other issues. Jean Jacques Patard the treatment of high risk disease can lead to (Rennes, France) discussed the trend favouring LRN superior results on overall and cancer specific instead of open partial nephrectomy. The survival compared to radiation therapy. Therefore, the role of RP for treating these cancers is growing. development of laparoscopy in urology is obvious. LRN However, achieving negative surgical margins is an is potentially less morbid for patients, he said. important goal in these cancers and can be Jan Roigas (Berlin, Germany) examined the role of achieved by the use of frozen sections during the biopsy and AS in small renal tumours. Renal biopsy is procedure increasingly used for patients with small renal Bob Djavan (New York, USA) on PSA: Do it earlier tumours. Although it is no standard diagnostic tool for (at young age) and repeat it once. Lower the cut-off patients with renal masses, it has a distinct meaning in patients with unclear renal masses when conventional and observe PSADT and PSAV. The Punglia/ imaging techniques such as CT or MRI failed and the Eastham data support the lowering of the PSA threshold to: 1.4 in men aged <60 years (senstivity question of surgery needs to be answered, said Roigas. Moreover, he added that although malignant 0.74, specificity 0.79), and 2.1 in men aged >60 behaviour of small renal masses is generally low, a years (sensitivity 0.68,specifity 0.70). stratification model is needed. AS and/or watchful waiting are options for selected patients (the elderly Mark Emberton (London) discussed improving and those with co-morbidities), he said. active surveillance (AS) to prevent under-staging and adverse outcome in PCa. He said imaging prior to biopsy will improve precision in terms of validity and reliability. He also emphasised the need for better stratification which implies more AS and tissue-preserving therapies. Samir Taneja (New York, USA) spoke on developments and challenges in focal therapy. Taneja: We have to consider the following questions: should it be image-guidance versus biopsy guidance? What are the methods of follow-up? Should it be biopsy, imaging, biomarkers or both? Bladder cancer issues In the session on bladder cancer (BCa) John Kelly (London) discussed microscopic haematuria, examining its incidence and role in detecting and screening for BCa and the need for a biomarkerdirected cystoscopy. At what point can we ignore haematuria? asked Kelly. He said the answer remains elusive although there are indications that too many patients receive unnecessary investigations. There is a need to adopt meaningful investigations and establish an algorithm to be tested, altered and improved, he added. Discussing the efficiency of blue light cystoscopy and narrow band imaging (NBI), De Reijke tackled the cost effectiveness of these devices and their efficiency in diagnosing BCa. Regarding photo dynamic diagnosis (PDD), De Reijke said studies showed that PDD has better detection rates and less residual tumours, although specificity is low compared to cystoscopy. On the other hand NBI-TURB procedures led to a significant reduction in the number of residual tumours, but confirmation is needed in prospective randomised studies.

Fifteen young urologists were invited to the STEPS programme

Franck Bladou (Marseille, France) gave tips on laparoscopic/robotic partial nephrectomy. LPN is emerging as a minimally invasive alternative with comparable oncological outcomes but limited by technical difficulty and learning curve, said Bladou as he mentioned that indications for LPH are SRMs less than 4 cm and cortical tumours. On focal therapy in RCC, Jean De la Rosette (Amsterdam, The Netherlands) said laparoscopic cryoablation and percutaneous RFA are the standards of management when focal therapy is the treatment of choice. The complication rate for both approaches is the same, whereas the laparoscopic approach goes with a longer hospital stay. Both treatments have equal functional outcomes in terms of serum creatinine preservation, said De la Rosette.

At the beginning I wasnt sure of the aim, but it turned out to be an interesting and relaxed meeting. The interaction with the invited expert was very helpful, said Mireia Musquera (Barcelona Spain) who participated in the renal cancer group chaired by Marberger. Participant Amine Benchikh El-Fegoun (Paris, France) also responded enthusiastically: The meeting provided helpful insights about our practice and we discussed a lot of issues. Antonio Alcaraz spoke on emerging trends in minimal ESOU board member Maurizio Brausi summed up the surgery such as Natural orifice transluminal endoscopic goals of STEPS. With this programme we hope to surgery (NOTES) and Laparoendoscopic single site provide opportunity for young urologists to share their surgery (LESS). He cited the experience of his ideas and research goals in an informal way. We department at Hospital Clinic, University of Barcelona, discussed surgery, basic research, imaging and with NOTES where living kidney donors expressed diagnoses, etc. The discussions were not only lively but satisfaction over the outcomes of transvaginal NOTES. this meeting would help the ESOU to identify and There is still limited data on these procedures, and recruit talented urologists.

Jeremy Crew (Oxford, UK) lectured on active surveillance as an option for NMIBC. Reiterating the medical slogan do no harm, Crew said the benefits of AS include absence of morbidity and surgery. Drawbacks include progression risk and the patients psychological anxiety. He discussed several active surveillance trials which showed some data on disease progression and tumour growth rates. Low-risk NMICB can be safely managed by periods of AS, and patients can be counselled about it, said Crew although no high-level evidence exists for AS and that prospective randomised trials are still More than 900 participants joined the 8th ESOU Meeting in London needed. European Urology Today 37

The 3rd European CME Forum

Continuing to guarantee high-quality medical education
Prof.Dr. H. Madersbacher Chairman EU-ACME Committee Innsbruck (AT) helmut. madersbacher@ tilak.at Ultimately, it is the patients who pay for the CME/CPD activities partaken in by their doctors. Regrettably, they are also the first to suffer the consequences if their doctors dont take part. The current status of Continuing Medical Education (CME) and Continuing Professional Development (CPD) for healthcare professionals across Europe and the important role of all the stakeholders involved was discussed during the 3rd European CME Forum which took place in Berlin, 16-17 November 2010. Beata Adamczyk Manager EU-ACME Arnhem (NL) Prostate cancer screening, diagnosis and staging F.C. Hamdy, I. Romics; Retropubic radical prostatectomy tips, tricks and pitfalls H. Van Poppel, O.W. Hakenberg; Advanced management of urethral stricture disease C.R. Chapple, P. Nyirady, G. Barbagli; Paediatric urology for the adult urologist: A practical update J.M. Nijman, G.A. Bogaert, S. Tekgl; Vaginal surgery for urologists D. Pushkar, D.J.M.K. De Ridder; Diagnosis and management of non-muscle invasive bladder cancer J. Palou, J.A. Witjes, M. Babjuk; Surgery or radiotherapy for localised and locally advanced prostate cancer B. Djavan, T. Wiegel; The infertile couple urological aspects W. Aulitzky, W. Weidner. The keypad At the entrance to the lecture rooms, each participant will receive the Audience Response System (ARS) Keypad. Each test will consist of about eight questions with four possible answers of which only one is correct.

b.adamczyk@ uroweb.org The accreditation of the CME event, such as an ESU course, confirms the scientific and educational quality of a programme, and allows the participants to receive CME credits for the time spent in the educational activity.

However, the time someone spends in a lecture room says little about the knowledge actually gained. Therefore the European School of Urology (ESU), together with the EU-ACME, started up a project in 2010 during the EAU congress in Barcelona, in which the knowledge gained in ESU courses was assessed As European CME evolves and becomes increasingly by pre- and post-knowledge tests using multiple important to European doctors becoming mandatory choice questions (MCQs). in more countries and more closely monitored in others each stakeholder group in Europe is looking Patients should benefit from more closely at the rules of engagement. The European CME scene is working on further developing standards in order to guarantee highquality medical education. Different stakeholders are observing the discussion with a closer look at their position and future implications. In 2009, The Good CME Practice Group was established, the main aim of which is to establish appropriate operating standards for CME development. Over a dozen education agencies are now collaborating to ensure high quality medical education, and to build a bridge to the fundamental guidance that is given by the national and European CME-bodies. So far, a basic set with core principles is agreed upon: Appropriate education - Educational programmes should address pre-identified educational needs. Fair balance - Educational programmes should be balanced fairly. Transparency - Relevant relationships between individuals and organisations, sources of funding, sources and generation of content, should be transparent. Effectiveness - Programmes should be reviewed and evaluated for their effectiveness. Since its inception in 1972, the European Association of Urology has focused its efforts to improve urological practice across Europe through educational, scientific and professional activities. With the goal of advancing patient care, the commitment to achieve high standards in urology remains at the core of the EAUs endeavours. From Attendance control to personal improvement CME consists of educational activities that serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services for patients, the public or the profession.

It is very important to enter the lecture rooms on time, in order to have both results for comparison. The tests are anonymous; however if a participant would like to receive the results he or she can pass on the number of the ARS keypad to the EU-ACME office after the course. The results will then be sent by e-mail to the participants. Two months after the congress, each participant of the above ESU courses will receive an e-mail with some short evaluation questions.

