Tag Archive for: USANZ

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BJUI Annual Awards

Trainees who have a paper accepted for publication in the BJU International Journal are eligible for one of the following three BJUI Journal Prizes, which are awarded annually, based on the authors’ geographical location when they conducted the research.

The BJUI Global prize

This is awarded to authors who are trainees based anywhere in the world other than the Americas and Europe. The prize is presented at the USANZ annual meeting. In 2019 the BJUI Global prize was presented to Dr Amila Siriwardana from St Vincent’s Prostate Cancer Centre in Sydney, Australia for his article: Initial multicentre experience of 68gallium‐PSMA PET/CT guided robot‐assisted salvage lymphadenectomy: acceptable safety profile but oncological benefit appears limited.

The Coffey-Krane prize

The Coffey-Krane prize is awarded to authors who are trainees based in The Americas and it is presented at the AUA annual conference, which was held this year in Chicago. There were two winners this year: Jeffrey J. Tosoian and Meera R. Chappidi from the Johns Hopkins University School of Medicine in Baltimore, USA for their work on: Prognostic utility of biopsy‐derived cell cycle progression score in patients with National Comprehensive Cancer Network low‐risk prostate cancer undergoing radical prostatectomy: implications for treatment guidance.

The John Blandy prize

The John Blandy prize is awarded to authors who are trainees based in Europe. The prize is presented at the BAUS annual conference and the winner gives a presentation. The 2019 award was given to Isabel Rauscher from the Technical University of Munich in Germany, who gave a talk at the conference in Glasgow in June. Her article is entitled: Value of 111In‐prostate‐specific membrane antigen (PSMA)‐radioguided surgery for salvage lymphadenectomy in recurrent prostate cancer: correlation with histopathology and clinical follow‐up.

BJUI Vattikuti Foundation Robotics prize

This prize is a one-off prize awarded for the best robotics paper recently published in the BJU International Journal. The prize is sponsored by the Vattikuti Foundation and voted for by an independent panel. The research was carried out by a team from the Yonsei University College of Medicine in Seoul, South Korea on: Does robot‐assisted radical prostatectomy benefit patients with prostate cancer and bone oligometastases?

BAUS/BJUI/USANZ Joint Session AUA 2019

British Association of Urological Surgeons/BJU International/Urological Society of Australia and New Zealand (BAUS/BJUI/USANZ) Joint Session AUA 2019

Sunday, May 5th 2:00 – 5.00 PM. McCormick Place Convention Center South Building – Room S102 BC

 

Registries /Smart Data /Complications – CHAIR: Duncan Summerton

 

1400-1420 Alan Partin

A contemporary look at biomarkers for diagnosis of Prostate Cancer

1420-1440 Chris Harding (BJUI sponsored BAUS lecture)

The Mesh Story – lessons learned and future plans

1440-1500 Nick Watkin

PROMs in Urology

1500-1520 Stephen Mark

Big Data and Urology – a pilot trial in New Zealand

1520-1540 Afternoon tea
 

Education /Training /Innovation – CHAIR: Prokar Dasgupta

 

1540-1600 Andrew Hung (BJUI sponsored lecture)

The emerging role of Artificial Intelligence in Surgical Science

1600-1620 Jonathan Kam

Zero learning curve Percutaneous Nephrolithotomy Access – Prone endoscopic combined intrarenal surgery and multimedia training aid to teach urology trainees

1620-1640 Madhu Koya (BJUI sponsored USANZ lecture)

Cx bladder reduces flexible cystoscopy in haematura and superficial TCC

1640-1700 Kamran Ahmad

Innovation in healthcare systems

1700-1705 BJUI Coffey-Krane Award for trainees based in The Americas presented by Prokar Dasgupta
1700-1900 BJUI Reception

 

“Is radiotherapy the work of the Devil?” – why we chose this title.

With the recent electronic publication of our editorial written for the BJUI USANZ supplement, we have been somewhat surprised with the Twitter response our title has generated with some very strong opinions expressed. Why would a radiation oncologist, who happens to be the Chair of their National Genito-Urinary group (“FROGG”) propose such a provocative title? The BJUI editorial board wisely suggested that we explain the origin of this title which would be lost on many outside Australia.

