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YUORDay23: How can we make a complicated topic simple?

Led by renowned experts, ESRU Chair Dr. Diego Carrión Monsalve (ES), and YUO Chair Dr. Juan Luis Vásquez (DK), the Special Session YUORDay23 took place on day two of EAU23. As well as the usual sessions on surgical tips and tricks and challenging the Guidelines, there were some new additions to the scientific programme this year. Moderators Dr. Ugo Falagario (IT) and Dr. Anna Goujon (FR) chaired a brand new session “Urology for dummies”, which embraced the concept of making complicated topics simple. The topics presented included infertility workup, metabolic study, castration-resistant prostate cancer and urodynamic study.

In the session on “Infertility workup”, Dr. Fabio Castiglione (GB) began his presentation with a description of the three types of infertility (primary, secondary, and recurrent pregnancy), before going into detail on when and what type of investigations to do. He indicated that when the female partner is more than 35 years old, investigations should take place straight away because the chance of getting pregnant is also related to age.

“When doing an infertility workup it is important to investigate both partners’ history simultaneously, examinations and sperm analysis. We now know that in 50% of involuntary childless couples, a male infertility-associated factor is found”.  According to Dr. Castiglione, male infertility can be impaired as a result of varicocele, genetics, infections, endocrine disturbances congenital or acquired urogenital abnormalities, gonadotoxic exposure, malignancy and ejection fraction.

On to topic of semen analysis, Dr. Castiglione said “According to the new WHO classification (6th edition), the lower fifth percentile of data from men in the reference population does not represent a limit between fertile and infertile men. For a general prediction of live birth in vivo as well as in vitro, a multiparametric interpretation of the entire man’s and partner’s reproductive potential are needed.”

Other testing detailed included hormone (FSH), imaging, infections and genetics. “The spermatozoa of infertile men show an increased rate of aneuploidy, structural chromosomal abnormalities and DNA damage carrying the risk of passing genetic abnormalities to the next generation,” said Dr. Castiglione.

Dr. Amelia Pietropaolo (GB) presented her lecture “Metabolic study”, beginning with the different types of kidney stones (struvite, calcium [75%], cystine and uric acid). “Kidney stones is a growing problem with increased hospital episodes by 70% over a 15-year period between 2000 and 2015.”

According to Dr. Pietropaolo, it is important to look at patient history, as well as diet, smoking, alcohol and exercise. “A family history accounts for between 30-50% of recurrence stone formers, although the patient’s environment makes up the other 50% and some of these factors are modifiable. These include low fluid intake, high BMI, sugar-sweetened beverages and excess animal protein. After stone passage, every patient should be assigned to a stone formation low- or high-risk group.”

In take-home messages from his presentation “Urodynamic study”, Dr. Benoit Peyronnet (FR) stated “Always monitor abdominal pressure for invasive urodynamics and remember that urodynamics are always biased. Do not be obsessed with detrusor overactivity, and poor bladder compliance matters only in neurogenic and radiated patients. The pressure flow study is the key step in urodynamics and lastly, use indexes such as BOOi, BCI and BOOIf to interpret pressure-flow studies.” 

Prizes and award presentations

YUORDay23 concluded with honouring excellence in urology research. First prize for the “Best Abstract by a Resident” went to Dr. Alexander Ng (GB) for the GLIMPSE study: Global variation in the quality of multiparametric magnetic resonance imaging of the prostate from the PRIME trial (A0970). Second prize went to Mr. Nir Rahav (IL) for his work Proximal urethrostomy (PU) versus urethroplasty (U) for complex urethral strictures (CUS) (A0447). Third prize went to Dr. Fredrik Möller (SE) with his research on Prostate cancers detected in the PSA interval 1.8-3 ng/mL – results from the Göteborg 2 prostate cancer screening trial.

This article reports on a small part of the full day session but you can (re)watch the full presentations, please go to EAU On Demand on the Virtual Platform. You may also be interested in the Meeting of the Young Academic Urologists (YAU) which was held yesterday (Friday, 10th March) and is also available on the Virtual Platform.