Bladder Trouble, Testosterone, Cancer Top AUA Meeting Agenda

Alicia Ault

May 12, 2015

NEW ORLEANS — A study on combination therapy for overactive bladder (mirabegron added to solifenacin) and a comparison of enclomiphene citrate (Endroxal) and testosterone gel (AndroGel) in overweight men with secondary hypogonadism are among the highly anticipated presentations here at the American Urological Association (AUA) 2015 Annual Meeting.

Results from the TERRAIN and STRIVE trials of enzalutamide and bicalutamide in castration-resistant prostate cancer are also being presented at the meeting.

Urologists are becoming more comfortable prescribing and monitoring oral chemotherapies and these trials could be "game-changers," said meeting organizer Gopal Badlani, MD, from Wake Forest Baptist Medical Center in Winston-Salem, North Carolina.

Value will also be addressed. "The United States has led in terms of innovation, but we also lead in terms of expensive care, so we have to look at value," said Dr Badlani.

A few sessions will examine whether advances in robotic surgery have been worthwhile. Inderbir Gill, MD, from the Keck School of Medicine at the University of Southern California in Los Angeles, who is a pioneer in robotic surgery, will give the Ramon Guiteras Lecture on quality of life after robotic prostatectomy.

There will also be an emphasis on multispecialty team treatment, which is the care model for the future, Dr Badlani told Medscape Medical News.

And because nurse practitioners and physician assistants are the future workforce of the new collaborative care model, and the fastest growing segment of the AUA, training tailored to their needs is being offered.

These trials could be 'game-changers.'

Several studies of long-term botulinum toxin treatment for urinary incontinence and overactive bladder will be presented.

"I expect this to have significant implications in the management of the nearly 20% of the population bothered by overactive bladder," said Chris Winters, MD, from the Louisiana State University School of Medicine in New Orleans.

Topics generating buzz in advance of the meeting include the use of MRI in prostate cancer, the appropriate use of testosterone, robotic technology for bladder cancer, and the contemporary management of overactive bladder and prolapsed bladder, Dr Winters reported.

Crossfire Controversies, Live Surgeries

During the Crossfire program, which attracted standing-room only crowds in 2014, participants will debate a variety of topics, such as whether vasectomy reversal is worth the effort in the era of intracytoplasmic sperm injection, whether focal therapy for prostate cancer is just hype, whether bladder sparing for invasive bladder cancer is cancer sparing, and whether extracorporeal shockwave lithotripsy should be retired.

All urologists will be interested in the debates on focal therapy and shockwave lithotripsy, in particular, which could foretell practice changes, said Dr Winters.

In a new program this year, more than 20 leaders in urology will take a critical "second look" at eight clinical cases.

In a town hall, an esteemed panel will take on the controversies surrounding testosterone therapy and separate fact from fiction. "I am really looking forward to the updates regarding testosterone therapy in men," said Dr Winters.

Five live procedures will be conducted during the meeting: a robotic-assisted partial nephrectomy; a physician-controlled percutaneous nephrolithotomy; male stress urinary incontinence sling surgery; prostatic urethral lift for benign prostatic hypertrophy; and plasma button bipolar transurethral resection of bladder tumor with narrow band imaging.

Guidelines and Live Tweeting, Streaming

A new guideline on Peyronie's disease will be released at the meeting, as will guideline updates on castration-resistant prostate cancer and interstitial cystitis.

Genomics and big data are outside the realm of most urology practices, said Dr Badlani; however, research and collaborations could be sparked by the John K. Lattimer Lecture on using the digital universe to build more predictive models of cancer. The lecture will be delivered by Eric Schadt, PhD, director of the Icahn Institute for Genomics and Multiscale Biology at the Mount Sinai Medical Center in New York City.

"As a urologist who doesn't practice oncology, I'm fascinated with the developments in genetic sequencing," Dr Winters said. "Genetic targeting through a number of different mechanisms seems plausible and very exciting," he explained.

During the meeting, tweets will be monitored in real time to see what urologists think of the plenary and all the other sessions, so keep an eye on #AUA15, Dr Badlani said. In 2014, there were more than 10,000 tweets from 1100 Twitter users.

In addition, many of the sessions will be live streamed.

Big Easy, A Big Draw

Nearly half the 11,000 professionals expected to attend the meeting will come from overseas, and will represent more than 120 countries, said Dr Badlani.

The architecture, culture, music, and food of New Orleans provides an entertaining backdrop for any convention, and is likely one of the reasons for the increase in attendance expected this year, he explained.

Attendees can learn about the city's unique architecture by taking a walking tour through a prominent New Orleans neighborhood, discover local history at one of the numerous museums, get a taste of the local flavor at one of the 1400 restaurants, or take in an evening of New Orleans Jazz at one of hundreds of music venues.


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