In mid-2014, a leading Australian urologist quipped that adjuvant post-prostatectomy radiotherapy was “the work of the Devil” when referring to some of the severe complications that can occur following post-prostatectomy radiation. This comment has become “infamous” in Australian Radiation Oncology circles leading to extensive discussions and interactions between our specialties with urologists stating that radiotherapy complications can occur late and be very challenging to treat and radiation oncologists stating that these complications are relatively uncommon and that overall quality of life is as good if not better when going down the radiotherapy pathway. This is the climate that the article by Ma et al was submitted to the BJUI describing the impact of radiotherapy complications on a tertiary urology service in Melbourne Australia over a 6 month period.

 

 

I was impressed that the BJUI approached a radiation oncologist to provide balance on such a paper. We provocatively titled the editorial “Is Radiotherapy the work of the Devil?” and were hoping the response to anyone reading the editorial would be a resounding “No”.  However, many have only seen “the headline” and not read the editorial itself which appears to have created offence especially from some of our international Radiation Oncology colleagues. The aim of such a title is that it will encourage people to read both the original article and the editorial which we feel provides a balanced view on the impact of radiotherapy complications in contemporary practice. We hope that in future, the response to our title: “Is Radiotherapy the work of the Devil” is “No – the Devil is in the detail”.

 

A/Prof Andrew Kneebone

Department of Radiation Oncology, Royal North Shore Hospital and Chair of the Faculty Of Radiation Oncology Genito-Urinary Group (FROGG)

 

 

 

USANZ 2018: Melbourne

G’day! The 71st  annual USANZ Congress, was held in Melbourne and had the biggest attendance on record for the past 6 years. The Urological Nurse’s congress: ANZUNS ran concurrently, encouraging multi disciplinary learning. An excellent and varied educational programme was masterminded by Declan Murphy, Nathan Lawrentschuk and their organising committee. Melbourne provided a great backdrop and soon felt like home with a rich and busy central business district, cultural and sporting venues, the Yarra river flowing past the conference centre, edgy graffiti and hipster coffee shops, plus too many shops, bars and restaurants to visit.

The programme included a day of masterclasses on a range of subjects, including: urological imaging, advanced robotic surgery with a live case from USC, metastatic prostate cancer and penile prosthetics. These were well attended by trainees and consultants alike. The PCNL session (pictured) with Professor Webb was popular and he generously gave his expertise.  The session was supported by industry and provided an opportunity to use the latest nephroscopes on porcine models and innovative aids to realistically practice different puncture techniques.

Two plenary sessions were held each morning covering the breadth and depth of urology and were well attended. Dr Sotelo is always a highlight; he presented, to an auditorium of collective gasps, a unique selection of ‘nightmare’ cases  His cases gave insight in how intraoperative complications occur and how they can be avoided.  Tips, such as zooming out to reassess in times of anatomical uncertainty during laparoscopy or robotic surgery have great impact when you witness the possible consequences. Tim O’Brien shared his priceless insights on performing IVC thrombectomy highlighting the need for preoperative planning, early control of the renal artery and consideration of pre-embolisation.  His second plenary on retroperitoneal fibrosis provided clarity on the management of this rare condition highlighting the role of PET imaging and, as with complex upper tract surgery, the importance of a dedicated team.

Tony Costello’s captivating presentation covered several myths in robotic prostate surgery, plus the importance of knowing your own outcome figures and a future where robotics will be cost equivalent to laparoscopy. Future technology, progress in cancer genomics and biomarkers were also discussed in various sessions.  One example of new technology was Aquablation of the prostate; Peter Gilling presented the WATER trial results suggesting non-inferiority to TURP.  A welcome addition to the programme was Victoria Cullen (pictured), a psychologist and Intimacy Specialist who provides education, support and strategies for sexual  rehabilitation. She described her typical consultation with men with sexual dysfunction and how to change worries about being ‘normal’ to focusing on what is important to the individual.

