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#AUA17: Highlights from Boston part 2

The #AUA17 meeting was starting to hot up with the anticipation of the crossfire sessions controversy in urology,  second opinion cases and surgical technique plenary session. The early crossfire session was looking at adult onset hypogonadism. The  debaters  gave convincing arguments on both sides of the discussion but we were left in no doubt that adult-onset hypogonadism is a true medical condition and urologists need to recognise the symptoms and treat when appropriate.

 

There was a lively crossfire debate on the use off transperineal biopsy  vs TRUS biopsy for the detection of prostate cancer. There we some moral arguments in favour of  transperineal biopsy stated. Laurence Klotz presented the AUA MRI targeted biopsy consensus statement.

 

 

 

 

 

The results of the 24 months follow-up of the aquablation study was presented. The mean operative time was 45 mins with a aquablation time of 5 mins!  There was a 34% prostate volume reduction. There were no cases of urinary innocence , ejection or erectile dysfunction. The WATER study was presented comparing aquablation vs TURP.  The study found aqua ablation superior to TURP in terms of safety, Q max and IPSS reduction. We look forward to long term data but the initial results presented look promising

 

 

 

 

In a packed breakfast session we were given an excellent overview of the role of Immune checkpoint inhibitors in bladder cancer. The audience was treated to a state-of-the-art update on the newer drugs on the horizon, their indications, side effects and early clinical trial data. Watch his space for the new check point inhibitors for treatment of metastatic bladder cancer.

 

 

Burnout was a main theme across many of the sessions at the AUA. The poster by Nash et al. looked at results from the AUA census. They found that 41% of urologist surveyed  between the ages of 29-65 experienced burnout. Other risk factors included working in a multi speciality practise. Paediatric  urologists and urologist older than 65 were least likely to suffer from burnout. Very important issues have been highlighted at this meeting and gives food for thought for us all.

 

 

 

 

 

 

The eagerly awaited results of the randomised open verses robotic cystectomy (RAZOR) trial was announced at the AUA. the findings of the study showed that robotic cystectomy is not inferior to open cystectomy with respect to 2 year progression free and overall survival. As expected blood loss, length  to stay favoured the robotic cystectomy group but complication rates, overall surgical margins and lymph node yield were similar.

 

 

Bladder cancer diagnosis cost effectiveness was highlighted in a plenary session. Cost-effectiveness of ultrasound vs CT with cystoscopy was presented. The study found that the use of CT rather than ultrasound increased costs by $65 million / 1 cancer detected. This study highlights the need to risk stratify the use of CT in investigation of patients with non visible heamaturia.

 

 

One of the major announcements was the much anticipated phase 3 trial results looking at immediate post-TURBT instillation of gemcitabine vs saline in patients with newly diagnosed or occasionally recurring low grade non-muscle invasive bladder cancer,  SWOG S0337. The study shows reduced recurrence by 34% with little toxicity. There was a lot of excitement regarding gemcitabine as it 5-10 times cheaper than the widely used mytomycin C.

 

 

 

 

 

baus-bjui-usanz17The BAUS-BJUI-USANZ joint session was a fantastic overview from some of the top UK, US and Australian urologists. The highlights of the session included the talks on personalised medicine. The president of the British Association of Urological Surgeons Mr Kieran O’Flynn gave an insightful talk on training and inspiring the next generation of urologists. This was followed up by the Australian perceptive on urological training for the future. Khurshid Guru, Director of Robotic Surgery at Roswell Park Cancer Institute, gave an overview of cognitive training in surger . Finally the Coffey-Krane Award – the BJUI Journal prize for trainees based in The Americas – was awarded to Drs. Ranjith Ramasamy and Jason Kovac on their paper titled ‘Hypogonadal symptoms in young men are associated with a serum total testosterone threshold of 400 ng/dL’.

ckprize17Dr Ramasamy receives the 2017 Coffey-Krane prize from Prof Dasgupta

The Christchurch Medal was awarded to  Dr. Catherine deVries for her work on developing urological training programs in Asia, Africa, and Latin America. Congratulations to all the award winners and the BJUI team on an  exceptional programme.

 

 

 

In a busy trauma symposium the management of grade 4 renal injuries was presented. A multi centre study  looking at  safety in early mobilisation after renal trauma examined the benefits. The study concluded that the advantages for early mobilisation included increase in return of bowel function, reduced length of hospital stay, but acknowledged the increased risk of early mobilisation in higher grade traumas. One study looking specifically at outcomes in grade 4 renal injuries found 14% of the patients were unstable on  presentation, 52% required a blood transfusion with 24 hours and 74% of those with grade 4 renal injury had associated injuries.

 

 

 

 

 

The medical expulsive therapy (MET) debate rumbled on in 2017 at the AUA. Results of the late breaking abstract the Study of Tamsuolsin for Urolithiasis in the Emergency department (STONE) was presented.  The end point was stone passage at 28 days, with CT used to confirm stone passage. The study found no difference for stone passage rates for stones less than 9 mm compared to placebo.

 

 

 

At the ROCK session UK urologist Matthew Bultitude (@MattBultitude) gave an excellent case against  MET has he debated with John Hollingsworth. It is safe to say now ‘MET IS DEAD’

 

 

 

The NBA playoff final were on the Monday evening with the Boston Celtics beating the  Washington Wizards 115-105 in Game 7 of the Eastern Conference semi-finals. Many of the conference attendee took time out to watch the game live and support their adopted team the Boston Celtics.

