Current cystinuria research is focused on methods of monitoring disease activity, as well as novel drug therapies and genotype-phenotype studies. This was one of the major conclusions by Prof. Anna Bujons Tur (ES). The future of research is national and international collaboration facilitated by European Reference Networks like eUROGEN or ERKNet. Prof. Bujons Tur’s comments came in the context of her state-of-the-art lecture on preventing recurrences of cystine stones in children.
In a clear case of saving the best till last, the fourth day of EAU22 started with plenary sessions on urinary stones and on liquid biomarkers. Other stone-related topics covered in session 8 were the use of access sheaths in children, devising a “perfect” algorithm for a follow-up schedule for stone disease, and several case discussions that served to highlight different approaches and different instruments.
A potentially promising new technology was presented by Prof. Jonathan Harper (US), the burst wave ESWL which uses ultrasound pulses instead of shock waves. This new technology might allow for shorter and in-office procedures. The first careful conclusions from Prof. Harper, based on the first series of in-human tests were that comminution was effective with only minimal safety concerns and that the treatment was well-tolerated and effective.
After sorting out some confusion as to what exactly “gone with the wind” meant in the context of single-use ureteroscopes, Dr. Thomas Tailly (BE) and Dr. Esteban Emiliani (ES) debated the advantages and disadvantages of the disposable scopes. With very similar clinical results, it mainly came down to a matter of cost per procedure (which each centre should calculate for itself), and the convenience of having instantly sterile and ready-to-go ureteroscopes.
Disposable models are mature and readily available and well suited to training (less disastrous if a resident breaks one), but reusable models were not written off yet in high-volume centres and in the hands of skilful urologists. Combinations of both types would be in use in the foreseeable future, both speakers agreed.
Game-changing trial results
Plenary Session 8 was preceded by the sixth Game-changing Session, which featured two moderated talks with the latest results of the ARASENS trial and a recent Phase III study which compared the diagnostic accuracy of mpMRI prostate to 18F-DCPyL PSMA PET/CT. Both talks from Game Changing Session 6 are currently free to watch in the EAU22 Virtual Platform and included in the daily e-mail newsletter.