Joint plenary sessions with the AUA and EAU were a particular highlight. Prof Chris Chapple confirmed the need for robust, evidence guidelines which support clinical decision making; and in many cases can be used internationally. He suggested collaboration is crucial between us as colleagues and scientists working in the field of urology. Stone prevention and analysis of available evidence was described by Michael Lipkin; unfortunately stone formers are usually under-estimaters of their fluid intake so encouragement is always needed! Amy Krambeck presented evidence for concurrent use of anticoagulants and antiplatelets during BOO surgery and suggested there can be a false sense of security when stopping these medications as it isn’t always safe. She championed HoLEP as her method of BOO surgery and continues medications, although the evidence does show blood transfusion rate may be higher. She also uses a fluid warming device which has less bleeding and therefore improved surgical vision; importantly it is preferred by her theatres nurses! MRI of the prostate was covered  by many different speakers, however Jochen Walz expertly discussed the limitations of MRI in particular relating negative predictive value (pictured). He eloquently explained the properties of cribiform Gleason 4 prostate cancer and how this variant contributed to the incidence of false negatives.

Moderated poster and presentation sessions showcased research and audit projects from the UK, Australia, New Zealand and beyond, mainly led by junior urologists. The best abstracts submitted by USANZ trainees were invited to present for consideration of Villis Marshall and Keith Kirkland prizes. These prestigious prizes were valiantly fought for and reflected high quality research completed by the trainees. Projects included urethral length and continence, no need for lead glasses, obesity and prostate cancer, multi-centre management of ureteric calculi, mental health of surgical trainees and seminal fluid biomarkers in prostate cancer. This enthusiasm for academia will undoubtedly stand urology in good stead for the future; this line up (pictured) is one to watch!

The Trade hall provided a great networking space to be able to meet with friends and colleagues and engage with industry. It also hosted poster presentation sessions, with a one minute allocation for each presenter – which really ensures a succinct summary of the important findings (pictured)! It was nice to meet with Australian trainees and we discussed the highs and lows of training and ideas for fellowships. Issues such as clinical burden and operative time, selection into the specialty, cost of training, burn out and exam fears were discussed and shared universally; however there is such enthusiasm, a passion for urology and inspirational trainers which help balance burdens that trainees face. Furthermore, USANZ ‘SET’ Trainees were invited to meet with the international faculty in a ‘hot seat’ style session which was an enviable opportunity to discuss careers and aspirations.

In addition to the Congress I was fortunate to be invited for a tour and roof-top ‘barbie’ at the Peter Mac Cancer centre; plus a visit to Adelaide with Rick (Catterwell, co-author) seeing his new hospital and tucking into an inaugural Aussie Brunch. Peter Mac and Royal Adelaide Hospital facilities indicated an extraordinary level of investment made by Federal and State providers; the Peter Mac in particular had impressive patient areas, radiotherapy suites and ethos of linking clinical and research. However beyond glossy exteriors Australian public sector clinicians voiced concerns regarding some issues similar to those we face in the NHS.

Despite the distance of travelling to Melbourne and the inevitable jet lag the world does feels an increasingly smaller place and the Urological world even more so. There is a neighbourly relationship between the UK, Australia and New Zealand as evidenced by many familiar faces at USANZ who have worked between these countries; better for the new experiences and teaching afforded to them by completing fellowships overseas. The Gala Dinner was a great chance to unwind, catch up with friends and celebrate successes in the impressive surrounding of Melbourne Town Hall (pictured); the infamous organ played particularly rousing rendition of Phantom of the Opera on arrival.

The enthusiasm to strive for improvement is similar both home and away and therefore collaboration both nationally and internationally is integral for the progress of urology. The opening address by USANZ President included the phrase ‘together we can do so much more’ and this theme of collaboration was apparent throughout the conference. The future is bright with initiatives led by enthusiastic trainee groups BURST and YURO to collect large volume, high quality data from multiple centres, such as MIMIC which was presented by Dr Todd Manning. Social media, telecommunications and innovative technology should be used to further the specialty, especially with research and in cases of rare diseases – such as RPF.  Twitter is a tool that can be harnessed and was certainly used freely with the hashtag #USANZ18. Furthermore, utilisation of educational learning platforms such as BJUI knowledge and evidence based guidelines help to facilitate high quality Urological practice regardless of state or country.

So we’d like to extend a huge thank you to Declan, Nathan and the whole team, and congratulate them for a successful, educational and friendly conference; all connections made will I’m sure last a lifetime and enable us to do more together.