Congress Announcement CME Accreditation

During the 26th EAU Annual Congress in Vienna, CME credit points will be granted automatically to Active EAU Members and EU ACME Members by scanning their congress badge. The request for the European Accreditation of the Congress is submitted to the UEMS/EACCME through the European Board of Urology (EBU). The number of the granted European CME Credits will be announced soon. The European Accreditation Council for CME (EACCME) and the European Board of Urology (EBU) are institutions of the European Union of Medical Specialists (UEMS). The EACCME/EBU credit system is based on 1 ECMEC per hour with a maximum of 3 ECMECs for half a day and 6 ECMECs for a full-day event. Each medical specialist should claim only those hours of credit that he/she actually spent in the educational activity. The EBU/EACCME CME Credits are recognised by most of the national CME authorities in Europe, which have agreed to cooperate in this European system. EACCME/EBU credits are recognised by the American Medical Association towards the Physicians Recognition Award (PRA). Please remember to let your congress badge be scanned when entering the session room, so credits can be attributed automatically. For questions regarding CME accreditation or collected CME credits, please visit the EU-ACME desk at the registration area.

the improved quality of care that should be the result of the CME/CPD performed by their doctors
In the EUT No. 3 June/July 2010, the preliminary results from the pilot were presented. As expected, the number of correctly answered questions after the courses significantly increased comparing to answers given at the beginning of the course. For instance, in one course - before 37% and after 60% correctly answered and in another course - before 31% and after 51%. Three months after the course, an evaluation questionnaire was sent to all participants of the pilot ESU courses. Although not too many colleagues reported back, it was clear that those who did send completed forms back indicated that after having followed the courses their knowledge and reassurance in daily practice increased.

Meanwhile, other national urological associations followed the example of the ESU in this matter, and also organised pre- and post-knowledge tests during the urological courses. Very interesting and informative results were collected after a preand post-knowledge test organised during a course at the Austrian School of Urology. Testing at the EAU Congress Following the positive feedback from the pilot project, the ESU Board decided to follow up on this initiative. This was also done to ensure that the lecture meets the requirements and the needs for knowledge, and from the boards desire to assure the quality standards of the CME, and developments in the CME. During the 26th Annual EAU Congress in Vienna, the following eight ESU courses will be organised with a pre- and post-knowledge test:

http://cem.uroweb.org

EAU 11th Central European Meeting (CEM)

28-29 October, Timisoara, Romania
EAU meetings and courses are accredited by the EBU in compliance with the UEMS/EACCME regulations

European Association of Urology

Fig. 1: Result of the pilot ESU courses evaluation questionnaire

EU-ACME Office

38

European Urology Today

December 2010/March 2011

Congress calendar 2011

March
1-5: Scottsdale, Arizona, USA
SUFU 2011 Winter Meeting Contact: Society for Urodynamics and Female Urology Phone: +1 847 517 7225 Fax: +1 847 517 7229 E-mail: info@sufuorg.com Website: http://www.sufuorg.com/meetings/2011/ default.aspx

Full, continually updated urological meeting calendar at

www.uroweb.org

5-10: Puerto Vallarta, Mexico

Annual Meeting of the Mexican Society of Urology Contact: Colegio Mexicano Urologa Nacional Phone: +52 55 9000 2092 Fax: +52 55 9000 2093 E-mail: smu@wtcmexico.com.mx Website: http://www.cmu.org.mx/beta/index.php

15-16: Berlin, Germany

4th Annual European Perspectives in Genitourinary Oncology Contact: Imedex Phone: +1 770 751 7332 Fax: +1 770 751 7334 E-mail: meetings@imedex.com Website: http://imedex.com/AppWeb/ announcements/A156-01.asp

12-14: Lugano, Switzerland

Educational Cancer Convention Lugano - What is new and what is true in genito-urinary oncology? Contact: European School of Oncology Phone: +39 02 8546451 Fax: +39 02 85464545 E-mail: eso@eso.net Website: http://www.eso.net/events-2.html

6-8: Bristol, United Kingdom

18th Annual Scientific Meeting United Kingdom Continence Society Phone: +44 179 451 1331/2 Fax: +44 179 451 1455 E-mail: ukcs@indexcommunications.com Website: http://www.ukcs.uk.net/docs/ UKCSA%20proof%20v4.pdf

1-2: London, United Kingdom

Operative Skills in Urology Course: Modules 3 and 4 Contact: The Royal College of Surgeons Phone: +44 20 7869 6300 Fax: +44 20 7869 6320 E-mail: education@rcseng.ac.uk Website: http://www.rcseng.ac.uk/education/ courses/operative-skills-in-urologymodules-3-4

20-24: Nagoya, Japan

99th Japanese Urological Association Annual Meeting Contact: The Japanese Urological Association Phone: +81 3 3814 7921 Fax: +81 3 3814 4117 E-mail: jpurol@mb.infoweb.ne.jp Website: http://www.urol.or.jp/en/index.html

13: Washington, DC, USA

Basic Sciences Symposium Stem Cells in Urologic Development and Disease Contact: AUA Foundation Phone: +1 410 689 3700 Fax: +1 410 689 3800 E-mail: auafoundation@auafoundation.org Website: http://www.urologyhealth.org/

7-9: Lago Maggiore, Italy

Leading Lights in Urology Meeting E-mail: m.koops@uroweb.org Website: http://www.uroweb.org/

1-5: Phoenix, AZ, USA

Annual Meeting of the Society of Urodynamics and Female Urology (SUFU) Contact: WJ Weiser & Associates Phone: +1 847 264 5918 Fax: +1 847 517 7229 E-mail: info@wjweiser.com Website: http://www.sufuorg.com/

21-23: Belgrade, Serbia

National Congress of the Serbian Association of Urology Contact: Central Office Urological Association of Serbia Phone: +381 11 2656277 E-mail: urologcl@eunet.rs Website: http://www.uas.org.rs/

14-19: Washington DC, USA

American Urological Association 2011 (AUA 2011) Contact: AUA Phone: +1 410 689 3700 Fax: + 410 689 3800 E-mail: registration@AUAnet.org Website: http://www.aua2011.org/

7-9: New York, NY, USA

Second Interdisciplinary Conference Prostate cancer: Predictive Models for Decision making Contact: European School of Oncology Phone: +39 02 85464527 Fax: +39 02 85464545 E-mail: prostate@eso.net

8-11: Mansoura, Egypt

3rd Training Course on Stress Urinary Incontinence: Evaluation and Management Contact: Mansoura Urology and Nephrology Center (UNC) Phone: +2050 2262222 Fax: +2050 2263717 E-mail: bassem_wadie@mans.edu.eg Website: http://www.unc.edu.eg/

22: ESU organised course on Prostate cancer at

the time of the national congress of the Serbian Association of Urology Contact: ESU

25-27: Amsterdam-Noordwijk, The Netherlands

4th International Symposium on Focal Therapy and Imaging in Prostate & Kidney Cancer Phone: +30 210 7257693 Fax: +30 210 7257532 E-mail: info@focaltherapy.org Website: http://www.focaltherapy.org/

8-12: Vancouver, Canada

World Congress of Nephrology 2011 Contact: ISN & CSN Phone: +1 708 486 0746 Fax: +1 708 344 4444 E-mail: info@wcn2011.org Website: http://www.wcn2011.org/

27-30: Copenhagen, Denmark

22nd Annual Congress of the European Society for Paediatric Urology (ESPU) Phone: +32 163 466 98 Fax: +32 167 021 53 E-mail: secretary@espu.org Website: http://www.espu2011.org/

June
2: London, United Kingdom
Urological Anatomy for Surgery Course Contact: The Royal College of Surgeons Phone: +44 20 7869 6300 E-mail: education@rcseng.ac.uk Website: http://www.rcseng.ac.uk/education/ courses/urological-anatomy.html

17-20: New Orleans, USA

75th Annual Meeting Southeastern Section of the AUA Contact: SESAUA Phone: +1 847 969 0248 Fax: +1 847 517 7229 E-mail: info@sesaua.org Website: http://www.sesaua.org/

10-12: Ghent, Belgium

Ghent Live Surgery Days Urethral Stricture Repair Contact: W. Oosterlinck, N. Lumen Phone: +32 9 332 22 79 Fax: +32 9 332 38 89 E-mail: poli.urologie@uzgent.be Website: http://www.ghentlivesurgery.com/

28 April-1 May: Tehran, Iran

14th Iranian Urological Association Congress (IUA) Phone: + 21 885 26900 Fax: + 21 885 26901 E-mail: info@iuanet.org Website: http://www.iuanet.org/Edefault.aspx

2-3: Chisinau, Moldova

National congress of the Moldavian Urological Association Phone: +373 22 403 522 Fax: +373 22 403 522 E-mail: vghicavii@yahoo.com

18-22: Vienna, Austria

26 Annual EAU Congress Contact: Congress Consultants B.V. E-mail: info@eauvienna2011.org Website: http://www.eauvienna2011.org/
th

11-14: Braga, Portugal

2nd Minimally Invasive Urological Surgical Week Contact: School of Health Sciences, Univ. of Minho Phone: +351 253 60 48 59 Fax: +351 253 60 48 47 E-mail: sec-pg@ecsaude.uminho.pt Website: http://www.ecsaude.uminho.pt/Default. aspx?tabid=8&pageid=377&lang=pt-PT

