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EAU 2017 Congress Days 3&4

London calling! On Sunday morning London called one hour earlier than I had planned – damn daylight saving time! Last nights’ celebrations with urology friends from around the world at the ESRU (European Society of Residents in Urology) dinner party made me pay. Yet this was going to be a great meeting day.

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Sunday morning sessions served as a wake-up call after a short night due to daylight saving time.

Dr. Rajesh Nair has already reported on a great kick-off and continuation of the EAU17 congress in his blog on congress days 1 & 2.

The Sunday programme started with a plenary session in eURO auditorium on redefining and optimising contemporary bladder cancer care. The EAU chose a great concept for the plenary session by presenting an easily digestible mix of different lectures: Experts in the field used case discussions to illustrate real-life clinical scenarios and everyday issues for urologist. Speakers delivered their best arguments in the debates on pros and cons on urgent clinical questions. Finally, State-of-the-art lectures summarized the most important aspects in the field.

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EAU17 Delegates joining the congress action.

Sunday’s State-of-the art lectures on bladder cancer were held by James Catto and Walter Artibani. Catto reported on “Enhanced Recovery After Surgery (ERAS) for bladder cancer: Non-surgical options to improve outcomes of cystectomy”. Catto systematically covered 22 ERAS items on preoperative, intraoperative and postoperative measures. Appliance of ERAS for radical cystectomy yielded better outcomes for length-of-stay as well as readmission and transfusion rates when compared to traditional recovery concepts.

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State-of-the-art lecture: Three principles of the Enhanced Recovery after Surgery (ERAS) Philosophy.

The second State-of-the-art lecture by Walter Artibani gave perspectives on “What determines Quality-of-Life after urinary diversion and how do we measure it?” Artibani pointed out that we have to do a better job in defining and researching health-related quality of life in order to compare outcomes of urinary diversions. Multidisciplinarity is a must and there is room and need for enhanced long-term personalized information and support programs.

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Quality of Life after urinary diversion – Walter Artibani’s twist of Albert Einstein’s wisdom.

Besides scientific meetings, the Annual Meeting of course is the place for board meetings of the EAU bodies. The EAU Section Office Members took the opportunity to step out of the congress and enjoy London’s incredibly good weather.

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EAU Section Office Members enjoying London’s sun for a group photo.

At high noon it was time for me to join the Advanced Course on Social Media – take it to the next level! An expert panel of Social media users in urology gave insights on the wide variety of Social media use in our field. Twitter queen Stacy Loeb (@LoebStacy) gave examples on the use of social media for scientific research and for dissemination of content. Matthew Cooperberg (@dr_coops) showed in his talk “reputation management” why and how urologists should take care of their digital self. Finally, Inge van Oort (@onco_uroloog) presented do’s and don’ts of Twitter use emphasizing the importance of Social Media guidelines.

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Great conclusion of the advanced Social Media Course by @LoebStacy.

Yet, ESU Courses weren’t limited to lectures and discussions. HOT – Hands on Training was offered to delegates with 1-on-1-supervision. I was amazed by the variety of simulators and technical equipment for course participants. But why would they use red irrigation fluid? – Making the TURP simulation a more realistic experience? 😉

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Simulation and tutoring during European School of Urology Hands-on-training courses.

On Monday morning the EAU launched a new initiative: the Young Urologist Office provided a new course format: the EAU Leadership Course. Ambitious urologists from all over the world gathered to expand on their leadership skills: What are my leadership styles? Can I flex my style? Am I effective? These were only some of the aspects covered by a team of specialized leadership coaches.

 

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One key skill for leadership: great rhetorical skills!

Another thing I liked about the EAU congress was the professional media coverage – EAU TV offered short interviews covering highlights from abstract sessions, plenary sessions and insights from the EAU bodies. It was EAU TV that attracted my attention to Amanda Chung’s study “Is your career hurting you? – The ergonomic consequences of surgery in 701 urologists worldwide”.  Against common presumption, Chung et al. didn’t find a dose-response relationship between volume of surgeries performed and back pain. A protective effect against back pain was found for exercise, instead increasing weight and BMI were associated with higher pain – thanks for these insights! I definitely aim for a lifestyle change after hearing these findings!

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EAU TV enriches the conference experience.

There were a lot of things to learn during the congress. During the congress first-ever e-Poster Abstract Session on New technologies: Urology and multimedia, I learned from session chair and BJUI’s editor-in-chief Prokar Dasgupta that the highest cited paper on Altmetrics in 2015 was on a new antibiotic that kills pathogens without detectable resistance. Maybe this is why the EAU heavily announced it’s thematic session on infections in urology: “Killer bacteria and viruses in urology”. One must-read I got from this session was an update on the management of sepsis and septic shock.

