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12:00
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TWTC - 1F Exhibition Hall
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08:30
10:00
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Chi Wai ManHong Kong, China
Speaker
UAA Honorary Member Lecture: Learning through Giving Expert Opinion, a Hong Kong Case BookLearning through giving expert opinion, a Hong Kong urology case book
Dr Man, Chi Wai
MBBS HK FRCS Edin FRCS Glas FCSHK FHKAM Dip Urol Lond LLB Beij
Consultant Urologist, Tuen Mun Hospital
In Hong Kong older urologists are often asked to give expert opinions to various parties including the Coroner and the Medical Council. The expert must give unbiased assistance to the justice system. I also try to explain that there are factors other than the urologist care to account for the outcome, and to look for possible improvements in our care. Thanks for allowing me to share with you my humble experience. The Coroner in HK has the duty to determine the cause of death. If the cause is mishap, civil or disciplinary action will follow. I need to explain why death was not preventable when that was the case. The Medical Council is the statutory body responsible for overseeing professional registration and discipline. It carries out inquiries into complaints of misconduct against doctors. Most of these were about unfavourable outcome and disregard of professional responsibilities. Medical Council actively collects evidence required for proof of medical negligence. Defence could be made by disproving damage or causation of damage. In most cases, proof of no breach of duty by focusing on standard of care is required. I need to explain in such cases that despite appropriate and proper care, an unfavourable outcome could still occur. While the Bolam principle still applies to most aspects of patient care, it is no longer the case in warning patients of risks since the Montgomery case. The most important lesson I learned was that good contemporaneous documentation in medical records is the most important line of defence for urologists.
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Chung-You TsaiTaiwan
Speaker
Bridging AI Frontiers and Urology: How Multimodal and Agentic AI Will Shape 20251. **Evolution of AI: From LLM to Agentic AI**
AI has progressed rapidly from basic language models (LLMs) to multimodal and agentic systems capable of autonomous decision-making and task execution.
2. **General vs. Domain-Specific LLMs**
General-purpose LLMs offer versatility, while domain-specific LLMs (e.g., medical models) provide higher accuracy in specialized fields like urology.
3. **AI Applications in Medical Practice**
LLMs and AI agents assist in research, academic writing, and clinical decision-making—transforming how urologists access and apply medical knowledge.
4. **Agentic AI & Multi-Agent Systems**
AI agents can orchestrate tools, reason through complex problems, and automate workflows without human input—enhancing productivity in healthcare.
5. **Benchmarking AI vs. Human Experts**
In prostate cancer risk assessment, top-tier LLMs demonstrated competitive or superior performance compared to human experts, indicating clinical potential.
How to Make AI as the Most Powerful Assistance for the Treatment of GU Cancer?
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Rajeev KumarIndia
Moderator
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
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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Noor Ashani Md YusoffMalaysia
Moderator
Technical Pearls: Node Dissection in Robotic CystectomyHighlight and Limitation in Urology Service in MalaysiaRobotic Pelvic LN Dissection: A critical Component of Bladder Cancer Surgery
TICC - 3F Plenary Hall
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Tai-Lung ChaTaiwan
Moderator
Novel Target for GU Cancer Metastasis and TherapeuticsCancer progression is shaped by both cell-intrinsic adaptations and complex extrinsic interactions within the tumor microenvironment (TME). Here, we identify a transmembrane protein, Meta1, as a shared therapeutic target that exhibits a Janus-like role: promoting malignant phenotypes in cancer cells while restraining tumor-supportive functions in non-cancerous stromal and immune cells. Meta1 is expressed in both compartments of the TME, orchestrating a dual program that supports metastasis and immune evasion. Mechanistically, we uncovered a malignancy-promoting factor (MPF) that acts as a functional ligand for Meta1, selectively enhancing pro-invasive signaling in cancer cells. We further identify Meta1 as an unconventional G protein–coupled receptor (GPCR) that plays as an accelerator in cancer cells of the TME. Meta1 interacts with Rho-GDI and Gαq to activate RhoA-mediated cytoskeletal remodeling and amoeboid migration, facilitating metastatic dissemination. We further identify MPF binding to Meta1 initiates Gβγ signaling, elevating intracellular cAMP and activating Rap1, thereby amplifying cell motility and metastatic potential. Leveraging the Meta1–MPF interaction, we designed MPF-derived peptides that specifically bind Meta1 and serve as the basis for a novel peptide-based PROTAC, which efficiently induces degradation of Meta1 and abrogates its pro-metastatic functions. Our study unveils Meta1 as an atypical GPCR with canonical signaling capacity and topological divergence, representing a shared and targetable vulnerability that bridges cancer cell-intrinsic adaptation with extrinsic TME communication. These findings establish the Meta1–MPF axis as a compelling therapeutic target for suppressing metastasis and reprogramming the TME.
