AUA 2024

AUA 2024: Key Takeaways for Sexual Dysfunction

(UroToday.com) While attendees to this year’s American Urological Association meeting in San Antonio can stream the Key Takeaway sessions through the conference website, other Urologists or Advance Practice Providers won’t have immediate access to this information. I had the pleasure of highlighting sexual dysfunction with Dr. Tobias Köhler MD, MPH from Mayo Clinic Urology.

AUA 2024: Long-term Dementia Risk with Use of Anticholinergic versus Beta-3-Agonist Pharmacotherapy for Overactive Bladder

(UroToday.com) The 2024 American Urological Association (AUA) annual meeting featured a session on overactive bladder, and a presentation by Dr. David Sheyn discussing long-term dementia risk with the use of anticholinergic versus beta-3-agonist pharmacotherapy for overactive bladder.

AUA 2024: EvoPAR-Prostate01: Phase III, Double-Blind, Placebo-Controlled, 2-Cohort, Randomized Study of Saruparib (AZD5305) in Combination with New Hormonal Agents in Patients with mCSPC +/- HRR Mutations

(UroToday.com) The 2024 American Urological Association (AUA) annual meeting featured a session on prostate cancer trials in progress, and a presentation by Dr. Neeraj Agarwal discussing EvoPAR-Prostate01, a phase III, double-blind, placebo-controlled, 2-cohort, randomized study of saruparib (AZD5305) in combination with new hormonal agents in patients with metastatic castration-sensitive prostate cancer (mCSPC) with and without homologous recombination repair (HRR) mutations. ADT plus new hormonal agents have improved outcomes for patients with mCSPC, but patients will eventually progress to mCRPC, which is associated with poor survival outcomes. As such, there is a need for effective treatments in mCSPC that can delay initiation of chemotherapy and progression to mCRPC. Combinations of PARP inhibitor plus new hormonal agents have demonstrated clinical benefit in patients with mCRPC [1-3]. In other indications, the clinical activity of PARP inhibitors in earlier lines of treatment has demonstrated potential to provide greater magnitude of benefit and delay disease progression. Of note, the efficacy and safety of PARP inhibitor therapy for patients with HRR mutated mCSPC are being assessed in the ongoing phase III studies TALAPRO-3 and AMPLITUDE.

AUA 2024: State-of-the-Art Lecture: Lasers in Endourology

(UroToday.com) In this edition of the State-of-the-Art lecture series, Dr. Bodo Knudsen provided an extensive overview of the progression and future prospects of laser lithotripsy technologies in endourology. His presentation traced the historical advancements in this field, discussed the current state of the technology, and speculated on future directions. Dr. Knudsen's insights offer a comprehensive guide to both the capabilities and limitations of laser technologies used in the treatment of urinary tract stones.

AUA 2024: Back to Medical School: Immunology in NMIBC and Neoadjuvant MIBC for the Urologist

(UroToday.com) The 2024 American Urological Association (AUA) annual meeting held in San Antonio, TX between May 3 and May 6, 2024, was host to the Society of Urologic Oncology (SUO) session Dr. Robert Svatek gave a brilliant talk on immunology in non-muscle invasive bladder cancer (NMIBC) and the role of immunology in neoadjuvant therapy for muscle-invasive bladder cancer (MIBC).

AUA 2024: State-of-the-Art Lecture: The UTI Vaccine

(UroToday.com) At the American Urological Association's 2024 Sunday morning plenary session, Dr. Chris Doiron delivered a compelling presentation on the emerging field of uro-immunomodulation and its role in preventing recurrent urinary tract infections (UTIs) through vaccination. The session, held against the backdrop of ongoing medical innovation, highlighted the UTI vaccine, which is currently endorsed by the European Association of Urology (EAU) but awaits full recommendation from the AUA due to incomplete evidence supporting its efficacy.

AUA 2024: Second Opinion Cases: Unable to Access Tight Ureter and UPJ Obstruction

(UroToday.com) An expert panel was gathered to discuss second-opinion cases and, the inability to access a tight ureter. Dr. Matthew Bultitude took the stage to introduce to topic at hand. He showed two photographs of patients with tight ureters, one appeared tight, and the other did not, which highlighted that visual assessment is not always possible.

