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08:30
17:00
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TWTC - 1F Exhibition Hall
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08:30
10:00
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Chun-Hou LiaoTaiwan
Moderator
Regeneration Medicine in Urology - A Promising Future or Hoax?Regenerative medicine comprises therapeutic strategies aimed at restoring tissue structure and function, rather than merely alleviating symptoms. By deploying cells, biomaterials, bioactive molecules, or combinations thereof, these interventions stimulate the body’s intrinsic repair mechanisms. This paradigm extends beyond traditional symptomatic treatment, offering the potential for true self-healing and organ reconstruction—ultimately prioritizing cure over chronic disease management.
Cell-based therapy has emerged as a promising intervention for various urogenital disorders, including erectile dysfunction (ED), bladder dysfunction, and male infertility. Current clinical research primarily focuses on mesenchymal stem cells (MSCs), investigating their safety, tolerability, and preliminary efficacy. Although early-phase studies suggest functional benefits—such as improved hemodynamics and tissue regeneration—most programs remain in preclinical or early clinical stages. A critical limitation remains the lack of standardization in MSC source, dose, and delivery route.
Among alternative sources, human amniotic fluid-derived stem cells (hAFSCs) have shown particular promise. In preclinical models of cavernous nerve injury, hAFSCs demonstrated prolonged retention in penile tissue and in-situ differentiation into α-smooth muscle actin-positive corporal smooth muscle cells, effectively replacing damaged tissue and restoring function. These findings represent an encouraging step toward curative therapy. However, the mechanisms governing their in vivo behavior—such as engraftment, differentiation, and immunogenicity—will ultimately determine their clinical translatability and therapeutic stability. Whether cell-based approaches can evolve from experimental platforms into routine clinical care remains a central question.
Platelet-Rich Plasma (PRP)
Platelet-rich plasma (PRP) is an autologous biologic product enriched with supraphysiologic levels of platelets, growth factors, chemokines, and extracellular vesicles. Upon activation, PRP releases a bioactive cocktail that promotes angiogenesis, neuroregeneration, and antifibrotic remodeling—key processes in the restoration of urogenital tissues.
In rodent models of cavernous nerve injury, PRP has been shown to preserve corporal sinusoidal endothelial cells and axonal scaffolds, while restoring erectile hemodynamics. Clinical studies further support PRP's safety in humans and report variable but promising improvements in IIEF scores following intracavernous injection. Nevertheless, the therapeutic response appears heterogeneous, likely influenced by patient factors, PRP preparation techniques, and injection protocols. Beyond ED, PRP has shown potential in other urologic indications such as stress urinary incontinence (SUI), interstitial cystitis/bladder pain syndrome (IC/BPS), and chronic pelvic pain, where it may contribute to tissue regeneration and symptom relief. However, broader adoption will require the establishment of individualized blood-quality metrics, standardized preparation methods, and randomized controlled trials demonstrating durable benefit.
Emerging Regenerative Strategies
Beyond cell-based and autologous biologics, a suite of innovative regenerative technologies is progressing from bench to bedside. These include:
Energy-based devices such as low-intensity extracorporeal shock wave therapy (Li-ESWT), which promotes neovascularization and tissue regeneration via mechanotransduction pathways.
Gene therapies, targeting dysfunctional or absent proteins in disorders like overactive bladder.
Smart biomaterials, capable of delivering cells or bioactive molecules in a controlled, responsive manner.
Extracellular vesicle (EV)-based therapeutics, which leverage cell-free vesicles derived from MSCs or urine-derived stem cells. These EVs carry signaling molecules (e.g., microRNAs, cytokines, growth factors) that mimic the paracrine effects of stem cells, offering a potentially safer and more scalable alternative to cell transplantation.
In preclinical models of ED and bladder dysfunction, EVs have demonstrated the capacity to promote smooth muscle regeneration, nerve sprouting, and fibrosis reduction, with functional improvements comparable to stem cell therapy.
Regenerative medicine has propelled the field of urologic tissue repair from theoretical promise to an early clinical reality. While substantial challenges remain—including the need for deeper mechanistic insight, protocol standardization, and regulatory clarity—the field is advancing rapidly. The convergence of cell therapy, PRP, EVs, and device-based modalities is creating a multifaceted toolkit for urologic regeneration. With continued scientific rigor, large-scale clinical trials, and interdisciplinary collaboration, regenerative medicine holds the potential to shift urologic care from chronic symptomatic management to durable, tissue-level cure.Stem Cell Therapy: Advancements and Clinical Insights for Erectile Dysfunction Treatment Erectile dysfunction (ED)—defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity—affects over 150 million men worldwide. While phosphodiesterase-5 inhibitors (PDE5is) remain the first-line treatment, many patients, particularly those with diabetes, age-related vascular decline, or neuropathy following radical prostatectomy, show suboptimal responses. Consequently, regenerative medicine—particularly stem-cell therapy—has gained interest for its potential to address the root causes of ED rather than merely managing symptoms.
Stem-cell therapy offers a multifaceted approach to treating ED through neuroregeneration, angiogenesis, anti-apoptotic signaling, and fibrosis inhibition. Once introduced into the target tissue, stem cells can differentiate into specific cell types or exert paracrine effects via secretion of growth factors and extracellular vesicles. Among the various sources studied, bone marrow-derived mesenchymal stem cells (BM-MSCs), adipose-derived stem cells (ADSCs), and umbilical cord-derived MSCs (UC-MSCs) have been most extensively explored.
Preclinical studies consistently demonstrate that MSC-based therapies enhance cavernous nerve regeneration, suppress fibrosis, and preserve endothelial integrity. In rat models of diabetes- or nerve-injury-induced ED, intracavernosal injections of ADSCs or BM-MSCs significantly restore intracavernosal pressure (ICP) and improve corpus cavernosum histology. Phase I/II clinical trials also support the safety and preliminary efficacy of stem-cell approaches. For example, in men with diabetic ED treated with autologous BM-MSCs, significant improvements in International Index of Erectile Function-5 (IIEF-5) scores and penile arterial flow have been reported without major adverse events. Similarly, ADSC therapy in post-prostatectomy ED has shown encouraging short-term results. However, large-scale trials are needed to clarify long-term efficacy, immune responses, and safety profiles.
Human amniotic fluid stem cells (hAFSCs) represent a promising alternative, offering characteristics that bridge embryonic and adult stem-cell profiles. These include broad multipotency, high proliferation, and low immunogenicity—traits ideal for allogeneic use and neuroregenerative purposes. Notably, hAFSCs secrete potent regenerative mediators such as brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and insulin-like growth factor-1 (IGF-1), all of which support neurovascular repair and smooth muscle integrity. Our recent studies demonstrate, for the first time, that hAFSCs persist long-term in penile tissue and can differentiate into cavernous smooth-muscle cells, effectively replacing damaged tissue and improving erectile function even in chronic neurogenic ED models.
Despite these advantages, our findings did not reveal in-vivo homing of hAFSCs to nerve injury sites or differentiation into neural tissue. This suggests a need for future studies to identify the specific microenvironmental cues required to induce such responses. Additionally, combining hAFSCs with platelet-rich plasma (PRP) may provide synergistic benefits—enhancing stem-cell homing, paracrine signaling, and in-vivo differentiation—thereby advancing a more effective, scalable, and safe therapeutic strategy.
Hann-Chorng KuoTaiwan
Speaker
ACU Lecture: Videourodynamic Study for Precision Diagnosis and Management of Lower Urinary Tract DysfunctionVideourodynamic Study in the Precision Diagnosis and Management of Lower Urinary Tract Dysfunctions
Hann-Chorng Kuo, M.D.
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
As a urologist, we are dealing with patients with lower urinary tract symptoms everyday. We did transurethral resection of the prostate (TURP) for elderly men with bothersome lower urinary tract symptoms (LUTS). We put a suburethral sling for women with stress urinary incontinence (SUI). We prescribed alpha-blocker for those who had difficulty in urination. We add antimuscarinics for patients with urgency urinary incontinence. Our seniors always told us these treatments are effective in treating patients with LUTS. However, patients still had LUTS after TURP, women still complained of urgency and dysuria after anti-incontinence surgery. Medication based on storage or emptying LUTS do not work all the time. Why? Because symptoms are not reliable, a large prostate does not indicate bladder outlet obstruction (BOO), and SUI is not solely a result of urethral incompetence. Therefore, in diagnosis and management of LUTS, we need precision medicine to direct an accurate pathophysiology of LUTS, and to guide an appropriate management based on the bladder and bladder outlet dysfunction. When we encounter patients who have LUTS refractory to the treatment based on our initial diagnosis, when we are treating patients who have complicated storage and emptying LUTS, when we are not sure patients could benefit from the invasive procedures for their LUTS, or patients who had both lower and upper urinary tract dysfunctions, videourodynamic study (VUDS) is an essential investigation for diagnosis and management of LUTS. In additional to benign prostate hyperplasia (BPH) and BOO, male patients with emptying LUTS might result from detrusor underactivity (DU), bladder neck dysfunction (BND), urethral sphincter dysfunction, or a hypersensitive bladder, which is not related with the prostate. Patients with BPH and LUTS might have latent neurogenic lesion, such as minor stroke, Parkinson's disease, or early dementia, causing LUTS. TURP without known the neurological disease might exacerbate LUTS after surgery. Mixed SUI comprises intrinsic sphincter deficiency (ISD) and detrusor overactivity (DO). The overactive bladder (OAB) symptoms may also result from an incompetent bladder outlet. Without comprehensive VUDS, we might cure the SUI, but OAB remains after placing a mid-urethral sling. Bladder pain is the cardinal symptoms of interstitial cystitis. However, bladder pain perceived by the patient might also originate from BOO or pelvic floor fascitis. VUDS can help in discrimination. DU and low compliant bladder and ISD could result in complicated storage and emptying LUTS. Large post-void residual (PVR) should alert us to investigate whether it is originated from low compliance or ISD. Dysfunctional voiding (DV) and BND in women with emptying LUTS. OAB symptoms are not always coming from the DO. BOO such as BND, DV, or urethral stricture might exist in men and women without voiding symptoms. Urinary difficulty in women is usually a result from low detrusor contractility, due to DU, or through inhibitory effect from a poorly relaxed pelvic floor or urethral sphincter. A simple bladder neck incision can effectively restore spontaneous voiding in men or women with dysuria due to DU or BND. However, a tight BN is necessary to predict a successful treatment outcome. Patients with central nervous system (CNS) disorders or spinal cord injury usually have complicated LUTD, including DO, BND, DV, detrusor sphincter dyssynergia (DSD), and vesicoureteral reflux (VUR). Management of LUTS in CNS disorders or SCI patients should know the current bladder and bladder outlet dysfunctions. Pediatric incontinence, children with myelomeningocele, DV, or recurrent urinary tract infection are complicated and need precision diagnosis before treatment. Especially when surgery is planned. Lower urinary tract dysfunctions is a dynamic condition. The bladder and bladder outlet dysfunction might change with time. Although VUDS is considered as an invasive investigation with radiation exposure, the advantages in accurate diagnosis and guiding management outweigh these disadvantages.
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Andrew HungUnited States
Speaker
Future Direction of AI Application in UrologyDr. Hung will share the contemporary applications of AI in Urology, and how it will be utilized in the near future.
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Mahendra BhandariUnited States
Speaker
Predictive Intelligence in Motion: Enabling Surgical Automation in Urologic RoboticsArtificial intelligence is rapidly transforming urologic robotic surgery, not by replacing the surgeon, but by enhancing anticipation, precision, and intraoperative decision-making. This talk focuses on how high-fidelity predictive models serve as the computational core of surgical automation enabling intelligent systems to respond to anatomical variation, predict surgical planes, and adapt in real time.
I will highlight the evolving landscape of AI-driven assistance in procedures like robotic prostatectomy and partial nephrectomy, where predictive analytics and multimodal data (vision, force, motion) converge to guide dissection and preserve function. A special emphasis will be placed on the emerging and underutilized concept of "no-fly zones “predefined anatomical areas digitally fenced off to prevent inadvertent damage. Widely applied in ophthalmology and orthopedic robotics, this concept has yet to be integrated into urologic surgical platforms, despite its potential to enhance safety during nerve-sparing or vascular dissection.
The presentation will explore:
• AI-based risk prediction and intraoperative guidance
• Learning from large, annotated video and sensor datasets
• A proposed roadmap to introduce “no-fly zones” in urologic procedures
Ultimately, the talk advocates for a future where predictive AI not only guides the hand but safeguards the intent, making surgery smarter, safer, and more consistent.
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Isaac KimUnited States
Speaker
Update on the Apa Neoadjuvant TrialIn patients with high-risk prostate cancer (PCa), neoadjuvant androgen deprivation therapy (ADT) is not an accepted standard of care. However, we hypothesize that neoadjuvant ADT may result in improved quality of life by down-staging prostate cancer and thereby, permitting a better quality of nerve sparing. has demonstrated benefit in surgical outcomes after radical prostatectomy (RP). To test this hypothesis, we conducted a prospective randomized trial evaluating the effect of neoadjuvant Apalutamide (Apa) +/- abiraterone acetate/prednisone (AAP) and a gonadotropin-releasing hormone (GnRH) agonist on nerve sparing during RP in men with high-risk PCa. Update on the Results of SIMCAP StudyApproximately 7% of new prostate cancer (PCa) patients in the US will be diagnosed with metastatic disease. The role of surgery in this population remains unclear. To investigate the therapeutic value of radical prostatectomy in men with de novo metastatic prostate cancer, we are conducting the phase 2.5 randomized clinical trial SIMCAP (NCT03456843).
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John YuenSingapore
Speaker
Technical Pearls: Total Extraperitoneal TechniquePractice-Changing Development in RaLRP
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Vipul R. PatelUnited States
Speaker
Lessons from 20,000 Robotic Prostatectomies: A Global Expert’s PerspectiveTechnical Considerations for Large Prostates over 100gmsTelesurgery: The Future of Surgery
TICC - 3F Plenary Hall
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Stephen S. YangTaiwan
Speaker
UTI & Hydronephrosis: What's New and Asian Guideline UpdateHydronephrosis is a common urological condition in both adults and children. It is frequently associated with urinary tract infection (UTI). However, not all hydronephrosis means upper urinary tract obstruction (UUTO). So, differentiating hydronephrosis into pathological or physiological is important. In pathological hydronephrosis or UUTO, risk factors of UTI should be identified. While in physiological UTI, no further study is required.
In this lecture, classification of upper urinary tract dilatation will be introduced, including SFU and UTD system. Other than intra-venous pyelourography, diuretic renal scan can be useful in differentiating hydronephrosis into physiological or pathological hydronephrosis. Pitfalls in interpreting diuretic renogram will be discussed. A brief review of risk factors of UTI will be done. Finally, Asian guideline on UTI will be updated.
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Rajeev KumarIndia
Speaker
Troubleshooting in Endoscopic Stone Surgery: How to Handle Unexpected Challenges in RIRS and ECIRSProstate Cancer Nomograms and Their Application in Asian MenNomograms help to predict outcomes in individual patients rather than whole populations and are an important part of evaluation and treatment decision making. Various nomograms have been developed in malignancies to predict and prognosticate clinical outcomes such as severity of disease, overall survival, and recurrence-free survival. In prostate cancer, nomograms were developed for determining need for biopsy, disease course, need for adjuvant therapy, and outcomes.
Most of these predictive nomograms were based on Caucasian populations. Prostate cancer is significantly affected by race, and Asian men have a significantly different racial and genetic susceptibility compared to Caucasians, raising the concern about the generalizability of these nomograms.
There are very few studies that have evaluated the applicability and validity of the existing nomograms in in Asian men. Most have found significant differences in the performance in this population. Thus, relying on such nomograms for treating Asian men may not be appropriate and collaborative efforts are required within Asian countries to develop locally relevant nomograms.What Is Critical Appraisal?Critical appraisal is the process of systematically evaluating research studies to assess their validity, relevance, and trustworthiness. The goal is to determine whether a study’s results are credible and useful for clinical decision-making, research, or policy. This has become increasingly important as there has been a massive increase in the number of scientific journals and not all published research is of equal quality. Critical appraisal helps healthcare professionals avoid being misled by poor-quality studies, make evidence-based decisions and improve patient outcomes.
The key purposes are to assess validity of the study and its results and determine applicability to the specific population. It involves assessing the study design, methodological quality, completeness of reporting, potential sources of bias and potential for misconduct.
There are number of reporting guidelines that can be used for performing critical appraisal. Additionally, being aware of essential reporting standards and common problems with studies can help readers make informed decisions.Scientific Misconduct and PitfallsNo abstractExample of the “Ideal” AbstractNo Abstract
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Eddie ChanHong Kong, China
Moderator
How to Escape Surgical ComplicationsSurgical complications can significantly impact patient outcomes and healthcare resources. This talk will focus on practical strategies to minimize complications in urologic surgery, tailored specifically for urology fellows. Real-life case examples will illustrate how thoughtful preparation and proactive communication can prevent or mitigate complications. Additionally, we will discuss structured approaches to managing complications when they arise, including communication with the patient and team, documentation, and timely intervention. Through real-life case examples, this session aims to enhance surgical judgment, promote patient safety, and build confidence in complication management.
Mikio SugimotoJapan
Speaker
Active Surveillance for Early Prostate CancerActive surveillance for early prostate cancer
The global incidence of prostate cancer is steadily increasing. While the prevalence has historically been lower in Asia compared to Western countries, recent trends suggest a significant rise in prostate cancer cases across the region. This increase is likely attributed to the Westernization of dietary habits and the aging population. The widespread use of prostate-specific antigen (PSA) screening has led to an increase in the detection of early-stage prostate cancer, which is a positive development. However, this has also resulted in the identification of a substantial number of low-grade, indolent cancers that are unlikely to impact life expectancy, raising concerns about overdiagnosis and overtreatment.
Active surveillance has emerged as a practical and effective strategy to address overtreatment in the PSA era. Although the adoption of active surveillance has increased dramatically in Western countries, its implementation in Asia remains limited. In Japan, a large-scale prospective observational study, PRIAS-JAPAN, has been underway since 2010, with over 1,400 patients enrolled to date. In this report, we briefly present the findings of PRIAS-JAPAN and explore strategies to promote the broader and more effective use of active surveillance in clinical practice.
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Bannakij LojanapiwatThailand
Speaker
PSA Kinetics Following PADT in mHSPC. Is It a Real-World Tool for Predicting Oncologic Outcome?PSA Kinetics following Primary Androgen Deprivation Therapy
(PADT) in mHSPC. Is it a Real-world Tool for Prediction Oncologic Outcome?
Bannakij Lojanapiwat, M.D.
Professor of Urology, Chiang Mai University, Thailand.
Of recent guidelines, upfront primary androgen deprivation monotherapy or combination therapy (PADT) is recommended for the treatment of metastatic hormone sensitive prostate cancer (mHSPC). Limitation of real-world treatment such as culture difference, financial barrier, geographic access to treatment and high operation/ radiation risks associated with medical comorbidity led to underutilization of combination therapy as the standard guideline. Prognostic factors are important in clinical practice which can predict the clinical outcome that offer the pre-treatment counseling for patients to select the optimal treatment.
Prostate specific antigen (PSA) levels is one of the important key prognostic markers. PSA kinetics of nadir PSA level and time to nadir PSA following the treatment are the important role for progression to CRPC and oncologic outcome. Our study and the previous studies reported better oncologic outcome especially overall survival, cancer specific survival and time to developed CRPC in mHSPC patients received upfront PADT who decline PSA≥95% (deep responder), PSA nadir ≤ 0.2 ng/ml (low PSA nadir level), time to PSA nadir ≥ 6 month and PSA decline velocity <11 ng/ml/month.