Bertrand TombalBelgium
Speaker
Impact of Relugolix versus Leuprolide on the Quality of Life of Men with Advanced Prostate Cancer: Results from the Phase 3 HERO Study (European Urology, 2023)
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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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Haruki KumeJapan
Speaker
Updates on Molecular Classification and Diagnostics of Upper Urinary Tract Urothelial CarcinomaUpper urinary tract urothelial carcinoma (UTUC) is a relatively common form of urothelial cancer. However, the molecular mechanisms underlying its carcinogenesis and progression have not been well understood. Most urologists previously believed that the mutational profiles of UTUC and urothelial bladder carcinoma (UBC) were similar. In 2021, by analyzing 198 cases of upper urinary tract cancer, we identified five distinct molecular subtypes of UTUC, each characterized by unique gene expression patterns, tumor locations/histology, and clinical outcomes: hypermutated, TP53/MDM2, RAS, FGFR3, and triple-negative subtypes. Notably, the hypermutated subtype, accounting for approximately 5% of all cases, was predominantly associated with Lynch syndrome, aligning with previous reports. In contrast, UBC is known to be rarely linked to Lynch syndrome. In this plenary session, I will delve into the molecular pathogenesis of UTUC and discuss future perspectives in this field.
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Osamu UkimuraJapan
Speaker
A Fully Automated Artificial Intelligence System to Assist Pathologists' Diagnosis to Predict Histologically High-Grade Urothelial Carcinoma from Digitized Urine CytologyBackground: Urine cytology, although a useful screening method for urothelial carcinoma, lacks sensitivity. As an emerging technology, artificial intelligence (AI) improved image analysis accuracy significantly.
Objective: To develop a fully automated AI system to assist pathologists in the histological prediction of high-grade urothelial carcinoma (HGUC) from digitized urine cytology slides.
Design, setting, and participants: We digitized 535 consecutive urine cytology slides for AI use. Among these slides, 181 were used for AI development, 39 were used as AI test data to identify HGUC by cell-level classification, and 315 were used as AI test data for slide-level classification.
Outcome measurements and statistical analysis: Out of the 315 slides, 171 were collected immediately prior to bladder biopsy or transurethral resection of bladder tumor, and then outcomes were compared with the histological presence of HGUC in the surgical specimen. The primary aim was to compare AI prediction of the histological presence of HGUC with the pathologist's histological diagnosis of HGUC. Secondary aims were to compare the time required for AI evaluation and concordance between the AI's classification and pathologist's cytology diagnosis.
Results and limitations: The AI capability for predicting the histological presence of HGUC was 0.78 for the area under the curve. Comparing the AI predictive performance with pathologists' diagnosis, the AI sensitivity of 63% for histological HGUC prediction was superior to a pathologists' cytology sensitivity of 46% (p = 0.0037). On the contrary, there was no significant difference between the AI specificity of 83% and pathologists' specificity of 89% (p = 0.13), and AI accuracy of 74% and pathologists' accuracy of 68% (p = 0.08). The time required for AI evaluation was 139 s. With respect to the concordance between the AI prediction and pathologist's cytology diagnosis, the accuracy was 86%. Agreements with positive and negative findings were 92% and 84%, respectively.
Conclusions: We developed a fully automated AI system to assist pathologists' histological diagnosis of HGUC using digitized slides. This AI system showed significantly higher sensitivity than a board-certified cytopathologist and may assist pathologists in making urine cytology diagnoses, reducing their workload.
Patient summary: In this study, we present a deep learning-based artificial intelligence (AI) system that classifies urine cytology slides according to the Paris system. An automated AI system was developed and validated with 535 consecutive urine cytology slides. The AI predicted histological high-grade urothelial carcinoma from digitized urine cytology slides with superior sensitivity than pathologists, while maintaining comparable specificity and accuracy.
Keywords: Artificial intelligence; Deep learning; The Paris System; Urine cytology; Urothelial carcinoma.
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Athanasios PapatsorisGreece
Speaker
BCG Refractory Cancer: Current Status of Intravesical TreatmentRecommendations in Laser Use for the Treatment of Upper Tract Urothelial Carcinoma
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Lui Shiong LeeSingapore
Moderator
Technical Pearls: Robotic Intra-Corporeal OBSThis session will demonstrate the key steps required in the intra-corporeal creation of a Studer type orthotropic bladder substitute.