Sophie Rintoul-Hoad and Rick Catterwell

 

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

The British are coming!

bju13868-fig-0001Historians report that Paul Revere never said these famous words; as Colonial Americans at the time still considered themselves British. Indeed, Americans still consider themselves European. The United States Census reports that 73% of Americans are of European descent, and 62% of these are of English, Scottish, Welsh or Irish ancestry.

These links to our heritage remain strong. With >1100 European members (close to 200 from the UK) and >300 members from Australia and New Zealand, our bonds of friendship and collaboration are tightly intertwined. So if Paul Revere won’t say it, I will!

The British are coming! Each year >2000 Europeans attend our Annual meeting (200 from the UK) and >100 from Australia and New Zealand. They are represented not only in quantity but also in quality. Of the 1700 scientific abstracts submitted from Europe to the 2017 Annual meeting, the acceptance rate was 38% for the UK, compared to an overall acceptance rate of 34%. Important science comes from the UK and Australia, and raises the quality of our meeting.

The BAUS–BJUI–USANZ Joint Session on Sunday 14 May in Boston is a clear example of how the BJUI family, as the official journal of the USANZ and the BAUS ‘raises the bar’ at the AUA Annual Meeting. With focuses on personalised medicine, genomics, systems biology, immunotherapy, and ‘training the brain’, it promises to stimulate and educate. Following this we look forward to toasting our transatlantic brothers and sisters with a Boston Lager at the BJUI reception.

The British are coming! We look forward to welcoming you in Boston in May.

Manoj Monga, AUA Secretary
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA

 

Capitalising On Our Strengths: The 70th USANZ ASM

Canberra, our nation’s capital and the host city for the 2017 USANZ ASM, is a gem in its own right, but one which was created to satiate two feuding states locked in a bitter rivalry. In 1908, Canberra embodied the very meaning of compromise and collaboration, a technique which has garnered much success for our Country over the ensuing 100 odd years. Arguably the first official Australian collaborative effort, this way of thinking has become an almost uniquely Australian attribute and a strength imbued in our national pride.

USANZ 2017 was held in CanberraCanberra from up high, a breathtaking backdrop for a fantastic USANZ ASM.

Given this year’s mantra of: “Capitalising on our strengths” It is perhaps fitting then, that the 70th anniversary of the Urological Society of Australia and New Zealand (USANZ) Annual Scientific Meeting (ASM) including the Australia and New Zealand Urological Nurses Society (ANZUNS) 22nd ASM, should be held in such a location. In addition to providing some wonderful tourist opportunities for guests including the War Memorial, the National Gallery and Parliament House.

Convenors A/Prof Nathan Lawrentschuk and Kath Schubach went to great efforts to successfully welcome both national and international guests and Scientific Program Directors A/Prof Shomik Sengupta and Carla D’Amico ensured a star-studded academic program addressing contemporary updates in Urological evidence based practice, which were aptly discussed both inside and outside the confines of the National Convention Centre.

1-2Senior YURO members standing outside Parliament House (from left to right): Dr. Daniel Christidis, Dr. Tatenda Nzenza, Dr. Todd Manning, Dr. Shannon McGrath

 

The representation by International faculty was exceptional, with countless urological household names from world leading centres across the globe both involved in the academic program and socially. Urological goliaths including Prof. Christopher Chapple, Prof. Prokar Dasgupta and Prof. Laurence Klotz weighed in on various topical issues providing an intercontinental perspective that complimented the equally impressive national line-up of speakers.

As with previous years, use of social media was rife, with those not able to attend kept in the loop via #Usanz17 and a steady stream from the ever focused twitterati. The ASM provided more than 5 million impressions and over 2800 individual tweets from more than 400 participants. The usual suspects were eminent as always, along with a few newcomers who provided impact in their own right. The official USANZ 2017 App also kept participants up to date via timely notifications and was user friendly.

Guests were spoilt for choice in the convention centre during well timed breaks, which was perpetually abuzz with attendees networking. In the background the ‘Talking Urology’ team headed by Mr Joseph Ischia and A/Prof Nathan Lawrentschuk provided a steady stream of captivating interviews with guests, regarding a myriad of urological topics. Simultaneously, numerous academics gave brief summaries of research posters during allocated presentation sessions. Exhibitors provided a captivating backdrop for these activities including many hands-on simulators and challenges for those keen to test their dextrous mettle. All the while guests relished a variety of delectable culinary options.

