European Urology Today: March 2023 - Congress-edition

38th Annual Congress of the European Association of Urology European Urology Today EAU23 Congress News

Vol. 35 No. 1 - 10-13 March 2023

Springtime in Milan: Host to Europe’s largest urology event 38th Annual Congress marks 50th Anniversary and change of Secretary General

By Chris Chapple EAU Secretary General, 2015-2023

scientist and a surgeon. He has the expertise, experience, and knowledge, having previously run our SCO, to be an excellent person to lead this organisation as it enters its sixth decade. I certainly know he will do this extremely successfully. I first attended the EAU Congress in Amsterdam in 1990. Almost exactly thirty years ago, I started getting involved in the EAU/EBU East West Programme, which would evolve into the European School of Urology. I became the ESU’s chair in 1999 and joined the EAU Executive in 2004 as Adjunct Secretary General for Education. I am very proud of the initiatives and Offices that we started during my tenure as Secretary General and I am pleased to leave behind a very robust organisation. We have a well-organised Central Office in the Netherlands, with a fantastic and dedicated crowd of people working for all the Offices and Sections. The Central Office means there is continuity across different periods of leadership. The strength of the EAU lies in the dedicated team of people working there. As urologists, we have a role as working doctors and surgeons; therefore, we work for the EAU part-time. But we obviously know we have a very professional, experienced, hard-working team of people who facilitate everything we do. The EAU is now one of the top, truly international societies. It’s a pan-European association but with affiliations across the world. Opening Ceremony All in all, I think you can agree that we have a great programme to look forward to, with special thanks to the wonderful Scientific Congress Office under the leadership of Peter Albers. I look forward to seeing you all in person and hereby invite you to join us in celebrating our colleagues who made a great contribution to our field during the EAU23 Opening Ceremony. See who will be honoured this year on pages 4 and 5 of this special Congress Edition of European Urology Today. Afterward the ceremony you are very welcome for a drink at the networking reception. I hope you have a great congress!

Welcome to Milan! We are returning to Italy’s fashion capital almost exactly ten years to the day that we held our 28th Annual Congress here. Much has changed in the meantime, so much so that we are also glad to be back to a springtime congress for the first time in four years. EAU23 is notable too in that it marks the end of our Anniversary Year, during which we have celebrated our fifty years as a urological society for all of Europe. Every participant in Milan will receive a copy of EAU:50 , a special commemorative publication that looks at the past, present and future of the EAU at fifty. In conjunction with EAU23, the EAU History Office is holding the 7th International Congress on the History of Urology. The day-long programme will examine some highlights in urology that coincide with the EAU’s five decades of excellence. The congress marks the conclusion of the EAU’s 50th Anniversary celebrations that started in Amsterdam at EAU22. Be sure to drop by on the first day of the congress if you are interested in insights on fifty years of the EAU but more importantly, fifty years of urology from the people who shaped the field. Admission is free for all EAU23 delegates. Scientific highlights For EAU23 we received a very healthy number of abstracts, allowing us to select the 1500 highest- quality submissions for a range of interesting poster and video sessions that will take place throughout the congress. Every congress day starts with two plenary sessions that cover the biggest topics in current- day urology. These sessions feature ground- breaking research, and state-of-the-art lectures by the undoubted experts in the field. The plenary sessions are followed by related game-changing sessions that offer the very latest, up-to-the-minute developments and trial results. On the first day of the congress, apart from the aforementioned History Congress, we are organising the EAU23 Patient Day. Our Patient Office is holding its second in-person Patient Day after a successful debut in Amsterdam. Patient Day offers a platform where healthcare

The recently-renovated Allianz MiCo, the largest congress venue in Europe, will host EAU23.

professionals and patient advocates can meet to share perspectives and experiences. Patient voices will also be represented throughout in the EAU23 Scientific Programme. "The congress marks the conclusion of the EAU’s 50th Anniversary celebrations that started in Amsterdam at EAU22." Friday also features the Urology Beyond Europe sessions, where we pair up for joint sessions with other urological societies. Look forward to a range of unique topics and speakers at these sessions! On Saturday, our focus turns to our younger colleagues. YUORday is a full-day programme by the Young Urologists Office and the European Society of Residents in Urology designed to meet the needs of urologists who are just starting out: information about scholarships and educational programmes, surgical techniques, getting into research and much more. We also have a redesigned live surgery programme with longer, simultaneous procedures and more opportunities for moderated interaction. The live surgery will

come from four Milanese hospitals with expert surgeons from all over the world. Following the plenary session on early detection, Sunday is “prostate cancer day” at EAU23 with four related thematic sessions. As on every congress day, there will be a range of courses on offer from the European School of Urology. We end EAU23 on Monday with two final plenary sessions, thematic and abstract sessions, and the “Best of EAU23” souvenir session. Change in leadership EAU23 will also be notable for me and for the future of our Association as at the General Assembly I will be formally stepping down as Secretary General after eight wonderful years. Our Secretary General-Elect since EAU22, Arnulf Stenzl (DE) will succeed me and lead the EAU in the coming years. Arnulf and I have worked together closely in the past years when he joined the EAU Executive and before, when he led the Scientific Congress Office. He is a great colleague with a well-deserved international reputation as a superb clinician, a

Secure and extract small stone fragments.


Some products may not be available in all markets. Please see product risk information in the IFU at

Prof. Chapple and his successor as Secretary General, Prof. Arnulf Stenzl. Read more about the transition in EAU:50, which features in-depth interviews with both.

© COOK 01/2023 URO-D67459-EN-F

European Urology Today

February/March 2023



Outcomes Study Educational Visualisation Tool

Scan the QR codes to access the BPH Outcomes Study and associated Educational Visualisation Tool to understand the outcomes in different individual profiles Discover more about how risk factors for disease progression interact and affect treatment response in individual profiles with moderate to severe LUTS/ BPH at the risk of progression.