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Highlights from the EAU Infectious diseases session “Killer bacteria and viruses in urology”.

As usual the EAU congress featured lots of live and semi-live surgeries. For some of them the Copenhagen Room wasn’t quite enough to accommodate all delegates interested.

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Live and semi live surgery as usual attracting lots of EAU delegates.

The EAU congress truly offered a cocktail of everything: the latest science presented in plenary & poster sessions, education, updates on guideline knowledge and of course lots of networking in form of meeting, greeting and tweeting.

Finally, my EAU17 journey ended on Monday night after lots of congress input, short nights and a great time meeting urology friends from around the world. Thanks a lot to all organisers and contributors for your hard work and great performance! See you in Copenhagen!

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Hendrik Borgmann, Urologist, University Hospital Mainz

@HendrikBorgmann

 

EAU 2016 Congress Days 1 & 2

Willkommen in München! I’m happy to give you some flavours of this year’s return of the EAU meeting to my home country after nine years of absence. Let’s start of with the first little episode that many of us might have encountered: Arriving at the congress centre, it took me only 1 minute to recognize that the EAU is always racing ahead: They placed the famous red London telephone box right in the centre of the entry hall. What a start! It created the scenery of joyful anticipation of EAU 2017 in England. Congress attendees were invited to take funny pictures. Great idea to do that on the first day of the congress rather than after many days of work and party. Not surprisingly the BJUI Board jumped in and seized this opportunity.

EAU-1-1Ben Challacombe and Matthew Bultitude
posing for EAU 17 in London.

 

 

 

 

 

 

 

But let’s get back to the present and to Munich’s highlights on Friday. The congress kicked off with the joint meetings of the EAU and various urological societies from around the globe. The EAU has started to reach out to urologists from all countries over the couple of years – one factor on their way to being currently recognized as the world’s leading association in our specialty. The joint sessions covered a colourful range of topics from urological oncology over men’s health to functional and reconstructive urology. Highlight of the day though was of course the opening ceremony on Friday night. I gave my best shot for BJUI’s best #selfie award when asking three beautiful violin artists to smile for the camera. I wasn’t successful, but it was fun anyhow.

🙂 You’ll find out the best #selfie winner later.

EAU-1-2@HendrikBorgmann at Opening Ceremony with Violin Artists

 

 

 

 

 

Still, the selfie experience made the girls feel so confident that they gave the audience a virtuoso, charmful atmospheric violin performance. EAU Secretary General Prof. Chapple gave out 13 awards for great achievements by pioneers in our field. Prof. Artibani received the Willy Gregoir Medal, Prof. Teillac the Frans Debruyne Life Time Achievement Award and Prof. Briganti the EAU Crystal Matula Award. Yet, the greatest honour was given to an absolute luminary in urology: When Michael Marberger received the EAU Honorary Member Award, standing ovations from the audience and an open-hearted applause created a goose bump atmosphere. There’s nothing more to say.

EAU-1-3Michael Marberger receiving the EAU Honorary Member Award

 

 

 

 

 

 

 

Waking up on Saturday after Friday nights activities – paying for it, as usual – drove me into the first plenary session: Evidence-based medicine vs. common practice / challenging the evidence. EAU Guidelines office chair James N’Dow and European School of Urology chair Joan Palou led the discussion, which used clinical cases to stimulate the debate between two opposing camps: pro vs. con for medical-expulsive therapy and personal experience vs. EAU guidelines for male incontinence after radical prostatectomy. The first plenary was rounded up by the AUA lecture by Abraham Morgentaler on a 40 years perspective on testosterone therapy.

 

EAU-1-4Lively discussions on the current state of evidence for medical expulsive therapy during the first plenary session

Munich’s conference centre made me cover some distance and burn some calories when rushing to the poster sessions. Funnily or annoyingly, depending on the point of view, a lot of poster presenters were fighting with rigid poster walls and poor needles. On top of that, scientific exchange was limited during the 20 minutes of poster viewing preceding the talks – shall we dedicate more time to talks instead?

EAU-1-5Poster presenters struggling to pin their research on stiff walls.

 

The EAU congress wasn’t all about the latest research though. Of course, education played a major role, which was reflected by over 70 hands-on training courses. You want to improve your surgical skills on adrenalectomy? No problem. Try out Green Light Laser Vaporisation and get advice from experts? Go ahead. Looking for advanced training on urethral stricture surgery? Sure! There were hands-on-training sessions for everybody.

EAU-1-6Practice, practice, practice. Trainers and trainees enjoying surgical simulation during hands-on-training course.