1-3Guests networking at the Gala Dinner, whilst being entertained by opera classics in the Great Hall foyer of Parliament House

 

The meeting’s common themes were strong and pertinent to contemporary urology. They centred around collaborative research efforts such as the ANZUP trials group and the Young Urology Researchers Organisation (YURO), technology especially PSMA PET and social media and social justice including women in urology and operating with respect. Discussions were directed by chairpersons during purposefully allocated Q&A times at the conclusion of each session, a new and well received addition to this years meeting. This was generously embraced by both senior and junior academics and led to intriguing symposiums and at times heated debate.

 

USANZ 2017 Friday Highlights

The first official day of proceedings provided a smorgasbord of morning and afternoon workshops ranging from technical skills courses to the medico-legal implications of E-Health and technology. This was followed by an allocated networking session for Urology trainees with International faculty.

Officially opening the conference in the Royal Theatre of the convention centre, A/Prof Lawrentschuk introduced this year’s Harry Harris orator; Elizabeth Cosson, AM CSC.  Her speech entitled “leading with grit and grace” eloquently detailed her journey in the armed forces and highlighted the difficulties of the unmistakably imbalanced workplace for women in the military. Her talk clearly underlined her role in not only forging a highly successful career for herself but also for those women following in her footsteps. Her inspiring dialogue was synchronous with contemporary issues surrounding Urological practice, especially concerning equality for women but more resolutely, appropriate equity both in training and established practice.

With the tone well established for an exceptional meeting, guests enjoyed a variety of canapés and drinks in the exhibition hall, unwinding with social discussion.

1-4YURO President, Dr Todd Manning talks to young researchers with help from Prof. Henry Woo and A/Prof. Lawrentschuk during the YURO annual meeting

 

Saturday Highlights

Plenary sessions aplenty began the second day of proceedings with International academic giants including Prof. Klotz, Prof. Chapple, Prof. Traxer and Prof Nitti mixed in with National heavy hitters such as Prof Frank Gardiner, Mr Daniel Moon and outgoing USANZ president Prof. Mark Frydenberg.

Afternoon sessions included subspecialty discussions and some stellar Podium Poster presentations, with an especially impressive mix of senior and junior researchers regarding countless and diverse urological topics.

 

Sunday Highlights

Heralding the beginning of another exceptional day, the ‘Women in Urology’ breakfast symposium chaired by Dr Anita Clark along side distinguished panellists including Dr Caroline Dowling and Dr Eva Fong was a conference stand out for many.

Following this, more plenary sessions filled the remainder of the pre-lunch program, leading into the highly anticipated Keith Kirkland and Villis Marshall presentations by Urology SET trainees. The presentations did not disappoint. As in previous years, research of unyielding professional and academic quality was offered by the group of future urologists, who as is tradition weathered the gauntlet of probing and tough questions from the floor. All presentations were captivating in their own right.  2017 Villis Marshall winner Dr Marlon Perera presented ground-breaking research regarding the reno-protective role of zinc in contrast nephropathy. Dr Amila Siriwardana was deservedly awarded the Keith Kirkland

award for his multicentre retrospective review on Robot assisted salvage node dissection to treat recurrences detected by PSMA PET.

Following these presentations, the YURO annual meeting once again heralded a complement of enthusiastic, innovative and clever minds from all Australian states, eager to pursue research opportunities through collaborative means. Joined this year by Prof. Henry Woo, the group was fortunate to receive his valuable insight and feedback regarding past success and future direction. The group solidified upcoming positions of leadership and highlighted new directions in educational, research and mentorship avenues for younger members.

The Gala Dinner is a stand out affair during each ASM and this year was no exception. Guests were provided with the unique opportunity to see Australia’s Parliament House from the inside. The night began with surprise operatic renditions of many well known classics in the spacious foyer of the Great Hall and culminated with a climactic performance of Nesson Dorma. Guests then enjoyed a delectable 3 course meal in identical fashion to a rare collection of political royalty including; Barack Obama, Prince William and the Duke and Duchess of Cambridge.