BPH Outcomes Study - Educational Visualisation Tool is intended for educational purposes and not for clinical use. The BPH tool is solely intended to inform healthcare professionals to help visualise and understand the results of the statistical modelling published by Gravas S et al 2022. The BPH Tool has not been validated for and is not intended for clinical use with individual patients. It is not intended to substitute for medical advice or intended to drive or inform to take decisions with diagnosis or therapeutic purposes of any condition for any individual patients. References: 1. Gravas S, et al. EAU Guidelines on the Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO), 2021. Available at: of-non-neurogenic-maleluts/ Accessed January 2023. 2. Avodart Italy SmPC Summary of Product Characteristics (SmPC) effective 22 October 2020. 3. Combodart Italy SmPC Summary of Product Characteristics (SmPC) effective 22 October 2020. Abbreviations: BPH, benign prostatic hyperplasia; LUTS/BPH, lower urinary tract symptoms secondary to benign prostatic hyperplasia. In Italy the registered trade name for dutasteride is Avodart and for dutasteride-tamsulosin is Combodart.

Abbreviated Product Information – Combodart Hard capsules 0,5 mg No prescription SSN Class C* Price € 32,70** *Providing system: medicinal product subject to medical prescription (RR) ** Without prejudice to any reductions and/or modifications imposed authoritatively by the competent Health Authority. Therapeutic Indications Combodart is indicated for the treatment of moderate to severe symptoms of benign prostatic hyperplasia (BPH). Reduction of the risk of acute urinary retention and surgery with moderate to severe symptoms of benign prostatic hyperplasia Posology and method of administration The recommended dose of Combodart is one capsule (0.5 mg/0.4 mg) once a day. When appropriate, Combodart can be used to replace dutasteride and tamsulosin hydrochloride used together in current dual therapy to simplify treatment.

Abbreviated Product Information – Avodart Soft Capsules 0,5 mg Prescription SSN Class A* Price € 11,78** *Providing system: medicinal product subject to medical prescription (RR) ** Without prejudice to any reductions and/or modifications imposed authoritatively by the competent Health Authority. Therapeutic Indications Avodart is indicated for the treatment of moderate to severe symptoms of benign prostatic hyperplasia (BPH). Reduction of the risk of acute urinary retention and surgery with moderate to severe symptoms of benign prostatic hyperplasia Posology and method of administration Avodart can be administrated alone or in combination with the alpha blocker tamsulosin (0,4 mg). Adults (including the elderly): The recommended dose is one capsule (0.5 mg) taken orally per day. The capsules must be swallowed whole and must not be chewed or opened as contact with the contents of the capsule may cause

irritation of the oropharyngeal mucosa. The capsules can be taken with or without food. Although early improvement can be seen, it may take up to 6 months before a response to treatment is achieved. No dose adjustment is required in the elderly. The most commonly observed adverse reactions include impotence, altered (decreased) libido, ejaculation disorder, breast disorder.

When clinically appropriate, a direct switch from dutasteride or tamsulosin hydrochloride monotherapy to Combodart may be considered. The most commonly observed adverse reactions include dizziness, impotence, altered (decreased) libido, ejaculation disorder, breast disorder. Full SmPC of COMBODART (23 November 2017) for EU is available at - Scan the QR code to access the Italian SmPC of Combodart

Full SmPC of AVODART (23 November 2017) for EU is available at - Scan the QR code to access the Italian SmPC of Avodart

For the use of registered medical practitioner or a Hospital or a Laboratory only. Avodart/Duodart is for use in men only. Avodart/Duodart trade marks are owned by or licensed to the GSK group of companies.

Adverse events should be reported. Reporting forms and information can be found at or search for MHRA Yellowcard in the Google Play or Apple App Store. Adverse events should also be reported to GlaxoSmithKline on 0800 221 441.

European Urology Today Submitted to AIFA on 23/01/2023 GlaxoSmithKline S.p.A. Viale dell’Agricoltura, 7 37135 Verona Italy PM-GBL-DUT-ADVT-230001 | Date of preparation: January 2023.


February/March 2023

Presenting the 2023 Congress Gift In new book, History Office Chair explores cultural norms on modesty

Prof. Philip Van Kerrebroeck (Antwerp, BE) is the proud author of this year’s Congress Gift book. We spoke to him about his newest publication.

interest in this topic. Furthermore I used the documentation I have accumulated on objects from my own collection. As a result this book presents information and several images that have never been published before.

Could you tell us, broadly speaking what your new book is about?

In what ways can the urologist relate to the topic at hand?

The 2023 Congress Gift Cache-sexe: Covered, uncovered, discovered delves into the heart of what are still controversial and emotionally charged issues in contemporary life: our genitals and the way we cover them. Although taboos around nudity and sex were largely eradicated in the second half of the 20th century, the genital area retains enigmatic aspects that make it a subject that is not often publicly discussed, let alone shown without reluctance. Therefore we can ask the question whether these are amongst the last elements of the human body to be uncovered and scrutinised? As an extension of these inhibitions, the cache-sexe is likewise a topic that is still approached with some hesitation. This book aims to discuss the following questions: how do humans perceive their genitals? How are our genitals perceived by others? And why do humans need, and use, a cache-sexe to cover their genitals? I will discuss the various forms of genital coverings, from the apron to the tanga, but also their absence

The EAU’s Secretary General Prof. Chris Chapple answers this question very well in his foreword to the book. He indicates “Cultural norms and sensitivities have always differed greatly, not just in terms of geography but also across time, and this book reminds us of how differently we experience nudity, shame and the covering of genitalia in different periods of human history and still do to this day. Many relevant aspects are addressed in this book: art, expression, shame, freedom, restriction and even religion.” He continues as follows with his personal appreciation of the book: “Short and long chapters have something to offer every reader, and make this a publication of general interest but also sometimes quite surprising and intriguing.” I hope that the EAU members attending the Annual Congress in Milan can appreciate the text and illustrations of Cache-Sexe: Covered, uncovered, discovered!

Figure 2: Female cache-sexe (ca. 1960), Kirdi people, Cameroon, private collection.