30 April-3 May: Denver, USA

Annual Meeting American Society of Paediatric Nephrology Contact: ASPN Phone: +1 281 419 0052 Fax: +1 281 419 0082 E-mail: info@aspneph.com Website: http://www.pas-meeting. org/2011Denver/default.asp

3: ESU organised course on Stones, laparoscopy,

non-muscle invasive bladder cancer and prostate advanced cancer at the time of the national congress of the Moldavian Urological Association Contact: ESU

18-22: ESU organised courses, HOT, Education

and Innovation at the time of the 26th EAU Annual Meeting Contact: ESU

19-21: 12th International EAUN Meeting

E-mail: info@congressconsultants.com Website: http://www.eauvienna2011.org/ 12th-eaun-meeting/

11: Chicago, IL, USA

Innovating for Continence: The Engineering Challenge Contact: The Simon Foundation for Continence Phone: + 1 800 237 4666 E-mail: info@simonfoundation.org Website: http://www.simonfoundation.org/ Meetings_Innovating_April_2011.html

30 April-4 May: Philadelphia, PA, USA

American Transplant Congress 2011 Contact: American Society of Transplantation (AST) & American Society of Transplant Surgeons (ASTS) Phone: +1 856 439 9986 Fax: +1 856 439 9982 E-mail: atc@ahint.com Website: http://www.atcmeeting.org/2011/index.cfm

2-4: Klagenfurt, Austria

Congress of the Bayrisch-Austrian Association of Urology Contact: Interplan AG Phone: +49 89 548234 20 Fax: +49 89 548234 44 E-mail: uro2011@interplan.de Website: http://www.uro2011.at/

24-27: Florence, Italy

2nd International Congress of the Society of CrossBorder Reproductive Care Phone: +41 225 330 948 Fax: +41 225 802 953 E-mail: mfridenzon@paragon-conventions.com Website: http://www.icgrt.com/

4: ESU organised course on Urological trauma at

the time of the 37 joint meeting of the Austrian and Bavarian Society of Urology Contact: ESU

12-13: Chicago, IL, USA

Innovating for Continence: The Engineering Challenge Conference Contact: The Simon Foundation for Continence Phone: + 1 800 237 4666 E-mail: info@simonfoundation.org Website: http://www.simonfoundation.org/ Meetings_Innovating_April_2011.html

May
6-7: Warsaw, Poland
6th European International Kidney Cancer Symposium Contact: Kidney Cancer Association Phone: +1 847 322 1051 Fax: +1 847 322 2978 Website: http://www.kidneycancersymposium.com/

31 March-3 April: Porto, Portugal

International Course on Pain Medicine (ICPM 2011) Phone: +41 22 533 0948 Fax: +41 22 580 2953 E-mail: icpm@icpm.net Website: http://www.icpm.net/

3-4: Warsaw, Poland

1st International Medical Congress - Woman and Man: Reproductive and Sexual Health Phone: +48 22 463 64 02 E-mail: biuro@ocinfo.pl Website: http://www.kobietaimezczyzna.info/

13-16: Charleston, SC, USA

American Association of Genitourinary Surgeons Annual Meeting Contact: American Association of Genitourinary Surgeons Phone: +1 734 232 4943 Fax: +1 734 936 8037 E-mail: sheskett@umich.edu Website: http://www.aagus.org/index.htm

31 March-2 April: Singapore, Singapore

Urofair 2011 Contact: Singapore Urological Association Phone: +65 3125 2077 Fax: +65 6234 1089 E-mail: choonhua@urofair.com Website: http://www.urofair.com/

6-8: Athens, Greece

31st Athenian Urology Days Contact: University of Athens, Medical School Phone: +30 210 7414700 Fax: +30 210 7257532 E-mail: info@athenianurologydays.gr Website: http://www.athenianurologydays.gr/
Continued on page 40

April
2-5: Montreal, Canada
36th Annual Meeting American Society of Andrology Contact: ASA Phone: +1 847 619 4909 Fax: +1 847 517 7229 E-mail: info@andrologysociety.org Website: http://www.andrologysociety.org/ meetings/

14-16: San Diego, CA, USA

ABS Annual Conference American Brachytherapy Society Contact: ABS National Office Phone: +1 703 234 4078 Fax: +1 703 435 4390 E-mail: rguggolz@drohanmgmt.com Website: http://www.americanbrachytherapy.org/ meetings/index.cfm

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

8-12: London, United Kingdom

ESTRO Anniversary Conference: 3 Decades of innovation & cancer care Contact: ESTRO Phone: +32 2 775 93 40 Fax: +32 2 779 54 94 E-mail: events@estro.org Website: http://www.estro-events.org/Pages/ Default.aspx 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

December 2010/March 2011

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Congress calendar 2011

3: Volgograd, Russia
Conference of the Russian Association of Oncological Urology in the South Federal District Contact: Russian Association of Oncological Urology (RAOU) Phone: +7 495 645 2198 Fax: +7 495 645 2198 E-mail: roou@roou.ru Website: http://www.roou.ru/

Full, continually updated urological meeting calendar at

www.uroweb.org

20-23: Liverpool, United Kingdom

BAUS 2011 Annual Meeting British Association of Urological Surgeons (BAUS) Phone: +44 207 869 6950 Fax: +44 207 404 5048 E-mail: events@baus.org.uk Website: http://www.baus.org.uk/

2-7: Prague, Czech Republic

9th European Urology Residents Education Programme (EUREP) Contact: Congress Consultants B.V. E-mail: j.mcgrath@congressconsultants.com Website: http://eurep.uroweb.org/

October
5-7: Hamburg, Germany
ERUS11: European Robotic Urology Symposium Latest developments in Robotic Surgery Contact: Ismar Healthcare Phone: +32 3 491 87 45 Fax: +32 3 491 82 71 E-mail: info@erusmasterclass.com Website: http://www.erus2011.com/

7-10: London, United Kingdom

1st Meeting of the EAU Section of Urolithiasis (EULIS) Contact: Congress Consultants B.V. E-mail: eulis2011@congressconsultants.com Website: http://eulis2011.uroweb.org/home/

25-26: Barcelona, Spain

ESU Masterclass in Medical treatment for urological cancer Contact: ESU

3-4: Budapest, Hungary

5th International Congress on the History of Urology in conjunction with the Andrology Update 2011 E-mail: e.stoffer@congressconsultants.com Website: http://www.uroweb.org/

5-7: Moscow, Russia

VI Congress of the Russian Association of Oncological Urology Contact: Russian Association of Oncological Urology (RAOU) Phone: +7 495 645 2198 Fax: +7 495 645 2198 E-mail: roou@roou.ru Website: http://www.roou.ru/

26-28: Poznan, Poland

Brachytherapy for Prostate Cancer Phone: +32 2 775 93 40 Fax: +32 2 779 54 94 E-mail: education@estro.org Website: http://www.estro-education.org/courses/ Pages/2011%20Courses.aspx

8-10: Gdansk, Poland

41st National Congress of the Polish Association of Urology Phone: +48 022 845 69 19 Fax: +48 022 845 69 10 E-mail: kongresptu@ptu.net.pl Website: http://www.pturol.org.pl/

5: Liepaja, Latvia
National congress of the Latvian Urological Association Phone: +37 1 29 262 596 E-mail: vjaters@gmail.com

5: ESU organised course at the time of the national congress of the Latvian Urological Association Contact: ESU 8-10: Paris, France
Challenges of Endourology AMC & UPMC Contact: Erasmus Conferences Tours Phone: +30 210 725 7693 Fax: +30 210 725 7532 E-mail: info@challenges-endourology.com Website: http://www.challenges-endourology.com/

28 June-2 July: Lisbon, Portugal

Annual Meeting International Urogynecological Association Contact: IUGA Office Phone: +1 954 659 6209 Fax: +1 954 659 5587 E-mail: office@iuga.org Website: http://www.iuga.org/annual-meetings

9: ESU organised course at the time of the national

congress of the Polish Association of Urology Contact: ESU

6-8: Tbingen, Germany

1st Joint Meeting of the EAU Section of European Society of Female and Functional Urology (ESFFU) and the EAU Section of Genito-Urinary Surgeons (ESGURS) Contact: Congress Consultants B.V. E-mail: m.koops@congressconsultants.com Website: http://esffu-esgurs.uroweb.org/

14-17: Hamburg, Germany

63rd Annual Meeting of the German Society of Urology (DGU) Contact: INTERPLAN Phone: +49 353 458 3446 Fax: +49 352 458 4333 E-mail: 2011@dgu.de Website: http://www.dgu-kongress.de/index. php?id=571

8-11: Malaga, Spain

Annual Congress Spanish Association of Urology (AEU) Phone: +34 91 364 08 49 Fax: +34 91 532 64 56 E-mail: aeu@aeu.es Website: http://www.aeu.es/aeu_webs/congreso/ default.aspx