1-5Twitter metrics tabulated from the conference via the #Usanz17 (courtesy of Symplur LLC)

 

Monday Highlights

The final day of proceedings saw once again provided an array of interesting and thought provoking topics.  The clear highlight of the morning was the metaphorical prize fight between Mr Joseph Ischia and Dr Shankar Siva debating the roles of surgery and radiotherapy in Oligometastatic disease. Although these two went toe to toe over many rounds, the inevitable conclusion was understandably a draw. Although on PowerPoint slide pictures alone, Dr Siva’s extensive use of Star Wars based analogies won my vote.

Insight and introduction to the 71st USANZ ASM was then delivered and as a Melbournian my bias was admittedly hard to hide. Attendees received a taste of the excitement to come, with what is assured to be another blockbuster cast of national and international urologists led boldly by Convenor Mr Daniel Moon and Scientific Program Director Prof. Declan Murphy. I for one, eagerly anticipate the return of the ASM to out Nation’s culinary and cultural capitol and I’m sure guests in 2018 will be captivated by the world most liveable city!

It can be said with certainty that this years USANZ 70th ASM presented a scientific program as strong as ever within a fascinating and historical backdrop and complimented by a lively social atmosphere. This consensus of a highly successful meeting, I’m sure was shared by all.

I look forward to seeing you all next year and hope you are eagerly anticipating the ‘flat whites’.

 

Dr. Todd G Manning, Department of Surgery, Austin Health, Melbourne, and Young Urology Researchers Organisation (YURO), Australia. Twitter: @DocToddManning

 

West Coast Urology: Highlights from the AUA 2016 in San Diego… Part 2

By Ben Challacombe (@benchallacombe) and Jonathan Makanjuola (@jonmakurology)

 

The AUA meeting was starting to hot up with the anticipation of the Crossfire sessions, PSA screening and the MET debate that appeared to rumble on.  We attended the MUSIC (Michigan Urological Surgery Improvement Collaborative) session. It is a fantastic physician led program including >200 urologists, which aims to improve the quality of care for men with urological diseases. It is a forum for urologists across Michigan, USA to come together to collect clinical data, share best practices and implement evidence based quality improvement activities. One of their projects is crowd reviewing of RALP by international experts for quality of the nerve spare in order to improve surgical outcomes.

AUA2.1 AUA2.2

 

 

 

 

 

 

The MET debate continues to cause controversy. In the UK there has been almost uniform abandonment of the use of tamsulosin for ureteric stones following The Lancet SUSPEND RCT.

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The MET crossfire debate was eagerly awaited. The debate was led by James N’Dow (@NDowJames) arguing against and Philipp Dahm (@EBMUrology) in favour of MET. Many have criticised the SUSPEND paper for lack of CT confirmation of stone passage. Dr Matlaga (@BrianMatlaga) stated that comparing previous studies of MET to SUSPEND is like comparing apples to oranges due to different outcome measures. He recommended urologists continue MET until more data is published. More conflicting statements were made suggesting that MET is effective in all patients especially for large stones in the ureter. The AUA guidelines update was released and stated that MET can be offered for distal ureteric stones less than 10mm.

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In a packed Endourology video session there were many high quality video presentations. One such video was a demonstration of the robotic management for a missed JJ ureteric stent. Khurshid Ghani (@peepeeDoctor) presented a video demonstrating the pop-corning and pop-dusting technique with a 100w laser machine.

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One of the highlights of the Sunday was the panel discussion plenary session, Screening for Prostate Cancer: Past, Present and Future. In a packed auditorium Stacy Loeb (@LoebStacy), gave an excellent overview of PSA screening with present techniques including phi, 4K and targeted biopsies. Freddie Hamdy looked into the crystal ball and gave a talk on future directions of PSA testing and three important research questions that still needed to be answered. Dr. Catalona presented the data on PSA screening and the impact of the PLCO trial. He argued that due to inaccurate reporting, national organisations should restore PSA screening as he felt it saved lives.

