Tag Archive for: Isaac Thangasamy


Bringing Out the Best: 69th USANZ ASM Highlights


The 69th Annual Scientific Meeting (ASM) of the Urological Society of Australia and New Zealand (USANZ) took place at a venue, well-known for its sun and surf – Gold Coast, Queensland. With some of Australia’s best beaches and coast line, the theme of the meeting was fitting: “Bringing out the Best”. Prem Rashid (@premrashid) and Peter Chin (@docpete888) convened a meeting boasting an impressive international and local faculty. Attendees were provided with a healthy balance of scientific update and social interaction to truly ‘bring out the best’ in each of us.


The meeting got off to a flying start with Dr. Mukesh Haikerwal AO (@DrMukeshH) delivering the Harry Harris Oration. His words were a timely reminder that the healthcare team has only one purpose: to care for the patient in need. The inspiring narrative of his time as a patient following a violent assault was told with humour and humility. The vastly underestimated issue of mental health was also brought to the fore. Despite a few technical malfunctions (Apple and Android!), the tone of the meeting was well and truly set. Attendees were then led out of the auditorium by a vibrant, rhythmic ensemble – a USANZ ASM first! Delegates at the welcome reception were joined by the SandMan, who created an artistic sand sculpture of the conference surfboard logo whilst delegates greeted one another over drinks and canapés.

drummingensemble_smA drumming ensemble lead delegates to the Welcome Reception

The plenary sessions were varied and engaging. Mornings were filled with world-class presentations by local and international faculty. Michael Cookson (@uromc) discussed management of advanced prostate cancer, Margit Fisch discussed urinary diversion options, and Armando Lorenzo discussed issues in transitional care, an area very dear to his heart. James N’Dow (@NDowJames) was especially engaging. He spoke on the importance of the EAU Guidelines and the recent ratification of the same by USANZ. The cross-continental collaborative spirit was further demonstrated by an announcement from Christopher Chapple that USANZ had been accepted as a member of the EAU. On a softer note, James N’Dow captured listeners’ hearts with tales of his philanthropic work in Sub-Saharan Africa and Scotland. His starkly honest account challenged all present to consider engaging in charitable works for those in need both local and abroad.

jamesndow_smJames N’Dow was particularly engaging, telling of his philanthropic work

Australia’s own Jeremy Grummet (@JGrummet) presented latest data on transperineal biopsy for the detection of prostate cancer. It was hard to argue with such impressive statistics: zero incidence of sepsis after more than 1000 biopsies and counting. He also reported early experiences with the Biobot Mona Lisa – a robotic technology for obtaining transperineal biopsies. Jeremy is to be congratulated for being recently appointed as an associate to the EAU Guidelines Committee.

Prokar Dasgupta @prokarurol presented the BJUI Global Prize to @maheshatw and Sean Huang.

Live debates provided robust discussion regarding hot topics. Kathleen Kobashi (@KKseattle) (described by the conference convenor as “the definition of intellectual elegance”!) and Kurt McCammon (@mccammonka) provided very topical debate regarding the merits and outcomes of native tissue versus synthetic slings. Focal therapy for prostate cancer was debated between our local expert Phil Stricker and international guest Jonathan Epstein, both of whom had very compelling arguments.

All this was conducted by the plenary session chairs, who looked particularly dapper behind the surf board faculty table! Only in Australia.

surfboard@DrRLC: “Only in Australia would a urological discussion around a surfboard be considered quite normal…”

Concurrent sessions were well attended throughout the meeting. Highlights include Thomas Knoll’s (@rockknoll) update on stone disease including his approach to difficult stones. He managed to enlighten and entertain even with topics such as “Metabolic Evaluation of Stones”! Mini-PCNL was in the spotlight with David Webb deserving of special mention. Run Wang discussed a practical approach to management of Peyronie’s disease, and Christian Gratzke (@cgratzke) discussed management of male LUTS and presented outcomes of prostatic urethral lift.

The program included non-scientific sessions titled “Getting My Message Across” (Henry Woo [@DrHWoo] & Declan Murphy [@declangmurphy]) and a fantastic education session (Stuart Philip & Melvyn Kuan [@MelvynKuan]). Trainees and consultants were updated on controlling their online presence in the internet age, publishing tips and pitfalls to avoid, and professionalism. Claus Roehrborn (@clausroehrborn) was especially illuminating on how to read a journal article. Equally, David Hillis (@dhillis1957) and Stephen Tobin (@deansurg) shared thoughts on professionalism that all surgeons would do well to heed. Speakers at the global health session inspired many to consider making an impact abroad.