July
3-6: Stockholm, Sweden
27th Annual Meeting European Society of Human Reproduction & Embryology Phone: +46 854 651 500 Fax: +46 854 651 599 E-mail: eshre@mci-group.com Website: http://www.eshre.eu/ESHRE/English/ Annual-meeting/Stockholm-2011/ Welcome/page.aspx/347

13-15: Abu Dhabi, UAE

The First International ABU DHABI Prostate Conference Management of Prostatitis, BPH and Prostate Cancer E-mail: rpesarillo@skmc.gov.ae Website: http://www.skmc.ae/en-us/PressRoom/ Events/Pages/eFIRSTINTERNATIONAL ABUDHABIPROSTATECONFERENCE.aspx

14-17: Dubrovnik, Croatia

4th Annual Scientific Meeting European Society for Paedriatic Nephrology Phone: +385 124 443 33 Fax: +385 124 314 78 E-mail: svjetlana@depol.org Website: http://www.espn2011.com/

8-11: Stockholm, Sweden

Urinary incontinence from basic science to clinical practice A Joint Symposium organized by INComb, TRUST and SEA with support from the EAU Contact: INComb, TRUST and SEA with support from the European Association for Urology Phone: +46 8 524 87201 Fax: +46 8 343988 E-mail: Cecilia.Lovdahl@ki.se Website: www.incomb.eu/

14-15: Skopje, Macedonia

EAU 7th South Eastern European Meeting (SEEM) Contact: Congress Consultants B.V. E-mail: seem2011@congressconsultants.com Website: http://seem.uroweb.org/

7-8: Beijing, China

Chinese Urology Education Programme (CUEP I) Contact: ESU

14-17: Los Angeles, CA, USA

20th SLS Annual Meeting and Endo Expo 2011 Society of Laparoendoscopic Surgeons Phone: +1 305 665 9959 E-mail: Conferences@SLS.org Website: http://www.sls.org/

15-19: Orlando, FL, USA

67th Annual Meeting of the American Society for Reproductive Medicine (ASRM) Contact: ASRM Phone: +1 205 978 5000 Fax: +1 205 978 5018 E-mail: asrm@asrm.org Website: http://www.asrm.org/

7-9: Torino, Italy

Video Urology 22nd World Congress 2011 Phone: +39 010 255146 Fax: +39 010 255009 E-mail: videourology2011@symposiacongressi.com Website: http://www.symposiacongressi.com/

9-11: Leipzig, Germany

Challenges in Laparoscopy & Robotics Contact: Vincenzo Pansadoro Foundation Phone: +39 066 641 8008 Fax: +39 066 630 771 E-mail: cil2011@fedracongressi.it Website: http://www.challengesinlaparoscopy. it/2011/index.html

15-17: Innsbruck, Austria

9th World Congress on Urological Research Contact: Congress Consultants B.V. E-mail: c.herrmann@congressconsultants.com Website: http://esur-sbur.uroweb.org (to be confirmed)

10-16: Salzburg, Austria

ESU Weill Cornell Masterclass in General Urology Contact: ESU Website: http://esusalzburg.uroweb.org/

16-20: Berlin, Germany

31st Congress of the Socit Internationale dUrologie Phone: +1 514 875 5665 Fax: +1 514 875 0205 E-mail: congress@siucongress.org Website: http://www.siucongress.org/

23-24: Tallinn, Estonia

EAU 5th North Eastern European Meeting (NEEM) Contact: Congress Consultants B.V. E-mail: neem2011@congressconsultants.com Website: http://neem.uroweb.org

9-10: Buenos Aires, Argentina

International Symposium Advances in Urology 2011 Contact: La Sociedad Argentina de Urologa Phone: +54 4963 4336 Fax: +54 4963 4337 E-mail: sau@sau-net.org Website: http://www.sau-net.org/agenda/ cursosycongresossau.htm

16-17: Washington, DC, USA

AUA Foundation/SBUR Summer Research Conference Aging and Urologic Diseases Contact: AUA Foundation Phone: +1 410 689 3700 Fax: +1 410 689 3800 E-mail: src@auafoundation.org Website: http://www.urologyhealth.org/

23-26: Rome, Italy

84th Congress of the SIU Contact: SIU Phone: +39 068 6202 637 Fax: +39 068 6325 073 E-mail: info@siu.it Website: http://www.siu.it/

23-27: Stockholm, Sweden

16th ECCO/36th ESMO Multidisciplinary Cancer Congress Contact: ECCO Phone: +32 277 50201 Fax: +32 277 50200 E-mail: stockholm201@ecco-org.eu Website: http://www.ecco-org.eu/

12-16: Glasgow, United Kingdom

World Congress for Sexual Health Contact: Kenes International Phone: +41 229 080 488 E-mail: was@kenes.com Website: http://www2.kenes.com/was2011/Pages/ Home.aspx

26-27: Nanjing, China

Chinese Urology Education Programme (CUEP II) Contact: ESU

29 Aug.-2 Sep.: Glasgow, United Kingdom

41st Annual Meeting of the International Continence Society ICS Contact: ICS Office Phone: +41 22 908 0488 ext. 987 Fax: 44 117 944 4882 E-mail: ics2011_reg@kenes.com Website: http://www.icsoffice.org/Events/ ViewEvent.aspx?EventID=106

26: Tashkent, Uzbekistan

National Congress of the Scientific Society of Urologists of Uzbekistan E-mail: bekzod.ayubov@gmail.com

28-29: Timisoara, Romania

EAU 11th Central European Meeting (CEM) Contact: Congress Consultants B.V. E-mail: cem2011@congressconsultants.com Website: http://cem.uroweb.org/

16-17: Indianapolis, IN, USA

4th International Urolithiasis Research Symposium Phone: +1 317 962 0647 E-mail: csprunger@clarian.org Website: http://www.iksi.org/index.php/stone_ conference/program/

26: ESU organised course on Update in female

urology and reconstruction at the time of the national congress of the Scientific Society of Urologists of Uzbekistan Contact: ESU

November
2-4: Buenos Aires, Argentina
Argentina Congress of Urology 2011 Contact: La Sociedad Argentina de Urologa Phone: +54 4963 4336 Fax: +54 4963 4337 E-mail: sau@sau-net.org Website: http://www.sau-net.org/agenda/ cursosycongresossau.htm

17-19: Washington DC, USA

Cancer Survivorship and Sexual Health Symposium SMSNA & ISSM Contact: SMSNA Office Phone: +1 847 517 7225 Fax: +1 847 517 7229 E-mail: info@smsna.org or issmoffice@ cancersurvivorsandsex.org Website: http://www.cancersurvivorsandsex.org/ site/

September
1-4: Busan, South Korea
6th Biennial Meeting of the Asia Pacific Society for the Study of Aging Male (APSSAM) Contact: MECI International Phone: +82 220 822 305 Fax: +82 220 822 314 E-mail: secretariat@apssam2011.org Website: http://www.apssam2011.org/

29 Sep.-1 Oct.: Athens, Greece

2nd International Meeting on Innovations & Evidence Based Medicine (EBM) in Urology Contact: AMC Amsterdam University & Athens Medical School Phone: +30 210 7414700 Fax: +30 210 7257532 E-mail: info@urology-ebm.com Website: http://www.urology-ebm.com/

Continued on page 41

40

European Urology Today

December 2010/March 2011

Successful andrology event in Athens attracts top specialists

Report on the European Congress of Andrology, 29 September to 1 October 2010, Athens, Greece
Mrs. Theodosia Zeginiadou Athens (GR) The Local Organising Committee worked hard to offer a congress that was scientifically interesting, and also provided opportunities for informal exchanges in a friendly climate. The committee was chaired by Dimitrios Adamopoulos, with the valuable contribution of Dr. H. Asvestis, President of HSA and a number of able colleagues including Profs. R. Angelopoulou and D. Goulis. The programme was designed based on all the suggestions made by the members of the Academy through communications with the committee, but was also designed to address hot topics and advances made during the months preceding the congress. As a result, the participants were updated about almost all aspects of clinical and basic andrology. The scientific programme included four plenary lectures, four postgraduate events, two symposia, two satellite events, 60 oral and 94 poster presentations. For those interested, the complete proceedings of ECA 2010 are available in the International Journal of Andrology, as a supplementary issue (vol. 34, suppl. 1, 2010). The Organising Committee was lucky to be able to engage all top specialists in their respective fields and in this respect the congress was a universal event, particularly since it was attended by almost 300 colleagues from 53 countries representing all continents.
Prof. G. Verhoeven giving the Presidential lecture on Androgen

asvesmed@otenet.gr

The 6th European Congress of Andrology (ECA) was held in Athens from 29 September to 1 October 2010. The Congress was organised by the Hellenic Society of Andrology (HSA) in collaboration with the European Academy of Andrology (EAA). This event was awarded to the HSA in a unanimous vote during the EAAs general assembly in Rome (2008) in recognition of what the then President F. Wu described as a disproportionally high contribution in Andrology over the years, considering the size of the country.

