European Urology Today - Pocket Guide To Urology

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European Urology TodayOfficial newsletter of the European Association of Urology4/5Vol. 25 No.6/Vol. 26 No.1 - Dec. 2013/Jan. 2014What to expect in Stockholm9th SEEM in GreeceFrom max to miniGet a preview of what’s on during theEAU Congress in StockholmFrom ‘country debates’ to research awards,the SEEM takes a new turnNeedlescopic surgery is back and the interest isgrowing1430Urologists, medical and radiation oncologists come together5th EMUC in Marseille gathers delegates from 61 countriesBy Loek KeizerOver the course of three days, three separate butintrinsically linked disciplines attended a scientificmeeting and exchanged views on the treatment ofurological cancers. The 5th edition of the EuropeanMultidisciplinary Meeting on Urological Cancers(EMUC) was organised by the EAU, the EuropeanSociety for Medical Oncology (ESMO) and the EuropeanSociety for Radiotherapy and Oncology (ESTRO).radiotherapists approach tumours with probabilitiesand sigmoid curves. I’m convinced that by learningeach other’s language and working together inmultidisciplinary teams is the future for the treatmentof urological cancers.”The meeting took place at in Marseille from 15-17November, at the capable facilities of the Palais desCongrès at the Parc Chanot. The congress centre was abrief boulevard stroll away from the Mediterraneancoast, with a temperate breeze being a warmwelcome to visitors from Northern Europe. TheA large turn-out of urologists, radiation and medical oncologists in the main hall of the Palais des Congrèsmodernist Unité d'Habitation, as designed by famousarchitect Le Corbusier was also in the neighbourhood.make-up of the 700-strong audience became clear. By of delegates came from Russia, the Netherlands,voting with their IML Connectors, it was establishedBelgium, the UK and Greece, with individuals andA diverse audiencesmaller groups coming from as far away as Argentina,Early on in the proceedings, as Prof. Manfred Wirththat just over 55% of the audience were urologists,the Philippines and South Africa.welcomed the delegates on behalf of the EAU, the20% were medical oncologists and 10% wereradiation oncologists.The essence of a multidisciplinary approachThe scientific programme of the meeting wasOther, smaller categories included radiologists,designed to appeal to all three specialties,researchers and industry representatives. Two thirdsemphasising particularly the way in which all threeof the attendees worked in an academic institution,work together in modern clinical practice. Prof. Marcoand 43% were not affiliated with any of the threeorganising associations. An overwhelming 86% of the Van Vulpen (Utrecht, NL) co-chaired several of thesessions, offering perspectives as a representative ofparticipants classified themselves as “Consultant/Staff”, with 14% qualifying as a trainee. The meeting the radiation oncologists.clearly brought a lot of expertise in its audience, withinteraction and counterpoints from the floor becoming “Multidisciplinary meetings like this are essential, asurologists and radiation oncologists aren’t fluenta regular sight over the course of the three days.enough in each other’s “language”. Urologists tend tobe more focused on surgical procedures whenRegistered delegates came from 61 countries,Prof. Marco Van Vulpen presents a case discussion as part ofrepresenting all inhabited continents. Sizeable groups dealing with urological cancers, whereasSession 3: High-risk localised/locally-advanced PCaGoing beyond collaborative linksEMUC shows insights on battling uro-oncological diseasesProf. Manfred WirthEditor-in-ChiefEAU ExecutiveMemberDresden (DE)Manfred.Wirth@uroweb.orgAt the recently held 5th European MultidisciplinaryMeeting on Urological Cancers (EMUC) in Marseille,we have seen the most recent and promisingdevelopments on uro-oncological research, provingonce again that events like the EMUC hasdemonstrated the effectiveness of having a sharedplatform for the various disciplines involved inurological cancers.With the primary focus of the EMUC to further boostour partnership with related medical disciplines, wehave identified key areas wherein we can pursueproductive activities in research, clinical trials and“I’m convinced that a common vision is the future.The next decade will show big strides. Meetings likethis are essential in achieving this. At the moment,the largest single group of participants is urologist.But the number of radiotherapists, as well as the totalnumber of attendees is growing compared to lastyear, so that’s an encouraging sign.”FULL REPORT on Page 8Wishing you all a happy, healthy and prosperous 2014credit for having the commitment to pursuecollaborative work in spite of tough and seeminglyimpossible challenges.We are all aware that this multidisciplinary path isfraught with challenges and pitfalls that may evenlead us to temporary drawbacks. But the vision andcontext are clear to all- without shared goals wecannot come up with shared and