The congress wouldn’t have been the same without it’s indispensable elixir of life: LIVE SURGERY. The Urotechnology, Robotic Urology and Urolithiasis Sections shined with their latest advancements: 3D-HD laparoscopy, fluorescence partial nephrectomy, SPIES-assisted and NBI-assisted ureterorenoscopy for upper tract urothelial cancer – the spectacle went on and on. Interestingly, a working group from Italy took on the hot topic of ethics in live surgery for an important study: In their work “Live surgery: Harmful or helpful? Experience of the ‘Challenge in Laparoscopy and Robotics’ meeting” the authors retrospectively reviewed 197 live surgery cases. The authors found an acceptable overall complication rate of 11.6% according to Clavien Dindo classification. Over the course of time, the interest in live surgery seemed to remain alive, as shown by the high number of 539 participants per event. I think the study is very original and we can anticipate an interesting paper on this very soon.

Sunday morning was all about the Plenary Session on prostate cancer in the eURO Auditorium. Results of the TOOKAD® Phase III trial were highly anticipated. High noon was at 8AM when Marc Emberton presented the results of their study “TOOKAD Soluble ® versus active surveillance in men with low risk prostate cancer – a randomized phase 3 clinical trial”. 413 patients were randomized 1:1 to vascular-targeted photodynamic (VTP) therapy vs. active surveillance. Progression free survival rates were higher for VTP (28% of patients progressed) when compared to active surveillance (58% progressed; hazard ratio: 0.34; 95% confidence interval: 0.24-0.46; p<0.001). Also, fewer VTP treated men underwent radical therapy within 24-months: 6% vs. 29%, RR=0.20 [0.11-0.36].

EAU-1-7Results from the TOOKAD study

Discussant Declan Murphy congratulated the group for the well-designed study and asked 3 questions:

1.) Does this type of very low-risk prostate cancer need intervention?

2.) What is going on in the control arm?

3.) What is the impact of TOOKAD on future intervention?

The population from the PRIAS study was comparable to the presented study population. PRIAS showed that active surveillance can be pursued safely in very low-risk prostate cancer patients. Moreover, the control arm of the TOOKAD study had much worse outcomes for histological progression, negative biopsy and need for radical intervention when compared to the PRIAS population. Finally, salvage radical prostatectomy post-TOOKAD had notable morbidity and disappointing oncological outcomes in a small study of 19 patients, which differs from outcomes observed for radical prostatectomy after active surveillance.

 

EAU-1-8Take home messages from discussant Declan Murphy

After this strong opening, the prostate cancer fireworks continued with debates on the role for pre-biopsy MRI, timing of radiotherapy after radical prostatectomy and indications for chemotherapy in hormone-naïve prostate cancer.

On Sunday afternoon magic happened: the #EAU16 Twitter feed took the 10,000-tweet-hurdle for the first time in #EAU Twitter history: Congratulations and thanks to all contributors. More numbers needed? Up to 15 million impressions, 1,400 users and 115 tweets/hour show that the Twitter fan community is constantly growing. No one of us knows when the boom will slow down.

EAU-1-9Urologic Twitterati contributing to the #EAU16 Twitter feed.

 

Which content went viral though? See for yourself in the wordle I pulled from Tweetarchivist and the Retweet analysis from Twitonomy.

EAU-1-10Wordle showing the top words used in the #EAU16 Twitter feed.

 

EAU-1-11Most retweeted tweets during #EAU16.

 

Despite that, the social media highlight was yet to come: the famous BJUI SoMe awards! The urologic Twitterati gathered in the beautiful roof-top lounge in Munich city centre for the “cult awards” as Prokar Dasgupta (@prokarurol), BJUI Editor-in-chief, justifiably stated. We warmed up with wine or beer and felt the suspense increasing when everybody was waiting for Declan’s last-minute slide editing to the start the show. Prokar honoured the Twitter community for their huge engagement. While everybody was enjoying the show, we were coming closer to the most awaited prize: the @BJUIjournal best selfie award! Morgan Roupret (@MRoupret) and Angelika Cebulla (@AngelikaCebulla) were fighting hard for it, but it the end Maria Ribal (MariaJRibal) raced ahead and won the coveted award. But the show wasn’t over and the best was still to come in the final round: the @BJUIjournal Social Media Award 2016. Stacy Loeb (@LoebStacy) made a great proof-of-principle when initiating the #ILookLikeAUrologist campaign, which reached close to 1,000 tweets and was the well deserved award winner.

EAU-1-12Stacy Loeb receiving the prestigious BJUI Social Media Award 2016 from Prokar Dasgupta and Declan Murphy

For more details of the Award winners look out for Declan’s forthcoming blog, coming to this site soon.

Congratulations to all social media entrepreneurs! Stay tuned for EAU congress days 3 and 4! Peace, love and #urology!

 

Hendrik Borgmann, Urologist, Mainz/Vancouver
@HendrikBorgmann

 

 

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