The scientific programme was organised by a special committee chaired by Profs. J. Toppari (clinical) and A. Meinhardt (scientific) during a two-day meeting in Athens (6-7 July, 2009) and it included an excellent choice of topics, finely balanced between clinical and Dr. Charis Asvestis, President of the Hellenic Society of basic research interests. Andrology, lecturing at the meeting in Athens

Emphasis was placed on young andrologists needs to action in the testis voice their own views by addressing the congress through a relatively large number of oral to visit the Acropolis and also the new Archaeological presentations as well as of a special session. Museum, treasuring the remains of the Golden The International Society of Andrology was fairly well Century of Ancient Athens. Warm weather gave those interested the chance to visit all the historical sites on represented: a number of ISA members were foot. The social programme included dinner at the registered for ECA 2010. A $1,000 travel grant was awarded to Drs. Cecilia Prez (Argentina) and Sunny famous Benaki museum, with a spectacular view of the Acropolis, and a Greek night with live music. O. Abarikwu (Nigeria), who participated in the congress and received their award from ISA officer At both occasions, participants were able to get to Prof. Csilla Krausz. know each other better, and exchange ideas on both The congress was hosted at the Megaron International social and scientific issues. The three-day conference ended with lots of interesting andrological Conference Centre very close to the centre of the city, which meant that the participants had the opportunity discussions, and warm memories of Greek hospitality.

Urological scholarship in Leuven, Belgium

How a Leuven scholarship boosts my plans to become a urologist
Dr. Matteo Manfredi Dept. of Urology San Luigi Gonzaga Hospital Orbassano Turin (IT) months were very useful for me to complete the final draft of my thesis on, Prostate cancer: role of positive surgical margins on biochemical recurrence in patients undergoing laparoscopic radical prostatectomy. Aside from being known as one of the best hospitals in Belgium, the urology department itself is renowned as one of the best schools for young urologists (or would-be urologists) in Europe. The department is European Board of Urology (EBU)-certified, and is known even outside Europe. cases, ward rounds and the outpatients clinic. I attended, assisted or carried out parts of adult and paediatric procedures such as uro-oncologic, reconstructive and functional surgery, both by open and laparoscopic / robot-assisted techniques. given me, I was treated like a resident rather than a student. On my return to Italy, Prof. Porpiglia saw a remarkable progress in my qualifications, both practical and theoretical, further encouraging my conviction to become a urologist.

I also received an intensive laparoscopy training in the Centrum voor Heelkundige Technologien (Centre for Surgical Technologies) and took part in seminars matteo.manfredi85@ on testicular cancer and on target therapy for bladder gmail.com cancer. Regarding the Erasmus Placement paperwork, everything was taken care of by the host university I am an Italian student of medicine and surgery in my and the office staff of Prof. van Poppel, allowing me to finale year at the San Luigi Medical School of the Turin I worked under the professional guidance of Prof. van concentrate on my training. University. In October I will graduate with a thesis in Poppel and his team, composed of Prof. Dirk De urology, after doing research under the supervision of Ridder, an expert in functional urology; Prof. Guy The experience in Belgium has been very useful for Prof. Dr. Francesco Porpiglia of the Department of Bogaert, paediatric urology professor and secretary of me to prepare some chapters in my thesis. In Prof. Urology of the San Luigi Gonzaga Hospital. the European Society of Paediatric Urology; Dr. Steven van Poppels department I assisted in many open Joniau, a specialist in reconstructive surgery and radical prostatectomies which I compared with the In the last phase of my internship, I applied for a uro-oncology; Dr. Ben van Cleynenbreugel, an expert laparoscopic technique on which my study is based. scholarship from the Lifelong Learning Programme in laparoscopy and endoscopy. All of them were Furthermore, the expert team of Prof. van Poppel (Erasmus Placement Programme) which promotes the always ready to answer my questions, from the have not only shown interest on the results of my mobility of young professionals in Europe, and also patients medical history to the surgical technique. thesis, but we also have engaged in spirited and provides an opportunity for students to join internship This, coupled with a student-oriented organisation of informative discussions regarding conclusions of programmes at training centres that have entered into the department and the entire hospital, allowed me studies that were published by both our departments. special agreements with universities. In my case I to return to Italy with a considerable practical as well joined the University Hospital of the Katholieke as theoretical knowledge. My stay in Leuven was a really amazing experience Universiteit in Leuven, Belgium. June 11 to September and I consider myself lucky to have this opportunity as 11 last year. I was part of the Department of Urology During my stay, I participated in all the clinical a medical student. Within the department, and in headed by Prof. Dr. Hendrik van Poppel. Those three activities of the unit including discussions of patients terms of responsibilities and opportunities that were

Congress calendar 2011

Continued from page 40

Full, continually updated urological meeting calendar at

www.uroweb.org

8-13: Philadelphia, PA, USA

Renal Week 2011 American Society of Nephrology Phone: +1 202 659 0599 Fax: +1 202 659 0709 E-mail: email@asn-online.org Website: http://www.asn-online.org/

11-13: Berlin, Germany

4th ESU Masterclass on Female and functional reconstructive urology Contact: ESU

December
1-2: St. Petersburg, Russia
Conference of the Russian Association of Oncological Urology in the Northwest Federal District Phone: +7 495 645 2198 Fax: +7 495 645 2198 E-mail: roou@roou.ru Website: http://www.roou.ru/ 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

4-6: Barcelona, Spain

3rd Multidisciplinary Meeting on Urological Cancers Embracing Excellence in Prostate, Bladder and Kidney Cancer Contact: EAU, ESMO and ESTRO E-mail: emuc-meeting2011@congressconsultants. com Website: http://www.emucbarcelona2011.org/

30 Nov.- 3 Dec.: Kyoto, Japan

29th World Congress on Endourology and SWL Phone: +1 516 520 1224 Fax: +1 516 520 1225 E-mail: wce2011@congre.co.jp Website: http://www.congre.co.jp/wce2011/ 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

9-12: Sofia, Bulgaria

National Congress of the Bulgarian Association of Urology Phone: +35 9 888 629 700 Fax: + 35 92 929 5072 E-mail: dmladenov@excite.com

4-5: Cologne, Germany

Congress of the German Continence Society Phone: +49 561 780604 Fax: +49 561 776770 E-mail: info@kontinenz-gesellschaft.de Website: http://www.kontinenz-gesellschaft.de/

11: ESU organised course at the time of the national congress of the Bulgarian Association of Urologists Contact: ESU

December 2010/March 2011

European Urology Today

41

A message from the Chair of the EAUN - December 2010

Bente Thoft Jensen, RN-MPH Chair EAUN rhus (DK) the General Assembly 2011 in Vienna. After Vienna I intend to continue contributing to the EAUN board but in another position. I am very confident about this period of transition, and I know that the EAUN will have a very competent person in the chair! For me personally, the EAUN has been a four-year journey, one of the most intensive -and most interesting- journeys I have taken. I took up my position in the EAUN in late January 2007. The EAUN was a positively charged brand, with huge potential and an extremely devoted board, members and employees. Yet I knew that we, like other associations, faced significant demands for change and we took on the challenge. In 2008, the EAUN shaped a strategy for the future, and called it the EAUN Long-term Plan. It was a tough plan, both to decide on and to put into practice. We reorganised ourselves in a new, more efficient way, with -for the first time- our own budget and strategy. This quickly brought significant activity for and comprehensive interest in the EAUN as a major partner in healthcare affairs. All in all, we weathered a storm and we came through in a way that makes me proud and grateful to EAUN staff and colleagues in and around Europe who have supported this journey. Our efforts to improve both our brand and the benefits for the members have picked up pace in recent years. The outstanding cooperation with the EAU, Prof. Abrahamsson and the European School of Urology (ESU) have contributed greatly to the status the EAUN enjoys today. These are some achievements with which I am particularly pleased: The 2010 Annual Congress. More than 400 attendees signed up, which was a new record Group membership is now very popular thanks to a perfect campaign of awareness of the EAUN The EAUN has been growing from 178 members to more than 2,500 as of 1 January 2011 The EAUN now publishes evidence-based guidelines which are recognised by the National Clearinghouse (US). The EAUN joined the Skeletal Care Academy EAUN involvement in establishing the Global Association of Urology Nursing GAUN Electronic newsletter and membership database Extended Fellowship programme Online education possibilities are being developed Accreditation and certification programmes are being developed, along with the framework of a European School of Urological Nursing Together, all these points mean that the EAUN has become an important partner in the urological society. We intend to continue contributing positively to continuous education and development for the benefit of our colleagues and the urological patient. Finally, I wish Ms. Fitzpatrick good luck in her new position, and to the members, I would like to say that it has been a privilege to be the chair of the EAUN.

b.thoft@eaun.org As some of you might know, I will leave my position as chair of the EAUN in the new year. Due to a heavy academic workload, I am unable to work for the board on a daily basis, which is what the position of chair entails. In my place, I want to propose the co-chair, Ms. Kate Fitzpatrick (Ireland) as the new chair of the EAUN. Ms. Fitzpatrick will be interim chair on a daily basis until