PSA Kinetics following Primary Androgen Deprivation Therapy (PADT) is one of a real-world tool for prediction oncologic outcome in the treatment of mHSPC.
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Seung Il JungKorea (Republic of)
Speaker
The Potential Role of Urinary Microbiome in Benign Prostate Hyperplasia/Lower Urinary TractHistorically, urine in the urinary tract was considered “sterile” based primarily on culture-dependent methods of bacterial detection. However, the advent of enhanced quantitative urine culture (EQUC) and 16S ribosomal RNA gene sequencing has revealed the presence of bacterial DNA and live bacteria in the urinary tract, fundamentally changing our understanding of the urogenital microbiome.
Recent studies have demonstrated that healthy men, like women, possess distinct urinary tract microbiota. While evidence linking the urinary microbiota to lower urinary tract symptoms (LUTS) in women is accumulating, the association between urinary microbiota and LUTS in men, particularly those with benign prostatic hyperplasia (BPH), remains under investigation.
Emerging evidence suggests that dysbiosis of the urinary microbiota may contribute to BPH development and symptom severity through mechanisms such as chronic prostatic inflammation, inflammasome activation (e.g., NLRP3), and microbial-driven DNA damage in prostate epithelial cells. Notably, organisms like Escherichia coli and Burkholderia spp. have been implicated in intraprostatic inflammation and progression of BPH.
Additionally, the gut–prostate axis has gained attention as gut microbiota composition—particularly a high Firmicutes/Bacteroidetes ratio—has been associated with BPH via metabolic and immunological pathways. These findings open new avenues for microbiome-targeted therapies, including probiotics and modulation of intestinal microbiota, to prevent or manage male LUTS/BPH.
This lecture reviews current evidence linking the urogenital microbiome to BPH pathogenesis and symptomatology in men. Despite promising findings, clinical translation remains limited due to heterogeneity in sampling methods and lack of robust, large-scale studies. Further research is required to validate microbial biomarkers and develop evidence-based, noninvasive strategies for prevention and treatment of male LUTS/BPH.
TICC - 3F Banquet Hall
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08:30
17:00
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Nursing Course
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Mei-Nan LiaoTaiwan
Speaker
Welcoming Speech from the President of the Taiwan Nurses Association
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Ching-Hui ChienTaiwan
Speaker
Self-Management with an Application in Urogenital Cancer PatientsProstate, kidney, and bladder cancers are among the most common urogenital malignancies. Of these, prostate cancer has the highest incidence and prevalence, yet
also imposes the greatest burden in terms of disability-adjusted life years (DALYs). Evidence suggests that self-management can enhance quality of life by improving
urinary and bowel symptoms, sexual dysfunction, emotional well-being, psychological health, confidence in symptom management, and self-efficacy in patients with prostate cancer. Our team developed and implemented an app-based self-management intervention specifically for prostate cancer patients. The findings showed significant improvements in urinary symptoms, social participation, and self-efficacy. Healthcare providers are encouraged to integrate app-assisted self-management
strategies into clinical practice to better address the holistic needs of patients.
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Pei-Hung LiaoTaiwan
Speaker
Applying Machine Learning to Identify Associations Between Phthalates and Bladder Cancer: Enhancing Nursing AssessmentCancer remains the leading cause of disease-related death, with both incidence and mortality rates alarmingly high. Despite its impact, most current research continues to concentrate on treatment development. However, cancer is often diagnosed at a late stage, as symptoms typically appear only after significant disease progression. This delay in detection limits treatment effectiveness. Therefore, there is an urgent need to shift focus toward prevention and early diagnosis. One promising direction is the development of a risk prediction model for bladder cancer, particularly by investigating its association with high-risk environmental hormone exposure.
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Nerissa M. GerialPhilippines
Moderator
Leadership in Quality: Empowering Urology Nurses to Drive CQI Initiatives This presentation explores the critical role of urology nurses in leading and sustaining Continuous Quality Improvement (CQI) initiatives in the clinical setting, with a focus on practical application within the National Kidney and Transplant Institute (NKTI). It begins by defining CQI as a structured, data-driven, and preventive approach to improving patient care and institutional performance, grounded in national regulatory frameworks from the Department of Health (DOH).
The session introduces the PDCA (Plan-Do-Check-Act) cycle as the core CQI methodology and walks the audience through each phase using examples and guidance relevant to nursing practice. A special focus is given to the role of nursing leadership in fostering a culture of quality through visibility, support, recognition, and resource allocation and how leadership behaviors directly influence CQI success.
Building a CQI culture is illustrated through the NKTI model, highlighting strategies such as the establishment of a dedicated CQI unit, regular trainings, guided proposal development, executive-level presentations, recognition systems, and integration of CQI into performance evaluation. A practical example of problem prioritization based on the criteria of the Philippine Society of Quality in Healthcare is also included to demonstrate structured decision-making.
The presentation concludes by showcasing CQI milestones and award-winning projects in urology nursing, reinforcing the message that quality is not an accident. It is the result of intentional, collaborative, and skillfully led efforts. Nurses, regardless of position, are empowered to become change agents and stewards of continuous improvement in healthcare.
Hoi-Chu ToHong Kong, China
Moderator
Quiet Nights Ahead: Effective Behavioral Techniques for NocturiaNocturia—the frequent need to urinate during the night—affects millions worldwide, disrupting sleep quality and diminishing overall well-being. While pharmacological interventions exist, behavioral strategies offer a non-invasive, sustainable path to relief. This lecture explores evidence-based behavioral techniques to reduce nocturnal awakenings and improve sleep continuity. The behavioral techniques with fluid management, dietary adjustments, sleep hygiene, and bladder retraining protocols. By integrating practical tools with clinical understanding, this session empowers healthcare professionals and caregivers to guide patients toward quieter, more restorative nights—without relying solely on medication.Technical Pearls: Wheel-Barrow Techniques
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Yueh-Er ChiouTaiwan
Speaker
Epidemiological and Clinical Insights into the Causes and Prevention of UrolithiasisUrolithiasis is a growing global health issue with rising prevalence and high recurrence rates. In Taiwan, up to 34.7% of patients experience recurrence within five years. While treatment options like extracorporeal shock wave lithotripsy (ESWL) are widely used, long-term prevention remains a challenge. Risk factors include inadequate hydration, high sodium and animal protein intake, obesity, and metabolic disorders such as diabetes and hypertension.
Nurses play a vital role in educating patients, promoting lifestyle changes, and supporting chronic disease management. Empowering patients through nurse-led interventions is key to reducing recurrence and improving outcomes in urolithiasis care.
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Yen-Chi LinTaiwan
Speaker
Management of Acute Rejection After Kidney Transplantation-Case StudyA 35-year-old male underwent living donor kidney transplantation, complicated by acute rejection. Discuss the diagnostic approach and management strategies.
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Shu-Cheng WuTaiwan
Speaker
Developments in Immunotherapy for Urologic CancersImmunotherapy has progressed rapidly in genitourinary (GU) oncology, especially in renal cell carcinoma and urothelial carcinoma, providing many patients with meaningful, quality-adjusted survival gains. Focusing on urothelial carcinoma, I will examine how physicians and patients engage in shared decision-making, and—drawing on real-world experience in Taiwan—outline the current applications and future prospects of immunotherapy for this malignancy.
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Marinelle DoctorAustralia
Speaker
Addressing Adverse Reactions: Strategies for BCG Treatment OptimizationIntravesical Bacillus Calmette-Guerin BCG Therapy has been a cornerstone in the management of non-muscle invasive bladder cancer for several decades, demonstrating efficacy in reducing recurrence and progression rates. Nonetheless,its application is frequently limited by adverse reactions experienced by patients. These reactions, ranging from mild local irritations to severe systemic manifestations, pose significant challenges to both clinicians and patients, potentially leading to treatment discontinuation and compromised therapeutic outcomes.This session aims to explore innovative strategies for optimizing BCG treatments by mitigating these side effects.
In addition to clinical approaches, this session will highlight recent advancements in predictive markers for susceptibility to adverse reactions, offering insights into tailoring individual treatment plans.Furthermore, this session will tackle the impact of psychological support in managing treatment-related side effects. Participants attending this session will gain deeper understanding on how to enhance patient experience, improve compliance with BCG therapy , and ultimately achieve better therapeutic outcomes in bladder cancer treatment.
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Jiun-Liang ChenTaiwan
Speaker
Traditional Chinese Medicine in the Care of Cancer PatientsCancer disease remains a formidable global health challenge, the conventional therapeutic approaches to enhance treatment efficacy and reduce adverse effects. Traditional Chinese Medicine (TCM) has been practiced for thousands of years and is widely accepted as an alternative treatment for cancer at the present time. The treatments include Chinese herbal medicine and non-pharmaceutical interventions such as acupuncture, massage, moxibustion, and other acupoint applications. Numerous studies have indicated that the combination of TCM with radiotherapy, other drugs or chemotherapy can enhance the survival rates of cancer patients, improve their quality of life, and stop the growth and spread of cancerous cells. It also can improve cancer patients with co-morbid depressive symptoms and decreases the side effect of radiotherapy , chemotherapy, immunotherapy, and targeted therapy.
Key words Traditional Chinese Medicine, Cancer , Chemotherapy , Radiotherapy , Adverse effects
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Yeong-Yuh JuangTaiwan
Speaker
Integrating Psychosocial Care in Urological Cancer Treatment: Supporting Patients and Their FamilyUrological cancers significantly impact not only the physical health of patients but also their emotional and psychosocial well-being. Effective cancer care requires a holistic approach that addresses the psychological, social, and emotional challenges faced by patients and their families. This presentation focuses on the integration of psychosocial care into urological cancer treatment, emphasizing the importance of supporting both patients and their families throughout the cancer journey.
Key topics covered include recognizing the psychosocial needs of urological cancer patients, understanding the emotional burden on family caregivers, and implementing evidence-based interventions to enhance coping and resilience. Strategies such as early psychosocial screening, counseling, and multidisciplinary collaboration are discussed, along with practical tools for improving communication between healthcare providers, patients, and families.
The presentation also highlights the benefits of integrating psychosocial care, including improved patient adherence to treatment, enhanced quality of life, and reduced caregiver stress.
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Nerissa M. GerialPhilippines
Speaker
Leadership in Quality: Empowering Urology Nurses to Drive CQI Initiatives This presentation explores the critical role of urology nurses in leading and sustaining Continuous Quality Improvement (CQI) initiatives in the clinical setting, with a focus on practical application within the National Kidney and Transplant Institute (NKTI). It begins by defining CQI as a structured, data-driven, and preventive approach to improving patient care and institutional performance, grounded in national regulatory frameworks from the Department of Health (DOH).
The session introduces the PDCA (Plan-Do-Check-Act) cycle as the core CQI methodology and walks the audience through each phase using examples and guidance relevant to nursing practice. A special focus is given to the role of nursing leadership in fostering a culture of quality through visibility, support, recognition, and resource allocation and how leadership behaviors directly influence CQI success.
Building a CQI culture is illustrated through the NKTI model, highlighting strategies such as the establishment of a dedicated CQI unit, regular trainings, guided proposal development, executive-level presentations, recognition systems, and integration of CQI into performance evaluation. A practical example of problem prioritization based on the criteria of the Philippine Society of Quality in Healthcare is also included to demonstrate structured decision-making.
The presentation concludes by showcasing CQI milestones and award-winning projects in urology nursing, reinforcing the message that quality is not an accident. It is the result of intentional, collaborative, and skillfully led efforts. Nurses, regardless of position, are empowered to become change agents and stewards of continuous improvement in healthcare.
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Pei-Shan HoTaiwan
Speaker
Continuous Quality Improvement for Post-Renal Transplantation PatientsUnplanned hospital readmission after kidney transplantation is a significant challenge affecting patient prognosis and the quality of medical care. Data indicate that from April 1, 2017, to March 31, 2018, the unplanned readmission rate within 30 days of kidney transplantation was as high as 33%. The primary reasons for readmission included: urinary tract infection (40%), abnormal renal function (20%), abnormal liver function (20%), and abnormal drug levels (20%).
Analysis of personnel factors revealed that patient-side issues contributed, such as poor fluid intake, poor hygiene habits, poor medication compliance, and unclear dietary concepts. Additionally, from the perspective of both patients and nurses, there was too much information provided and a lack of educational tools. Although the educational content was comprehensive, it lacked intuitiveness and focus, making it difficult for patients to remember and learn, leading to quick forgetting of what was learned. These issues were also identified as workflow design problems.
To address these challenges, the project implemented several countermeasures:
•Improved care skills: This involved guiding patients to learn the correct concept of drinking water and utilizing QR Codes to assist with health education.
•Optimized educational tools: This included the development of tabletop games and the provision of practical aids such as specialized water bottles and medicine boxes.
•Introduction of a checklist.
•Strengthened interprofessional collaboration: As part of discharge planning, a nutritionist joined the patient care on postoperative day 7, and a pharmacist provided discharge education 3 days before discharge.
These multi-faceted quality improvement measures have effectively resolved the issue of unplanned readmissions among post-renal transplantation patients, significantly enhancing patient care quality and prognosis. These improved measures continue to be applied in clinical practice.
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Piao-Yi ChiouTaiwan
Speaker
A Quality Improvement Approach to Discharge Planning Services in NTUH Urology WardBackground:
Unplanned hospital readmissions are associated with increased morbidity and mortality, particularly among older adults. Although structured discharge planning and follow-up may reduce readmissions and improve post-discharge outcomes, more evidence is needed to confirm their effectiveness in high-risk populations.
Objectives:
This quality improvement project aimed to (1) reduce 30-day unplanned readmissions, (2) enhance discharge readiness through structured education, and (3) improve patient and caregiver satisfaction with discharge planning and transitional care.
Methods:
A nurse-led, multidisciplinary discharge planning program was implemented in a urology ward of a medical center in Northern Taiwan. High-risk patients were identified based on impaired function, medical tubing, unhealed wounds, recent transplantation, or chemotherapy. Interventions included nurse training, tailored patient education, caregiver coaching, follow-up calls within one week of discharge, and referrals to home or long-term care services.
Results:
In 2023, 1,042 high-risk patients were enrolled, with 99.4% completing follow-up. Sixteen cases (1.5%) involved unplanned readmissions or emergency visits, down from 19 cases (1.7%) in 2022. Common concerns included wound care, catheter issues, and symptom management. Patient satisfaction with nursing and medical care averaged 4.9/5, and family satisfaction remained high (4.7/5). Thirteen patients were referred for further care. Internal audits showed improved nurse compliance with risk screening and documentation.
Conclusion:
This structured, nurse-led discharge program effectively reduced readmissions and improved satisfaction among high-risk urological patients. Findings support the value of individualized, patient-centered transitional care. Digital tools may enhance future outcomes.
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Marcerey Sison QuejadaUnited Arab Emirates
Speaker
Charting Our Course to COEU: Our Hospital Journey in Urology Accreditation for Patient Safety and Care QualityOur hospital’s pursuit of Center of Excellence in Urology (COEU) accreditation focused on advancing patient safety and care quality through evidence-based practices, staff competency development, and workflow optimization. By refining protocols, fostering multidisciplinary collaboration, and leveraging performance data, we achieved measurable gains in safety indicators, procedural efficiency, and patient satisfaction. This journey highlights accreditation as a catalyst for lasting improvements in urology care delivery.
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Marcerey Sison QuejadaUnited Arab Emirates
Moderator
Charting Our Course to COEU: Our Hospital Journey in Urology Accreditation for Patient Safety and Care QualityOur hospital’s pursuit of Center of Excellence in Urology (COEU) accreditation focused on advancing patient safety and care quality through evidence-based practices, staff competency development, and workflow optimization. By refining protocols, fostering multidisciplinary collaboration, and leveraging performance data, we achieved measurable gains in safety indicators, procedural efficiency, and patient satisfaction. This journey highlights accreditation as a catalyst for lasting improvements in urology care delivery.
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William J. HuangTaiwan
Speaker
Male Infertility: Challenges and Opportunities in AsiaMale infertility contributes to nearly 50% of all infertility cases, with an increasing burden observed across Asia. In parallel, a dramatic decline in birth rates has emerged in several Asian countries—including South Korea, Japan, Taiwan, and Singapore—reaching historically low total fertility rates (TFRs) of under 1.0. While multifactorial in nature, this demographic crisis underscores the urgent need to address all aspects of reproductive health, including the often-overlooked role of male infertility. Epidemiological data reveal significant regional disparities in the prevalence, diagnosis, and treatment of male infertility. Cultural stigma, limited andrology training, fragmented referral systems, and inadequate coverage of assisted reproductive technologies (ART) have impeded timely diagnosis and intervention. Environmental exposures, endocrine-disrupting chemicals, occupational heat, and increased paternal age have all been linked to declining semen quality, as evidenced by longitudinal studies showing decreased sperm concentration and motility in several urban centers across Asia. Current diagnostic tools—including semen analysis, hormone profiling, genetic testing (e.g., Y-chromosome microdeletion, karyotyping), and imaging—enable better etiological categorization. Microsurgical sperm retrieval techniques such as mTESE have provided new hope for patients with non-obstructive azoospermia, while ICSI and sperm cryopreservation have become increasingly utilized where available. Nevertheless, access remains inconsistent, particularly outside metropolitan regions. Recent integration of AI-based systems for semen evaluation, patient triage, and digital counseling offers promising strategies to improve care delivery, especially in under-resourced settings. However, data privacy, regulatory standards, and user trust continue to pose barriers to widespread implementation. Opportunities for systemic improvement include the development of regional male infertility registries, integration of andrology into national reproductive health frameworks, expansion of insurance coverage for fertility services, and public awareness campaigns to destigmatize male infertility. In light of Asia’s fertility decline, repositioning male reproductive health as a public health and demographic priority is essential for sustainable population policy and long-term healthcare planning.
The Peri-Operative Care of MIST For Prostate HyperplasiaMinimally invasive surgical therapies (MIST), particularly UroLift and Rezūm, have transformed the treatment landscape for benign prostatic hyperplasia (BPH), offering effective symptom relief with reduced morbidity and preservation of sexual function. However, optimal outcomes depend not only on procedural execution, but also on well-structured peri-operative care protocols encompassing pre-, intra-, and post-operative management. Pre-operative evaluation includes comprehensive assessment of prostate anatomy—especially size, shape, and presence of median lobe—via imaging (TRUS or cystoscopy) to determine candidacy. Careful patient selection is essential: UroLift is typically suited for prostates <80 cc without obstructive median lobes, while Rezūm accommodates broader anatomical variability but may have delayed symptom resolution. Baseline symptom scores (e.g., IPSS), uroflowmetry, and post-void residual volume establish functional benchmarks and guide patient counseling. Anesthesia planning must consider procedural setting and patient comorbidities. UroLift can often be performed under local anesthesia with light sedation, whereas Rezūm may require short general anesthesia or deeper sedation due to thermal discomfort. Appropriate selection reduces intraoperative stress and facilitates same-day discharge. Intraoperative care focuses on minimizing trauma and ensuring device precision. UroLift requires accurate deployment of implants to maintain lateral lobe retraction without compromising sphincter integrity. In Rezūm, the number and duration of vapor injections must be titrated based on lobe size and configuration to balance efficacy and tissue inflammation. Real-time visualization and standardized protocols reduce variability and improve safety. Post-operative management involves anticipating and controlling transient irritative symptoms, such as dysuria, urgency, and hematuria. Alpha-blockers and anti-inflammatory medications are commonly used for 3–7 days post-procedure. Catheterization strategies differ by technique: UroLift may avoid catheter use entirely, whereas Rezūm often requires 7-14 days of catheter drainage due to anticipated edema. Monitoring for urinary retention, UTI, or clot obstruction is critical during the early recovery phase. Follow-up care typically occurs at 2–4 weeks and includes reassessment of voiding function, symptom scores, and patient satisfaction. Reinforcement of realistic expectations is especially important with Rezūm, which may take 4–6 weeks to achieve peak efficacy. Longitudinal studies indicate sustained symptom relief and low retreatment rates when peri-operative care is standardized and patient education is emphasized. Adverse event profiles differ between techniques: UroLift is associated with less dysuria but higher retreatment rates in large prostates, while Rezūm presents higher rates of transient discomfort but favorable durability. Structured peri-operative care pathways—including patient education, standardized medication protocols, and clear complication management plans—enhance recovery, minimize adverse events, and improve overall clinical success.