EAU23 marks 50th Anniversary and change ofSecretaryGeneral. . . . . . . . . . . . . 1 Presenting the 2023 Congress Gift. . . . . . 3 EAU23 Award Gallery . . . . . . . . . . . 4-5 Why is advanced tumour visualisation useful?.................. 6 MRI-guided active surveillance strategy . . . . 8 Population-based organised prostate cancertesting.. . . . . . . . . . . . . . 9 Pathophysiology of persistent LUTS after BPH surgery . . . . . . . . . . . . . . . . . . 1 0 Wound healing and PROs in Fournier's gangrene................. 10 Opinion: Are you prepared to be naked? . . . . 11 Precision medicine for patients with mCRPC................. 12 Genetic testing in renal stone disease . . . . 13 What is the best method of risk stratification beforebiopsy?. . . . . . . . . . . . . . 14 Sexuality in metastatic prostate cancer . . . 15 Classification of mesh complications . . . . 16 Application of AI to overcome scientific information overload . . . . . . . . . . . . 17 Sleep-related painful erections . . . . . . . 18 Are bacteriophages replacing antibiotics?. . . 20 Treatment of stress incontinence after BPO surgery . . . . . . . . . . . . . . . . . 21 Patient Day at EAU23 puts patients first . . . 22 New 2023 EAU Guidelines to be presented in Milan.................. 22 Phalloplasty for Penile cancer . . . . . . . . 23 EAU23 Scientific Programme . . . . . . . . 24 Schedule of ESU and HOT Courses . . . . . 25 What is the best urodynamic test to diagnoseDU?.............. 26 Young urologists: A career in kidney transplantation? . . . . . . . . . . . . . 28 Experience with a new bladder voiding management system . . . . . . . . . . . 28 Imaging standards for testicular cancer . . . 29 Management & prevention of UTI after kidney transplantation . . . . . . . . . . . 30 Sexual dysfunction after a radical cystectomy................ 31 What’s new in neurogenic bladder dysfunction treatment? . . . . . . . . . . 33 Which supportive care intervention is best?. . 35 EAU leads innovative data initiatives . . . . 37 Paradigm shifts in urology . . . . . . . . . 38 Management of floppy glans after penile prosthesis surgery . . . . . . . . . . . . . 39 VI-RADS: The new PI-RADS for bladder cancer?................. 40 Fournier’s gangrene primary and secondary management............... 41 Is precision medicine possible in patients withmCRPC?............... 42 Management of paediatric kidney trauma. . . 43 New transrectal prostate biopsy approach may improve tolerability and safety . . . . . 44 The (hidden) role of the nurse and the stoma therapist................. 45 Nerve-sparing radical prostatectomy: A European discovery?................ 46 EAU journey on advocacy on prostate cancer . 47

in some situations and societies. Controversial types of cache-sexe will be addressed, as well as more subtle forms. The aim is to present a broad view of the topic, including medical, geographical, historical and anthropological perspectives. I elaborate on the meanings of the different forms of cache-sexe and refer to typical real-life examples, but also representations in various artworks and ritual objects, based on unique and sometimes hitherto unpublished documentation. (Fig.1) The daily use of the cache-sexe is illustrated with rare and even historic photographs. I also take a look at the present day and how we deal with the cache- sexe in the 21st century.

Is this a topic you have been interested in for a while or was there recent inspiration?

Indeed I have been interested in this topic for more than 40 years, and collected information, documentation and even examples of cache-sexe. (Fig.2) I have discovered that women and men of all times, ages, worldwide have been using some form of cache-sexe, but sometimes documentation and certainly examples are difficult to find. First of all these were utensils and hence once worn out, they were abandoned or thrown away. Secondly some types of cache-sexe were considered ‘taboo’ or indecent by early colonisers and hence destroyed. Already for a long time I wanted to bring together the information I had accumulated all these years, and hence I am very grateful to the Executive of the EAU and the EAU History Office that they accepted my proposal for this book. I reviewed extensively the existing literature and interviewed several anthropologists that did field research, and curators of museums and collections worldwide with an

EAU Members with the right entitlements can collect their copy of Cache-Sexe at the EAU Booth, K36 in the Exhibition Hall (Blue Area).

Figure 1: A lonka-lonka, shell and natural pigments (ca. 1970), Western Australia, private collection.

7th International Congress on the History of Urology Paradigm Shifts in Urology: 50 Years of Major Developments

Free to attend for all EAU23 Delegates!

Friday, 10 March 8:00 - 16:30

Yellow Area, Amber 7

In conjunction with

European Urology Today

February/March 2023


EAU23 Award Gallery

EAU Crystal Matula Award

EAU Willy Gregoir Medal

EAU Frans Debruyne Life Time Achievement Award

EAU Innovators in Urology Award

L. Martínez-Piñeiro Madrid, Spain For a significant contribution to the development of the urological specialty in Europe

J. Catto Sheffield, United Kingdom For a longstanding and important contribution to the activities and development of the EAU

J. Gómez Rivas Madrid, Spain For a young promising European urologist

P. Wiklund Stockholm, Sweden

For inventions and clinical contributions which have had a major impact on influencing the treatment and/or diagnosis of a urological disease

Previous Winners 2022

Previous Winners 2022

Previous Winners 2022

Previous Winners 2022

V. Kasivisvanathan London, United Kingdom

J. Palou, Barcelona, Spain

K-E. Andersson, Lund, Sweden M. Wirth, Dresden, Germany F. Hamdy, Oxford, United Kingdom

Y. Fradet, Quebec, Canada

2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1996

V. Phé, Paris, France


H. Van Poppel, Leuven, Belgium



J. Barentsz, Nijmegen, The Netherlands

D. Tilki, Hamburg, Germany M. Albersen, Leuven, Belgium S. Silay, Istanbul, Turkey C. Gratzke, Munich, Germany A. Briganti, Milan, Italy M. Rouprêt, Paris, France S. Shariat, Vienna, Austria P. Bostrőm, Turku, Finland

2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006

F. Montorsi, Milan, Italy

2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1996 1994 1994 1992 1990 1988

2019 2017 2016 2015 2014 2013 2012 2011

P. Alken, Mannheim, Germany

D. Jacqmin, Strasbourg, France P-A. Abrahamsson, Malmö, Sweden

V. Mirone, Naples, Italy

R. Turner-Warwick, Exeter, United Kingdom † J. Gil-Vernet Vila, Barcelona, Spain † S. Horenblas, Amsterdam, The Netherlands