The customary trainee breakfast grilling session was chaired by Nathan Lawrentschuk (@lawrentschuk) and his partner in crime, Louis Kovoussi (@DrKavoussi). Trainees were interrogated on all topics and benefited immensely from Louis’ expertise. Kurt McCammon (@mccammonka) taught the trainees on posterior urethral reconstruction, but also inspired their minds with career and life advice – a charge to be happy, do what you love, and prioritise family. His parting words “Don’t leave any potential on the table”, certainly urged trainees to, Bring out the Best from within.

Socially, the meeting was an absolute delight. Faculty dinners, industry dinners, dinners between friends and colleagues, were dotted around various restaurants all over the Gold Coast. The social highlight of the Meeting was the annual Gala Dinner, held at Australia’s Movie World, hosted by Batman and Marilyn Monroe! Alfresco style, the night was fresh and lively, with food, chatter, singing and dancing. The convenors @premrashid and @docpete888 were congratulated for a successful meeting. Prize winners were announced and congratulated: Ahmed Saeed Goolam (@asgoolam) for the BAUS Trophy, Matthew Winter (@matthewwinter01) for the Keith Kirkland prize, David Wetherell (@DrDRW) for the Villis Marshall prize, and Ailsa Wilson (@Willyedwards) for the inaugural Low-Arnold Prize in Female and Functional Urology.

galadinner_smGuests siphoning into Australia’s Movie World for the Gala Dinner

galadinner2_smThe Gala Dinner – the social highlight of the USANZ ASM

The Meeting flew by at phenomenal pace and soon it was time to pack our bags and say goodbye (or go for another surf!). Time sure flies when you’re having fun, and learning constantly! The 69th USANZ ASM surely brought out the best.

We’d like to extend our gratitude to the international and local experts who attended the meeting and generously shared of their expertise and collegiality. International guests include: Christopher Chapple, Michael Cookson, Jonathan Epstein, Prokar Dasgupta @prokarurol, Shin Egawa, Margit Fisch, Pat Fulgham (@patfulgham), Mantu Gupta, Christian Gratzke (@cgratzke), Louis Kavoussi, Thomas Knoll, Kathleen Kobashi (@kkseattle), Daniel Lin (@DanLinMD), Armando Lorenzo, Kurt McCammon, James N’Dow, Claus Roehrborn, Mark Speakman (@Parabolics), Anil Varshney and Run Wang. On behalf of ANZ Urologists and Trainees (@USANZurology), we thank you for your time, expertise, and friendship. We hope you are either enjoying some much deserved recreational time Down Under, or else have arrived safely home.

We would also like to thank the Meeting’s sponsors, in particular, platinum sponsor Abbvie for supporting the Meeting.

We are also grateful to everyone who participated in #usanz16 on social media, making #usanz16 the most active USANZ ASM on Twitter ever! With over 5 million impressions, the conference fun and science was more far-reaching than we could ever know. Thank you for helping to Bring out the Best.


A special mention for Ruth Collins (@DrRLC) for her witty tweets and Photoshop talent throughout the meeting.

shark@DrRLC: “Henry Woo & David Winkle ponder the risks of hanging out on a surf board all morning #usanz16

We look forward to the 70th USANZ ASM which will be held in Canberra, the nation’s capital (24-27th February 2017). Although the 69th USANZ ASM will be a hard act to follow, no doubt, convenors Nathan Lawrentschuk @lawrentschuk and Shomik Sengupta @shomik_s, will have some great tricks up their sleeves and we look forward to the program they have compiled. Till next time!



Amanda Chung is a Urological Surgeon and PhD candidate in Sydney, NSW and Isaac Thangasamy  @USANZUrology trainee in Queensland, Australia



sLND for Prostate Cancer Nodal Recurrence: #urojc September 2014 summary

The September 2014 edition of the International Urology Journal Club (#urojc) returned to familiar territory – prostate cancer. In particular, the discussion focused on salvage lymph node dissection following radical prostatectomy. For the second time (first in July 2014), two journal articles were selected. Both were kindly made available to open access by The Journal of Urology (@JUrology).

The first paper from the Mayo Clinic by Karnes et al., titled ‘Salvage Lymph Node Dissection (sLND) for Prostate Cancer Nodal Recurrence Detected by 11C-Choline Positron Emission Tomography/Computed Tomography (PET/CT)’, reported on a retrospective single-surgeon series of 52 men who underwent salvage lymph node dissection for nodal recurrence post radical prostatectomy. Median follow-up was 20 months. Three-year Biochemical recurrence (BCR)-free survival rate was 45.5% (PSA <0.2). Metastatic/systemic progression-free and cancer-specific survival rates were 46.9% and 92.5% respectively. They concluded that sLND may delay further progression of disease but highlighted the need for randomised controlled trials.