pioneeringachievements.In this issue of the EUT readers will find a range ofarticles, news and developments that offer a glimpseof the aims, plans and ambitions of the urologicalcommunity in and outside Europe. There are othersimilar collaborative work and knowledge-sharingbeing done across Europe, and as long as wecontinue to reach out to other medical disciplines, webenefit from the synergies. After all, it is the humanWe know the short-cuts others have resorted to inpursuit of blind ambition, for them only to beconfronted later on with the folly of their schemes.Scientific integrity is at the core of all scientificadvancements, and we can only remind ourselves thatthere is no substitute for critical and creative thinking,not even the most beneficent largesse that medicalresearch can buy.When asked about how some of Van Vulpen’scolleagues might look at this proposed prominent roleof the urologist, he acknowledged: “Yes, in theworkplace there’s often a clash between theprofessions, about paying for equipment orradiotherapy staff. But if you look at the boards of theEAU, AUA, and ESTRO, everyone agrees that wecannot continue in this manner.”HAPPY NEW YEARscientific projects, whilst bearing in mind that theunderlying goal is to come up with optimal and safetreatment options for patients with urological cancers.The scientific and medical world has longacknowledged that breakthroughs in science are theresult of communal efforts which are avidly sustaineddespite initial doubts. What is therefore crucial in thisenvironment is that space to allow dissenting oropposing thought, that critical eye that can only berightly met or responded to with an equallydisciplined process of scientific query.On the current state of urological cancer treatment:“We shouldn’t be working as separate, sometimesopposing columns within medicine: collaboration isvital to receive funding and improve care for thepatient. We are starting to see multidisciplinaryclinics in the United States, where urologists buy theirown radiotherapy equipment, and employ radiationtherapists. This approach is very promising, in myopinion.”and humane links that will swing us to the side ofvictory.In another but related topic, communication work forthe EAU, with the publication of this printednewsletter being one of them, may also change in thefuture as we continue with the improvements indigital technology. Whatever form the EAUcommunicates with its membership and its partners,we are always mindful that work becomes moreeffective whenever challenges are met head-on by acommitted and collaborative community.11-15 April 201429th Annual EAU CongressRegister before 27 January to catch the early bird fee!www.eaustockholm2014.orgThus, the EAU, being in the frontline to push theenvelope of multidisciplinary work, certainly doesitself proud in co-organising the EMUC. We are in thefifth year of providing this platform and years fromnow, perhaps, future generations will give us theDecember 2013/January 2014European Urology Today1

EBU certifies Sestre Milosrdnice in ZagrebCertification of Urology Department coincides with Croatia’s EU membershipDr. Igor TomaškovicKB Sestre MilosrdniceDept. of UrologyZagreb (CR)igor.tomaskovic@kbcsm.hrProf. Dr. Davor TrnskiKB Sestre MilosrdniceDept. of UrologyZagreb (CR)University hospital centre Sestre Milosrdnice in Zagreb, Croatiadavor.trnski@kbcsm.hrAs of 1 July 2013, Croatia became the 28th member inthe European Union. Croatia (land area of 56,594 sqkm) has a population of 4.5 million and there are 179urology specialists serving this population.Urologists in Croatia have also prepared for the EUaccession and have complied with European Board ofUrology (EBU) standards with the certification of atraining centre in 2011. The EBU certification wasawarded to the Urology Department of ‘SestreMilosrdnice’ University Clinical Centre, the country’soldest urology department founded way back in 1894when the first patients with urological diseases weretreated in the hospital by Prof. Dragutin Mašek. By1928 the centre became an independent ward led byProf. Aleksandar Blaskovic.European Urology TodayEditor-in-ChiefProf. M. Wirth, Dresden (DE)Section EditorsDr. A. Cestari, Milan (IT)Mr. Ph. Cornford, Liverpool (GB)Prof. O. Hakenberg, Rostock (DE)Prof. P. Meria, Paris (FR)Prof. J. Rassweiler, Heilbronn (DE)Prof. O. Reich, Munich (DE)Prof. Th. Roumeguère, Brussels (BE)Dr. J.L. Vasquez, Frederiksberg (DK)Special Guest EditorProf. F. Montorsi, Milan (IT)The EBU certification, being a mark of excellence, wasthe result of joint efforts by our urologists to achievethe best standard of care for our patients and offerurological education and training whose quality is onpar with the rest of Europe.of expertise is stone disease with the clinic’s longtradition of endoscopic treatment. Roughly 160 PCNLsare performed annually in recent years.The department provides full-range urologicalpractice except kidney transplantation. With full-dayurologic services, about 30,000 outpatients aretreated every year. Subspecialty consultation is alsoavailable, such