P. Abrams, Bristol, United Kingdom

P. Teillac, Toulouse, France

W. Artibani, Verona, Italy

H. Villavicencio, Barcelona, Spain L. Denis, Antwerp, Belgium † J. Breza, Bratislava, Slovakia R. Hautmann, Neu-Ulm, Germany

L. Boccon-Gibod, Paris, France M. Pavone-Macaluso, Palermo, Italy

R. Gaston, Bordeaux, France U. Studer, Berne, Switzerland

C. Abbou, Creteil, France

J. Wickham, Dorking, United Kingdom †

M. Marberger, Vienna, Austria U. Studer, Berne, Switzerland

C. Chaussy, Munich, Germany

P. Bastian, Düsseldorf, Germany S. Joniau, Leuven, Belgium J. Catto, Sheffield, United Kingdom M. Ribal Caparros, Barcelona, Spain

A. Le Duc, Paris, France

R. Vela Navarrete, Madrid, Spain J. Mattelaer, Kortrijk, Belgium R. Ackermann, Düsseldorf, Germany † L. Boccon-Gibod, Paris, France C. Schulman, Brussels, Belgium

F. Debruyne, Nijmegen, The Netherlands P. Van Cangh, Brussels, Belgium †

F. Pagano, Padua, Italy

V. Ficarra, Padua, Italy

H. Frohmüller, Würzburg, Germany † A. Borkowski, Warsaw, Poland

M. Michel, Mannheim, Germany A. De La Taille, Creteil, France

R. Turner Warwick, Exeter, United Kingdom † F. Schröder, Rotterdam, The Netherlands

M. Matikainen, Tampere, Finland P. Mulders, Nijmegen, The Netherlands B. Malavaud, Toulouse, France M. Kuczyk, Hanover, Germany B. Djavan, Vienna, Austria A. Zlotta, Toronto, Canada G. Thalmann, Berne, Switzerland

A. Le Duc, Paris, France R. Küss, Paris, France †

J. Blandy, London, United Kingdom † H. Marberger, Innsbruck, Austria † T. Hald, Copenhagen, Denmark † F. Solé-Balcells, Barcelona, Spain †

F. Montorsi, Milan, Italy

A. Steg, Paris, France † L. Giuliani, Genoa, Italy †

F. Hamdy, Oxford, United Kingdom

G. Chisholm, Edinburgh, United Kingdom † J. Martínez-Piñeiro, Madrid, Spain R. Hohenfellner, Mainz, Germany H. Hopkins, Reading, United Kingdom †

Supported by LABORIE

Best Papers published in Urological Literature Awards

European Urology ® Awards

European Urology ® Awards

Best Abstract Awards Oncology

Best Paper on Fundamental Research Determinants of anti-PD-1 response and resistance in clear cell renal cell carcinoma Cancer Cell 39 (2021); L. Au , E. Hatipoglu, M. Robert de Massy, K. Litchfield, G. Beattie, A. Rowan, D. Schnidrig, R. Thompson, F. Byrne, S. Horswell, N. Fotiadis, S. Hazell, D. Nicol, S. Shepherd, A. Fendler, R. Mason, L. Del Rosario, K. Edmonds, K. Lingard, S. Sarker, M. Mangwende, E. Carlyle, J. Attig, K. Joshi, I. Uddin, P. Becker, M. Werner Sunderland, A. Akarca, I. Puccio, W. Yang, T. Lund, K. Dhillon, M. Vasquez, E. Ghorani, H. Xu, C. Spencer, J. López, A. Green, U. Mahadeva, E. Borg, M. Mitchison, D. Moore, I. Proctor, M. Falzon, L. Pickering, A. Furness, J. Reading, R. Salgado, T. Marafioti, M. Jamal-Hanjani, on behalf of the PEACE Consortium, G. Kassiotis, B. Chain, J. Larkin, C. Swanton, S. Quezada, S. Turajlic (London, Sutton, United Kingdom; Bizkaia, Spain; Melbourne, Australia; Antwerp, Belgium) Best Paper on Clinical Research Neoadjuvant Pembrolizumab and Radical Cystectomy in Patients with Muscle-Invasive Urothelial Bladder Cancer: 3-Year Median Follow-Up Update of PURE-01 Trial Clin Cancer Res (2022); CCR-22-2158 G. Basile, M. Bandini, E. Gibb, J. Ross, D. Raggi, L. Marandino, T. Costa de Padua, E. Crupi, R. Colombo, M. Colecchia, R. Lucianò, L. Nocera, M. Moschini, A. Briganti, F. Montorsi, A. Necchi (Milan, Italy; Vancouver, Canada; Massachusetts, New York, United States of America)

Best Scientific Paper Stereotactic Radiotherapy and Short-course Pembrolizumab for Oligometastatic Renal Cell Carcinoma—The RAPPORT Trial European Urology; Volume 81, Issue 4, P364-372, April 1, 2022 S. Siva, M. Bressel, S. Wood, M. Shaw, S. Loi, S. Sandhu, B. Tran, A. Azad, J. Lewin, K. Cuff, H. Liu, D. Moon, J. Goad, L-M. Wong, M. LimJoon, J. Mooi, S. Chander, D. Murphy, N. Lawrentschuk, D. Pryor (Melbourne, Brisbane, Australia)

Best Scientific Paper on Robotic Surgery Robot-assisted Prostate-specific Membrane Antigen– radioguided Salvage Surgery in Recurrent Prostate Cancer Using a DROP-IN Gamma Probe: The First Prospective Feasibility Study European Urology; Volume 82, Issue 1, P97-105, July 1, 2022 H. de Barros, M. van Oosterom, M. Donswijk, J. Hendrikx, A. Vis, T. Maurer, F. van Leeuwen, H. van der Poel, P. van Leeuwen (Amsterdam, Leiden, The Netherlands; Hamburg, Germany)