The second paper from German group Tilki et al., titled ‘Salvage Lymph Node Dissection for nodal recurrence of prostate cancer after Radical Prostatectomy’, also reported on a retrospective series of 58 patients who underwent sLND for nodal recurrence on PET/CT post radical prostatectomy. Median follow-up was 39 months. All but 1 patient had BCR. Five-year clinical recurrence-free and cancer-specific survival rates were 35.9% and 71% respectively.  Tilki et al. concluded that while most patients had BCR, sLND may delay ADT and clinical recurrence in selected cases.

A common sentiment shared during the discussion related to the lack of randomised evidence for sLND:

There were some serious concerns about the methodology and results from the two articles:

Discussions quickly shifted away from the two articles to the actual clinical question of sLND in oligometastatic disease and delay to ADT. Matthew Katz provided useful links to the use of stereotactic radiation therapy.

Issues surrounding sLND training and the paradigm shift in recent years were also highlighted:

Opinions were divided on the question of surgical morbidity versus the potential increase in time to ADT:

Pop culture references were in vogue this month. An article by the Mayo Clinic on the 11C-Choline PET scan sparked the linked exchange:

Some take home messages pertained to the uncertainty regarding patient selection and the role of sLND in the broader multidisciplinary arena of prostate cancer treatment:

The winner of the Best Tweet Prize is Brian Chapin (@ChapinMD) for his tweet above.  We thank the Journal of Clinical Urology for supporting this month’s prize by way of a one year electronic subscription to their journal.  We also thank the Journal of Urology for supporting this month’s discussion by way of allowing time limited open access of both articles.

Staying true to form, this month’s edition of #urojc provided a forum for lively international discussion. We look forward to next month’s installment and especially encourage trainees to make use of this excellent educational opportunity.


Isaac Thangasamy is a second year Urology Trainee currently working at the Royal Brisbane and Women’s Hospital, Brisbane, Australia. He is passionate about education and social media. Follow him on Twitter @iThangasamy


To TVT or TVT-O, does it even matter?

The March, 2014 edition of twitter-based international urology journal club discussion experienced a change of scenery as incontinence took center stage. The discussion focused on the five-year results of a randomised controlled trial (RCT) comparing retropubic versus transobturator midurethral slings for stress incontinence. The platinum priority article by Laurikainen et al. was made available open access thanks to European Urology. Special mention is also given to senior corresponding author Carl Nilsson, whose contributions were relayed via the #urojc guest account.

The prospectively registered, independent RCT was conducted across several Finnish centers. The study reported that at five-year follow up there was no difference in cure rate between the two procedures and that patient satisfaction was high. Initial discussion comments focused on the impressive length of follow up. Furthermore, the study reported that 94.8% of women (254 of 268) returned for five-year follow up.


The question of whether or not urodynamics should form part of the pre-operative workup of urinary incontinence was also raised. The study reported that urodynamics to investigate urgency incontinence was not performed.

The study defined a negative 24hr pad test as being <8g leakage/day. An interesting point was raised as to how this compares with the definition used post radical prostatectomy.

A limitation in the study’s methodology was highlighted.

At this point it became obvious that the usual heavyweight #urojc contributors were missing. Even the ‘King of Twitter’ was unusually silent.

The thirst for knowledge was also evident amongst practicing urologists.


To further shed light on the differences in complications between the two procedures, we were directed to the study’s shorter-term results. While higher complication rate following transobturator sling was statistically significant, it was not regarded as clinically significant.

We were also directed to an excellent review of the surgical management of female stress urinary incontinence.

While the results of the study show no difference between retropubic versus transobturator midurethral slings, the generalisability of this data across various populations was questioned. The mean age and BMI of patients in the study was 53 and 26 respectively.

Surgeon expertise in vaginal/prolapse surgery was an important issue especially in light of litigation.

A few take home messages

While this month’s #urojc discussion did not have the usual level of participation it was nonetheless a valuable conversation concerning two common sling procedures for the management of stress incontinence. Best tweet prize was an iPad app subscription thanks to BJU International which goes to Helen Nicholson (@DrHLN) for above tweet. We look forward to the next installment of #urojc in April.

Isaac Thangasamy is a second year Urology Trainee currently working at the Royal Brisbane and Women’s Hospital, Brisbane, Australia. He is passionate about education and social media. Follow him on Twitter @iThangasamy



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