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Fang-Wen HuTaiwan
Speaker
Empowering Optimal Care: A Tiered Approach to Preventing Inappropriate Urinary Catheter Use in Hospitalized Older PatientsThe prevalence of urinary catheter use in hospitalized older patients is approximately 25%, with an estimated 43.9% to 54% deemed inappropriate. Indwelling urinary catheters are associated with extended hospital stays and increased mortality. To address these concerns, we developed a tiered approach framework aimed at reducing inappropriate urinary catheter use and its associated adverse outcomes. This three-year interrupted time series study employed a systematic approach to design, implement, and evaluate the effectiveness of this model. In the first year, we assessed the incidence, risk factors, and outcomes related to inappropriate catheter use among hospitalized older patients. Additionally, we explored knowledge, attitudes, perceptions, and practices concerning catheter use among physicians, nurses, hospitalized older patients, and their primary caregivers. Using a modified Delphi method, we developed a tiered approach model comprising four components: (1) restricting catheter use to appropriate indications (Tier 1A), (2) encouraging the use of alternatives when feasible (Tier 1B), (3) ensuring aseptic techniques for catheter insertion and maintenance (Tier 1C), and (4) facilitating timely catheter removal (Tier 1D). Based on findings from the first year, we implemented educational interventions during the second year, targeting healthcare professionals, patients, and caregivers. Simultaneously, the tiered approach was integrated into routine clinical care processes and subjected to pilot testing. In the third year, the model was fully implemented across clinical settings, and its effectiveness in reducing inappropriate urinary catheter use in hospitalized older adults was systematically evaluated.Empowering Optimal Care: A Tiered Approach to Preventing Inappropriate Urinary Catheter Use in Hospitalized Older Patients
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Hoi-Chu ToHong Kong, China
Speaker
Quiet Nights Ahead: Effective Behavioral Techniques for NocturiaNocturia—the frequent need to urinate during the night—affects millions worldwide, disrupting sleep quality and diminishing overall well-being. While pharmacological interventions exist, behavioral strategies offer a non-invasive, sustainable path to relief. This lecture explores evidence-based behavioral techniques to reduce nocturnal awakenings and improve sleep continuity. The behavioral techniques with fluid management, dietary adjustments, sleep hygiene, and bladder retraining protocols. By integrating practical tools with clinical understanding, this session empowers healthcare professionals and caregivers to guide patients toward quieter, more restorative nights—without relying solely on medication.Technical Pearls: Wheel-Barrow Techniques
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TICC - 2F 201AF
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10:00
10:30
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TWTC - 1F Exhibition Hall
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10:30
12:00
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Michael WongSingapore
Speaker
Introduction to Asia School of UrologyAsian School of Urology 2022-2026 – New initiatives
Dr Michael YC Wong
Principal Director of ASU 2022-2026
President Endourological Society and WCET 2026
Introduction
Asian School of Urology (ASU) officially started in 1999 with the appointment of her first director Prof Pichai Bunyaratavej from Thailand (1999-2002) Subsequent directors were Dato Dr Rohan Malek from Malaysia (2002-2006) Prof Foo Keong Tatt from Singapore (2006-2010) Prof Rainy Umbas from Indonesia (2010-2014 ) and Prof Shin Egawa from Japan ( 2014-2022 ).
One of the highlights of the ASU in the early days were the organization of several workshops outside of UAA congress by three active sub-specialty sections of UAA namely Asian society of Endourology (over 16 workshops held from 1998-2008), Asian Society of Female Urology and Asia-Pacific society of Uro-Oncology. Other subspecialty sections were subsequently introduced and have matured very well including Asian Society of UTI and STI, Asian-Pacific Society of Andrological and Reconstructive Urology Surgeons.
In the last 8 years, ASU has seen tremendous growth under the steady leadership of Prof Shin Egawa with introduction of UAA lecturers at national Meetings and further maturation of the subspecialty sections of UAA e.g., Conversion of Asian society of endourology to Asian Robotic Urological Society to reflect the growth and development of UAA. During the past 8 years, ASU-South-East Asia section has also managed to organize 15 physical workshops and 4 webinars outside of UAA congress.
The Growth Trajectory for the next 4 years 2022-2026
There are many areas where ASU can grow further. Bearing in mind our limited resources and our excellent relationships with the world urological leaders at this point in our history.
There are three areas which I will focus on. Please remember that ASU is always open to other new initiatives as we must stay relevant to our Asian urological community.
1. Lasting and strong Relationships
1.1 AUA. Over a dish of chili crab with AUA secretary general Gopal Badlani, we explored the common desire to elevate Asian Urology and strengthen UAA Family. This led to our first joint UAA-AUA residency course at UAA Singapore 2016. After successful completion, a MOU was signed at AUA 2017 with Richard Babayan, Manoj Monga, Allen Chiu and myself in attendance. The AURC at UAA Hong Kong under Prof Eddie Chan was the result of this signed MOU. We are extremely grateful for the generosity of AUA for this program. What may not be obvious is that Gopal Badlani, Manoj Monga, John Denstedt and I served as faculty and board directors at WCE. We will sign the extension MOU in 2023 for another three years.
1.2 EAU. We have a very successful UAA-EAU Youth program since UAA Thailand 2012. This has been the work of several UAA senior members. From 2023, we are exploring joint webinars with EAU to build on this relationship.
1.3 SIU and WCE. We will further explore options based on available resources and manpower. Joint Webinar are planned for early 2026
2. Education Platform for Asian Urology Residents
From 2023, we will continue to grow our relationship with BJUI. BJUI has developed a world class online learning platform with tremendous investments since 2013. This platform is called BJUI Knowledge. ASU will reach out to all Asian residents via their national urological association president and secretary to encourage every resident to sign up for a free access to more than 420 interactive 30-minute modules covering the whole urology syllabus suitable for learning, exit exams and recertification exams. I am personally involved in developing all modules under Endourology and urolithiasis Section and have been associate editor since May 2013. The modest aim is for at least 10 residents per country to sign up by UAA 2023. We will report progress at each UAA council meeting. Pls see attached information and if there are any questions pls email me personally at email@drmichaelwong.com
3. Re-Strategize Training cum fellowship sites for ASU.
3.1 In the past we have always talked about the possibility about training sites for UAA and ASU. It has always been a difficult task due to financial and multiple logistics issues.
3.2 What can we do that is possible? Let us consider two options in the next 4 years.
3.3 For the last 6 years a group of Asian urologists started AUGTEG to design and provide two-day surgical training which includes lectures as well as dry and wet lab to develop surgical skills. AUSTEG has direct access to physical training centres in Thailand, South Korea, and China.
ASU will work with AUGTEC to pool resources since we are the same people working on both sides e.g., Anthony Ng (chairman of AUSTEG) Michael Wong (vice chairman) Eddie Chan (treasurer). AUGTEG is registered in HK.
3.4 The second option is to recognise elected university or training Asian centres to allow an attachment for young urologist post residency in a flexible format. ASU will recognise officially these sites as endorsed by UAA. At UAA 2025 , several potential ASU/UAA fellowship sites directors will be presenting their programmes to kickstart this initiative
4. In conclusion, ASU will continue to grow and serve the Asian Urological Community. The above initiatives are only the beginning of a next chapter. Can you contribute your ideas and current available resources for this purpose? If you can, Pls email me personally at email@drmichaelwong.com
Which Position is the Best for PCNL in 2025?With tremendous advances in both technique and technology , the MIS approach to staghorn calculi has evolved significantly over the last 30 years.
It is timely to review all the landmark articles on patient positioning as this ultimately determines renal access which in turn plays a major role in stone free rates. We will gain much insight as we debate and attempt to answer the question of which position is best in 2026!
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Albert El HajjLebanon
Speaker
Battle of the Robots in Flexible Ureteroscopy: What's the Verdict?AAU Lecture: Robotic Flexible Ureterorenoscopy— Gimmick or a True Helper? What’s It Cost Performance Value?
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BM Zeeshan HameedIndia
Speaker
Artificial Intelligence and Machine Learning in Endourology - Is It the Way Forward?
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Rajeev TPIndia
Speaker
Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith
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Nobutaka ShimizuJapan
Speaker
Clinical Utility of AINAFHIC: AI-Guided Navigation for Hunner's Lesion and Interstitial CystitisBackground: Hunner lesion (HL)-type interstitial cystitis (IC) is a distinct subtype of IC/BPS characterized by epithelial denudation and submucosal inflammation. However, endoscopic detection is highly operator-dependent, with reported detection rates ranging from 5% to 57%. To enhance diagnostic consistency, we developed AINAFHIC (AI Navigation for Hunner and IC), a deep-learning–based system designed to assist in HL detection using cystoscopic images under white light imaging (WLI) and narrow band imaging (NBI). Methods: A total of 6,230 cystoscopic images (WLI, 2,238; NBI, 3,992) were retrospectively extracted from the video recordings of 103 patients with IC/BPS. The images were annotated by an expert urologist based on the definition of ESSIC-HL. The AINAFHIC was developed using a Cascade Mask R-CNN framework to detect HL, non-HL mucosal changes, and artifacts such as air bubbles. The models were trained separately for WLI and NBI images. Results: The AINAFHIC demonstrated an HL detection accuracy of over 90% for WLI and 67% for NBI. Clinical case analysis revealed improved identification of subtle HLs missed during visual inspection. Conclusions: AINAFHIC facilitates objective, high-accuracy detection of Hunner’s lesions from standard cystoscopic videos. This tool holds promise for standardizing HL diagnosis and supporting tailored treatment decisions in patients with IC/BPS. Future directions include multi-institutional validation and development of real-time AI-guided cystoscopy.
TICC - 3F Plenary Hall
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Erectile Dysfunction: Cardiovascular and Regenerative Advances
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Hung-Chieh ChiuTaiwan
Speaker
Erectile Dysfunction and Cardiovascular Health: Insights from the Updated Princeton Consensus1. PDE-5i exposure was associated with lower incidence of MACE, CV death, and overall mortality risk compared to non exposure and risk reduction correlated with PDE-5i exposure level.
2. Highlight of PDE5i and cardiac health in the 4th Princeton Consensus Conference.
3. ED symptoms precede clinically evident CVD by as long as 2 to 5 years.
4. ED management in patients taking nitrate-containing medications or substances.
5. Drug–drug interactions and CV safety of PDE5 inhibitors( real-world observation data) .
6. PDE5 inhibitors may have cardioprotective effects and might play a role in preventative cardiology in the future.
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Bang-Ping JiannTaiwan
Speaker
Phosphodiesterase Type 5 Inhibitors (PDE5Is) and Their Role in Cardiovascular Health Phosphodiesterase type 5 inhibitors (PDE5Is) recommended as the first line treatment for erectile dysfunction (ED) in men. The increasing experience from PDE5Is use in ED along with a deeper understanding of cGMP-regulated mechanisms, gradually stimulated the scientific interest for further potential applications. PDE5Is were found to ameliorate pulmonary vascular resistance by augmenting NO-mediated vasodilation in the lungs. In animal models, PDE5Is were found to attenuate ischemia-reperfusion myocardial injury and reduce arrhythmia burden. In human studies, PDE5Is substantially improve myocardial contractility and clinical variables in patients with systolic heart failure. Meanwhile, PDE5Is have been shown to reduce pro-inflammatory mediators and improve markers of vascular aging in patients with ED. The pooled analysis of 16 studies demonstrated that the risk of major adverse cardiovscular events and all-cause mortality was reduced by 22% and 30%, respectively, in patients exposed to PDE5Is compared to controls. The use of PDE5Is provides important clinical benefits that extend beyond ED and include cardioprotective effects and improved survival after acute myocardial infarction.
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Vinod K.VIndia
Speaker
Testosterone Therapy: Implications for Cardiovascular Health Sexual Function Preservation in MIS for BPH
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Weida LauSingapore
Speaker
An Indepth Discussion on Male InfertilityIn this lecture, we will look at the urologist role in the diagnosis and management of male infertility. We will take an indepth look at the timing of male infertility consult and the assessment of patient focusing on risk factors and the diagnosis of important etiologies of male infertility. Next, we address the interpretation of basic semen analysis and other essential tests for male infertility. Lastly, without being too exhaustive, we learn to manage specific management scenarios including varicocele, obstructive azoospermia, medical management of male infertility, and the issue of sperm retrieval. Low-Intensity Shockwave Therapy: Current Evidence and Applications in Erectile DysfunctionIn this lecture, we aim to understand the basic science behind the use of LiESWT for erectile dysfunction and summarize the evidence that supports the utility of LiESWT for ED. Next, the lecture will address the role of LiESWT in the present armamentarium for the management of ED, including selection of patients who will best benefit from the treatment. Lastly, the talk will touch on current trends in the use of shockwave treatment including the prevalence in the use of radial shockwaves that has gained popularity in some regions despite the lack of evidence for efficacy.
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Yi-Kai ChangTaiwan
Speaker
A Practical Guide on Management for Sexual DysfunctionPlatelet-Rich Plasma (PRP) Therapy: Current Evidence and Applications in Erectile Dysfunction
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Chun-Hou LiaoTaiwan
Speaker
Regeneration Medicine in Urology - A Promising Future or Hoax?Regenerative medicine comprises therapeutic strategies aimed at restoring tissue structure and function, rather than merely alleviating symptoms. By deploying cells, biomaterials, bioactive molecules, or combinations thereof, these interventions stimulate the body’s intrinsic repair mechanisms. This paradigm extends beyond traditional symptomatic treatment, offering the potential for true self-healing and organ reconstruction—ultimately prioritizing cure over chronic disease management.
Cell-based therapy has emerged as a promising intervention for various urogenital disorders, including erectile dysfunction (ED), bladder dysfunction, and male infertility. Current clinical research primarily focuses on mesenchymal stem cells (MSCs), investigating their safety, tolerability, and preliminary efficacy. Although early-phase studies suggest functional benefits—such as improved hemodynamics and tissue regeneration—most programs remain in preclinical or early clinical stages. A critical limitation remains the lack of standardization in MSC source, dose, and delivery route.
Among alternative sources, human amniotic fluid-derived stem cells (hAFSCs) have shown particular promise. In preclinical models of cavernous nerve injury, hAFSCs demonstrated prolonged retention in penile tissue and in-situ differentiation into α-smooth muscle actin-positive corporal smooth muscle cells, effectively replacing damaged tissue and restoring function. These findings represent an encouraging step toward curative therapy. However, the mechanisms governing their in vivo behavior—such as engraftment, differentiation, and immunogenicity—will ultimately determine their clinical translatability and therapeutic stability. Whether cell-based approaches can evolve from experimental platforms into routine clinical care remains a central question.
Platelet-Rich Plasma (PRP)
Platelet-rich plasma (PRP) is an autologous biologic product enriched with supraphysiologic levels of platelets, growth factors, chemokines, and extracellular vesicles. Upon activation, PRP releases a bioactive cocktail that promotes angiogenesis, neuroregeneration, and antifibrotic remodeling—key processes in the restoration of urogenital tissues.
In rodent models of cavernous nerve injury, PRP has been shown to preserve corporal sinusoidal endothelial cells and axonal scaffolds, while restoring erectile hemodynamics. Clinical studies further support PRP's safety in humans and report variable but promising improvements in IIEF scores following intracavernous injection. Nevertheless, the therapeutic response appears heterogeneous, likely influenced by patient factors, PRP preparation techniques, and injection protocols. Beyond ED, PRP has shown potential in other urologic indications such as stress urinary incontinence (SUI), interstitial cystitis/bladder pain syndrome (IC/BPS), and chronic pelvic pain, where it may contribute to tissue regeneration and symptom relief. However, broader adoption will require the establishment of individualized blood-quality metrics, standardized preparation methods, and randomized controlled trials demonstrating durable benefit.
Emerging Regenerative Strategies
Beyond cell-based and autologous biologics, a suite of innovative regenerative technologies is progressing from bench to bedside. These include:
Energy-based devices such as low-intensity extracorporeal shock wave therapy (Li-ESWT), which promotes neovascularization and tissue regeneration via mechanotransduction pathways.
Gene therapies, targeting dysfunctional or absent proteins in disorders like overactive bladder.
Smart biomaterials, capable of delivering cells or bioactive molecules in a controlled, responsive manner.
Extracellular vesicle (EV)-based therapeutics, which leverage cell-free vesicles derived from MSCs or urine-derived stem cells. These EVs carry signaling molecules (e.g., microRNAs, cytokines, growth factors) that mimic the paracrine effects of stem cells, offering a potentially safer and more scalable alternative to cell transplantation.
In preclinical models of ED and bladder dysfunction, EVs have demonstrated the capacity to promote smooth muscle regeneration, nerve sprouting, and fibrosis reduction, with functional improvements comparable to stem cell therapy.
Regenerative medicine has propelled the field of urologic tissue repair from theoretical promise to an early clinical reality. While substantial challenges remain—including the need for deeper mechanistic insight, protocol standardization, and regulatory clarity—the field is advancing rapidly. The convergence of cell therapy, PRP, EVs, and device-based modalities is creating a multifaceted toolkit for urologic regeneration. With continued scientific rigor, large-scale clinical trials, and interdisciplinary collaboration, regenerative medicine holds the potential to shift urologic care from chronic symptomatic management to durable, tissue-level cure.Stem Cell Therapy: Advancements and Clinical Insights for Erectile Dysfunction Treatment Erectile dysfunction (ED)—defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity—affects over 150 million men worldwide. While phosphodiesterase-5 inhibitors (PDE5is) remain the first-line treatment, many patients, particularly those with diabetes, age-related vascular decline, or neuropathy following radical prostatectomy, show suboptimal responses. Consequently, regenerative medicine—particularly stem-cell therapy—has gained interest for its potential to address the root causes of ED rather than merely managing symptoms.
Stem-cell therapy offers a multifaceted approach to treating ED through neuroregeneration, angiogenesis, anti-apoptotic signaling, and fibrosis inhibition. Once introduced into the target tissue, stem cells can differentiate into specific cell types or exert paracrine effects via secretion of growth factors and extracellular vesicles. Among the various sources studied, bone marrow-derived mesenchymal stem cells (BM-MSCs), adipose-derived stem cells (ADSCs), and umbilical cord-derived MSCs (UC-MSCs) have been most extensively explored.
Preclinical studies consistently demonstrate that MSC-based therapies enhance cavernous nerve regeneration, suppress fibrosis, and preserve endothelial integrity. In rat models of diabetes- or nerve-injury-induced ED, intracavernosal injections of ADSCs or BM-MSCs significantly restore intracavernosal pressure (ICP) and improve corpus cavernosum histology. Phase I/II clinical trials also support the safety and preliminary efficacy of stem-cell approaches. For example, in men with diabetic ED treated with autologous BM-MSCs, significant improvements in International Index of Erectile Function-5 (IIEF-5) scores and penile arterial flow have been reported without major adverse events. Similarly, ADSC therapy in post-prostatectomy ED has shown encouraging short-term results. However, large-scale trials are needed to clarify long-term efficacy, immune responses, and safety profiles.