First Prize Proteomic profiling of muscle invasive bladder cancer treated with neoadjuvant chemotherapy Abstract Nr. AM23-2797 A. Contreras-Sanz, M. Reike , G. Negri, Z. Htoo, S. Spencer Miko, K. Nielsen, M. Roberts, J. Scurll, K. Ikeda, G. Wang, R. Seiler, G. Morin, P. Black (Vancouver, Canada) Second Prize The Stockholm3 prostate cancer screening trial (STHLM3): An interim analysis of mortality results after 6.5 years of follow-up Abstract Nr. AM23-3772 C. Micoli, A. Crippa, A. Discacciati, H. Vigneswaran, T. Palsdottir, M. Clements, M. Aly, J. Adolfsson, W. Fredrik, P. Wiklund, T. James, J. Lindberg, H. Grönberg, L. Egevad, T. Nordström, M. Eklund (Solna, Sweden)

Supported by ELSEVIER


Best Scientific Paper on Fundamental Research A Phase 2 Trial of the Effect of Antiandrogen Therapy on COVID-19 Outcome: No Evidence of Benefit, Supported by Epidemiology and In Vitro Data European Urology; Volume 81, Issue 3, P285-293, March 1, 2022 K. Welén, E. Rosendal, M. Gisslén, A. Lenman, E. Freyhult, O. Fonseca-Rodríguez, D. Bremell, J. Stranne, Å. Balkhed, K. Niward, J. Repo, D. Robinsson, A. Henningsson, J. Styrke, M. Angelin, E. Lindquist, A. Allard, M. Becker, S. Rudolfsson, R. Buckland, C. Carlsson, A. Bjartell, A. Nilsson, C. Ahlm, A-M. Connolly, A. Överby, A. Josefsson (Gothenburg, Umea, Uppsala, Lingkoping, Jonkoping, Malmo, Sweden)

Resident’s Corner Award (2) for the Best Scientific Paper by a Resident First-in-human Intravesical Delivery of Pembrolizumab Identifies Immune Activation in Bladder Cancer Unresponsive to Bacillus Calmette-Guérin European Urology; Volume 82, Issue 6, P602-610, Dec. 1, 2022 K. Meghani, L. Cooley, B. Choy, M. Kocherginsky, S. Swaminathan, S. Munir, R. Svatek, T. Kuzel, J. Meeks (Chicago, San Antonio, United States of America) Updating and Integrating Core Outcome Sets for Localised, Locally Advanced, Metastatic, and Nonmetastatic Castration- resistant Prostate Cancer: An Update from the PIONEER Consortium European Urology; Volume 81, Issue 5, P503-514, May 01, 2022 K. Beyer, L. Moris, M. Lardas, M. Omar, J. Healey, S. Tripathee, G. Gandaglia, L. Venderbos, E. Vradi, T. van den Broeck, P-P. Willemse, T. Antunes-Lopes, L. Pacheco-Figueiredo, S. Monagas, F. Esperto, S. Flaherty, Z. Devecseri, T. Lam, P. Williamson, R. Heer, E. Smith, A. Asiimwe, J. Huber, M. Roobol, J. Zong, M. Mason, P. Cornford, N. Mottet, S. MacLennan, J. N’Dow, A. Briganti, S. MacLennan, M. Van Hemelrijck , on behalf of the PIONEER Consortium (London, Aberdeen, Liverpool, Newcastle-upon-Tyne, Cardiff, United Kingdom; Leuven, Belgium; Athens, Greece; Milan, Rome, Italy; Rotterdam, Utrecht, Arnhem, The Netherlands; Berlin, Dresden, Germany; Porto, Braga, Portugal; Leon, Spain; Paris, St. Etienne, France; Massachusetts, New Jersey, United States of America)

Supported by ELSEVIER

Best Scientific Paper on Clinical Research Circumcision and Risk of Febrile Urinary Tract Infection in Boys with Posterior Urethral Valves: Result of the CIRCUP Randomized Trial European Urology; Volume 81, Issue 1, P64-72, January 1, 2022 L. Harper, T. Blanc, M. Peycelon, J. Michel, M. Leclair, S. Garnier, V. Flaum, A. Arnaud, T. Merrot, E. Dobremez, A. Faure, L. Fourcade, M. Poli-Merol, Y. Chaussy, O. Dunand, F. Collin, L. Huiart, C. Ferdynus, F. Sauvat (Saint Denis de La Réunion, Bordeaux, Paris, Nantes, Montpellier, Rennes, Marseille, Limoges, Reims, Besançon, Saint-Pierre, France)

Supported by ELSEVIER

Platinum Awards M. Albersen, Leuven, Belgium J-N. Cornu, Rouen, France T. Morgan, Ann Arbor, United States of America A. Mottrie, Melle, Belgium G. Novara, Padova, Italy A. Vickers, New York, United States of America

European Urology Today


February/March 2023

EAU23 Award Gallery

EAU Hans Marberger Award

EAU Prostate Cancer Research Award

New EAU Honorary Members

EAU Ernest Desnos Prize

For an important influence on European urology

R. Campi Florence, Italy For the best European paper published on Minimally Invasive Surgery in Urology Robotic Versus Open Kidney Transplantation from Deceased Donors: A Prospective Observational Study. European Urology 39 (2022) 36- 46;

E. Ventimiglia Milan, Italy For the best paper published on clinical or experimental studies in prostate cancer Long-term Outcomes Among Men Undergoing Active Surveillance for Prostate Cancer in Sweden. JAMA Network Open (2022); https://doi:10.1001/jamanetworkopen.2022.31015

R. Vela Navarrete Madrid, Spain For extraordinary contributions to the History of Urology

A. Chiu Taipei, Taiwan

C. Evans Sacramento, United States of America

Previous Winners 2022

Previous Winners 2022

Previous Winners 2022

A. Jardin (on behalf of the Cercle Félix Guyon) , Paris, France M. Moran, Tucson, United States of America

A. Martini, Milan Italy

T. Nordström, Stockholm, Sweden


2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2006 2004

A. Gallioli, Barcelona, Spain

2021 2020 2019 2018 2017 2016 2015 2014 2013

W. Fendler, Essen, Germany

2019 2018

Karl Storz SE & CO.KG

H. Haas Heppenheim, Germany

A. Larcher, Milan, Italy G. Simone, Rome, Italy

D. Osses, Rotterdam, The Netherlands V. Kasivisvanathan, London, United Kingdom

S. Musitelli, Zibido San Giocomo, Italy †

D. Dalela, Detroit, United States of America R. Autorino, Cleveland, United States of America M. Gundeti, Chicago, IL, United States of America