AUA 2024: Evaluating AI Assistance in Prostate bpMRI Interpretation: A Multi-Reader Study

(UroToday.com) Mr. David Gelikman of the National Cancer Institute (NIH) gave a fascinating podium talk on the integration of artificial intelligence (AI) assistance in interpreting biparametric magnetic resonance imaging (bpMRI) for prostate cancer (PCa) analysis. Currently, there exists significant inter-reader variability in bpMRI interpretation among clinicians. With technological advancements, AI has emerged as a promising tool to mitigate this variability by enhancing accuracy and consistency in diagnostic imaging interpretation. Given these challenges, Mr. Gelikman and his team investigated the efficacy of a deep-learning AI model in assisting radiologists with diverse experience levels in identifying patients with PCa, interpretation of prostate bpMRI scans, index lesion size agreement, and index lesion Prostate Imaging Reporting and Data System (PI-RADS) score agreement.

AUA 2024: State of the Art: Endocrinological Factors in the Etiology of Stone Disease

(UroToday.com) Naim Maalouf took the stage and delivered a riveting talk regarding various endocrine factors in the etiology of stone disease. He placed the formation and propagation of the two most common stones, calcium oxalate, and uric acid, in the context of factors related to acquired defects of metabolism, diet, and genetics.

AUA 2024: Panel Discussion: Tricks and Tips of Penile Prosthesis Surgery

(UroToday.com) The Sunday morning plenary sessions covered various topics within the field of men’s sexual medicine. In this particular discussion, a decorated panel of men’s health specialists engaged in a panel discussion regarding the tips and tricks for penile prosthesis surgery. The panel was comprised of Dr. Petar Bajic from Cleveland Clinic, Dr. Amy Guise from Froedtert and Medical College of Wisconsin, Dr. Steven Wilson from the Institute for Urologic Excellence, Dr. Charles Welliver from Albany Medical College, Dr. Hossein Sadeghi-Nejad from NYU Langone Grossman School of Medicine, and Dr. Jonathan Clavell Hernandez from Clavell Urology.

AUA 2024: Paradigm-Shifting, Practice-changing Clinical Trials in Urology: Office-Based Removal of Small Urinary Stones

(UroToday.com) Dr. Matthew Sorensen (University of Washington) comprehensively reviewed the evolving approach to managing small stones and fragments. This is essential, especially since all currently available minimally invasive therapies have an increased likelihood of leaving residual stone fragments in place. Although previously referred to as “clinically insignificant”, these urolith fragments serve as a nidus for growth and require retreatment in up to 20% of patients with long-term follow-up data.

AUA 2024: A Randomized Control Trial Assessing Renal Damage Caused by New High Power Lasers During Ureteroscopic Laser Lithotripsy

(UroToday.com) The use of lasers for treating kidney stones, also known as nephrolithiasis, is a hot topic due to recent advancements in laser technology. However, concerns have been raised about high-power lasers that include thulium fiber lasers for kidney stone removal.1 In a well-attended presentation, Dr. Alan Yaghoubian and his team from Mt. Sinai in New York investigated whether high-power Holmium (Ho:YAG) and thulium fiber lasers (TFL) might cause kidney damage during kidney stone removal procedures. This was the first human study to confirm and measure the damage using specific urinary protein markers as indicators of renal damage.

AUA 2024: Panel Discussion: Interstitial Cystitis/ Systemic Therapy for Bladder Pain Syndrome: Which Patient and Which Therapy?

(UroToday.com) At the AUA 2024 plenary session held on Sunday morning, urologists gathered to delve into the intricacies of bladder pain syndrome (BPS). Dr. William Reynolds opened the discussion, emphasizing the importance of categorizing patients based on their phenotypic characteristics using tools like the Michigan Body Map. He highlighted ongoing advancements in AUA guidelines, particularly categorizing patients into three groups: those with Hunner's lesions, those with localized bladder pain, and those with widespread pain.