High-level congress of the Association of Urological Nurses

Report on the Nurses four-day congress marking the 21st National Congress of Urology in Turkey
Ronny Pieters, RN Chair Educational Group Ghent (BE) The actual congress started on Sunday, 31 October. Themes of this day were education and communication in urology nursing, with an EAUN vision on the European education in urology nursing as well as on evidence-based urology nursing. The afternoon covered urinary stone disease, and the prevention of urinary infection. Monday started with operating room security, and developments in the care for the urological cancer patient. The afternoon covered the topic of male and Bente and I were invited to Istanbul for the fourth female incontinence, conservative treatments, and I congress of the Turkish Urological Nurses Association personally covered the contribution of the ICS to to represent the EAUN and European urology nursing. continence nursing in Europe. The day was concluded with the presentation of 12 abstracts on urology This four-day conference started with two courses: nursing topics. one on the current practice of laparoscopic and robotic nursing in urology, and one on voiding On Tuesday we had to go home, so we couldnt dysfunction in children. participate in the last day of the conference which ronny.pieters@ rug.ac.be covered the nursing application in prostate cancer, the management of urology problems in neurological patients and OR nursing in urology. This day was scheduled to end with 11 poster presentations. The sessions we participated in (the Turkish association kindly provided simultaneous translation) were graded (by Bente and me) as being of a high standard, well-documented and referenced; and what was most interesting to us was the interaction and participation in the discussion by the audience. The Turkish urology nurses are very eager to learn, ask to-the-point questions, but most of all are already working on a high level. We would like to congratulate the Turkish Urology Nurses Association with the organisation of this congress, to thank them for inviting us, and above all, we would like to encourage them to continue the way they are doing now. We also would like to thank the

EAUN Board
Chair Vice-chair Board member Board member Board member Board member Board member Bente Thoft Jensen (DK) Kate Fitzpatrick (IRE) Tina Christiansen (SE) Willem De Blok (NL) Veronika Geng (DE) Ulli Haase (NL) Dora Mair (AT)

www.eaun.uroweb.org

Turkish Urology Association for their support of the nurses.

EAUN NZUNS cooperation

An invitation to extend ties to New Zealand Urological Nurses Society
Sue Osborne, RN Waitemata District Health Board North Shore Hospital Urology Auckland (NZ) Sue.Osborne@ waitematadhb.govt.nz The committee of the Australia and New Zealand Urology Nurses Society (ANZUNS) was pleased to be able to host Bente Thoft and several of her colleagues at the ANZUNS conference in Perth, Australia in 2010. Discussions at that event have lead to strengthened ties between our groups, and we continue to aspire to share ideas and initiatives with one another. This regular newsletter contribution is the foundation of our partnership at the moment. We would be delighted if any members of EAUN would like to attend our conferences or even contribute to our newsletter in the coming years. We would also welcome contact via e-mail if any of you wish to establish links with New Zealand Urology Nurses who may have similar interests or workplaces to your own. I know we seem a long way away and that you might imagine we are limited in our developments by our small population and distance from large centres. This is not the case however, with creative care-delivery models being utilized at many locations in order to meet our populations needs within our workforce constraints. Nursing plays a key role in this model of care with advanced practice nurses running clinics for lower urinary tract symptom assessment, continence assessment, flexible cystoscopy, urodynamic testing, intravesical therapies, post operative follow-up and prostate cancer follow-up to name a few. We are also actively involved in audit and quality initiatives. Auckland is home to over 1.3 million people (one third of our total population) and is the fastest growing region in New Zealand. It is a culturally diverse city with 37% of residents born overseas. The population is spread over a wide geographical area, with three large district health boards providing publicly-funded healthcare. There are also many private sector healthcare providers offering a full range of services. Urological nurses work across both sectors, and appreciate the chance to network while undertaking ongoing education together. AstraZeneca NZ has once again kindly sponsored the Auckland Regions Urological Education Programme for nurses working in both public and private urology services. The 2011 programme commences in May and includes male catheterisation credentialing training for registered nurses, as well as special topic days. This year, we are focusing on bladder cancer education and workshops for advanced urology nurses which include literature reviews, medication updates and topics of interest. Our community nurses are involved in catheter care, teaching intermittent self-catheterisation, assessment of post-void residual volumes with bladder scans, and continence management. In order to ensure our community-based staff remains well-educated on urological matters, we also run an annual urology update day specifically for them. It is always well-attended, and it provides a valuable opportunity to strengthen links between hospital/clinic-based nurses and community-based nurses. In closing, we wish you all well as you start another year of urological nursing practice, and we hope that you find educational events to attend that keep you stimulated and interested in our specialty. We are sure that your new years resolutions also include achieving or maintaining a work/life balance with plenty of leisure activities, outside of work. For us at this time of year, leisure activities include long lazy lunches at vineyards, or barbecues on the beach. The sun is shining as I type this column and the great outdoors is beckoning. Take care and goodbye for now.. see you in March!
Sue Osborne is a Urology Nurse Practitioner. She has just completed a Masters of Nursing degree and she has met the NZ Nursing Council requirements to become a Nurse Practitioner with prescribing rights. At present she conducts nurse led clinics for patients with lower urinary tract symptoms and men undergoing treatment or surveillance for prostate cancer. She also undertakes a nurse led flexible cystoscopy, providing surveillance for those diagnosed with bladder cancer.

Tena koutou / Greetings from the New Zealand Urological Nurses Society (NZUNS). We are delighted to be invited to contribute to your newsletter and look forward to receiving news of your activities in return! We hope you have enjoyed a restful and enjoyable festive season, and that the extremes of weather have not inconvenienced you too much. We have followed the big snowfalls across England and Europe with interest, particularly as many of us have friends and family living on your side of the world. Once again, Mother Nature has demonstrated her ability to disrupt well made travel plans, much like the volcanic eruption that hampered the Barcelona meeting in March 2010. As some of you already know, I am making my way to Vienna, Austria for the International Meeting of the EAUN in March, and certainly hope nothing hinders me in my travels! This will be the first time I have attended one of your meetings so I am particularly excited about the opportunity to learn from your vast and varied experience, and to meet many more of you face to face. These opportunities to strengthen ties are invaluable, but they seem to be getting harder and harder to achieve with funding constraints impacting widely on the attendance of international meetings. 42 European Urology Today

EAUN around the world

The EAUN Board have been involved in or attended the following activities throughout the world recently: October 2010 National Meeting of the Swedish Urology Nurses Association, Malm, Sweden 21st National Congress of the Turkish Association of Urology, Istanbul, Turkey SUNA Annual Conference, Boston, USA November 2010 Proactive Prostate Coalition Task Force. Brussels, Belgium December 2010 1st Consultation in EAUN towards accreditation, Brussels, Belgium January 2011 EAUN Board Meeting, EAUN Board, Amsterdam, The Netherlands January 2011 Irish Annual Meeting, Dublin, Ireland February 2011 Skeletal Care Academy, Madrid, Spain Is your National Society organising a meeting and would you like the EAUN to be present? Contact our chair at k.fitzpatrick@eaun.org

October 2010

October 2010

December 2010/March 2011

EAUN Fellowship report

Learning the importance of specialised nurses at the University College London Hospital, 25-29 October 2010
Lone Aarvig Registered Nurse rhus University Hospital rhus (DK) The programme for the week: Sunday 24 October Meeting with Sharon at the hotel Visiting the Hospital and the CNS nurses office at the Euston road house Visiting the Florence Nightingale museum Introduction to the program for the week Monday 25 October Introduction to the department of urology Ward Clinic at the Urinary Diversion with Sharon Fillingham Outdoor Clinic for Prostate patients with CNS nurse Jane Coe and Radiology meeting. higher salary, and also has more opportunities and responsibilities. The ward was a very busy, but also very attractive place to work in, because the staff got good training, lots of opportunities, the ward has a good reputation, and the hospital is located in central London. The CNS nurses The CNS (Clinic Nurse Specialists) consists of nurses with a large amount of experience of urology nursing, as well as a degree in that field. Some of the CNS nurses have a Masters education as well, and they are all expected to achieve a Masters degree while working as a CNS. The CNS nurses work with both treatment and caring. The nurses work with patients in the ward, in the clinic, at the outpatient clinic, in theatres at the urology department and in other departments where their expertise is called for.

loneaarv@rm.dk In spring 2010 I was fortunate enough to partake in the EAUNs fellowship programme. I have worked in the field of urology for 9 years as a Senior nurse of the ward at the Urological Department of rhus University Hospital, Skejby.