H. Ahmed, London, United Kingdom

M. Shiota, Fukuoka, Japan J. Pencik, Vienna, Austria M. Spahn, Berne, Switzerland Z. Culig, Innsbruck, Austria

A. Rodríguez Winston Salem, United States of America

S. Tyritzis, Athens, Greece C. Netsch, Hamburg, Germany J. Rassweiler, Heilbronn, Germany A. Alcaraz, Barcelona, Spain M. Rouprêt, Paris, France M. Marszalek, Vienna, Austria H. Jung, Fredericia, Denmark J. Grosse, Aachen, Germany E. Pieras Ayala, Barcelona, Spain

M. Roobol Rotterdam, The Netherlands

EAU Patient Advocacy Medal of Excellence

I. Ahmed, Glasgow, United Kingdom


A. de la Taille Créteil, France

R. Giles Duivendrecht, The Netherlands For effective advocacy and a positive impact on European urology

Supported by KARL STORZ SE & CO.KG

Best Abstract Awards Non-Oncology

Best Abstracts by Residents-in-Urology Awards

Young Academic Urologists Awards

Best Patient Poster Awards

First Prize Similar artefact susceptibility for water- and air-filled urodynamic systems: Results from a randomized controlled non-inferiority trial Abstract Nr. AM23-4013 M. Kasten, O. Gross, M. Wettstein, C. Anderson, V. Birkhäuser, J. Borer, M. Koschorke, S. Mccallin, U. Mehnert, H. Sadri, L. Stächele, T. Kessler, L. Leitner (Zürich, Switzerland)

First Prize Global variation in the quality of multiparametric magnetic resonance imaging of the prostate from the PRIME Trial (the GLIMPSE Study) Abstract Nr. AM3-3336 A. Ng, F. Giganti, A. Asif, V. Chan, M. Rossiter, A. Nathan, P. Khetrapal, L. Dickinson, S. Punwani, C. Brew-Graves, A. Freeman, M. Emberton, C. Moore, C. Allen, V. Kasivisvanathan, Q. Prime (London, United Kingdom) Second Prize Proximal urethrostomy (PU) versus urethroplasty (U) for complex urethral strictures (CUS) Abstract Nr. AM23-0748

Best Paper by YAU Three-dimensional Model-assisted Minimally Invasive Partial Nephrectomy: A Systematic Review with Meta-analysis of Comparative Studies F. Piramide, K. Kowalewski, G. Cacciamani, I. Rivero Belenchon, M. Taratkin, U. Carbonara, M. Marchioni, R. De Groote, S. Knipper, A. Pecoraro, F. Turri, P. Dell’Oglio, S. Puliatti, D. Amparore, G. Volpi, R. Campi, A. Larcher, A. Mottrie, A. Breda, A. Minervini, A. Ghazi, P. Dasgupta, A. Gozen, R. Autorino, C. Fiori, M. Di Dio, J. Gomez Rivas, F. Porpiglia, E. Checcucci (Turin, Bari, Chieti, Peschiera del Garda, Modena, Milan, Florence, Cosenza, Italy; Arnhem, The Netherlands; Mannheim, Hamburg, Germany; Seville, Barcelona, Madrid, Spain; Moscow, Russia; Aalst, Melle, Belgium; New York, Virginia, United States of America; London, United Kingdom; Edirne, Turkey) Best Abstract by YAU Can we rely on available models to identify candidates for extended Pelvic Lymph Node Dissection (ePLND) in men staged with PSMA-PET? External validation of the Briganti nomograms and development of a novel tool to identify optimal candidates for ePLND G. Gandaglia, D. Robesti, L. Bianchi, R. Schiavina, E. Brunocilla, L. Afferi, A. Mattei, F. Zattoni, P. Rajwa, S. Shariat, C. Kesch, J. Sierra, P. Gontero, G. Marra, H. Guo, J. Gomez Rivas, J. Zhuang, D. Amparore, F. Dal Moro, F. Porpiglia, C. Darr, W. Fendler, M. Picchio, F. Montorsi, A. Briganti (Milan, Bologna, Padua, Orbassano, Turin, Italy; Lucerne, Switzerland; Vienna, Austria; Essen, Germany; Madrid, Spain; Nanjing, China)

First Prize Global Patient Survey: Reported Experience of Diagnosis, Management, and Burden of Renal Cell Carcinomas in >2,200 Patients from 39 Countries Abstract Nr. AP23-0022 R. Giles, L. Marconi, D. Maskens, R. Martinez, K. Kastrati, C. Castro, J. Julian Mauro, R. Bick, M. Hickey, J. Björkqvist, D. Heng, J. Larkin, A. Bex, E. Joasch, S. Maclennan, M. Jewett (Duivendrecht, The Netherlands; Coimbra, Portugal; Toronto, Calgary, Canada; Mountain View, Houston, USA; Weikersheim, Germany; Mexico City, Mexico; Madrid, Spain; London, Aberdeen, United Kingdom) Second Prize A comprehensive summary of patient and caregiver experiences with bladder cancer: Results of a survey from 49 countries Abstract Nr. AP23-0027 L. Makaroff, A. Filicevas, S. Boldon P. Hensley, A. Kamat (Cambridge, United Kingdom; Brussels, Belgium; Toronto, Canada; Lexington, Houston, USA) Third Prize How can we improve patient-clinician communication in men diagnosed with prostate cancer? Abstract Nr. AP23-0021 K. Beyer, A. Lawlor, S. Remmers, L. Venderbos, P-P. Willemse, M. Omar, E. Smith, C. Bezuidenhout, L. Collette, S. Maclennan, S. Evans-Axelsson, J. N’Dow, M. Roobol, M. Van Hemelrijck (London, Aberdeen, United Kingdom; Rotterdam, Utrecht, Arnhem, The Netherlands; Stockholm, Sweden; Leuven, Louvain-la-Neuve, Belgium)

Supported by IBSA

Best Video Awards

N. Rahav , M. Udah, S. Cohen, B. Chertin, O. Shenfeld (Jerusalem, Israel)

First Prize Multi-center, prospective, single arm, pivotal study to evaluate the efficacy and safety of robotic-assisted surgery easyuretero-100 in patients in need of retrograde intrarenal surgery V040