as andrology, neurourology andurodynamics, stone disease and uro-oncology. Basicresearch is conducted with other specialists andscientists, mostly focusing on prostate cancer."The EBU certification, being amark of excellence, was the resultof joint efforts by our urologists toachieve the best standard of carefor our patients and offer urologicaleducation and training whosequality is on par with the rest ofEurope."training programme was established by Ministry ofHealth and the Croatian Board of Urology. Currently,eight residents employed by other hospitals in Croatiareceive their training in our department. The residentsparticipate in case discussions, decision-making, andmultidisciplinary activities such as weekly conferencesthat involve uro-oncology and uro-pathology.The trainees participate or are involved in dailysurgical activities, and have full access to both thetraditional and on-line libraries of the department.They are encouraged to actively participate inmeetings and congresses. Residents have a work loadof 48 to 60 hours per week. The EBU in-serviceassessment is taken every year by all residents.Although the EBU exam is promoted it is notobligatory in Croatia.During 60 months of their urological training,residents apply and refine their theoretical andpractical knowledge and skills under the supervisionof leading physicians. Throughout the training periodresidents in urology undergo education andcomprehensive training at various departments,commonly referred to as ‘rotation training.’ They haveto complete two semesters of postgraduate studies aswell. The rotation training includes:Urology trainingToday, the Urology Department of Sestre MilosrdniceThe Urology Department is also well-known for itsat the University Clinical Centre, headed by Prof. Davor educational activities, training a growing number ofTrnski, is a modern urology department with 13medical students and urology residents. The residenturologists (including 10 who have Ph.D), two residentsand 46 nurses. One specialist has earned the FEBUtitle. The department has 32 beds and another eight1 month2 months4 months5 monthsbeds in the post-intensive care unit. About 2,000VascularUltrasonography Outpatient & emergency Urolithiasissurgical procedures and 800 ESWL treatments aresurgeryin urologyurologyperformed each year.Plastic andUrodynamicsLaparoscopy andreconstructivemodern technologiesThe department is well-known for its oncologicsurgerysurgery, particularly radical prostatectomies withabout 200 procedures performed each year. It is alsoNephrologyAndrologya reference centre for prostatic tumours. Another areaand dialysisEBU Certified CentresUrologicgynaecology6 months12 monthsAbdominalsurgeryUrologiconcologyGeneral urologyTransplantationPaediatricurologyFounding EditorProf. F. Debruyne, Nijmegen (NL)Editorial TeamH. Lurvink, Arnhem (NL)E. Starkova, Arnhem (NL)J. Vega, Arnhem (NL)L. Keizer, Arnhem (NL)EUT Editorial OfficePO Box 300166803 AA ArnhemThe NetherlandsT 31 (0)26 389 0680F 31 (0)26 389 0674EUT@uroweb.orgDisclaimerNo part of European Urology Today (EUT) may bereproduced without written permission from theCommunication Office of the EuropeanAssociation of Urology (EAU). The comments ofthe reviewers are their own and not necessarilyendorsed by the EAU or the Editorial Board. TheEAU does not accept liability for the consequencesof inaccurate statements or data. Despite ofutmost care the EAU and their CommunicationOffice cannot accept responsibility for errors oromissions.The staff of the Sestre Milosrdnice urology Department2European Urology TodayDecember 2013/January 2014

MAGNOLIA trial now in 54 sites, 10 countriesRomania, Ukraine and Russia start patient screeningDr. Wim WitjesScientific and ClinicalResearch DirectorEAU ResearchFoundationArnhem (NL)w.witjes@uroweb.orgDr. RaymondSchipperClinical ProjectManagerEAU ResearchFoundationArnhem (NL)r.schipper@uroweb.orgThe MAGNOLIA study is a multicentre, prospective,placebo-controlled, parallel group, double-blindedphase II trial in which the safety and efficacy ofCancer Immunotherapy (CI) with the investigationalcompound recMAGE-A3 AS15 in patients withmuscle invasive bladder cancer (MIBC) after radicalcystectomy is evaluated. This study is the firstEuropean bladder cancer study sponsored by thenon-commercial EAU Research Foundation and theonly European study evaluating a Cancer AntigenSpecific Immunotherapy in patients after cystectomy.Study statusTen countries (Germany, France, Spain, Italy, theNetherlands, Poland, Czech Republic, Ukraine,Romania and Russia) are participating with a total of51 active centres. Three new MAGNOLIA centres willEAU Research Foundationbe opened, one in Germany (Dr. Bolenz, Mannheim)and two in Spain (Dr. Villacampa, Madrid; Prof.Morote, Barcelona).As of press time (cut-off date November 25, 2013) 423patients gave their consent, 327 tumour tissuesamples were screened, of which 52% were positivefor MAGE-A3, and 65 patients (54 male and 11 femalepatients) were randomised. Pathological T-stage wasT2, T3 or T4 in 28, 28 and 9 