Human amniotic fluid stem cells (hAFSCs) represent a promising alternative, offering characteristics that bridge embryonic and adult stem-cell profiles. These include broad multipotency, high proliferation, and low immunogenicity—traits ideal for allogeneic use and neuroregenerative purposes. Notably, hAFSCs secrete potent regenerative mediators such as brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and insulin-like growth factor-1 (IGF-1), all of which support neurovascular repair and smooth muscle integrity. Our recent studies demonstrate, for the first time, that hAFSCs persist long-term in penile tissue and can differentiate into cavernous smooth-muscle cells, effectively replacing damaged tissue and improving erectile function even in chronic neurogenic ED models.
Despite these advantages, our findings did not reveal in-vivo homing of hAFSCs to nerve injury sites or differentiation into neural tissue. This suggests a need for future studies to identify the specific microenvironmental cues required to induce such responses. Additionally, combining hAFSCs with platelet-rich plasma (PRP) may provide synergistic benefits—enhancing stem-cell homing, paracrine signaling, and in-vivo differentiation—thereby advancing a more effective, scalable, and safe therapeutic strategy.
TICC - 2F 201BC
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Robotic Surgery
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Jian-Ri LiTaiwan
Moderator
Applying Vision Augmentation in Robotic Surgery: Reality or FictionApplying Vision Augmentation in Robotic Surgery: Reality or Fiction
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Ketan BadaniUnited States
Speaker
Expanding horizons: SP for complex RAPNThe Future of Urological Robotic SurgerySingle-Port Robotic Partial Nephrectomy for Multiple or Large Renal TumorsHow to Standardize Training by AI-Learning from The Best Practice of Urological Robotic SurgerySP Partial Nephrectomy
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Allen W. ChiuTaiwan
Speaker
Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques.
This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system.
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Steven L. ChangUnited States
Speaker
The Progression Landscape of Diagnostic and Treatment Options for Kidney CancerPros and Cons in the daVinci SP System Applications in Urological Surgeries
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TICC - 2F 201DE
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Chung-Cheng WangTaiwan
Commenter
Ureteral Stent and SelectionUreteral stents are widely used in urology for the management of obstructive uropathies, including urologic or non-urologic malignancy, radiation therapy, ureteral calculus, infection, surgical or nonsurgical trauma, or congenital factors. An untreated ureteral obstruction could result in urinary tract infection, abdominal or flank pain, and a deterioration of renal function. Despite their widespread utility, the selection of an appropriate ureteral stent remains a complex clinical decision involving multiple variables including patient-specific factors, disease pathology, duration of stenting, and the desired balance between drainage efficacy and patient comfort.
Advancements in stent technology have led to the development of a variety of stent types, distinguished by their material composition (e.g., polyurethane, silicone, and hydrophilic-coated polymers), design features (e.g., double-J, multi-length, tail stents), drug-eluting capabilities, reinforced metallic stent, and biodegradable stents. Each design aims to optimize certain aspects of performance such as resistance to encrustation, migration, infection, and stent-related symptoms.
Key considerations in stent selection include indwelling time, risk of infection or encrustation, patient anatomy, and comorbidities or prior urologic surgery. For short-term use, polyurethane or co-polymer stents are often preferred due to their balance of flexibility and cost-effectiveness. In contrast, silicone stents may be more appropriate for long-term indwelling due to their superior biocompatibility and reduced encrustation rates. Drug-eluting stents are emerging as promising options in cases of recurrent infection or tumor-associated obstruction. Softer materials, tapered tips, and biodegradable stents aim to reduce stent-related lower urinary tract symptoms.
Recently, we reported the efficacy and safety of Allium metallic ureteral stents in treating 13 patients with refractory ureteral strictures. The median (IQR) age of the patients was 63 (46–76) years. The median (IQR) follow-up was 15 (13.5–21) months. Treatment success and improvement were noted in 9 (69.2%) and 3 (23.1%) patients, respectively. Compared to the preoperative levels, the median (IQR) serum creatinine levels were significantly improved at 3 months after the operation [1.6 (1.25–2.85) vs. 1.2 (1.05–2.05), p = 0.02] and at the last visit [1.6 (1.25–2.85) vs. 1.2 (1.05–1.8), p = 0.02]. Stent migration and encrustation were noted in three (23.1%) and one (7.7%) patients, respectively. The preliminary results showed that Allium ureteral stents were safe and effective for patients with refractory ureteral strictures.
In conclusion, as technology continues to evolve, the future of ureteral stenting lies in personalized device selection based on real-time patient feedback, predictive analytics, and enhanced biomaterials. Further clinical trials and comparative studies are essential to establish evidence-based guidelines that can assist clinicians in making the most appropriate stent choices for optimal outcomes
Fixed and Adjustable Male Slings: Key Techniques for Primary Implantation and Troubleshooting in Challenging CasesMale slings have emerged as an effective surgical solution for stress urinary incontinence (SUI) following radical prostatectomy, offering an alternative to artificial urinary sphincters, particularly in patients with mild to moderate incontinence. Among the available options, fixed and adjustable male slings represent two major categories, each with distinct mechanisms of action, implantation techniques, and postoperative management considerations.
Fixed male slings work by repositioning and compressing the bulbar urethra against the pubic ramus to restore continence. These slings rely on proper patient selection—typically individuals with preserved sphincter function, low-volume leakage, and no prior pelvic radiation. Key technical considerations include precise dissection of the perineal space, adequate urethral mobilization, tension-free sling placement, and symmetric anchoring of the arms. Avoidance of over-tensioning is crucial to prevent postoperative urinary retention and perineal discomfort.
Adjustable male slings offer intraoperative or postoperative modification of sling tension to accommodate varying degrees of incontinence or suboptimal initial outcomes. These slings are particularly useful in patients with higher degrees of incontinence, previous pelvic surgery, or radiation. The implantation techniques vary but generally involve positioning a cushion or compressive element under the urethra, with external or subcutaneous access ports for saline adjustment. Mastery of device calibration, port placement, and infection prevention are critical to long-term success.
Challenging cases—such as those involving prior sling failure, prior pelvic radiation, fibrosis, or altered anatomy—require tailored strategies. In irradiated patients, tissue integrity and healing potential are compromised, often necessitating the use of adjustable systems with minimal tissue dissection or the combination of sling and bulking agents. In reoperative fields, precise identification of tissue planes and modified dissection techniques are required to prevent urethral injury or inadequate compression. Troubleshooting sling failure involves assessing continence status, sling positioning via imaging or endoscopy, and determining whether revision, adjustment, or conversion to an artificial urinary sphincter is most appropriate.
Postoperative complications including infection, urethral erosion, urinary retention, and persistent incontinence can be mitigated by proper surgical technique, patient education, and regular follow-up. Management of these complications should be proactive and individualized, balancing intervention timing with patient expectations and functional goals. In this topic, we will share our experiences to avoid these complications and increase the successful outcome.
Steffi YuenHong Kong, China
Speaker
The Power of Powerbend in Management of Lower Pole and Complex StonesThe management of lower pole stones (LPS) and complex renal calculi remains one of the most challenging aspects of contemporary urolithiasis treatment, with the deflection capability of flexible ureteroscopes serving as the critical determinant of surgical success. Modern flexible ureteroscopes achieve impressive bidirectional deflection angles of 270° or even more, representing a significant advancement from earlier generation instruments. However, this “working deflection” capacity becomes substantially compromised when therapeutic instruments, such as laser fibers or stone baskets, are inserted through the working channel.
The anatomical challenges of lower pole access, particularly steep infundibulopelvic angles, necessitate prolonged maximal deflection during lithotrispy that significantly increases the risk of ureteroscope damage and surgeon fatigability. Deflection deterioration is also directly proportional to instrument usage, with newer single-use scopes coming to the rescue.
The introduction of flexible and navigable suction access sheaths (FANS) has revolutionized lower pole stone management allowing direct access to performing lithotriopsy and stone fragments retrieval, reducing the need for stone basket in stone relocation and fragment retrieval. Recent multicenter studies demonstrate comparable stone-free rates (<2mm) between lower pole and non-lower pole locations (96.6% vs 98.4%) when using FANS, with minimal complications and low reintervention rates. With current technological advancements, combined with improved surgical techniques and the strategic choice of single-use ureteroscopes with good deflection power, one can significantly achieve high stone-free rates with low infectious complications and reinterventions with FANS flexible ureteroscopy in the treatment of complex lower pole stones.
FANs in Endourology: Finding the Best Combination with Lasers and Scopes for Optimal Outcomes
TICC - 1F 102
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New Advance (C) & BPH & Endourology
TWTC - 1F Exhibition Hall
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10:30
12:00
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Endourology (B)
Yi-Sheng TaiTaiwan
Moderator
Which Laser for RIRS: Thulium Fiber Laser Thulium Fiber Laser (TFL)is a type of fiber laser, distinct from Thulium laser used for prostate surgey. It’ a cutting-edge laser and rapidly gaining traction in urology The machine is compact, portable, quiet with air-cooling, and lower power consumption.It employs a thulium-doped silica fiber powered by diode lasers, emitting light at 1940 nm, matching water absorption peaks. This results in a high absorption coefficient and shallow penetration (~0.1 mm), enabling precise energy delivery and minimizing tissue damage.Compared to Holmium lasers, TFL operates at lower energies (down to 25mJ) and higher frequencies (up to 2000Hz) for delicate tissue ablation and fine stone dusting.
The most notable change is pulse modulationHo:YAG lasers has Spike-shaped pulses and indicate greater energy concentration, resulting in higher localized heating, uneven fragmentation, and increased retropulsion.TFL produces pulses with uniform energy distribution and lower peak power, resulting in consistent ablation with less retropulsion and fewer thermal spikes.Higher water absorption rapidly forms a vapor channel, enhancing ablation efficiency.
But, TFL is not as ideal in surgical scenarios. At settings of low pulse energy (0.2 J) and high frequency (100 Hz), it tends to cause troublesome char formation and spark generation, particularly when treating calcium phosphate stones. These phenomena, explosive combustion and carbonization can reduce ablation efficiency and increase the risk of thermal damage and fiber degradation. Optimizing TFL settings is very important for outcome and safety and ongoing evaluation. AI in Medical Imaging – Converting 2D Black & White to 3D and Applications in Mixed Reality (MR) used in RIRS Artificial Intelligence (AI) and Extended Reality (XR) are at the forefront of innovation in modern medicine. In endoscopic surgery, these technologies are increasingly being integrated to enhance procedural precision and intraoperative guidance.
One experimental application involves using AI to convert 2D CT scans into 3D visualizations, offering surgeons a more intuitive understanding of anatomical structures. Devices like the Apple Vision Pro may be used to create fully immersive virtual environments, although it is not currently approved as a medical device.
In clinical practice, Mixed Reality (MR)—which blends real and virtual environments with real-time interaction—has shown promise. MR has been used during Retrograde Intrarenal Surgery (RIRS) to reduce the risk of missed stones, and in Endoscopic Combined Intrarenal Surgery (ECIRS) to overlay anatomical data, improving puncture accuracy during Percutaneous Nephrolithotomy (PCN).
As an emerging field, further advancements will depend on enhanced imaging resolution, improved intrarenal navigation and integration of AI-driven real-time stone detection.
Yi-Yang LiuTaiwan
Moderator
Complex Renal Stone: PCNL or RIRS or Combination?Mini-percutaneous nephrolithotomy (mini-PCNL) provides stone-free rate (SFR) 85 to 95 % in children with complex burdens, and recent systematic reviews report overall complications < 7 % and transfusion requirements ≈3 % when tracts ≤18 Fr are used. Its drawbacks are the need for percutaneous access, risk of bleeding, and potential parenchymal scarring, especially when multiple tracts are required.
Retrograde intrarenal surgery (RIRS) avoids renal puncture and shows the lowest incidence of high-grade complications (<1 %); contemporary series in preschool children describe initial SFRs of 60–78 %, with secondary procedures needed in up to one-third of cases because of narrow, tortuous ureters. Pre-stenting, staged dilation and longer operative time can offset its minimally-invasive appeal for stones ≥2 cm.
Endoscopic combined intrarenal surgery (ECIRS) merges an antegrade mini-PCNL channel with simultaneous flexible ureteroscopy. The first multicenter pediatric series and a 2024 comparative study confirm SFRs of 75–92 %, shorter hospital stay and lower fluoroscopy or transfusion risk than standalone PCNL despite treating more complex stones. Its limitations are the need for two skilled teams, specialized equipment and the Galdakao-modified supine Valdivia position, which lengthen setup and raise costs.
In summary, mini-PCNL remains the most efficient monotherapy for large or staghorn calculi; RIRS is ideal when bleeding risk or unfavorable percutaneous windows predominate; ECIRS offers the best compromise between clearance and morbidity where resources and expertise allow. Individualized, anatomy-based algorithms and further pediatric RCTs are still required.
ECIRSIn this session, we will demonstrate the technique about Totally-X-ray free ultrasound guided endoscopic combind intrarenal surgery in Galdakao modified supine Valdivia position.A Critical Appraisal on Percutaneous NephrolithotripsyPercutaneous nephrolithotripsy (PCNL) has evolved from a uniform prone, fluoroscopy-guided, large-tract technique into a precision endourological platform that emphasizes patient-tailored positioning, radiation-free puncture, miniaturized tracts, energy-efficient lasers and nascent robotic–AI augmentation. Contemporary evidence affirms that stone-free rates now approach a plateau, making safety metrics—bleeding control, infection prevention and intrarenal pressure modulation—the key differentiators among modern approaches. Miniaturized optics, suction-regulated sheaths and thulium-fiber or dual-wavelength laser consoles have collectively reduced hemoglobin loss and postoperative sepsis while preserving clearance efficacy. Future success will hinge on harmonizing technological innovation with rigorous evidence so that every incremental advance translates into measurable gains for both efficacy and safety in stone surgery.Echo guide Puncture in Supine PCNL: Tips and Tricks for an Efficient and Safe ProcedureMastery of ultrasound-guided supine PCNL begins with precise anatomical orientation. Color-Doppler mapping pinpoints the target calyx, which is punctured transpapillary with an echogenic-tip needle after artificial hydronephrosis is produced by retrograde ureteroscopic irrigation. A hydrophilic, floppy-tip yet stiff-shaft guidewire is then advanced through the needle, allowing atraumatic navigation of the collecting system under ureteroscopic visualization. Balloon dilation—used in place of sequential dilators—prevents guidewire dislodgement. When necessary, a through-and-through guidewire from flank skin to urethral meatus may be created to secure renal access. Finally, antegrade nephroscopy along this coaxial tract confirms unobstructed entry, provides panoramic inspection, and optimizes lithotripsy efficiency—all without fluoroscopy. Collectively, these steps deliver reliable access, eliminate radiation, and streamline stone clearance in a single, ergonomically favorable supine position.
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Role of Da Vinci SP in Urology
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Allen W. ChiuTaiwan
Speaker
Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques.
This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system.
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Allen W. ChiuTaiwan
Moderator
Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques.
This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system.
Jian-Ri LiTaiwan
Speaker
Applying Vision Augmentation in Robotic Surgery: Reality or FictionApplying Vision Augmentation in Robotic Surgery: Reality or Fiction
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Allen W. ChiuTaiwan
Moderator
Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques.
This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system.
Simone CrivellaroUnited States
Speaker
Single-Port vs. Multi-Port Robotic Prostatectomy: Balancing Innovation, Precision, and OutcomesThe Application & Limitation of Urological SP SurgerySingle Port Retroperitoneal Partial NephrectomySingle Port Prostate Surgery
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TICC - 2F 201BC
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Redefining the Trajectory of Prostate Cancer
TICC - 2F 201DE
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Advancing Focal Therapy with HIFU for Localized Prostate Cancer
TICC - 2F 201AF
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Dornier Thulio – ONE Laser for all Your Endourology Needs
TICC - 1F 101A
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Beyond oncologic outcomes: new approaches to Prostate and Bladder Cancer Care
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Chi-Fai NgHong Kong, China
Speaker
Novel Robotic Surgery PlatformsOver the past decades, robotic surgery has become an essential approach in urological care. The recent blooming of different robotic platforms, in particular in Asian countries, has helped popularize robotic surgery in less developed countries. The introduction of robotic technology in endoluminal surgery has also helped to open up opportunities to further improve endourology. In the future, the incorporation of AI in robotic systems will help upgrade the standard of care in urology.
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Chi-Fai NgHong Kong, China
Moderator
Novel Robotic Surgery PlatformsOver the past decades, robotic surgery has become an essential approach in urological care. The recent blooming of different robotic platforms, in particular in Asian countries, has helped popularize robotic surgery in less developed countries. The introduction of robotic technology in endoluminal surgery has also helped to open up opportunities to further improve endourology. In the future, the incorporation of AI in robotic systems will help upgrade the standard of care in urology.
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Chi-Fai NgHong Kong, China
Moderator
Novel Robotic Surgery PlatformsOver the past decades, robotic surgery has become an essential approach in urological care. The recent blooming of different robotic platforms, in particular in Asian countries, has helped popularize robotic surgery in less developed countries. The introduction of robotic technology in endoluminal surgery has also helped to open up opportunities to further improve endourology. In the future, the incorporation of AI in robotic systems will help upgrade the standard of care in urology.
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Hung-Jen WangTaiwan
Moderator
Technical Pearls: Nerve-SparingPreserving the neurovascular bundles (NVB) during robotic-assisted radical prostatectomy (RARP) is crucial for maintaining postoperative continence and sexual function, while still ensuring complete cancer removal. We will share "technical pearls" for nerve-sparing in RARP, emphasizing practical innovations that enhance surgical precision without compromising oncologic control.
Retrograde nerve-sparing involves a bottom-up (apex-to-base) dissection of the NVB using an athermal, gentle approach. This technique, adapted from open surgery, allows early identification and release of the nerves under direct vision. By minimizing traction and avoiding cautery near the NVB, it reduces inadvertent nerve injury and even lowers the risk of positive margins at the prostatic base. Clinically, adopting a retrograde approach (often with 30° lens “toggling”) has been linked to faster functional recovery of potency, contributing to potency rates approaching 90% at 1 year in fully nerve-sparing cases.
Parallel advances in augmented reality (AR) are providing real-time surgical navigation. AR technology superimposes 3D virtual models (e.g. from MRI) onto the operative field, enhancing visualization of patient-specific anatomy. Surgeons can pinpoint tumor location relative to the NVB, enabling selective, confidence-guided nerve preservation even in locally advanced disease. This approach helps modulate nerve-sparing extent on a case-by-case basis, maintaining oncologic safety (low positive surgical margin rates) while maximizing nerve preservation.
Finally, refined anatomical landmarks have emerged to guide nerve-sparing. A notable example is the identification of a consistent small arterial branch (“landmark artery”) at the NVB’s medial aspect. This vessel serves as a guide for partial nerve-sparing: dissecting just lateral to it yields an approximate 3 mm tissue margin from the prostatic capsule, sufficient to clear potential extracapsular extension while preserving the remaining nerve fibers. Such landmark-oriented dissection provides a reproducible framework for tailoring nerve-sparing to tumor risk, moving beyond the traditional “all-or-none” approach.
These advanced techniques and concepts are empowering robotic surgeons to achieve optimal outcomes. By integrating retrograde nerve-sparing, AR-assisted navigation, and anatomical landmark guidance, one can improve early continence recovery and postoperative sexual function for patients without sacrificing cancer control.