University College London Hospital

Tuesday 26 October Meeting with Ward sister Georgina Turnbull, Over the years, the department has worked to develop urological ward of long-term stay and refine the urological specialty and to offer some Meeting with Lecturer Practitioner of Urology care, rare and highly specific urological treatments and Rachel Leaver surgery. The department therefore receives patients Meeting with Ward sister, Paula O`Brien, urological from all over the region. ward of short-term stay Intravesical Clinic (BCG) with CNS nurse Rachel After the Danish government imposed treatment Leaver guarantee regarding cancer treatment, the number of Acupuncture Clinic with CNS nurse Julie Jenks patients with a urological cancer has increased in the department. Surgery and treatment of these patients Wednesday 27 October now dominate and take up the largest part of the Robotics Theatre with CNS Gilly Basnett activities. Continence Advisors CNS Claire Nicholls

information and advice about the disease and writes a full medical chart. The nurse was responsible for the patients progress through treatment, and the patient could always call the nurse and get advice and guidance. The nurse cooperated closely with the doctors.

CNS robotic surgery: The nurse was responsible for The CNS nurses share an office in a building next to teaching the surgery team the procedure for robotic the hospital, which gives the nurses a fair bit of surgery. The nurse was educated in surgery and running between the buildings. Still, the office was an performed the initial intervention while she important place for the nurses to work with tasks like educated a new doctor. The nurse had a close getting in contact with the community and home care cooperation with the doctor in charge of the nurses, and answering questions from and keeping surgery. follow-up appointments with patients. Many patients phone in to get advice and help from the CNS nurses. Continence advisors: The continence advisors work I got the impression that the CNS nurses are highly all over the hospital with patients who need their We continually restructure the department to adapt to Thursday 28 October important in securing a professional and correct advice and knowledge. The ward or outpatient new requirements and approaches in the care and treatment of the patients because of their special Urinary Diversion in patients with CNS Sue Fell clinic helps the patients to get an appointment with treatment of patients, and with regards to the knowledge and skills. continence advisor. The continence nurse also does financial resources we have available. In line with the The Ward and education of nurses urodynamic examinations in the outpatient clinic. changes, we have increased staff qualifications CNS nurses have specialised in: The ward has 60 beds with a mixture of urological through training and instruction to meet new care CNS nurses in the Intravesical clinic: Nurses treat and orthopaedic patients. The reason for this mixture and treatment requirements. Urinary Diversion: Nurses work in the wards every patients with bladder cancer with Bacillus was a matter of organisation and sharing staff. The day and pay all patients with urinary diversions a mixture of patients was fairly new, the ward had Calmette-Gurin (BCG) injections. I therefore was interested in getting an insight into new earlier been accustomed to be only urological. visit and help them out if needed. They ensure that ways of dealing with urological patients. The aim for the patient is given the right aid, teach them to care What to learn the visit was to achieve insight in and knowledge of: for their urinary diversion, ensure that skin and Ive seen nurses with specialised knowledge and The ward is divided in two, with 30 female beds and stoma are alright, and give counselling about life skills that work with great enthusiasm and 30 male beds. Beds are placed in groups of four to Development of nursing qualifications with a urinary diversion after being dismissed from professionalism on a very high level. Its been a great five, with curtains between them, and there are only The organisation of the training of the student hospital. pleasure to meet nurses who work with such great a few one person rooms. This is very unusual to us nurses pride in their profession and are so dedicated to their coming from a culture where patients are put in two The organisation of daily work and care in the The nurses not only ensure that the patient receives patients. Although they were very busy and work hard to four-bed rooms with walls and doors! patients ward professional care regarding their urinary diversion for long hours, I experienced their catching The organisation of the stay of the variety of while staying in hospital, but they also contact the The ward sister gave me the impression that the ward enthusiasm for their subjects and their abilities. patients home care nurses to establish further care after the was very big (too big) and that the mixture of the two patient is dismissed and they order the products different specialties posed challenges to knowledge It has also been a great pleasure to speak with nurses I wanted to visit an English hospital because British that the patients needs for their urinary diversion. about nursing and discuss our common practice. I and skills of the staff. The organisation required nurses have been specially trained for many years. Patients can always get an appointment with their experienced great openness for this among the nurses enormous flexibility in the management of the staff. This development was initiated in light of a former urinary diversion nurse when they experience who have shown great interest and willingness to doctor shortage in the country. Nurses were educated Introduction and training of new staff was undertaken problems of any kind regarding their urinary show us their practice and also wanting to learn and trained to perform medical areas of treatment. diversion: even after dismissed from hospital. by experienced staff along with some classes by the something from our practice. Lecturer Practitioner nurse. There was a training The stoma care nurse of our department, Berit Kiesbye, programme covering both urology and orthopaedics. They also see patients before their surgery to give Educating clinical nurse specialists is an investment participated in writing the EAUN guideline Incontinent The education regarding the management of information about the surgery and prepare them to that makes nurses stay in the job for many years and Urostomy. Berit had a pleasurable experience a life with a urinary diversion- a very important experience more satisfaction through their work. This medicine was more thorough than the procedure that cooperating with one of the other authors, clinical talk that clearly made the patients feel much better can only be beneficial for the patients. Im familiar with in Denmark. New nurses must go nurse specialist in urinary diversions Sharon Fillingham through a form of practical examination before they and much more secure. from the University College Hospital London. I contacted may handle medicine in the department. The CNS nurses also teach and educate not only However, I suppose that it is important to constantly Sharon Fillingham and she has been extraordinarily nurses and students in the ward but also outside at keep in mind that not all nurses should be expert helpful in planning the visit for me. The nurses work 37.5 hours a week but in 12-hour conferences and meetings. nurses. It is important that nurses who work in the shifts, and many of the nurses are studying alongside ward feel valued and achieve a good level of It was a fortunate that Berit Kiesbye also got the their work to get a degree in urology nursing. I was Acupuncture: CNS nurses in acupuncture treat qualifications, so that patients always have skilled opportunity to participate in visiting the University very impressed by their work. Rachel Leaver (the patients with bladder disorders in the outpatient staff around them. College Hospital London and Sharon Fillingham, thanks lecturer practitioner) informed me that the clinic. The nurse has a degree in nursing which to a local scholarship at our department. It has been a government wishes for and encourages all nurses to gives the possibility to treat patients in the ward. Thank you to the CNS nurses at the University College great advantage to be travelling together as a team. We get a degree. It takes about three years to complete a London Hospital for a very nice week. Special thanks have been able to discuss all the new impressions, degree while also working. The nurses are doing CNS regarding prostate cancer patients: The CNS to Sharon Fillingham. evaluate the days and help each other out. some of the study time at work and some they have to has its own outpatient clinic. The nurse examines do in their spare time. With a degree, a nurse enjoys a the patient, listens to heart and lungs, provides Edited by Berit Kiesbye

Call for Papers

The International Journal of Urological Nursing - The Official Journal of the BAUN
From left: Berit Kiesbye, Sue Fell, Sharon Fillingham, Lone Aarvig

The University College Hospital London University College Hospital London was founded in 1834. In 2005 the Hospital moved to new buildings containing 655 beds and all-new equipment. My host, Clinic Nurse Specialist (CNS) Sharon Fillingham works at the department of Urology. Sharon works as a CNS nurse for patients undergoing surgery resulting in different urinary diversions. December 2010/March 2011

The International Journal of Urological Nursing is clinically focused and evidence-based and welcomes contributions in the following clinical and nonclinical areas: General urology Clinical audit Continence care Clinical governance Oncology Nurse-led services Andrology Reflective analysis Stoma care Education Paediatric urology Management Mens health Research There are many benefits to publishing in IJUN, including:

Broad readership of papersall published papers will be available in print and online to institutional subscribers and all members of the British Association of Urological Nurses Fast and convenient online submissionarticles can be submitted online at http://mc. manuscriptcentral.com/ijun Fast turnaroundpapers will be reviewed and published quickly and efficiently by the editorial team Quality feedback from Reviewers and Editorsdouble-blind peer review process with

detailed feedback Citation trackingauthors can request an alert whenever their article is cited Listed by the Science Citation Index Expanded (Thomson ISI)

For further information and a free sample copy go to: www.wileyonlinelibrary.com/journal/ijun

European Urology Today

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Hong Kong nurses gain valuable insights in the UK