patients, respectively,whereas the pN-stage was N0, N1 or N2 in 50, 8 and 7patients, respectively. A total of 24 (37%) patients hadpT4 tumours or N disease. The randomisation armswere equally distributed with regards to prognosticgroups and centres. The randomised patients arerepresentative for the MIBC population after radicalcystectomy. All tumours express MAGE-A3 and 37% ofthe patients have extravesical or node-positivedisease and hence are at high risk for developingdisease relapse.Fifty-eight patients received in total 331 injections. Forthe patients currently enrolled, the MAGE-A3 cancerimmunotherapeutic showed a clinically acceptablesafety profile with no unexpected safety concerns.Investigators collaborate to optimise recruitmentThe MAGNOLIA study is challenging and involvesdifferent disciplines (urology, oncology, radiology andpathology) and is targeted at a complex patientpopulation. Therefore, the MAGNOLIA team organises,at a national level, teleconferences and face-to-facemeetings to discuss the country-specific recruitmentchallenges and to exchange ideas how to organize,identify and manage patients for the study.Recently, national teleconferences have been held inCzech Republic (22 October 2013) and Italy 19November 2013). Following the National Meeting forGermany (25th of September 2013 in Dresden,German), a meeting for the participating sites inRussia was held on the 6th of November 2013 inMoscow, Russia, concurrently held with the 13thCongress of Russian Association of Urology. Theparticipants were Prof. Igor Korneyev (St. Petersburg),Dr. Maria Peters (Moscow), Dr. Maksim Golovaschenko(Moscow), Dr. Kirill Nyushko (Moscow), Mrs.YuliaPolevay (Moscow), Dr. Nikolay Keshishev (Moscow),Dr. Andrey Koryakin (Moscow) and Dr. ArmenGalstyan (Rostov-on-Don).The main obstacle for recruitment, as mentioned bythe site staff, was the relatively short time betweencystectomy and randomization (a maximum of nineweeks after cystectomy). It was recommended thatboth ICFs (for Screening and Study Participation)could be signed before cystectomy, and the nineweek period can be prolonged (up to 12 weeks). Themeeting was well received and the sites have startedidentifying and screening eligible patients.To increase the public awareness of the MAGNOLIAtrial the members of the Steering Committee (Prof. M.Colombel, Prof. A. Heidenreich, Prof. L. MartínezPiñeiro, Prof. M. Babjuk, Prof. I. Korneyev, Ass. Prof. C.Surcel, Prof. P. Yakovlev, Prof. R. Colombo, Prof. P.Radziszewski, Prof. F. Witjes, Dr. R. Schipper, Prof. P.Mulders, Dr. W. Witjes) collaborated on an editorialarticle entitled ”Perioperative Chemotherapy inMuscle-invasive Bladder Cancer: Overview and theUnmet Clinical Need for Alternative Adjuvant Therapy asStudied in the MAGNOLIA Trial“ which will bepublished in European 3022838(13)01194-9/abstract)MAGNOLIAUrologists, medical and radiationoncologists come together. . . . . . . . . . . . . . . 1Going beyond collaborative links. . . . . . . . . . 1EBU certifies Sestre Milosrdnice in Zagreb. . . 2MAGNOLIA trial now in 54 sites,10 countries . . . . . . . . . . . . . . . . . . . . . . . . . . 4EULIS: Anti-stones formulae in traditionalmedicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6EUSP: Urology training Down Under. . . . . . . . 7Meet the candidates. . . . . . . . . . . . . . . . . . . . 7EMUC13: Covering all major urologicalcancers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8EUSP aims to attract best researchersfrom across Europe. . . . . . . . . . . . . . . . . . . . . 9For more detailed information(study overview, study entry criteria,study locations) on the MAGNOLIAtrial, visit the website at Functional urology: my Leuvenexperience. . . . . . . . . . . . . . . . . . . . . . . . . . . 9Book reviews. . . . . . . . . . . . . . . . . . . . . . . . 10EU-ACME: Accreditation of internationalLive Educational Events (LEE). . . . . . . . . . . . . 11Key articles from international medicaljournals. . . . . . . . . . . . . . . . . . . . . . . . . . 12-13EuropeanEuropeanletter of theOfficial newsnephrectomy k clipsHem-o-loLiving-donorin the use ofThe legal gaps9Prof. Enrique, and co-authorsLledó-GarcíadayUrology ToAssociationVol. 25 No.4of UrologyMalmöforward inPCTRE Meetingfor new waysExperts search25Prof. AndersBjartell, andco-authors- August/Sep29is to promoteNew techniqueinvasive urologyDr. BogdanPetrutentenlargemprostateon on gistsinformatiurolontpatients andes patiebenefits for bothEAU launchproject'shighlightEAU 9th South Eastern European Meetingin Greece . . . . . . . . . . . . . . . . . . . . . . . . . . . 14tember 2013technologyin minimallyAttitude trackings expand horizonsbetter use ofthe healthcareand patientset alsoglossary. Thetract, aan extensivelower

Urology training The Urology Department is also well-known for its educational activities, training a growing number of medical students and urology residents. The resident training programme was established by Ministry of Health and the Croatian Board of Urology. Currentl

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