Jeremy TeohHong Kong, China
Speaker
Transurethral En Bloc Resection of Bladder Tumor: Where Are We Now?There is increasing evidence that transurethral en bloc resection of bladder tumour (ERBT) could lead to better peri-operative and oncological outcomes in patients with non-muscle-invasive bladder cancer. Modified approaches of ERBT have also been proposed to expand its indications for larger bladder tumours. The quality of resection is also the key for bladder-sparing treatment for muscle-invasive bladder cancer. We foresee an exciting journey ahead for ERBT, and as a urologist, we must embrace this novel technique for the best interest of our bladder cancer patients. To Publish or not to Publish? Navigating the path to academia in urologyDoing good science is the basis for technological advancement in healthcare. However, pursuing a path to academic in urology is often tough, stressful and frustrating. In this talk, I will share with you what I have learnt throughout my 15 years of research work. I will let you know what's the best and fastest way to become a globally renowned and successful researcher. Most importantly, I will explain what it takes to develop a great team and create a positive impact in people's lives. Believe in yourself! If I can do it, so can you.SIU Lecture: Role of MISTs in Male LUTS Surgical Management (Will TUR-P/ Laser Prostatectomy be Replaced?)Transurethral resection of prostate (TURP) is the current gold standard in treating patients with benign prostatic hyperplasia. Laser prostatectomy has also been used widely especially in patients who are on anticoagulants. However, both TURP and laser prostatectomy are associated with several problems including the need of spinal / general anaesthesia and the risk of male sexual dysfunction. In the past decade, we have witnessed the introduction of multiple new technologies including Rezum, Urolift, iTind and Aquablation. in this SIU lecture, we will discuss about the technical details, as well as the pros and cons of every new technology. We will also invite you to be our jury and decide whether TURP and laser prostatectomy will be replaced in the future. Novel Intravesical Therapeutics in the Evolving Landscape of NMIBCNon-muscle-invasive bladder cancer (NMIBC) is well known to be a difficult disease to manage, with a 1-year recurrence rate of up to 61% and 5-year recurrence rate of 78%. Despite the use of intravesical BCG therapy, NMIBC patients may still experience recurrence and develop what we call BCG-unresponsive NMIBC. Conventionally, we offer upfront radical cystectomy for patients with BCG-unresponsive NMIBC, however, this is an ultra-major surgery with significant risk of complications and could also lead to significant deterioration in quality of life in the long run. We are in urgent need for novel therapies to manage this difficult condition. In this lecture, we will discuss the evidence on the different novel intravesical therapies in treating BCG-unresponsive NMIBC. SIU Lecture: Role of MISTs in Male LUTS Surgical Management (Will TUR-P/ Laser Prostatectomy be Replaced?)
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Hung-Jen WangTaiwan
Speaker
Technical Pearls: Nerve-SparingPreserving the neurovascular bundles (NVB) during robotic-assisted radical prostatectomy (RARP) is crucial for maintaining postoperative continence and sexual function, while still ensuring complete cancer removal. We will share "technical pearls" for nerve-sparing in RARP, emphasizing practical innovations that enhance surgical precision without compromising oncologic control.
Retrograde nerve-sparing involves a bottom-up (apex-to-base) dissection of the NVB using an athermal, gentle approach. This technique, adapted from open surgery, allows early identification and release of the nerves under direct vision. By minimizing traction and avoiding cautery near the NVB, it reduces inadvertent nerve injury and even lowers the risk of positive margins at the prostatic base. Clinically, adopting a retrograde approach (often with 30° lens “toggling”) has been linked to faster functional recovery of potency, contributing to potency rates approaching 90% at 1 year in fully nerve-sparing cases.
Parallel advances in augmented reality (AR) are providing real-time surgical navigation. AR technology superimposes 3D virtual models (e.g. from MRI) onto the operative field, enhancing visualization of patient-specific anatomy. Surgeons can pinpoint tumor location relative to the NVB, enabling selective, confidence-guided nerve preservation even in locally advanced disease. This approach helps modulate nerve-sparing extent on a case-by-case basis, maintaining oncologic safety (low positive surgical margin rates) while maximizing nerve preservation.
Finally, refined anatomical landmarks have emerged to guide nerve-sparing. A notable example is the identification of a consistent small arterial branch (“landmark artery”) at the NVB’s medial aspect. This vessel serves as a guide for partial nerve-sparing: dissecting just lateral to it yields an approximate 3 mm tissue margin from the prostatic capsule, sufficient to clear potential extracapsular extension while preserving the remaining nerve fibers. Such landmark-oriented dissection provides a reproducible framework for tailoring nerve-sparing to tumor risk, moving beyond the traditional “all-or-none” approach.
These advanced techniques and concepts are empowering robotic surgeons to achieve optimal outcomes. By integrating retrograde nerve-sparing, AR-assisted navigation, and anatomical landmark guidance, one can improve early continence recovery and postoperative sexual function for patients without sacrificing cancer control.
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Redefining the Trajectory of Prostate Cancer
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Redefining the Trajectory of Prostate Cancer
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Latest Advances in mHSPC to Fight Tumor Heterogeneity: Experience from Australia and Japan
TICC - 3F South Lounge
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How to Optimize ADT Therapy in PC and BPH Treatment: From Evidence to Practice
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Yann NeuzilletFrance
Speaker
Drug-induced androgen suppression: the importance of galenic formulation for carcinological efficacy.
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TWTC - 1F Exhibition Hall
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15:00
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Fabian StanglSwitzerland
Speaker
How to Be a Good Mentor?Mentorship is one of the most powerful tools for shaping future leaders in urology—but being a good mentor requires more than clinical experience. In this talk, I will explore the essential qualities of effective mentorship, from active listening and goal setting to creating a safe environment for growth and feedback. Drawing on personal experience and successful mentorship models within the EAU and beyond, I will share practical strategies for building meaningful mentor-mentee relationships, supporting diverse career paths, and fostering a culture of mutual learning. Good mentors don’t just teach—they inspire.Why be an EAU Member? Education Opportunities in EuropeThe European Association of Urology (EAU) is more than just a professional society—it is a global platform that empowers urologists at every stage of their career. In this talk, I will highlight the key benefits of EAU membership with a focus on the extensive educational opportunities it offers, particularly for young urologists. From hands-on training, online courses, and fellowships to mentorship programmes and academic collaborations, the EAU provides access to world-class resources that foster clinical excellence and academic growth. I will also share practical examples of how young leaders can connect, learn, and thrive through the EAU network—and why now is the best time to become an active member.
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Fabian StanglSwitzerland
Speaker
How to Be a Good Mentor?Mentorship is one of the most powerful tools for shaping future leaders in urology—but being a good mentor requires more than clinical experience. In this talk, I will explore the essential qualities of effective mentorship, from active listening and goal setting to creating a safe environment for growth and feedback. Drawing on personal experience and successful mentorship models within the EAU and beyond, I will share practical strategies for building meaningful mentor-mentee relationships, supporting diverse career paths, and fostering a culture of mutual learning. Good mentors don’t just teach—they inspire.Why be an EAU Member? Education Opportunities in EuropeThe European Association of Urology (EAU) is more than just a professional society—it is a global platform that empowers urologists at every stage of their career. In this talk, I will highlight the key benefits of EAU membership with a focus on the extensive educational opportunities it offers, particularly for young urologists. From hands-on training, online courses, and fellowships to mentorship programmes and academic collaborations, the EAU provides access to world-class resources that foster clinical excellence and academic growth. I will also share practical examples of how young leaders can connect, learn, and thrive through the EAU network—and why now is the best time to become an active member.
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TICC - 3F Banquet Hall
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Yao-Chi ChuangTaiwan
Moderator
Road to Excellent ResearchYao Chi Chuang, Professor of Urology, Kaohsiung Chang Gung Memorial Hospital, and National Sun Yat-sen University Taiwan.
Medical research is what allows doctors to explore unmet medical need and decide how to best treat patients. It is what makes the development of new diagnostic tools, new biomarkers, new medicines, and new procedures. Without medical research, we would not be able to creative new knowledge and decide if new treatments are better than our current treatments.
There are some Tips on what to do about what research is and how to get into it:
1. Ask a good question from your daily practice, what is unmet medical need?
2. Search the old literature of your research interests- what is known? What is unknown?
3. Find a new method to solve your question or an old method but applying to a new field.
4. Start from jointing a pre-planned research project, and join a research collaborative.
5. Try to be an independent researcher from a small project without funding support, retrospective study.
6. Try to get funding support from your institute, national grant, or industry.
As a young doctor, it’s important to look after yourself and maintain a healthy balance between daily practice and research work. There is a range of options for doctors interested in research, from smaller time commitments as a co-investigator to longer-term projects and experience as chief investigator. Research works are all optional activities, so do what you can but don’t overwhelm yourself. Road to Excellent Research
Po-Ming ChowTaiwan
Speaker
Conventional Artificial Urinary Sphincter ImplantationA step-by-step video of a standard approach of AUS implatation is shown in this semi-live session.
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Yao-Chi ChuangTaiwan
Moderator
Road to Excellent ResearchYao Chi Chuang, Professor of Urology, Kaohsiung Chang Gung Memorial Hospital, and National Sun Yat-sen University Taiwan.
Medical research is what allows doctors to explore unmet medical need and decide how to best treat patients. It is what makes the development of new diagnostic tools, new biomarkers, new medicines, and new procedures. Without medical research, we would not be able to creative new knowledge and decide if new treatments are better than our current treatments.
There are some Tips on what to do about what research is and how to get into it:
1. Ask a good question from your daily practice, what is unmet medical need?
2. Search the old literature of your research interests- what is known? What is unknown?
3. Find a new method to solve your question or an old method but applying to a new field.
4. Start from jointing a pre-planned research project, and join a research collaborative.
5. Try to be an independent researcher from a small project without funding support, retrospective study.
6. Try to get funding support from your institute, national grant, or industry.
As a young doctor, it’s important to look after yourself and maintain a healthy balance between daily practice and research work. There is a range of options for doctors interested in research, from smaller time commitments as a co-investigator to longer-term projects and experience as chief investigator. Research works are all optional activities, so do what you can but don’t overwhelm yourself. Road to Excellent Research
Véronique PhéFrance
Speaker
New Artificial Urinary SphinterStress urinary incontinence remains a major quality-of-life concern, particularly following pelvic surgery. Despite being the gold standard, the AMS 800 artificial urinary sphincter (AUS) presents significant limitations, including mechanical failure, urethral atrophy, and challenges for elderly or disabled patients. Recent innovations in AUS design now incorporate mechatronics, remote control, adaptive pressure systems, and miniaturized components aimed at improving usability, autonomy, and continence outcomes. This presentation reviews the current landscape of next-generation AUS, focusing on ARTUS, UroActive®, and other devices under clinical evaluation. We discuss preclinical and first-in-human data, regulatory pathways, patient-reported preferences, and remaining barriers such as infection risks and training requirements. Intelligent, connected AUS devices hold promise to transform continence care after decades of technological stagnation.Choosing between Laparoscopic Sacrocolpopexy and Lateral Suspension: Weighing the Pros and ConsPelvic organ prolapse (POP) is a common condition requiring surgical intervention to restore apical support. Among minimally invasive options, laparoscopic sacrocolpopexy (LSCP) remains the gold standard, while laparoscopic lateral suspension (LLS) is gaining renewed interest for its reduced invasiveness and simplified technique. This presentation compares LSCP and LLS across multiple dimensions: anatomical restoration, functional outcomes, complication profiles, patient selection, and surgical learning curves. LSCP offers robust long-term results and better posterior compartment support but carries increased operative complexity. LLS provides effective anterior/apical correction with fewer vascular risks and a shorter learning curve. Both techniques have comparable mesh exposure rates and subjective success. Individualized decision-making based on patient anatomy, comorbidities, and surgeon expertise remains key. Emerging technologies and robotic assistance may further refine these approaches in the future.Robotic Novel Artificial Urinary Sphincter ImplantationThis video shows a step by step robotic artificial urinary sphincter implantation in women using AMS800 and Artus devices.First robot-assisted implantation of ARTUS (Affluent Medical) electromechanical artificial urinary sphincter in a female cadaverIntroduction
Artificial urinary sphincters (AUS) are effective tools for the treatment of female stress urinary incontinence. Nonetheless, hydraulic sphincters present with some limitations: complex and time-consuming preparation, need for preserved manual dexterity and constant pressure exertion on the bladder neck. The ARTUS® Artificial Urinary Sphincter is a novel electro-mechanical device designed to overcome these limitations thanks to its rapid and straight-forward implantation, intuitive remotely controlled manipulation and continuously adjustable cuff pressure.
Materials and methods
The ARTUS® system is currently under pre-market investigation in men, in an interventional, prospective, single arm, multicentric, international study. A cadaver lab session was carried out in Decembre 2024 to test the technical feasibility of ARTUS® implantation in female patients. The procedure was performed by an expert surgeon with extensive experience in AUS implantation and robotic surgery.
Results
One female patient was successfully implanted during the session. The technique has been developed following the principles of the traditional robot-assisted AUS implantation: the patient is placed in gynecological 23° Trendelenburg position. The robot has a 4-arms configuration. The procedure starts with the dissection of the vesicovaginal plane, to approach the bladder neck posteriorly. The lateral surfaces of the bladder neck are developed on both sides. The anterior peritoneum is opened to gain access to the antero-lateral surfaces of the bladder. The separation of the bladder neck from the vagina is performed through dissection of the pre-vaginal fascia bilaterally. The cuff is introduced and it is passed through the antero-lateral peri-vesical spaces, sliding behind the bladder neck from the right side to the left side. The anterior peritoneum is opened to gain access to the anterior surface of the bladder neck. The cuff is closed anteriorly, passing the transmission line inside the hole at the distal part of the cuff. The tightening around the bladder neck is achieved by pulling the transmission cable through. An optimal adjustment of the cuff around the bladder neck is provided tightening the ARTUS cuff clamping notch. Then, a supra-pubic 4 cm skin incision is made to implant the control unit. The tip of the cuff is passed outside through the incision. A lodge is prepared incising along the external oblique muscle aponeurosis. The cuff is connected to the control unit and a test with the remote control is performed to verify the functioning of the system. Finally, the control unit is placed into the lodge, anchored with non-absorbable sutures to the aponeurosis.
Conclusions
Robot-assisted ARTUS® implantation is technically feasible in female patients. This straight-forward technique may reduce operative time. The device has the potential to reduce the pressure and facilitate manipulation in patients with impaired dexterity.
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Yao-Chi ChuangTaiwan
Moderator
Road to Excellent ResearchYao Chi Chuang, Professor of Urology, Kaohsiung Chang Gung Memorial Hospital, and National Sun Yat-sen University Taiwan.
Medical research is what allows doctors to explore unmet medical need and decide how to best treat patients. It is what makes the development of new diagnostic tools, new biomarkers, new medicines, and new procedures. Without medical research, we would not be able to creative new knowledge and decide if new treatments are better than our current treatments.
There are some Tips on what to do about what research is and how to get into it:
1. Ask a good question from your daily practice, what is unmet medical need?
2. Search the old literature of your research interests- what is known? What is unknown?
3. Find a new method to solve your question or an old method but applying to a new field.
4. Start from jointing a pre-planned research project, and join a research collaborative.
5. Try to be an independent researcher from a small project without funding support, retrospective study.
6. Try to get funding support from your institute, national grant, or industry.
As a young doctor, it’s important to look after yourself and maintain a healthy balance between daily practice and research work. There is a range of options for doctors interested in research, from smaller time commitments as a co-investigator to longer-term projects and experience as chief investigator. Research works are all optional activities, so do what you can but don’t overwhelm yourself. Road to Excellent Research
Ching-Pei TsaiTaiwan
Speaker
Robotic/Laparoscopic Sacrocolpopexy and Pelvic Floor ReconstructionAbdominal sacrocolpopexy has been the gold standard operation for POP. Currently, the trend is minimal-invasive surgeries such as laparoscopy(LSC) or robot-assisted laparoscopy(RASC) to promote recovery. However, surgeons hesitated to do it because of longer learning curve and complicated surgical procedures. How to simplify the above operations is the most important issue.
The use of robotic assisted surgery has grown since the advent of better wrist dexterity, a 3D view, and motion scaling, which has great advantages in performing sacrocolpopexy. But the efficacy of RASC and LSC is comparable as indicated in previous studies, and the only difference is less bleeding with the RASC.
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Cheng-Chia LinTaiwan
Speaker
DISS plus FANS used in RIRSNew technologies and techniques are constantly emerging, but the most important part of our discussions is how to use them most effectively. Through this surgical demonstration, we hope to share the procedure and our experience with everyone.健保各領域審查共識及討論－結石
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Yi-Sheng TaiTaiwan
Speaker
Which Laser for RIRS: Thulium Fiber Laser Thulium Fiber Laser (TFL)is a type of fiber laser, distinct from Thulium laser used for prostate surgey. It’ a cutting-edge laser and rapidly gaining traction in urology The machine is compact, portable, quiet with air-cooling, and lower power consumption.It employs a thulium-doped silica fiber powered by diode lasers, emitting light at 1940 nm, matching water absorption peaks. This results in a high absorption coefficient and shallow penetration (~0.1 mm), enabling precise energy delivery and minimizing tissue damage.Compared to Holmium lasers, TFL operates at lower energies (down to 25mJ) and higher frequencies (up to 2000Hz) for delicate tissue ablation and fine stone dusting.
The most notable change is pulse modulationHo:YAG lasers has Spike-shaped pulses and indicate greater energy concentration, resulting in higher localized heating, uneven fragmentation, and increased retropulsion.TFL produces pulses with uniform energy distribution and lower peak power, resulting in consistent ablation with less retropulsion and fewer thermal spikes.Higher water absorption rapidly forms a vapor channel, enhancing ablation efficiency.
But, TFL is not as ideal in surgical scenarios. At settings of low pulse energy (0.2 J) and high frequency (100 Hz), it tends to cause troublesome char formation and spark generation, particularly when treating calcium phosphate stones. These phenomena, explosive combustion and carbonization can reduce ablation efficiency and increase the risk of thermal damage and fiber degradation. Optimizing TFL settings is very important for outcome and safety and ongoing evaluation. AI in Medical Imaging – Converting 2D Black & White to 3D and Applications in Mixed Reality (MR) used in RIRS Artificial Intelligence (AI) and Extended Reality (XR) are at the forefront of innovation in modern medicine. In endoscopic surgery, these technologies are increasingly being integrated to enhance procedural precision and intraoperative guidance.
One experimental application involves using AI to convert 2D CT scans into 3D visualizations, offering surgeons a more intuitive understanding of anatomical structures. Devices like the Apple Vision Pro may be used to create fully immersive virtual environments, although it is not currently approved as a medical device.
In clinical practice, Mixed Reality (MR)—which blends real and virtual environments with real-time interaction—has shown promise. MR has been used during Retrograde Intrarenal Surgery (RIRS) to reduce the risk of missed stones, and in Endoscopic Combined Intrarenal Surgery (ECIRS) to overlay anatomical data, improving puncture accuracy during Percutaneous Nephrolithotomy (PCN).
As an emerging field, further advancements will depend on enhanced imaging resolution, improved intrarenal navigation and integration of AI-driven real-time stone detection.
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Hsiang-Ying LeeTaiwan
Moderator
Best Laser for UTUCManagement of Total Ureteral Avulsion during Ureteroscopy
Yi-Yang LiuTaiwan
Speaker
Complex Renal Stone: PCNL or RIRS or Combination?Mini-percutaneous nephrolithotomy (mini-PCNL) provides stone-free rate (SFR) 85 to 95 % in children with complex burdens, and recent systematic reviews report overall complications < 7 % and transfusion requirements ≈3 % when tracts ≤18 Fr are used. Its drawbacks are the need for percutaneous access, risk of bleeding, and potential parenchymal scarring, especially when multiple tracts are required.