Third Prize Prostate cancers detected in the PSA interval 1.8-3 ng/mL - results from the Göteborg 2 prostate cancer screening trial Abstract Nr. AM23-1041

S. Cho, J. Kim, B. Cheon, J. Han, D-S. Kwon, J. Lee (Seoul, South Korea)

F. Möller, M. Månsson, J. Wallström, M. Hellström, J. Hugusson, R. Arnsrud Godtman (Skövde, Gothenburg, Sweden)

Second Prize Robotic augmentation cystoplasty: 1-year outcome of the anterior and posterior approaches V083

Best reviewer YAU Riccardo Bertolo, Rome, Italy

C. Yee , P. Lam, Y. Hong, P. Lai, Y. Tam, T. Ng, S. Yuen, M. Tam, C. Chan, K. Lo, J. Teoh, P. Chiu, C. Ng (Hong Kong, China)

Third Prize Technique and outcomes from prostate capsule-sparing during robotic male cystectomy V016

European Urological Scholarship Programme Awards

Helmut Haas Award

A. Ta, J. Olphert, W. Tan, M. Alkhamees, G. Shaw, A. Sridhar, J. Kelly (London, United Kingdom)

H. Heers Marburg, Germany For a significant scientific contribution to the development of the Outpatient and Office Urology

EUSP Best Scholar Analysis of gene expression signatures and immune cell infiltrates in tumour tissue and microenvironment after neoadjuvant treatment with axitinib and avelumab in patients with localized high-risk RCC to assess mechanisms and predictors of response

End of life care - Preferences of patients with advanced urologic malignancies

Y. Abu Ghanem, Ramat Gan, Israel

H. Heers, F. Urhahn, A. Pedrosa Carrasco, A. Morin, M. Gschnell, J. Huber, L. Flegar, C. Volberg (Marburg, Germany)

European Urology Today

February/March 2023


Why is advanced tumour visualisation useful? A constructive review of imaging (PDD, NBI, IMAGE1 S)

alone without SIIC was associated with a lower probability of a 12-months recurrence rate and the addition of SIIC further lowered recurrence rates. Results for NBI were comparable to those of PDD according to the surface under the cumulative ranking (SUCRA) curve. There were only a small number of randomised controlled clinical trials with NBI, which the authors noted as a limitation [2]. In another recent systematic review and meta- analysis of 12 randomised controlled trials (RCT) with 2,288 patients, authors compared TURBT using WLC to PDD. The primary outcomes were recurrence rates at 12 and 24 months. The secondary outcome was to evaluate reported adverse effects. Authors focused on the medium- and long-term effects of PDD and studies reporting results from shorter periods were excluded. Use of PDD led to a reduction of recurrence rates at both 12 months and 24 months. Use of WLC only was clearly associated with increased risk of recurrence after 12 and 24 months, respectively. According to GRADE analysis, the certainty of evidence was considered moderate for recurrence rate outcomes. Two included studies reported lower recurrence rates even after 60 months of follow up. Only two out of twelve studies reported all encountered adverse events, including haematuria and bladder irritation symptomatology (spasms, frequency and urgency). In one case, the frequency of adverse events was similar between PDD and WLC, while the other reported higher rates of symptoms in the PDD group (28% vs 17.5%) [3]. Partially opposed to these encouraging results, isa recent Cochrane systematic review that encompassed 16 randomised controlled trials up until March 2021. Although authors suggested that PDD may reduce the risk of tumour recurrence depending on the risk group, the certainty of evidence was low [4]. Some level of scepticism is supported by recently published results of the prospective randomised multicentre “PHOTO” trial. This research not only contradicted benefit in terms of mid-term recurrence rates but failed to find any cost-effectiveness of PDD compared to standard visualisation. Authors analysed results of 426 patients that underwent TURBT for primary NMIBC (209 with PDD and 217 with WLC). Median follow-up was 44 months. Baseline structure of tumour risk groups was comparable, as were the rates of postoperative single instillations and adjuvant intravesical treatments between the two arms. Three-year recurrence-free survival rates were also comparable at 57.8% and 61.6% for PDD and WLC, respectively. However, the number of recurrences in the WLC control group was higher during the first 12 months. The difference was the most pronounced in the course of the first 6 months (23 WLC group vs 12 PDD group). Proportion of recurrences reversed after one year of follow-up [5]. In real life we need to remember some practical limitations of PDD. This method expects special equipment (light source, telescope, camera) which must be mutually compatible. Together with the instilled substance, it significantly increases the cost of the procedure. Additionally, PDD is dependent on exogenous administration of the precursor that must be metabolised to photoactive form. This process requires a certain time. Usual recommendations for HAL are 1-2 hours before the procedure. Moreover, the photodynamic effect can be observed for a limited time only (photo- bleaching). Narrow-band imaging (NBI) Principle of the method In NBI technology white light is filtered into 2

Prof. Marko Babjuk Dept. of Urology, Hospital Motol and 2nd Faculty of Medicine, Charles University, Praha (CZ)


The success of treatment in Non-muscle-invasive bladder cancer (NMIBC) is dependent upon the biological characteristics of the tumour and on correctly selected and performed treatments. The strategy is based on transurethral resection, followed by individually tailored adjuvant treatment according to individual risk of tumour recurrence and progression. Transurethral resection of bladder cancer (TURBT) is the initial and critical step in the management of NMIBC. This procedure has a diagnostic and therapeutic role and its quality can be measured according to the early recurrence rate after completed procedures. In some studies, the 3-months recurrence rate varies between 0-61.3%, showing a huge heterogeneity in the quality of transurethral resection. It is well known, that up to 50% of patients develop a tumour recurrence within 12 months from primary treatment, most likely the result of missed lesions. There are more options for improving the outcomes of TURBT, one of them is getting a higher quality of tumour visualisation. When using the modern equipment (cameras and light source), white light cystoscopy (WLC) remains the gold standard in the diagnosis of bladder cancer. It may be today supplemented with enhanced optical technologies, which improve tumour detection, particularly of small papillary and flat lesions such as carcinoma in situ (CIS) and reduce the risk of undetected tumours.