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There was a twitter competition for residents and fellows requiring participants to  tweet an answer to a previously tweeted question including the hashtag #scopesmart and #aua16. The prize was Apple Watch. Some of the questions asked included; who performed the 1st fURS? And what is the depth of penetration of the Holmium laser?

UK trainees picked up the prizes on the first two days.

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The British Association of Urological Surgeons (BAUS) / BJU International (BJUI) / Urological Society of Australia and New Zealand (USANZ) session was a real highlight of day three of the AUA meeting. There were high quality talks from opinion leaders in their sub specialities. Freddie Hamdy from Oxford University outlined early thoughts from the protecT study and the likely direction of travel for management of clinically localised prostate cancer. Prof Emberton (@EmbertonMark) summarised the current evidence for the role of MRI in prostate cancer diagnosis including his thoughts on the on going PROMIS trial. Hashim Ahmed was asked if HIFU was ready for the primetime and bought us up to speed with the latest evidence.

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The eagerly awaited RCT comparing open prostatectomy vs RALP by the Brisbane group was summarised with regards to study design and inclusion criteria. It is due for publication on the 18th May 2016 so there was a restriction of presenting results.  Dr Coughlin left the audience wanting more despite Prof. Dasgupta’s best effort to get a sneak preview of the results!  We learnt from BAUS president Mark Speakman (@Parabolics) about the UK effort to improve the quality of national outcomes database for a number of index urological procedures.

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Oliver Wiseman (@OJWiseman) gave us a flavour of outcomes from the BAUS national PCNL database and how they are trying drive up standards to improve patient care. A paediatric surgery update was given by Dr Gundeti. The outcomes of another trial comparing open vs laparoscopic vs RALP was presented. There was no difference in outcomes between the treatment modalities but Prof. Fydenburg summarised by saying that the surgeon was more important determinant of outcome than the tool. Stacy Loeb closed the meeting with an excellent overview of the use of twitter in Urology, followed by a drinks reception.

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It was not all about stones and robots. The results of the Refractory Overactive Bladder: Sacral NEuromodulation vs. BoTulinum Toxin Assessment (ROSETTA) trial results were presented. Botox came out on top against neuromodulation in urgency urinary incontinence episodes over 6 months, as well as other lower urinary tract symptoms.

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The late breaking abstract session presented by Stacy Loeb highlighted a paper suggesting a 56% reduction in high-grade prostate cancer for men on long term testosterone. This was a controversial abstract and generated a lot of discussion on social media.

 

 

 

 

 

 

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It has been an excellent meeting in San Diego and we caught up with old and met new friends. It was nice to meet urologists from across the globe with differing priorities and pressures. There was a good British, Irish and Australian contingent flying the flag for their respective countries. It was another record-breaking year for the #AUA16 on twitter. It surpassed the stats for #AUA15 with over 30M impressions, 16,659 tweets 2,377 participants. See you all in Boston for AUA 2017.

 

Bringing Out the Best: 69th USANZ ASM Highlights

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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.

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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.

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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

 

 

The professional benefits of USANZ trainee week 2015

sanchia photoI landed on a bright sunny Brisbane morning for the Urological Society of Australia and New Zealand (USANZ) Trainee Week 2015 – an annual, 5 day, comprehensive, bi-national conference specifically for trainees.  I have much to be grateful for including sponsorship from BAUS, TUF, USANZ and SURG. All these organisations had realised international organisation inter-working is required to foster a higher level of teaching for trainees.

Later that day, I had opportunities to meet trainees from all over Australia and New Zealand (ANZ). The quality of training given is truly remarkable. When looked at in detail, the ANZ system focuses on general surgery training initially, prior to moving to urology as a separate speciality. The result of this are that they are superb open surgeons. This is often a dying art and difficult to gain.

Our first day started with a chance to observe mock FRACS stations. The standard of the candidates was incredibly high, despite it being a mock exam. As part of this, an overview of the FRACS exam was given by one of the FRACS senior examiners, Mr. Neil Smith. The day concluded with meetings of trainees for each region within ANZ – again another fantastic way to support the trainees. I have never seen anything quite like this. This also ensures trainees are receiving adequate training as concerns and issues are relayed directly to the training board chair. The evening concluded with a Welcome reception and barbeque at Brisbane Surf club.