Retrograde intrarenal surgery (RIRS) avoids renal puncture and shows the lowest incidence of high-grade complications (<1 %); contemporary series in preschool children describe initial SFRs of 60–78 %, with secondary procedures needed in up to one-third of cases because of narrow, tortuous ureters. Pre-stenting, staged dilation and longer operative time can offset its minimally-invasive appeal for stones ≥2 cm.
Endoscopic combined intrarenal surgery (ECIRS) merges an antegrade mini-PCNL channel with simultaneous flexible ureteroscopy. The first multicenter pediatric series and a 2024 comparative study confirm SFRs of 75–92 %, shorter hospital stay and lower fluoroscopy or transfusion risk than standalone PCNL despite treating more complex stones. Its limitations are the need for two skilled teams, specialized equipment and the Galdakao-modified supine Valdivia position, which lengthen setup and raise costs.
In summary, mini-PCNL remains the most efficient monotherapy for large or staghorn calculi; RIRS is ideal when bleeding risk or unfavorable percutaneous windows predominate; ECIRS offers the best compromise between clearance and morbidity where resources and expertise allow. Individualized, anatomy-based algorithms and further pediatric RCTs are still required.
ECIRSIn this session, we will demonstrate the technique about Totally-X-ray free ultrasound guided endoscopic combind intrarenal surgery in Galdakao modified supine Valdivia position.A Critical Appraisal on Percutaneous NephrolithotripsyPercutaneous nephrolithotripsy (PCNL) has evolved from a uniform prone, fluoroscopy-guided, large-tract technique into a precision endourological platform that emphasizes patient-tailored positioning, radiation-free puncture, miniaturized tracts, energy-efficient lasers and nascent robotic–AI augmentation. Contemporary evidence affirms that stone-free rates now approach a plateau, making safety metrics—bleeding control, infection prevention and intrarenal pressure modulation—the key differentiators among modern approaches. Miniaturized optics, suction-regulated sheaths and thulium-fiber or dual-wavelength laser consoles have collectively reduced hemoglobin loss and postoperative sepsis while preserving clearance efficacy. Future success will hinge on harmonizing technological innovation with rigorous evidence so that every incremental advance translates into measurable gains for both efficacy and safety in stone surgery.Echo guide Puncture in Supine PCNL: Tips and Tricks for an Efficient and Safe ProcedureMastery of ultrasound-guided supine PCNL begins with precise anatomical orientation. Color-Doppler mapping pinpoints the target calyx, which is punctured transpapillary with an echogenic-tip needle after artificial hydronephrosis is produced by retrograde ureteroscopic irrigation. A hydrophilic, floppy-tip yet stiff-shaft guidewire is then advanced through the needle, allowing atraumatic navigation of the collecting system under ureteroscopic visualization. Balloon dilation—used in place of sequential dilators—prevents guidewire dislodgement. When necessary, a through-and-through guidewire from flank skin to urethral meatus may be created to secure renal access. Finally, antegrade nephroscopy along this coaxial tract confirms unobstructed entry, provides panoramic inspection, and optimizes lithotripsy efficiency—all without fluoroscopy. Collectively, these steps deliver reliable access, eliminate radiation, and streamline stone clearance in a single, ergonomically favorable supine position.
TICC - 3F Plenary Hall
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Urothelial Cancer
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Chi-Hang YeeHong Kong, China
Moderator
Robotic Total Intracorporeal Urinary Diversion – from Ileal Conduit to Neobladder to Ileal Interposition Prostate Cancer Focal Therapy: Ready for Prime Time?
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Hammad Ather Pakistan
Speaker
Current Evidence Supporting Adjuvant and Neo-Adjuvant TreatmentThe Upper Tract Urothelial Cancer (UTUC) is increasingly being considered as a genetic disorder. Following RNU, the IHC can detect a deficiency in mismatch repair proteins or microsatellite instability (MSI) using PCR. In the presence of MSI, it is necessary to undergo germline testing. High-grade UTUC is an aggressive cancer and is often associated with micrometastases, resulting in early recurrence and development of metastases. Risk classification and recognising more aggressive cancers in whom adjuvant or even neoadjuvant chemotherapy may be of benefit. One of the most crucial steps in considering patients for chemotherapy is the platinum eligibility, renal function (<30ml/min), functional status (ECOG >2) and comorbidities >2 grade are considered ineligible. There is good-quality evidence of improved survival for adjuvant chemotherapy in eligible patients following RNU for pT2–T4 and/or pN+ disease. The 2025 EAU guidelines recommend discussing adjuvant nivolumab with PD-L1-positive patients unfit for, or who declined, platinum-based adjuvant chemotherapy for ≥ pT3 and/or pN+ disease after previous RNU alone or ≥ypT2 and/or ypN+ disease after previous neoadjuvant chemotherapy, followed by RNU. However, the evidence supporting this recommendation is weak. Single intravesical chemotherapy is strongly recommended. There is currently no level 1 evidence supporting neo-adjuvant chemotherapy; however, non-randomised series have shown a decreased incidence of positive surgical margins, recurrence, and improved survival over RNU alone.Avoiding Complication in Orthotopic NeobladderIn most large series from Europe, approximately 1-2 of every 10 patients undergoing radical cystectomy have an orthotopic neobladder (ONB). Data is supporting ONB in terms of quality of life, cosmetics, and improved patient satisfaction. Early and late morbidity in up to 22% of patients is reported. The terminal ileum is the GI segment most often used for orthotopic bladder substitution. With ileo-ureteral anastomoses, there is UUT reflux, and renal functional deterioration is a concern. Various forms of UUT reflux protection, including a simple isoperistaltic tunnel, ileal intussusception, tapered ileal prolongation implanted subserosally, and direct (sub)mucosal or subserosal ureteral implantation, have been described. Superiority of one over the other is not proven. Urethral recurrence is a significant concern; therefore, patient selection must be optimal. Short-term complications are related to the GI tract, including atelectasis and metabolic acidosis. They are all preventable with standardised post-operative measures. The ERAS protocol is particularly useful in avoiding short-term complications and decreasing postoperative hospital stay, among other benefits. The key to success in preventing complications is meticulous patient selection and the implementation of preemptive measures to avoid common complications.Prostate Biopsy Technique: Current EvidenceOptimal prostate biopsy is critical in risk-stratifying patients for appropriate patient care. The traditional TRUS-guided biopsy is associated with UTI sepsis and other infectious complications. Recently, the use of the transperineal route has been advocated for the diagnosis of prostate cancer. Biopsy is either systematic or targeted. There is evidence supporting the notion that MRI-targeted biopsy without systematic biopsy significantly reduces the over-diagnosis of low-risk disease, compared to systematic biopsy. This seems true even when systematic biopsies are indicated after risk stratification with the Rotterdam Prostate Cancer Risk Calculator. EAU recommends performing prostate biopsy using the transperineal approach due to the low risk of infectious complications and better antibiotic stewardship. They also recommend using either target prophylaxis based on rectal swab or stool culture, or augmented prophylaxis (two or more different classes of antibiotics), for transrectal biopsy.
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Chi-Hang YeeHong Kong, China
Speaker
Robotic Total Intracorporeal Urinary Diversion – from Ileal Conduit to Neobladder to Ileal Interposition Prostate Cancer Focal Therapy: Ready for Prime Time?
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Ali Hamidi MadaniIran
Speaker
Changing Treatment Landscape of Urothelial Cancers in New Era of Immunotherapy
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Khurram Mutahir SiddiquiOman
Speaker
Kidney Preservation Strategies for Upper Tract Urothelial CancerAbstract: Upper tract urothelial carcinoma (UTUC) is a rare but aggressive malignancy that affects the renal pelvis and ureter, often leading to significant challenges in treatment and kidney preservation. This lecture provides a comprehensive overview of the state-of-the-art kidney preservation techniques employed in the management of UTUC, with a focus on preserving renal function while ensuring oncological control. Surgical approaches, including nephron-sparing surgery (NSS) and minimally invasive techniques, such as endoscopic resections and robotic-assisted procedures, are discussed, highlighting their role in achieving optimal outcomes with reduced morbidity. In addition, the importance of careful patient selection based on tumor characteristics, location, and stage is emphasized, as these factors significantly influence the decision-making process regarding kidney preservation versus radical nephroureterectomy.
The lecture further explores the evolving role of neoadjuvant and adjuvant therapies, including chemotherapy and immunotherapy, in conjunction with surgical intervention, to improve survival rates while maintaining renal function. Recent advancements in genetic profiling and molecular diagnostics are also addressed, as these innovations may lead to more personalized treatment strategies that preserve the kidney while effectively targeting the malignancy.
Lastly, the challenges of balancing oncological safety with renal preservation are discussed, and future directions in research, including potential breakthroughs in regenerative medicine and advanced surgical techniques, are explored. This lecture aims to provide a current and thorough understanding of the multidisciplinary approaches to kidney preservation in UTUC, offering insights into best practices and emerging trends in the field.
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TICC - 2F 201BC
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New Frontiers in RIRS Surgery
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Vineet GauharSingapore
Speaker
Experimental and Real World Take Away Messages on DISSSuction in Renal Stone Treatment: DISS, FANS or Combined Procedure?Need of Future EndourologyChoosing the Correct Laser and Flex Scope Combination in Suction Ureteroscopy Can Be the Deal Breaker
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Vineet GauharSingapore
Speaker
Experimental and Real World Take Away Messages on DISSSuction in Renal Stone Treatment: DISS, FANS or Combined Procedure?Need of Future EndourologyChoosing the Correct Laser and Flex Scope Combination in Suction Ureteroscopy Can Be the Deal Breaker
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Yi-Sheng TaiTaiwan
Speaker
Which Laser for RIRS: Thulium Fiber Laser Thulium Fiber Laser (TFL)is a type of fiber laser, distinct from Thulium laser used for prostate surgey. It’ a cutting-edge laser and rapidly gaining traction in urology The machine is compact, portable, quiet with air-cooling, and lower power consumption.It employs a thulium-doped silica fiber powered by diode lasers, emitting light at 1940 nm, matching water absorption peaks. This results in a high absorption coefficient and shallow penetration (~0.1 mm), enabling precise energy delivery and minimizing tissue damage.Compared to Holmium lasers, TFL operates at lower energies (down to 25mJ) and higher frequencies (up to 2000Hz) for delicate tissue ablation and fine stone dusting.
The most notable change is pulse modulationHo:YAG lasers has Spike-shaped pulses and indicate greater energy concentration, resulting in higher localized heating, uneven fragmentation, and increased retropulsion.TFL produces pulses with uniform energy distribution and lower peak power, resulting in consistent ablation with less retropulsion and fewer thermal spikes.Higher water absorption rapidly forms a vapor channel, enhancing ablation efficiency.
But, TFL is not as ideal in surgical scenarios. At settings of low pulse energy (0.2 J) and high frequency (100 Hz), it tends to cause troublesome char formation and spark generation, particularly when treating calcium phosphate stones. These phenomena, explosive combustion and carbonization can reduce ablation efficiency and increase the risk of thermal damage and fiber degradation. Optimizing TFL settings is very important for outcome and safety and ongoing evaluation. AI in Medical Imaging – Converting 2D Black & White to 3D and Applications in Mixed Reality (MR) used in RIRS Artificial Intelligence (AI) and Extended Reality (XR) are at the forefront of innovation in modern medicine. In endoscopic surgery, these technologies are increasingly being integrated to enhance procedural precision and intraoperative guidance.
One experimental application involves using AI to convert 2D CT scans into 3D visualizations, offering surgeons a more intuitive understanding of anatomical structures. Devices like the Apple Vision Pro may be used to create fully immersive virtual environments, although it is not currently approved as a medical device.
In clinical practice, Mixed Reality (MR)—which blends real and virtual environments with real-time interaction—has shown promise. MR has been used during Retrograde Intrarenal Surgery (RIRS) to reduce the risk of missed stones, and in Endoscopic Combined Intrarenal Surgery (ECIRS) to overlay anatomical data, improving puncture accuracy during Percutaneous Nephrolithotomy (PCN).
As an emerging field, further advancements will depend on enhanced imaging resolution, improved intrarenal navigation and integration of AI-driven real-time stone detection.
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Takaaki InoueJapan
Speaker
New Advancement on Retrograde Intrarenal SurgeryRetrograde intrarenal surgery (RIRS) has dramatically grown up around world for stone management. Why has RIRS been getting popullar and increasing nowadays?. The reaseon are absoulutely "Technological development with collaborated engineering comapny" and " Global communicaton and collaboration in Endourology". Endourology has still been improving and expanding more and more. Thereby, many novel devices and machine are launching faster. We, urologists should catch up this faster trend and acquire these knowledge for our clinical use. However, most of urologists can not catch up it. Therefore, I will share you all these novel chage of mind and tech-knowledge of stone field in this session. Do We Need Augmented Reality for Renal Stone Management?What is Augmented reality and Vertual reality in medicine?. The paradigm shift of medicine which includes AI, Robotics, VR, and AR etc named Digital transformation has been still emerging. Of course, these shift is gradually permeating in stone field. Especially, in terms of VR, AR, we wonder if this kind of DX is useful in stone management. if so, how do we use it in clinical practice? Today, I will talk these future role in stone management, and expectation. Which Laser for RIRS: Pulsed Thulium YAG Laser We can use three kind of laser such as Holumium YAG, Thulium YAG, and Thulium fiber laser for stone management. Which lase are best option for stone patients? I will talk about featurs and advantage of pulsed-Thulium YAG laser. There are two kinds of p-Tm;YAG laser machine nowadays. P^Tm;YAG has unique characteristics as laser wave. Therefore, this laser would be able to use Stone, BPH, UTUC. Especially, p-Tm YAG laser can utilize for Stone ablation, fragmentingand and UTUC ablation, shock wave. We will share our experoence and thoughts. New Advancement on Retrograde Intrarenal Surgery
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Anil ShresthaNepal
Speaker
Clearpetra the Sheath of Choice for Lower Pole StonesSFR Assessment: Timing and Modalities
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TICC - 2F 201DE
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Rajeev KumarIndia
Speaker
Troubleshooting in Endoscopic Stone Surgery: How to Handle Unexpected Challenges in RIRS and ECIRSProstate Cancer Nomograms and Their Application in Asian MenNomograms help to predict outcomes in individual patients rather than whole populations and are an important part of evaluation and treatment decision making. Various nomograms have been developed in malignancies to predict and prognosticate clinical outcomes such as severity of disease, overall survival, and recurrence-free survival. In prostate cancer, nomograms were developed for determining need for biopsy, disease course, need for adjuvant therapy, and outcomes.
Most of these predictive nomograms were based on Caucasian populations. Prostate cancer is significantly affected by race, and Asian men have a significantly different racial and genetic susceptibility compared to Caucasians, raising the concern about the generalizability of these nomograms.
There are very few studies that have evaluated the applicability and validity of the existing nomograms in in Asian men. Most have found significant differences in the performance in this population. Thus, relying on such nomograms for treating Asian men may not be appropriate and collaborative efforts are required within Asian countries to develop locally relevant nomograms.What Is Critical Appraisal?Critical appraisal is the process of systematically evaluating research studies to assess their validity, relevance, and trustworthiness. The goal is to determine whether a study’s results are credible and useful for clinical decision-making, research, or policy. This has become increasingly important as there has been a massive increase in the number of scientific journals and not all published research is of equal quality. Critical appraisal helps healthcare professionals avoid being misled by poor-quality studies, make evidence-based decisions and improve patient outcomes.
The key purposes are to assess validity of the study and its results and determine applicability to the specific population. It involves assessing the study design, methodological quality, completeness of reporting, potential sources of bias and potential for misconduct.
There are number of reporting guidelines that can be used for performing critical appraisal. Additionally, being aware of essential reporting standards and common problems with studies can help readers make informed decisions.Scientific Misconduct and PitfallsNo abstractExample of the “Ideal” AbstractNo Abstract
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Rajeev KumarIndia
Speaker
Troubleshooting in Endoscopic Stone Surgery: How to Handle Unexpected Challenges in RIRS and ECIRSProstate Cancer Nomograms and Their Application in Asian MenNomograms help to predict outcomes in individual patients rather than whole populations and are an important part of evaluation and treatment decision making. Various nomograms have been developed in malignancies to predict and prognosticate clinical outcomes such as severity of disease, overall survival, and recurrence-free survival. In prostate cancer, nomograms were developed for determining need for biopsy, disease course, need for adjuvant therapy, and outcomes.
Most of these predictive nomograms were based on Caucasian populations. Prostate cancer is significantly affected by race, and Asian men have a significantly different racial and genetic susceptibility compared to Caucasians, raising the concern about the generalizability of these nomograms.
There are very few studies that have evaluated the applicability and validity of the existing nomograms in in Asian men. Most have found significant differences in the performance in this population. Thus, relying on such nomograms for treating Asian men may not be appropriate and collaborative efforts are required within Asian countries to develop locally relevant nomograms.What Is Critical Appraisal?Critical appraisal is the process of systematically evaluating research studies to assess their validity, relevance, and trustworthiness. The goal is to determine whether a study’s results are credible and useful for clinical decision-making, research, or policy. This has become increasingly important as there has been a massive increase in the number of scientific journals and not all published research is of equal quality. Critical appraisal helps healthcare professionals avoid being misled by poor-quality studies, make evidence-based decisions and improve patient outcomes.
The key purposes are to assess validity of the study and its results and determine applicability to the specific population. It involves assessing the study design, methodological quality, completeness of reporting, potential sources of bias and potential for misconduct.
There are number of reporting guidelines that can be used for performing critical appraisal. Additionally, being aware of essential reporting standards and common problems with studies can help readers make informed decisions.Scientific Misconduct and PitfallsNo abstractExample of the “Ideal” AbstractNo Abstract
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TICC - 1F 101A
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13:30
15:00
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Advancing Urologic Care Through Technology and Minimally Invasive Innovation
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Hann-Chorng KuoTaiwan
Moderator
ACU Lecture: Videourodynamic Study for Precision Diagnosis and Management of Lower Urinary Tract DysfunctionVideourodynamic Study in the Precision Diagnosis and Management of Lower Urinary Tract Dysfunctions
Hann-Chorng Kuo, M.D.