A two-week urology nursing attachment at Homerton University Hospital
Angus Tsang, RN Academic Convener of UNAHK Private Urology Clinic Hong Kong Homerton University Hospital The Homerton urology team includes three consultant surgeons, one consultant clinical oncologist, three trainee urologists, one junior doctor and three urology specialist nurses. They run nurse services in haematuria, PSA monitoring, rapid access TRUS and biopsy, prostate cancer follow-up, prostate cancer telephone follow-up, intravesical therapies, bone metastases, bisphosphonate treatments and flexible cystoscopy. They have developed a nurse practitioner-led prostate cancer follow-up clinic and rapid access prostate biopsy clinic. The benign nurse-led service involves a catheter complications clinic, prostate assessment clinic, erectile dysfunction clinic, intravesical therapy clinic for bladder pain and urodynamics. Out-patient services During the two weeks attachment, we have visited all of the departments and we have followed our mentors to manage patients common urological problems like BPH, haematuria, UTI, prostate cancer and bladder cancer. We are so surprised that the number of patients with raising PSA and patients who diagnosed with prostate cancer requiring treatments like radical prostatectomy, RT, chemotherapy and hormonal therapy are far higher in the UK than in Hong Kong. clinic for patients with prostate and bladder cancer. He has demonstrated nursing autonomy and professionalism in taking care of the cancer patients. Mr. Turner also performs TRUS biopsy, flexible cystoscopy and orders prescriptions independently. It is amazing that the nurse-led clinic can be run so smoothly and systematically by only a few specialist nurses. It has not only greatly reduced the doctors workload, but also significantly shortened the patients waiting time. Moreover, it allows more nurse involvement which is also good for the nurse practitioners own professional development. We hope we can bring back this best practice and to further develop the nurse-led clinic in Hong Kong. However, more specialised trainings should be provided to our nurses to strengthen their knowledge. Why did we choose the UK? The United Kingdom is the first European country which came across our minds for our attachment country since Hong Kong was a British colony in the past and there is no language barrier in the UK. Therefore, we chose our most familiar European country for our first attachment in Europe. bonus trip to the University of Manchester to attend an Oncology Masterclass about Prostate Cancer before our attachment at Homerton University Hospital. We caught a train from London to Manchester on Sunday and we had a nice welcome dinner that night where we had a chance to chat with other UK nurses. On Monday, we attended a full day class and we found it is very informative and useful. One thing that impressed me was the classroom setting. Instead of the traditional classroom setting, the desks were arranged in small groups like clusters so that each group mate was able to communicate easily with the other. UNAHK can consider using this kind of classroom setting for our future conferences.

juicepuls124@ gmail.com

Gilbert Lui, RN, BN, MN, MBA President of UNAHK Pamela Youde Nethersole Eastern Hospital Hong Kong lgilbertlui@ gmail.com I have started my nursing career since 2000 and I have been a urology specialist nurse at a private urology clinic for almost three years. I also completed the Da Vinci Robotic Surgical System Training Programme (for nurse role) in January 2010. My major duties include surgery arrangement and preparation, Flexible cystoscopy, Urethral dilatation and TRUS prostate biopsy assistance, Intravesical therapy and Foley catheter related problem handling, minor surgery and pre & post nursing care for urology patients. Being the President and Academic Convener of Urology Nurses Association of Hong Kong (UNAHK), we would like to observe the differences in patient care and management between Hong Kong and Europe through this valuable attachment opportunity so that we can bring back the best practices and treatments in Europe to share with our Hong Kong nurses. We also hope to take this opportunity to see how the specialist nurse system works in Europe.

Valuable experience & relationship building We are certain that this attachment has broadened our views on specific nursing care for urological cancer patients and management of the nurse-led clinic at the outpatient department. Other than gaining practical insights from this attachment, we have also Bonus trip to University of Manchester built a good relationship with the British nurses and Thanks to Bruces information and invitation, we got a doctors that fosters our future knowledge sharing. We highly recommend this attachment to our Hong Kong colleagues and I am sure they would find this a For these kinds of patients, early detection, counseling valuable and memorable experience for them too. and education is very important. However, we only have urology specialist nurse to take care of benign Sincere gratitude urology patients in Hong Kong. We had never heard We are very grateful to all the staff of Homerton that there is an uro-oncology specialist nurse University Hospital as well as all the warm welcome specifically assigned to take care of these patients from Ms. Pati and Mr. Nargund, Consultant and until this attachment, it will be a great benefit for the Urologist of the Department of Urology; Mr. Bruce urology patients if this can also be implemented in Turner, Ms. Clare Smart and Ms. Sacha Ali, our Hong Kong. mentors. Besides, we would like to extend our heartfelt thanks to Mrs. Kate Fitzpatrick and Mr. Bruce Nurse-led service Turner for introducing and offering this valuable Mr. Bruce Turner, Uro-oncology Nurse Practitioner, Left to right: Gilbert Lui - Chair UNAHK, Bruce Turner - Urolearning opportunity to us. I would also like to take works with another specialist nurse leading the oncology Nurse Practitioner Homerton, Sacha Ali - Specialist this opportunity to particularly thank Mr. Bruce Turner benign urology nursing service at Homerton Univerity Care Nurse in Urology Homerton, Angus Tsang - Education Lead for tailor-making such a great attachment programme Hospital. Mr. Turner has developed a one-stop cancer UNAHK and all the nice arrangements for us.

12 th International Meeting of the European Association of Urology Nurses (EAUN)

in conjunction with the 26th Annual EAU Congress 19-21 March 2011, Vienna, Austria

For more information please check www.eauvienna2011.org or contact Congress Consultants at info@congressconsultants.com

www.eauvienna2011.org
14.30 16.15 Poster Abstract Session Chairs: T. Christiansen, Malm (SE) K. Fitzpatrick, Dublin (IE) EAUN Board members Bente Thoft Jensen, rhus (DK) Kate Fitzpatrick, Dublin (IE) Tina Christiansen, Malm (SE) Veronika Geng, Lobbach (DE) Ulli Haase, Nieuwegein (NL) Willem De Blok, Amsterdam (NL) Dora Mair, Innsbruck (AT)

Programme
Friday, 18 March (pre-congress)
09.00 11.00 Hospital visit in 3 hospitals* 11.00 13.00 Hospital visit in 3 hospitals*

14.00 14.40 Special session of the Austrian Society for the Scientific Nursing Advancement of Continence and Stoma Advice The conflicting priorities of daily consulting and nursing science H. Anzinger, Linz (AT) B. Nussbaumer-Grillitsch, Graz (AT) 15.15 15.30 EAUN Opening P-A. Abrahamsson, Malm (SE) K. Fitzpatrick, Dublin (IE) 15.30 15.45 Good Practice in Health Care Transrectal ultrasound guided biopsy of the prostate Ph. Aslet, Basingstoke (UK) 16.00 17.00 Symposium The evidence behind the new SpeediCath Compact Male: a revolutionary and discreet catheter for men Chair: E. Chartier- Kastler, Paris (FR)
Sponsored by: COLOPLAST AS

Monday, 21 March
09.00 10.30 EAUN Nursing Research Competition Chair: R. Pieters, Ghent (BE) 10.45 11.45 Symposium The psycho-social impact of intermittent catheterisation (IC) K. Wilkinson, Bradford (UK)
Sponsored by: HOLLISTER

Saturday, 19 March
08.15 09.45 EAUN Workshop Treatment of kidney stones it is all about the team Chair: C. Seitz, Vienna (AT) 08.30 10.30 EAUN Workshop Bridging evidence-based research and clinical nursing J. Hokanson Hawks, Omaha (US) A. Krintel Petersen, rhus (DK) S. Laustsen, rhus (DK) 10.30 12.30 EAUN Workshop Quality of life in urology stoma patients S.P. Fillingham, Kent (GB) B. Kiesbye, Risskov (DK) 10.30 - 12.30 EAUN Workshop Cryoablation for prostate and kidney cancer; an overview on background, procedure and nurses responsibilities S. Hieronymi, Frankfurt am Main (DE) U. Witzsch, Frankfurt am Main (DE)

17.00 18.00 Welcome reception

11.45 12.05 State-of-the-art lecture Non-surgical management of renal cell cancer L. Pyle, London (UK) 12.20 13.20 EAUN Workshop Nursing solutions in difficult cases Case studies Chair: W.M. De Blok, Amsterdam (NL) 13.30 14.00 EAUN General Assembly K. Fitzpatrick, Dublin (IE) 14.00 14.30 State-of-the-art lecture The importance of patient positioning and safety on a urological OR K. Fitzpatrick, Dublin (IE) 14.45 16.00 Oral Abstract Session Chairs: W.M. De Blok, Amsterdam (NL) U.L.M. Haase, Nieuwegein (NL) 16.45 17.00 Award Session K. Fitzpatrick, Dublin (IE)
Awards supported by unrestricted educational grants from AMGEN and FERRING PHARMACEUTICALS

Online Registration until 1 March 2011

Sunday, 20 March
08.00 10.15 ESU Course Sexual dysfunction in women Chair: A. Ponholzer, Vienna (AT) 10.30 11.00 State-of-the-art lecture Effects of prostate cancer on spouses and families M. Gea-Snchez, Lleida (ES) 11.00 11.15 Urology Nursing Quiz T. Christiansen, Malm (SE) 11.30 12.30 State-of-the-art lecture New development in urological cancer care including the nursing aspects H.A.M. Van Muilekom, Amsterdam (NL) 12.30 14.30 EAUN Workshop Nursing tools for patient instruction on prostate cancer Chair: W.M. De Blok, Amsterdam (NL)
Supported by unrestricted educational grants from AMGEN and FERRING PHARMACEUTICALS

12:45 13.45 Lunch Symposium Optimising patient benefits in non-muscle invasive bladder cancer management Chair: K. Chatterton, London (UK)
Sponsored by: GE HEALTHCARE

* Optinal visit to the urological wards and outpatient clinics of the AKH, Donau or Rudolfstiftung Hospitals. Limited places are available and registration will be on a first-come, first-served basis through the online system.

European Association of Urology Nurses

44

European Urology Today

December 2010/March 2011