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The next day started with a series of lectures on bladder cancer, led by Mr Shomik Sengupta (Melbourne) and Mr. Roger Watson (Brisbane). There were many learning points for trainees to take away, including case based management discussions, role of cystoprostatectomy and role of bladder preservation (Dr Tanya Holt, Brisbane).

Also covered were the roles of neoadjuvant vs adjuvant chemotherapy, (Dr. Niara Oliveira, Brisbane), the pros and cons of urinary diversion (Dr. Sarah Azer), and LND (Dr. Jonathan Chambers, Brisbane).  After lunch the most amazing teaching was given on uro radiology, with a focus on nuclear medicine and also on pathology. The FRACS exam is very different from any other end of training exam, as there will be both radiology and pathology stations.

The next day dawned bright and early, with a whole morning of paediatric urology.  I can think of many registrars, who would love a whole morning of teaching on this subject- it is not often easy to get access to paediatric urology.  Testicular embryology and maldescent were very nicely covered by Mr. Peter Borzi, (Brisbane). Both normal and abnormal conditions were discussed including reasons for orchidopexy with maldescent. Former USANZ President, David Winkle then spoke on translation care. Mr Pete McTaggart, then covered Adolescent voiding dysfunction, a profoundly difficult subject to manage, given the age of the patient and the disease involved.

The next focus was on the adrenal including functions of the adrenal, management of the adrenal mass and investigations and phaeochromocytoma. This again, is another area, which is not often covered or encountered in clinical practice.

The morning concluded with a Board of Urology update addressed by Mr Richard Grills, Board Chair, covering the training programme for urologists. Also covered were training policies and involvement of RACS in governing this. Most impressively, USANZ has negotiated membership for all of its’ trainees with EAU, SIU and AUA. A good step forward regarding international working and fellowship.

The next day started with a breakfast meeting, on how to pass the FRACS exam. This session was chaired by Dr. Matt Winter. Big congratulations also went out to Dr. Tim Smith, who had had a baby the day before and still attended to teach. Topics covered were perspectives of preparing emotionally, physically, and psychologically. This recognised how difficult it can be to prepare. All tips and tricks were given by former trainees, who had passed the exam. Further mock practice also occurred, being taken through a pathology exam.

A whole session was dedicated to renal cancer covering topics such as active surveillance, partial and radical nephrectomy, RFA and cryotherapy. A really fantastic lecture was given by Mr. Simon Wood on management of RCC and cyotreductive nephrectomy, followed by oncological management of metastatic RCC. This is an area, which unless you are in a renal fellowship, may not see.

The next session involved teaching on upper tract and transplant. This was absolutely brilliant at covering donor assessment, management of transplant ureter and assessment of renal function and prognosis. Unless a transplant job were done, this knowledge would not be gained.  All of this contributes to making a far better surgeon.

The afternoon focused on mastering difficult interactions with colleagues. Lastly, the day ended, with case based discussions, focused on FRACS viva practice. After having gone through that, I have a greater respect for all candidates going through post graduate exams. The evening was completed by a lovely boat ride through Brisbane and farewell dinner.

2The next day, started with a bang, with Prof Samaratunga (Brisbane) talking on prostate grading. It is wonderful to have a lady professor. It shows the forward thinking of the Australia medical field, clearly ahead of others. Next, very valuable teaching was received from Dr. Peter Swindle (Brisbane). This was followed by teaching on PSA screening by Dr John Yaxley (Brisbane).  PSMA PET was then covered by Dr. Rob Clarke (Brisbane), and its role in detection of prostate cancer. A fantastic presentation on management of elevated PSA was covered via a balloon debate- much loved by all and a different way of learning.

The conference ended with a quiz- Masters of the Uroverse. Teams from different regions of Australia battled it out for the title. It ended the conference is a very fun and unusual way. After having been to this meeting, my knowledge base has grown.

Our thanks go to Ms. Deborah Klein, the star organiser who is Education and Training Manager of USANZ, the Convener Mr. Stuart Philip and Mr. Richard Grills Chair, Board of Urology for hosting a thoroughly enjoyable event. Also to all the trainees and consultants who made us incredibly welcome.

 

Sanchia Goonewardene, University of Warwick, UK. @survivorshipuk

 

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