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
As a urologist, we are dealing with patients with lower urinary tract symptoms everyday. We did transurethral resection of the prostate (TURP) for elderly men with bothersome lower urinary tract symptoms (LUTS). We put a suburethral sling for women with stress urinary incontinence (SUI). We prescribed alpha-blocker for those who had difficulty in urination. We add antimuscarinics for patients with urgency urinary incontinence. Our seniors always told us these treatments are effective in treating patients with LUTS. However, patients still had LUTS after TURP, women still complained of urgency and dysuria after anti-incontinence surgery. Medication based on storage or emptying LUTS do not work all the time. Why? Because symptoms are not reliable, a large prostate does not indicate bladder outlet obstruction (BOO), and SUI is not solely a result of urethral incompetence. Therefore, in diagnosis and management of LUTS, we need precision medicine to direct an accurate pathophysiology of LUTS, and to guide an appropriate management based on the bladder and bladder outlet dysfunction. When we encounter patients who have LUTS refractory to the treatment based on our initial diagnosis, when we are treating patients who have complicated storage and emptying LUTS, when we are not sure patients could benefit from the invasive procedures for their LUTS, or patients who had both lower and upper urinary tract dysfunctions, videourodynamic study (VUDS) is an essential investigation for diagnosis and management of LUTS. In additional to benign prostate hyperplasia (BPH) and BOO, male patients with emptying LUTS might result from detrusor underactivity (DU), bladder neck dysfunction (BND), urethral sphincter dysfunction, or a hypersensitive bladder, which is not related with the prostate. Patients with BPH and LUTS might have latent neurogenic lesion, such as minor stroke, Parkinson's disease, or early dementia, causing LUTS. TURP without known the neurological disease might exacerbate LUTS after surgery. Mixed SUI comprises intrinsic sphincter deficiency (ISD) and detrusor overactivity (DO). The overactive bladder (OAB) symptoms may also result from an incompetent bladder outlet. Without comprehensive VUDS, we might cure the SUI, but OAB remains after placing a mid-urethral sling. Bladder pain is the cardinal symptoms of interstitial cystitis. However, bladder pain perceived by the patient might also originate from BOO or pelvic floor fascitis. VUDS can help in discrimination. DU and low compliant bladder and ISD could result in complicated storage and emptying LUTS. Large post-void residual (PVR) should alert us to investigate whether it is originated from low compliance or ISD. Dysfunctional voiding (DV) and BND in women with emptying LUTS. OAB symptoms are not always coming from the DO. BOO such as BND, DV, or urethral stricture might exist in men and women without voiding symptoms. Urinary difficulty in women is usually a result from low detrusor contractility, due to DU, or through inhibitory effect from a poorly relaxed pelvic floor or urethral sphincter. A simple bladder neck incision can effectively restore spontaneous voiding in men or women with dysuria due to DU or BND. However, a tight BN is necessary to predict a successful treatment outcome. Patients with central nervous system (CNS) disorders or spinal cord injury usually have complicated LUTD, including DO, BND, DV, detrusor sphincter dyssynergia (DSD), and vesicoureteral reflux (VUR). Management of LUTS in CNS disorders or SCI patients should know the current bladder and bladder outlet dysfunctions. Pediatric incontinence, children with myelomeningocele, DV, or recurrent urinary tract infection are complicated and need precision diagnosis before treatment. Especially when surgery is planned. Lower urinary tract dysfunctions is a dynamic condition. The bladder and bladder outlet dysfunction might change with time. Although VUDS is considered as an invasive investigation with radiation exposure, the advantages in accurate diagnosis and guiding management outweigh these disadvantages.
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Simone CrivellaroUnited States
Speaker
Single-Port vs. Multi-Port Robotic Prostatectomy: Balancing Innovation, Precision, and OutcomesThe Application & Limitation of Urological SP SurgerySingle Port Retroperitoneal Partial NephrectomySingle Port Prostate Surgery
TICC - 1F 101B
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Recent Advancements in Muscle-Invasive Urothelial Carcinoma
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Cheng-Kuang YangTaiwan
Speaker
Robotic Radical Prostatectomy: Trying to Fit the Right Surgery to the Right PatientDefinitive treatment for localized prostate cancer included radical prostatectomy and radiation. Successful criteria of radical prostatectomy have to meet oncology control, not persistent PSA after surgery without salvage therapy. MRI imaging stage and PSA density are predictors for short‐term BCR after prostatectomy. NCCN‐defined high‐risk patients with a high initial PSA 28 density, imaging stage (T3aN0M0 and T3bN0M0), and 29 pathologic stage (any N1) had a higher risk of BCR when 30 compared with other patients with undetectable PSA, while 31 those with pathologic stage (T3bN0M0 or any N1) displayed 32 a higher risk of postoperatively detectable PSA. These find‐ 33 ings may help urologists to identify patients for whom active 34 therapeutic protocols are necessary.
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Cheng-Kuang YangTaiwan
Speaker
Robotic Radical Prostatectomy: Trying to Fit the Right Surgery to the Right PatientDefinitive treatment for localized prostate cancer included radical prostatectomy and radiation. Successful criteria of radical prostatectomy have to meet oncology control, not persistent PSA after surgery without salvage therapy. MRI imaging stage and PSA density are predictors for short‐term BCR after prostatectomy. NCCN‐defined high‐risk patients with a high initial PSA 28 density, imaging stage (T3aN0M0 and T3bN0M0), and 29 pathologic stage (any N1) had a higher risk of BCR when 30 compared with other patients with undetectable PSA, while 31 those with pathologic stage (T3bN0M0 or any N1) displayed 32 a higher risk of postoperatively detectable PSA. These find‐ 33 ings may help urologists to identify patients for whom active 34 therapeutic protocols are necessary.
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TICC - 1F 101C
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Jeremy TeohHong Kong, China
Moderator
Transurethral En Bloc Resection of Bladder Tumor: Where Are We Now?There is increasing evidence that transurethral en bloc resection of bladder tumour (ERBT) could lead to better peri-operative and oncological outcomes in patients with non-muscle-invasive bladder cancer. Modified approaches of ERBT have also been proposed to expand its indications for larger bladder tumours. The quality of resection is also the key for bladder-sparing treatment for muscle-invasive bladder cancer. We foresee an exciting journey ahead for ERBT, and as a urologist, we must embrace this novel technique for the best interest of our bladder cancer patients. To Publish or not to Publish? Navigating the path to academia in urologyDoing good science is the basis for technological advancement in healthcare. However, pursuing a path to academic in urology is often tough, stressful and frustrating. In this talk, I will share with you what I have learnt throughout my 15 years of research work. I will let you know what's the best and fastest way to become a globally renowned and successful researcher. Most importantly, I will explain what it takes to develop a great team and create a positive impact in people's lives. Believe in yourself! If I can do it, so can you.SIU Lecture: Role of MISTs in Male LUTS Surgical Management (Will TUR-P/ Laser Prostatectomy be Replaced?)Transurethral resection of prostate (TURP) is the current gold standard in treating patients with benign prostatic hyperplasia. Laser prostatectomy has also been used widely especially in patients who are on anticoagulants. However, both TURP and laser prostatectomy are associated with several problems including the need of spinal / general anaesthesia and the risk of male sexual dysfunction. In the past decade, we have witnessed the introduction of multiple new technologies including Rezum, Urolift, iTind and Aquablation. in this SIU lecture, we will discuss about the technical details, as well as the pros and cons of every new technology. We will also invite you to be our jury and decide whether TURP and laser prostatectomy will be replaced in the future. Novel Intravesical Therapeutics in the Evolving Landscape of NMIBCNon-muscle-invasive bladder cancer (NMIBC) is well known to be a difficult disease to manage, with a 1-year recurrence rate of up to 61% and 5-year recurrence rate of 78%. Despite the use of intravesical BCG therapy, NMIBC patients may still experience recurrence and develop what we call BCG-unresponsive NMIBC. Conventionally, we offer upfront radical cystectomy for patients with BCG-unresponsive NMIBC, however, this is an ultra-major surgery with significant risk of complications and could also lead to significant deterioration in quality of life in the long run. We are in urgent need for novel therapies to manage this difficult condition. In this lecture, we will discuss the evidence on the different novel intravesical therapies in treating BCG-unresponsive NMIBC. SIU Lecture: Role of MISTs in Male LUTS Surgical Management (Will TUR-P/ Laser Prostatectomy be Replaced?)
Chih-Chieh LinTaiwan
Facilitator
Vesico-Vaginal Fistula: General Concept and Patient Preparation健保各領域審查共識及討論－功能性
Steven L. ChangUnited States
Speaker
The Progression Landscape of Diagnostic and Treatment Options for Kidney CancerPros and Cons in the daVinci SP System Applications in Urological Surgeries
Simone CrivellaroUnited States
Speaker
Single-Port vs. Multi-Port Robotic Prostatectomy: Balancing Innovation, Precision, and OutcomesThe Application & Limitation of Urological SP SurgerySingle Port Retroperitoneal Partial NephrectomySingle Port Prostate Surgery
TICC - 1F 102
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Oncology Prostate (D)
TICC - 1F 101D
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Andrology & BPH
I-Shen HuangTaiwan
Moderator
New Horizons in Clinical Predictors for Sperm Retrieval in Non-Obstructive Azoospermia Patients
Weida LauSingapore
Moderator
An Indepth Discussion on Male InfertilityIn this lecture, we will look at the urologist role in the diagnosis and management of male infertility. We will take an indepth look at the timing of male infertility consult and the assessment of patient focusing on risk factors and the diagnosis of important etiologies of male infertility. Next, we address the interpretation of basic semen analysis and other essential tests for male infertility. Lastly, without being too exhaustive, we learn to manage specific management scenarios including varicocele, obstructive azoospermia, medical management of male infertility, and the issue of sperm retrieval. Low-Intensity Shockwave Therapy: Current Evidence and Applications in Erectile DysfunctionIn this lecture, we aim to understand the basic science behind the use of LiESWT for erectile dysfunction and summarize the evidence that supports the utility of LiESWT for ED. Next, the lecture will address the role of LiESWT in the present armamentarium for the management of ED, including selection of patients who will best benefit from the treatment. Lastly, the talk will touch on current trends in the use of shockwave treatment including the prevalence in the use of radial shockwaves that has gained popularity in some regions despite the lack of evidence for efficacy.
TICC - 3F South Lounge
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13:30
15:00
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Transplantation & AI & Training
TICC - 3F North Lounge
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Functional Urology (A)
TICC - 4F Elegance Lounge
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Partial Nephrectomy Workshop
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Henry HoSingapore
Speaker
Technical Pearls: Wheel-Barrow TechniquesBringing Innovation to PatientRobotic Partial Nephrectomy: Beyond Technique
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Tanet ThaidumrongThailand
Speaker
Technical Pearls: Retzius SparingTreating SRM in a 65-Year-Old ECOG 1 with Multiple Previous Operations-Is Minimally Invasive Treatment Feasible?
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Po-Hung LinTaiwan
Speaker
Robotic Prostatectomy Using da Vinci SP SystemIn this semi-live section I will demonstrate the steps of extraperitoneal-approach radical prostatectomy using DAVINCI SP system.How to Make the Best Decision with Systemic Therapy Sequence in Respective of Genetic AnalysisRenal cell carcinoma (RCC) is a biologically heterogeneous disease driven by a limited set of convergent pathways that together shape oncogenesis, immune evasion, and therapeutic response. Across clear-cell RCC (ccRCC), recurrent alterations include VHL, PBRM1, BAP1, and SETD2, mapping onto five dominant axes: hypoxia signaling (VHL–HIF), PI3K/AKT/mTOR, chromatin remodeling, cell-cycle control, and metabolic rewiring. These lesions variably interact—e.g., mTORC1 enhances HIF translation—creating therapeutic opportunities (VEGF tyrosine-kinase inhibitors, HIF-2α inhibition, mTOR blockade) and constraints (adaptive resistance via metabolic plasticity). While immune checkpoint inhibitors (ICIs) and ICI–TKI combinations have improved outcomes in metastatic RCC, robust predictive biomarkers remain elusive. Tumor mutational burden is typically low and noninformative; PD-L1 shows assay- and context-dependent utility; PBRM1 and BAP1 are more prognostic than predictive. Emerging signals include angiogenic versus T-effector/myeloid transcriptional signatures, sarcomatoid/rhabdoid histology as a surrogate of immune-inflamed state, and host factors such as HLA genotype and gut microbiome composition. Liquid-biopsy modalities (ctDNA and methylome profiling) and spatial/single-cell atlases reveal intratumoral heterogeneity, T-cell exclusion niches, and myeloid programs (e.g., TREM2⁺ macrophages) linked to recurrence or ICI benefit. Early data support metabolism-targeted strategies (e.g., glutaminase inhibition) and rational combinations co-targeting angiogenesis, hypoxia signaling, and immune checkpoints; however, toxicity management and resistance evolution require prospective, biomarker-integrated trials. A clinical schema that pairs baseline multi-omic and microenvironmental profiling with adaptive surveillance (serial liquid biopsies, functional imaging) can lead to dynamically select among ICI–ICI, ICI–TKI, targeted, and experimental regimens. Robotic Prostatectomy Using da Vinci SP System
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Toshikazu TakedaJapan
Speaker
Resection/Enucleation techniques and RenorrhaphyRobot-assisted partial nephrectomy is a highly complex surgical procedure aimed at cancer control and preservation of renal function. It involves multiple critical steps, including securing the renal artery, exposing the tumor and determining the surgical margin, clamping the renal artery, tumor excision, suturing the tumor bed, unclamping the renal artery, and renorrhaphy. In this presentation, I will focus on tumor excision, renal artery unclamping, and renorrhaphy, and discuss the surgical techniques and key considerations associated with these steps.
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Henry HoSingapore
Speaker
Technical Pearls: Wheel-Barrow TechniquesBringing Innovation to PatientRobotic Partial Nephrectomy: Beyond Technique
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TWTC - 2F Conference Room 4
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Andrology (A) & Novel Advance (A)
Vinod K.VIndia
Moderator
Testosterone Therapy: Implications for Cardiovascular Health Sexual Function Preservation in MIS for BPH
TWTC - 2F Conference Room A+
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15:00
15:30
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TWTC - 1F Exhibition Hall
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15:00
17:00
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TWTC - 1F Exhibition Hall
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15:30
17:00
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Meet the Future: Urology Fellowship Opportunities
TICC - 3F Banquet Hall
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Rajeev TPIndia
Moderator
Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith
Po-Hung LinTaiwan
Speaker
Robotic Prostatectomy Using da Vinci SP SystemIn this semi-live section I will demonstrate the steps of extraperitoneal-approach radical prostatectomy using DAVINCI SP system.How to Make the Best Decision with Systemic Therapy Sequence in Respective of Genetic AnalysisRenal cell carcinoma (RCC) is a biologically heterogeneous disease driven by a limited set of convergent pathways that together shape oncogenesis, immune evasion, and therapeutic response. Across clear-cell RCC (ccRCC), recurrent alterations include VHL, PBRM1, BAP1, and SETD2, mapping onto five dominant axes: hypoxia signaling (VHL–HIF), PI3K/AKT/mTOR, chromatin remodeling, cell-cycle control, and metabolic rewiring. These lesions variably interact—e.g., mTORC1 enhances HIF translation—creating therapeutic opportunities (VEGF tyrosine-kinase inhibitors, HIF-2α inhibition, mTOR blockade) and constraints (adaptive resistance via metabolic plasticity). While immune checkpoint inhibitors (ICIs) and ICI–TKI combinations have improved outcomes in metastatic RCC, robust predictive biomarkers remain elusive. Tumor mutational burden is typically low and noninformative; PD-L1 shows assay- and context-dependent utility; PBRM1 and BAP1 are more prognostic than predictive. Emerging signals include angiogenic versus T-effector/myeloid transcriptional signatures, sarcomatoid/rhabdoid histology as a surrogate of immune-inflamed state, and host factors such as HLA genotype and gut microbiome composition. Liquid-biopsy modalities (ctDNA and methylome profiling) and spatial/single-cell atlases reveal intratumoral heterogeneity, T-cell exclusion niches, and myeloid programs (e.g., TREM2⁺ macrophages) linked to recurrence or ICI benefit. Early data support metabolism-targeted strategies (e.g., glutaminase inhibition) and rational combinations co-targeting angiogenesis, hypoxia signaling, and immune checkpoints; however, toxicity management and resistance evolution require prospective, biomarker-integrated trials. A clinical schema that pairs baseline multi-omic and microenvironmental profiling with adaptive surveillance (serial liquid biopsies, functional imaging) can lead to dynamically select among ICI–ICI, ICI–TKI, targeted, and experimental regimens. Robotic Prostatectomy Using da Vinci SP System
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Rajeev TPIndia
Moderator
Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith
Chang Wook JeongKorea (Republic of)
Speaker
Extravasculare Renal Denervation to Treat Resistant HypertensionResistant hypertension is defined as uncontrolled blood pressure above the target, despite the concurrent use of three or more antihypertensive medications. Individuals with resistant hypertension are at a high risk for severe cardiovascular events and mortality. Managing resistant hypertension is challenging, and many non-pharmacological treatments, including renal denervation (RDN), have been introduced.
This presentation will demonstrate the surgical technique of the extravascular RDN (eRDN) using the HyperQure™ System performed as part of the first-in-human trial. The surgeries were performed as a retroperitoneal approach in a modified prone position.
The preliminary results will be presented, too. In the United States, a prospective, multicenter, early feasibility study is also underway.
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Rajeev TPIndia
Moderator
Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith
Aaron GohMalaysia
Speaker
Game Changer or Gimmick? Evaluating the shift to Retzius SparingRetzius-sparing radical prostatectomy (RS-RP) offers a significant functional advantage, particularly in terms of immediate continence recovery. Despite early skepticism, non-inferior oncological outcomes have been observed in our personal case series, supporting its wider adoption. However, many surgeons still perceive the transition from the conventional anterior approach as technically challenging.
A practical way to bridge this gap is through the hood-sparing technique, which modifies the anterior approach to preserve anterior support structures while gradually introducing the anterior dissection plane in a more familiar sequence. One critical but often overlooked determinant of success is the role of the bedside assistant. In academic centres, assistants are usually well-trained fellows; in many other settings, assistance is limited to rotational nurses or junior trainees. A clipless RS-RP technique simplifies the assistant’s role, requiring mainly suctioning and instrument passage. Concerns regarding nerve injury can be addressed using pinpoint monopolar or low-power bipolar energy, which allows for precise dissection with minimal lateral thermal spread.
This session will demonstrate the RS-RP technique in a semi-live format, highlighting steps to safely adopt it outside high-volume centres. With structured modifications and thoughtful case selection, the shift to RS-RP can be both practical and beneficial.
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Rajeev TPIndia
Moderator
Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith
Guan Hee TanMalaysia
Speaker
Transperineal Fusion Biopsy of Prostate: Tips and TricksTransperineal MRI-ultrasound fusion biopsy has emerged as a highly accurate and safe approach for prostate cancer diagnosis. The transperineal approach to prostate biopsy offers high precision in diagnosing clinically-significant prostate cancer while minimizing infection risks. This semi-live video presentation demonstrates a step-by-step approach to the procedure using the Koelis platform, focusing on optimal setup, image registration, and targeted sampling techniques. Key aspects include patient positioning, probe fixation, and system calibration to ensure accurate fusion of pre-procedural MRI with real-time ultrasound. I will highlight strategies for efficient lesion targeting, including trajectory planning, and needle deployment when performing this procedure. This video aims to provide viewers with a clear, practical guide to performing transperineal fusion biopsy on the Koelis system, enhancing diagnostic accuracy and procedural efficiency.
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Rajeev TPIndia
Moderator
Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith
Henry HoSingapore
Speaker
Technical Pearls: Wheel-Barrow TechniquesBringing Innovation to PatientRobotic Partial Nephrectomy: Beyond Technique
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Rajeev TPIndia
Moderator
Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith
Lih-Ming WongAustralia
Speaker
Nephro-Ureterectomy with Cystectomy & Other Uncommon Uro-Oncology CasesTo generate discussion and interest, a selection of uncommon tumours excised robotically will be presented. These will be chosen from a selection of prostate sarcoma, pelvic liposarcoma, retroperitoneal schwannoma, distal ureterectomy and urachal adenocarcinoma.
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TICC - 3F Plenary Hall
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AI and Novel Techs in GU Cancer Application
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Wei-Yu LinTaiwan
Moderator
Step-by-Step: Intra-Corporeal Orthotopic Bladder CreationIntra-corporeal orthotopic neobladder creation is a technically demanding yet feasible procedure performed following robotic radical cystectomy. Using a 40–50 cm segment of ileum, the bowel is isolated, detubularized along the antimesenteric border, and configured into a low-pressure reservoir. Urethro-ileal anastomosis is carefully performed to ensure a tension-free, watertight connection, followed by uretero-ileal anastomoses using the Wallace technique with ureteral stent placement. The intra-corporeal approach minimizes bowel handling, facilitates faster recovery, and preserves pelvic anatomy, offering potential advantages in continence and postoperative outcomes when performed by experienced robotic surgeons.