Figure 2: Residual high-grade lesion after resection with PDD and WLC

Figure 3: TaLG papillary tumour with NBI and WLC

bandwidths of 415nm (blue) and 540nm (green). These wavelengths are strongly absorbed by haemoglobin, thus enhancing surface capillary visualisation and contrast between normal urothelium and hypervascular tumour areas. The utilisation of NBI is simple and devoid of a learning curve, with no need for patient preparation, no contraindications and no adverse effects. The surgeon is able to toggle between WL and NBI mode, taking on average an additional 3 minutes to complete the procedure. It can be used an endless number of times and the cost is likened to WLC TURBT. Clinical efficacy and available evidence The use of NBI in urology was first described in a study by Bryan et al in 2008 using a flexible cystoscope in a group of patients with recurrent NMIBC [6]. This was the first report of an increased tumour detection rate versus WLC. The improved detection rate of NBI comparing to WLC was demonstrated by more authors [7]. A prospective comparative study between WLC, NBI and PDD included 175 high-risk patients demonstrated that both NBI and PDD had a higher diagnostic sensitivity for CIS and flat dysplasia (95,7% vs WL 65,2%) with similar specificities (NBI 52%, PDD 48%, WL 56,8%) [8]. The research concluded that for this purpose, NBI is a reliable alternative to PDD. Similarly, a recently published retrospective single centre evaluation suggested non-inferiority of NBI compared to PDD in the detection of CIS [9]. The role of NBI-assisted resection on recurrence rates has been studied in a large randomised multicentre trial by the Clinical Research Office of the Endourological Society (CROES). This study included only primary tumours and revealed no differences in the tumour recurrence rate at 12 months, with the exception of the low-risk patient group [10]. However, the value was burdened with some methodological limitations. In 2022, the Cochrane group published results of their comprehensive literature search, which evaluated the potential benefit of NBI guided TURBT compared to WLC guided TURBT. Based on limited confidence in the time-to-event data, authors found that participants who underwent NBI + WLC TURBT had a lower risk of disease recurrence over time compared to participants who underwent WLC TURBT (6 studies, 1244 participants; low certainty of evidence). No studies examined disease progression as a time-to-event outcome or a dichotomous outcome. There was no effect on the risks of major or minor adverse events. [11].

The concept is based on several image enhancement modalities containing a white light, spectra A, spectra B, chroma and clara mode. Spectra A and B increases image contrasts by colour tone shift algorithms, chroma enhances the sharpness of the displayed image, and clara uses a local brightness adaptation in the image to achieve greater visibility of darker regions within the image. Additionally, the system is able to provide a standard WLC with the IMAGE1 S image simultaneously. Clinical efficacy and available evidence IMAGE1 S was recently investigated in a large prospective international trial organised by CROES. The results showed no difference in the overall recurrence rates between IMAGE1S and WL assistance 18-mo after TURBT in patients with NMIBC. However, IMAGE1S-assisted TURBT considerably reduced the likelihood of disease recurrence in primary, low/intermediate risk patients [12]. There is no doubt that the data needs further validation. Summary and conclusion Tumour visualisation using modern equipment and advanced imaging is essential for high quality TURBT. During procedures, it improves the visibility and detection of CIS and small papillary lesions (Figure 1) and improves the evaluation of tumour areas before, during and after resection (Figure 2,3). Most of the research data supports the opinion that these benefits are translated into a reduced number of recurrences in patients’ after TURBT. For this reason, the EAU guidelines recommend the application of advanced imaging during TURBT if these methods are available. The optimal method of advanced visualisation however remains to be specified. References 1. Mowatt, G. Int J Technol Assess Health Care 2011; 27: 3-10. 2. Sari Motlagh, R. BJU Int 2021; 128: 280-9. 3. Veeratterapillay, R. Eur Urol Open Sci 2021; 31: 17-27. 4. Maisch, P. Cochrane Database Syst Rev. 2021. 5. Heer, R. NEJM Evidence 2022. 6. Bryan, RT. BJU Int 2008; 101: 702-6. 7. Kim, SB. Investig Clin Urol 2018; 59: 98-105. 8. Drejer, D. Urology 2017; 102: 138-42. 9. Kumarasegaram, V, Urology, 2022; 61: 83−6. 10. Naito, S. Eur Urol 2016; 70: 506-15.

Fluorescence diagnosis (PDD) Principle of the method

Fluorescence-guided photodynamic diagnosis (PDD) is a technique of tumour visualisation based on the intravesical instillation of 5-aminolevulinic acid (5-ALA) or its hexyl ester (HAL). These prodrugs are metabolised into protoporphyrin IX, whereby, accumulation in cancer cells produces an intensive red fluorescence when excited by blue light. Clinical efficacy and available evidence It has been confirmed that fluorescence-guided biopsy is more sensitive than WLC for the detection of malignant lesions. This benefit was particularly evident in patients with CIS. In a systematic review and meta-analysis, PDD had higher sensitivity than WLC in the pooled estimates for analyses. It improved sensitivity at the patient-level from 71% to 92% and the biopsy-level from 65% to 93%. On the other hand, the specificity of PDD was 63%, which was lower than 81% of WLC [1]. Most often PDD-guided TURBT is connected with reduced recurrence rates compared to standard white-light TURB. In a recent systematic review and network meta-analysis that included 22 studies with 4519 patients, they compared the recurrence rates of NMIBC depending on the type of tumour visualiation during TURBT (WLC vs PDD vs NBI) combined with single immediate intravesical chemotherapy (SIIC) administration. In total, 6 subgroups were established, including a control group ‘WLC without SIIC’. In these settings, PDD

11. Lai, LY, Cohrane Database Syst Rev 2022. 12. De la Rosette, J. WJU 2022; 40: 727-38.

Saturday, 11 March 15:18 - 15:37 Thematic Session: Rapid-fire debates: Common problems and controversies in bladder cancer Yellow Area, eURO Auditorium 2

Professional Image Enhancement System (IMAGE1 S) Principle of the method

Figure 1: TaLG bladder cancer with PDD and WLC

European Urology Today


February/March 2023

Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48

Powered by