AUA 2024: Crossfire: Controversies in Urology: Detrusor Underactivity in Men in Retention: To TURP or Not to TURP?

(UroToday.com) The Saturday morning plenary sessions discussed men’s health screening. Dr. Mitchell Humphreys representing Mayo Clinic Arizona, Dr. Nicole Miller representing Vanderbilt University, Dr. Ricardo Gonzalez representing Houston Methodist Hospital, Dr. Christopher Tenggardjaja representing Kaiser Permanente, and Dr. Matthew Rutman representing New York – Presbyterian Allen Hospital engaged in a fascinating crossfire session regarding outlet procedures for detrusor underactivity, often referred to as TURP.

AUA 2024: Direct In-Scope Suction: An in Vitro Evaluation of a Single-Use Flexible Ureteroscope with Integrated Suction Capability

(UroToday.com) In a podium presentation, Dr. Aideen Madden introduces a novel flexible ureteroscope with an integrated suction developed by Zhuhai Pusen Medical Technology. Advances in laser technologies have allowed for the breakdown of stones into fine particles (defined as < 250µm) during stone laser lithotripsy; however, the issue that emerges is how urologists can efficiently extract all these remnants. The answer comes in various innovative approaches to remove these stone particles such as ureteral access sheath outflow with or without suction as well as direct in-scope suction (DISS). Dr. Madden aims to evaluate the performance of this novel DISS device in vitro by assessing the suction rate, quality, and limitation in a stone size dependent manner.

AUA 2024: Crossfire: Controversies in Urology: Testosterone Therapy May Be Reasonably Offered to Men on Active Surveillance – Pro/Con

(UroToday.com) Recent developments in urology have increasingly challenged the once prevalent notion that testosterone therapy exacerbates prostate cancer (PCa) progression. Dr. Abraham Morgentaler, in the latest session of the Crossfire: Controversies in Urology series, highlighted a significant shift over the past three decades, moving from a global reluctance to a cautious acceptance of testosterone therapy, even in the context of prostate cancer management.

AUA 2024: Can Genitourinary Cancer Survivors Understand Quality of Life (QoL) Questionnaires? Assessing the Readability of Commonly Used Urologic Oncology QoL Instruments

(UroToday.com) During the American Urological Association’s annual meeting, Dr. Hannah Kay presented research assessing the readability of various QoL questionnaires used in urologic oncology. She began by explaining the importance of effectively assessing the quality of life (QoL) of patients with cancer, reviewing that this process heavily relies on patients' ability to self-report their experiences through questionnaires.

AUA 2024: Clear Urinary Tract Infection Protocol Improves Urology Staff and Provider Satisfaction

(UroToday.com) On Friday, May 3rd, 2024, at the American Urological Association’s annual meeting, the Quality Improvement and Patient Safety session included a presentation by Dr. Sabrina Stair, describing her group’s experience in developing a streamlined approach for acute urinary tract infection (UTI) patient inquiries in an ambulatory urology setting.

AUA 2024: Can I use Markers and Imaging to Avoid Local Consolidation for Patient who has cT0 stage after Neoadjuvant Chemo or IO?

(UroToday.com) The 2024 American Urological Association (AUA) annual meeting held in San Antonio, TX between May 3 and May 6, 2024, was host to the AUA-IBCG Bladder Cancer Forum. Drs. Stephen Williams, Arnulf Stenzl, and Petros Grivas discussed whether biomarkers and imaging can be used to avoid local consolidation for patients who are cT0 after neoadjuvant chemo-or-immunotherapy (IO)

AUA 2024: Automated Analysis of Stone Dust During Ureteroscopy to Predict Stone-Free Status Using Computer Vision Models

(UroToday.com) During the annual American Urological Association (AUA) meeting in San Antonio, Dr. Kimberly Maciolek and colleagues presented on artificial intelligent computer models for stone dust evaluation. The technique of dusting following laser ablation during flexible ureteroscopy (fURS) provides urologists with an efficient approach to stone management. However, it is estimated that 20-30% of patients will require surgical intervention within a two-year period1. Therefore, it can be surmised that endoscopic stone clearance can predict recurrence of stone disease2.