 

 

 

 

 

It has been another excellent AUA in Boston. It was good to catch up with old friends and urologists from across the globe to debate and update on the latest management in urology. It was another record breaking year for the #AUA17 on twitter. It surpassed the stats for #AUA16 with over 52 million impressions, 20,530 tweets 3,591 participants. See you all in San Fransisco  for AUA 2018.

 

 

 

By Jonathan Makanjuola (@jonmakurology) and Nicholas Raison (@NicholasRaison)

 

 

The 5th BJUI Social Media Awards

It’s hard to believe that we have been doing the BJUI Social Media Awards for five years now! I recall vividly our inaugural BJUI Social Media Awards in 2013, as the burgeoning social media community in urology gathered in the back of an Irish Bar in San Diego to celebrate all things social. At that time, many of us had only got to know each other through Twitter, and it was certainly fun going around the room putting faces with twitter handles for the first time. That spirit continues today as the “uro-twitterati” continues to grow, and the BJUI Awards, (or the “Cult” Awards as our Editor-in-Chief likes to call them), remains a fun annual focus for the social-active urology community to meet up in person.

As you may know, we alternate the Awards between the annual congresses of the American Urological Association (AUA) and of the European Association of Urology (EAU). Last year, we descended on Munich, Germany to join the 13,000 or so other delegates attending the EAU Annual Meeting and to enjoy all the wonderful Bavarian hospitality on offer. This year, we set sail for the #AUA17 Annual Congress in Boston, MA, along with over 16,000 delegates from 100 different countries. What a great few days in beautiful Boston and a most welcome return for the AUA to this historic city. Hopefully it will have a regular spot on the calendar, especially with the welcome dumping of Anaheim and Orlando as venues for the Annual Meeting.

Awards

On therefore to the Awards. These took place on Saturday 13th May 2017 in the City Bar of the Westin Waterfront Boston. Over 80 of the most prominent uro-twitterati from all over the world turned up to enjoy the hospitality of the BJUI and to hear who would be recognised in the 2017 BJUI Social Media Awards. We actually had to shut the doors when we reached capacity so apologies to those who couldn’t get in! Individuals and organisations were recognised across 12 categories including the top gong, The BJUI Social Media Award 2017, awarded to an individual, organization, innovation or initiative who has made an outstanding contribution to social media in urology in the preceding year. The 2013 Award was won by the outstanding Urology Match portal, followed in 2014 by Dr Stacy Loeb for her outstanding individual contributions, and in 2015 by the #UroJC twitter-based journal club. Last year’s award went to the #ilooklikeaurologist social media campaign which we continue to promote.

This year our Awards Committee consisted of members of the BJUI Editorial Board – Declan Murphy, Prokar Dasgupta, Matt Bultitude, Stacy Loeb, John Davis, as well as BJUI Managing Editor Scott Millar whose team in London (Max and Clare) drive the content across our social platforms. The Committee reviewed a huge range of materials and activity before reaching their final conclusions.

The full list of winners is as follows:

Most Read [email protected] – “The optimal treatment of patients with localized prostate cancer: the debate rages on”. Dr Chris Wallis, Toronto, Canada

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Most Commented [email protected] – “It’s not about the machine, stupid”. Dr Declan Murphy, Melbourne, Australia

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Most Social Paper – “Novel use of Twitter to disseminate and evaluate adherence to clinical guidelines by the European Association of Urology”. Accepted by Stacy Loeb on behalf of herself and her colleagues.

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Best BJUI Tube Video – “Combined mpMRI Fusion and Systematic Biopsies Predict the Final Tumour Grading after Radical Prostatectomy”. Dr Angela Borkowetz, Dresden, Germany

AUA

Best Urology Conference for Social Media – #USANZ17 – The Annual Scientific Meeting of the Urological Association of Australia & New Zealand (USANZ) 2017. Accepted by Dr Peter Heathcote, Brisbane, Australia. President of USANZ.

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Best Urology App – The EAU Guidelines App. Accepted by Dr Maria Ribal, Barcelona, Spain, on behalf of the EAU.

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Innovation Award – BJUI Urology Ontology Hashtags keywords. Accepted by Dr Matthew Bultitude, London, UK, on behalf of the BJUI.

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#UroJC Award – Dr Brian Stork, Michigan, USA. Accepted by Dr Henry Woo of Brian’s behalf.

UroJC
Most Social Trainee – Dr Chris Wallis, Toronto, Canada

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Best Urology Journal for Social Media –Journal of Urology/Urology Practice. Accepted by Dr Angie Smith, Chapel Hill, USA, on behalf of the AUA Publications Committee.

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Best Urology Organisation – Canadian Urological Association. Accepted by Dr Mike Leveridge, Vice-President of Communications for CUA.

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The BJUI Social Media Award 2017 – The Urology Green List, accepted by Dr Henry Woo, Sydney, Australia.

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All the Award winners (except Dr Brian Stork who had to get home to work), were present to collect their awards themselves. A wonderful spread of socially-active urology folk from all over the world, pictured here with BJUI Editor-in-Chief, Prokar Dasgupta.

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A special thanks to our outstanding BJUI team at BJUI in London, Scott Millar, Max Cobb and Clare Dunne, who manage our social media and website activity as well as the day-to-day running of our busy journal.

See you all in Copenhagen for #EUA18 where we will present the 6th BJUI Social Media Awards ceremony!

 

Declan Murphy

Peter MacCallum Cancer Centre, Melbourne, Australia

Associate Editor, BJUI

@declangmurphy

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