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Cheryn SongKorea (Republic of)
Speaker
Assistance of the AI during RAPN - Surgical Navigation to Outcome PredictionArtificial Intelligence (AI) has deeply infiltrated many, if not every, aspects of our lives - both professional and ordinary corners. In medicine, it seems that any research dealing with large amounts of data has to employ AI in one way or another - from radiomics and radiogenomics to drug developments and simulations. In managing patients with renal tumors, majority of which now present with localized, small masses, I have focused on developing a tool to help establish a plan preoperatively and navigate throughout the surgery, in real-time with the help of the AI. Using kidney dynamic CT scans of 100 patients undergoing robot-assisted partial nephrectomy, software was developed to render a 3-dimensional image of the kidney harboring the tumor along with several other tools to enhance visualization of the lesion. Scans from an additional 30 patients were used to test for performance and validate the software. Before surgery, main renal pedicles, tumor location with respect to the major hilar vasculature, important landmarks including the calyces and branches of the vessels can be studied from all angles; tumor shape especially when it is not a perfect sphere can be visually presented and the excision of the tumor with desired margin thickness can be simulated to see what vital structures come into contact. Connected to the surgeon console through the TilePro® screen, it was designed to aid a urologic surgeon from before surgery as well as throughout the procedure as needed. In a phase I feasibility trial investigating the efficacy of the system, we confirmed that the integration of the 3D navigation system into RAPN was both feasible and safe, providing enhanced anatomical information while maintaining a consistent level of operative risk. The use of navigation system resulted in reduced renal parenchymal volume resected, suggesting potential benefits in renal function preservation. Subsequent phase 2 trial investigating accuracy of the reconstruction and a multicenter randomized controlled trial with surgeons with varying degrees of experience are underway to validate the benefits.
On the other hand, the fundamental question as to best manage the small renal masses – i.e. indications for partial nephrectomies - still harbor some gray areas: is partial nephrectomy at all possible situations the best? In a given patient how will oncological and renal functional outcome differ between partial and radical nephrectomy? Previous statistical methods could only calculate risk ratios in the best-matched cohorts and the issue of counterfactual remained. Using demographic and tumor descriptive parameters of 1,448 patients with pT1N0M0 RCC patients from three academic centers, causal inference was modeled using a double machine learning algorithm to predict progression-free survival and eGFR at five years according to each surgical method: partial and radical nephrectomy. We identified significant factors and their contribution to the outcomes of interest to be included in the model. Selecting a model with the highest performance among various machine learning models for each outcome, an online interface was constructed. External validation confirmed the robustness, presenting AUROC of 0.758, AUPRC of 0.200 with XGBoost model for recurrence, and RMSE of 15.9 with GBM model for eGFR. By presenting numerical predictions of oncologic and functional outcomes associated with partial and radical nephrectomy in a given patient, our model facilitates individualized, evidence-based clinical decision-making.
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Chi-Hang YeeHong Kong, China
Speaker
Robotic Total Intracorporeal Urinary Diversion – from Ileal Conduit to Neobladder to Ileal Interposition Prostate Cancer Focal Therapy: Ready for Prime Time?
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Hong-Cheng Gan Taiwan
Speaker
Training AI as Our Best Helper in Prediction of Continence Recovery after Robotic Prostatectomy
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TICC - 2F 201BC
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Diversified Approaches to Stone Management
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Deok-Hyun HanKorea (Republic of)
Speaker
The Era of ECIRS: Prone Still Matters!Endoscopic combined intrarenal surgery (ECIRS) couples antegrade and retrograde endoscopy to raise stone-free rates while limiting morbidity. Although the Galdakao-modified supine position is widely used, surgeons experienced with prone percutaneous nephrolithotomy (PCNL) can realize distinct advantages when ECIRS is performed in the prone split-leg position. This lecture reviews practical operating-room setup and positioning—including feasible workarounds when a split-leg positioner is unavailable—monitor layout, and puncture trajectory planning. It details endoscope-guided puncture and coordinated intrarenal navigation, and highlights scenarios where prone ECIRS is particularly advantageous: posterior and upper-pole access, narrow calyces, complex collecting-system anatomy, and situations requiring stable distension and visualization. We discuss how prone positioning can improve irrigation dynamics, enable a “vacuum-cleaner” effect for fragment clearance, reduce thermal injury risk, and limit retrograde fragment migration—often without a ureteral access sheath. Strategies for comprehensive residual-fragment assessment and efficient D-J stent placement are outlined, along with trade-offs (airway considerations, workspace and monitor configuration, and the brief learning curve for retrograde orientation). In sum, prone ECIRS is a feasible, reproducible extension of prone PCNL that offers a natural transition path for prone PCNL surgeons and may improve stone-free outcomes in selected patients. Further prospective data and standardized workflows will refine its role.
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Yi-Sheng TaiTaiwan
Moderator
Which Laser for RIRS: Thulium Fiber Laser Thulium Fiber Laser (TFL)is a type of fiber laser, distinct from Thulium laser used for prostate surgey. It’ a cutting-edge laser and rapidly gaining traction in urology The machine is compact, portable, quiet with air-cooling, and lower power consumption.It employs a thulium-doped silica fiber powered by diode lasers, emitting light at 1940 nm, matching water absorption peaks. This results in a high absorption coefficient and shallow penetration (~0.1 mm), enabling precise energy delivery and minimizing tissue damage.Compared to Holmium lasers, TFL operates at lower energies (down to 25mJ) and higher frequencies (up to 2000Hz) for delicate tissue ablation and fine stone dusting.
The most notable change is pulse modulationHo:YAG lasers has Spike-shaped pulses and indicate greater energy concentration, resulting in higher localized heating, uneven fragmentation, and increased retropulsion.TFL produces pulses with uniform energy distribution and lower peak power, resulting in consistent ablation with less retropulsion and fewer thermal spikes.Higher water absorption rapidly forms a vapor channel, enhancing ablation efficiency.
But, TFL is not as ideal in surgical scenarios. At settings of low pulse energy (0.2 J) and high frequency (100 Hz), it tends to cause troublesome char formation and spark generation, particularly when treating calcium phosphate stones. These phenomena, explosive combustion and carbonization can reduce ablation efficiency and increase the risk of thermal damage and fiber degradation. Optimizing TFL settings is very important for outcome and safety and ongoing evaluation. AI in Medical Imaging – Converting 2D Black & White to 3D and Applications in Mixed Reality (MR) used in RIRS Artificial Intelligence (AI) and Extended Reality (XR) are at the forefront of innovation in modern medicine. In endoscopic surgery, these technologies are increasingly being integrated to enhance procedural precision and intraoperative guidance.
One experimental application involves using AI to convert 2D CT scans into 3D visualizations, offering surgeons a more intuitive understanding of anatomical structures. Devices like the Apple Vision Pro may be used to create fully immersive virtual environments, although it is not currently approved as a medical device.
In clinical practice, Mixed Reality (MR)—which blends real and virtual environments with real-time interaction—has shown promise. MR has been used during Retrograde Intrarenal Surgery (RIRS) to reduce the risk of missed stones, and in Endoscopic Combined Intrarenal Surgery (ECIRS) to overlay anatomical data, improving puncture accuracy during Percutaneous Nephrolithotomy (PCN).
As an emerging field, further advancements will depend on enhanced imaging resolution, improved intrarenal navigation and integration of AI-driven real-time stone detection.
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Hung-Yi ChenTaiwan
Speaker
How to Use Intrarenal Pressure Monitoring to Identify Risky Steps during RIRS Surgery, and the Function of FANS.Intrarenal pressure (IRP) elevation during retrograde intrarenal surgery (RIRS) is associated with increased risks of renal injury and infection. Real-time IRP monitoring enables identification of risky procedural steps—such as access sheath insertion, stone fragmentation, and basketing—where pressure spikes commonly occur. Recognizing these moments allows timely adjustments to irrigation and technique. The Flexible and Navigable Suction Ureteric Access Sheath (FANS) plays a key role in pressure management by facilitating continuous suction and efficient outflow, thereby reducing IRP and improving visibility. Incorporating both IRP monitoring and FANS enhances surgical safety and may improve patient outcomes in RIRS.
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Yi-Yang LiuTaiwan
Speaker
Complex Renal Stone: PCNL or RIRS or Combination?Mini-percutaneous nephrolithotomy (mini-PCNL) provides stone-free rate (SFR) 85 to 95 % in children with complex burdens, and recent systematic reviews report overall complications < 7 % and transfusion requirements ≈3 % when tracts ≤18 Fr are used. Its drawbacks are the need for percutaneous access, risk of bleeding, and potential parenchymal scarring, especially when multiple tracts are required.
Retrograde intrarenal surgery (RIRS) avoids renal puncture and shows the lowest incidence of high-grade complications (<1 %); contemporary series in preschool children describe initial SFRs of 60–78 %, with secondary procedures needed in up to one-third of cases because of narrow, tortuous ureters. Pre-stenting, staged dilation and longer operative time can offset its minimally-invasive appeal for stones ≥2 cm.
Endoscopic combined intrarenal surgery (ECIRS) merges an antegrade mini-PCNL channel with simultaneous flexible ureteroscopy. The first multicenter pediatric series and a 2024 comparative study confirm SFRs of 75–92 %, shorter hospital stay and lower fluoroscopy or transfusion risk than standalone PCNL despite treating more complex stones. Its limitations are the need for two skilled teams, specialized equipment and the Galdakao-modified supine Valdivia position, which lengthen setup and raise costs.
In summary, mini-PCNL remains the most efficient monotherapy for large or staghorn calculi; RIRS is ideal when bleeding risk or unfavorable percutaneous windows predominate; ECIRS offers the best compromise between clearance and morbidity where resources and expertise allow. Individualized, anatomy-based algorithms and further pediatric RCTs are still required.
ECIRSIn this session, we will demonstrate the technique about Totally-X-ray free ultrasound guided endoscopic combind intrarenal surgery in Galdakao modified supine Valdivia position.A Critical Appraisal on Percutaneous NephrolithotripsyPercutaneous nephrolithotripsy (PCNL) has evolved from a uniform prone, fluoroscopy-guided, large-tract technique into a precision endourological platform that emphasizes patient-tailored positioning, radiation-free puncture, miniaturized tracts, energy-efficient lasers and nascent robotic–AI augmentation. Contemporary evidence affirms that stone-free rates now approach a plateau, making safety metrics—bleeding control, infection prevention and intrarenal pressure modulation—the key differentiators among modern approaches. Miniaturized optics, suction-regulated sheaths and thulium-fiber or dual-wavelength laser consoles have collectively reduced hemoglobin loss and postoperative sepsis while preserving clearance efficacy. Future success will hinge on harmonizing technological innovation with rigorous evidence so that every incremental advance translates into measurable gains for both efficacy and safety in stone surgery.Echo guide Puncture in Supine PCNL: Tips and Tricks for an Efficient and Safe ProcedureMastery of ultrasound-guided supine PCNL begins with precise anatomical orientation. Color-Doppler mapping pinpoints the target calyx, which is punctured transpapillary with an echogenic-tip needle after artificial hydronephrosis is produced by retrograde ureteroscopic irrigation. A hydrophilic, floppy-tip yet stiff-shaft guidewire is then advanced through the needle, allowing atraumatic navigation of the collecting system under ureteroscopic visualization. Balloon dilation—used in place of sequential dilators—prevents guidewire dislodgement. When necessary, a through-and-through guidewire from flank skin to urethral meatus may be created to secure renal access. Finally, antegrade nephroscopy along this coaxial tract confirms unobstructed entry, provides panoramic inspection, and optimizes lithotripsy efficiency—all without fluoroscopy. Collectively, these steps deliver reliable access, eliminate radiation, and streamline stone clearance in a single, ergonomically favorable supine position.
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Ching-Heng YenTaiwan
Speaker
What are the New Supportive Modalities in the Horizon to Increase the Efficacy of ESWL Extracorporeal shock wave lithotripsy (ESWL) has long been a standard non-invasive modality for managing urinary stones, yet its efficacy remains suboptimal in certain scenarios due to variable stone composition, size, and anatomical factors. Recent advancements have introduced several supportive modalities aimed at enhancing stone fragmentation and clearance. Among these, Burst Wave Lithotripsy (BWL) emerges as a promising technology utilizing focused, low-intensity ultrasound bursts to achieve finer stone fragmentation with greater precision and reduced tissue injury. In parallel, adjunctive approaches such as external physical vibration, ultrasonic propulsion, and optimized patient positioning are gaining traction. Pharmacologic aids including alpha-blockers and potassium citrate have also demonstrated improved stone passage rates post-ESWL. Furthermore, artificial intelligence–driven targeting and real-time imaging advances contribute to improved shock wave focusing and treatment personalization. This review explores the evolving landscape of supportive technologies, with a focus on BWL and its integration with existing ESWL protocols, potentially reshaping the future paradigm of non-invasive stone management.
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Hsiang-Ying LeeTaiwan
Speaker
Best Laser for UTUCManagement of Total Ureteral Avulsion during Ureteroscopy
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Chinnakhet
Ketsuwan Thailand
Speaker
Intra Renal Pressure Defines Outcomes: Current EvidenceIntrarenal pressure (IRP) is a crucial physiological parameter during endourological interventions, as elevated IRP is closely linked to increased fluid absorption, intrarenal backflow, compromised renal perfusion, and postoperative complications. Experimental studies in animal models have consistently demonstrated a correlation between increased IRP and augmented irrigation fluid absorption, renal parenchymal backflow, and reductions in renal blood flow. Clinical studies have reported baseline IRP values ranging from 14 to 17 mmHg, with transient peristaltic peaks reaching up to 25 mmHg. Notably, IRP frequently surpassed 60 mmHg during endoscopic procedures, particularly when utilizing manual hand-pump irrigation or employing ureteral access sheaths (UAS) with smaller diameters. Significant risk factors identified for sustained elevations of IRP include non-prestented ureters, Asian ethnicity, and omission of UAS placement. Furthermore, elevated IRPs have demonstrated a direct association with infectious adverse events, notably postoperative sepsis. Randomized controlled trials have established that manual hand-pump irrigation generates substantially higher IRPs compared to pressurized irrigation bags. Additionally, serial manual irrigation boluses have been shown to produce prolonged IRP elevations, with maximum peaks exceeding 100 mmHg and durations surpassing 40 seconds. Collectively, both preclinical and clinical evidence underscores the necessity of meticulous intraoperative IRP management during endourological procedures. Strategic optimization of irrigation techniques and appropriate UAS selection are imperative to effectively maintain IRP within safe physiological limits, thereby minimizing the risk of complicationsRole of VR/AR/MR in Endourology and Urolithiasis Renal stone disease is a common urological condition affecting diverse patient populations. Percutaneous nephrolithotomy (PCNL) is widely recognized as the primary treatment for large or complex renal calculi, offering high stone-free rates with low complication profiles. Nevertheless, achieving accurate percutaneous renal access (PCA) remains technically challenging due to anatomical proximity to vital structures and insufficient hands-on training opportunities for urologists. Virtual reality (VR) simulators, such as the PERC Mentor and Uro Mentor, have demonstrated significant improvements in PCA proficiency, operative efficiency, and complication reduction, establishing their validity as effective training platforms. Additionally, mixed reality (MR) and 3D holographic technologies, exemplified by HoloLens, enhance surgical planning and procedural accuracy, particularly in calyceal targeting during PCNL. Recent nationwide training needs assessments have further advocated for the integration of these advanced simulation technologies into urological education curricula. Ultimately, systematic incorporation of VR and MR simulation into residency training holds substantial promise in bridging existing skill gaps, refining surgical competencies, and circumventing ethical concerns associated with traditional methods of surgical education.
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TICC - 2F 201DE
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PSMA – Revolutionizing Prostate Cancer Care
TICC - 1F 101B
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15:30
17:00
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Advancing Precision Medicine in Advanced PC: From Patient-Specific Factors to Real-World Evidence
TICC - 1F 101C
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Oncology Prostate (E)
TICC - 1F 101D
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Oncology Bladder UTUC (D) & Functional Urology (B)
TICC - 1F 102
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Novel Advances
TICC - 3F South Lounge
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Nursing
Ching-Hui ChienTaiwan
Moderator
Self-Management with an Application in Urogenital Cancer PatientsProstate, kidney, and bladder cancers are among the most common urogenital malignancies. Of these, prostate cancer has the highest incidence and prevalence, yet
also imposes the greatest burden in terms of disability-adjusted life years (DALYs). Evidence suggests that self-management can enhance quality of life by improving
urinary and bowel symptoms, sexual dysfunction, emotional well-being, psychological health, confidence in symptom management, and self-efficacy in patients with prostate cancer. Our team developed and implemented an app-based self-management intervention specifically for prostate cancer patients. The findings showed significant improvements in urinary symptoms, social participation, and self-efficacy. Healthcare providers are encouraged to integrate app-assisted self-management
strategies into clinical practice to better address the holistic needs of patients.
TICC - 3F North Lounge
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15:30
17:00
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Functional Urology (C)
TICC - 4F Elegance Lounge
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Oncology: Kidney
Siros JitpraphaiThailand
Moderator
RCC and IVC ThrombectomyRCC and IVC thrombus
Siros Jitpraphai
Division of Urology, Department of Surgery,
Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, THAILAND
Abstract
Renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombus represents a complex surgical challenge, with an incidence of venous involvement in 4-10% of cases. This case report demonstrates the successful surgical management of a 58-year-old female patient with a large left-sided renal mass and IVC thrombus. The patient presented with gross hematuria and was diagnosed with a 10 cm clear cell renal cell carcinoma (Fuhrman nuclear grade 3) extending into the renal vein and IVC. Recognizing the complexity of the case, a multidisciplinary approach was employed, involving urological and hepatobiliary surgical teams. The comprehensive treatment strategy included an open radical nephrectomy with IVC thrombectomy. The surgical technique was meticulously planned and executed, with several key considerations. Preoperative imaging was crucial in determining the exact level of thrombus, allowing for precise surgical planning. The procedure emphasized careful vascular control and en-bloc tumor removal, with intraoperative ultrasound used to ensure accurate thrombus localization. Surgical teams worked collaboratively to minimize potential complications and maximize surgical success. Operatively, the procedure was substantial, with an estimated blood loss of 900 mL and a total operative time of 5 hours. The patient required two days of postoperative intensive care and was discharged from the hospital seven days after the surgery. Pathological examination confirmed the diagnosis of clear cell renal cell carcinoma, with no lymph node metastasis detected and positive tumor thrombus. Importantly, surgical margins were found to be free of tumor.
Follow-up evaluations have been encouraging, with no signs of tumor recurrence observed during regular intervals. This case illustrates the critical importance of a systematic surgical approach, precise technical execution, and comprehensive multidisciplinary management in successfully treating RCC with IVC thrombus. It provides valuable insights into the complex surgical management of this challenging condition, potentially offering guidance for similar cases in the future.
Keyword: RCC (Renal Cell Carcinoma), IVC Thrombus, Thrombectomy, Surgical Technique, Multidisciplinary Management
Highlight: RCC with IVC thrombus is a complex surgical challenge affecting 4-10% of cases. Successful management requires meticulous preoperative imaging, multidisciplinary team approach, and precise surgical technique. With careful planning and execution, 45-70% of patients can be cured through radical nephrectomy and IVC thrombectomy.
Robotic Partial Nephrectomy in Complex and Difficult Tumor Location
TWTC - 2F Conference Room 4
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Oncology RCC (B)
TWTC - 2F Conference Room A+
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18:30
22:00
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