Yuki EndoJapan
Speaker
UTUC Treatment — Evidence & Guideline Recommendation "Current Status and Future Perspectives of Robot-Assisted Nephroureterectomy (RNU) in the Treatment of Upper Tract Urothelial Carcinoma (UTUC): Evidence and Guideline Recommendations"
The standard treatment for upper tract urothelial carcinoma (UTUC) is surgical therapy. With the advancement of robot-assisted surgery, robotic procedures have become widespread in both upper and lower urinary tracts. In Japan, robot-assisted laparoscopic nephroureterectomy (RNU) for UTUC was included in health insurance coverage in 2019, and the proportion of RNUs for UTUC treatment is expected to increase. RNU, supported by robotic assistance, enables minimally invasive and precise procedures, allowing for reduced postoperative complications and shorter recovery periods (O'Sullivan et al., BJUI Compass. 2023). With further accumulation of data from randomized prospective trials and long-term follow-up studies, improvements in therapeutic outcomes, such as reduced postoperative recurrence, are anticipated.
However, as a new technology, there is currently no established evidence. In a notable study, the only prospective randomized trial comparing laparoscopic nephroureterectomy (LNU) with open nephroureterectomy (ONU) showed no difference in disease-specific survival overall. However, in the pT3 or higher group, disease-specific survival and metastasis-free survival were significantly lower in the LNU group (Simone G et al., Eur Urol, 2009). Based on these results, both the European Association of Urology (EAU) guidelines and the Japanese Urological Association (JUA) guidelines recommend ONU for cT3 or higher stages.
In addition, drug therapies, including immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs), are rapidly advancing, and reports of new clinical trials combining these therapies are changing the surgical strategies for MIUC. I would like to review the current positioning of RNU in each guideline and discuss cancer control points when performing RNU, which is expected to become more widespread, with the latest evidence.
TICC - 3F Banquet Hall
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08:30
15:30
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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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AI Technology in Urology and How to Patent It
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Chung-Cheng WangTaiwan
Moderator
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.
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Cherry YangTaiwan
Speaker
The AI Breakthrough in Andrology: A New Era for Male Fertility Analysis
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Frank LuTaiwan
Speaker
How to Strategically Patent Your IdeaFrom ideas to IP. Co-work with IP attorney. Know the application strategies to meet your needs (timeline of the product, market, money, etc.).
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Juan Carlos Santa-RosarioUnited States
Speaker
AI for Precision Pathology in Prostate Cancer Diagnosis in a Real-World SettingBackground:
Accurate and timely prostate cancer diagnosis is crucial yet challenged by rising case volumes, inter-observer variability, and diagnostic delays. Artificial intelligence (AI) offers a compelling solution when integrated effectively into real-world pathology workflows.
Objectives:
To assess the real-world performance, diagnostic impact, and workflow integration of an AI-based second-read tool over a three-year validation period in routine prostate cancer diagnostics.
Methods:
A clinically deployed AI algorithm was implemented as a second reader for prostate biopsy specimens in a high-volume pathology setting. Key metrics included diagnostic accuracy, concordance rates, turnaround time (TAT), and clinical utility of AI-assisted reads versus standard practice.
Results:
Over three years of real-world use, the AI system consistently enhanced diagnostic performance. It reduced diagnostic discordances, improved overall concordance, and contributed to more efficient workflows with shorter TATs. These outcomes demonstrate AI's viability as a supportive second reader in routine pathology practice.
Conclusions:
This study validates that AI, when embedded as a second-read system, can bolster diagnostic consistency, efficiency, and quality in prostate cancer pathology. Its success in real-world clinical settings underscores AI’s readiness to augment pathologists’ expertise and drive precision diagnostics.
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TICC - 3F Banquet Hall
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健保與基層: 健保審查與爭議共識 & 診所開業講座之開源節稅大作戰! (中文)
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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.
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Chih-Chieh LinTaiwan
Speaker
Vesico-Vaginal Fistula: General Concept and Patient Preparation健保各領域審查共識及討論－功能性
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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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TICC - 2F 201BC
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Innovations in Male Infertility and Reproductive Health
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Hyun Jun Park Korea (Republic of)
Moderator
The Evolutionary Role of Varicocelectomy in Andrology Varicocelectomy is among the most commonly performed surgical procedures in contemporary andrological practice. Historically, varicocele management focused primarily on alleviating symptomatic discomfort and addressing infertility characterized by impaired semen parameters. However, the conceptual framework and indications for varicocelectomy have evolved significantly over recent decades, reshaping its clinical implications and expanding its therapeutic potential.
Initially, open surgical approaches such as retroperitoneal and inguinal varicocelectomy were predominant, yet they carried considerable risks, including recurrence, hydrocele formation, and potential damage to testicular arteries. With the advent of microsurgical techniques, particularly subinguinal microsurgical varicocelectomy, procedural efficacy and safety have markedly improved. This has resulted in reduced complication rates and enhanced fertility outcomes, positioning microsurgical varicocelectomy as the current gold standard.
Modern andrological literature emphasizes varicocelectomy’s broader physiological benefits beyond fertility. Recent studies highlight its role in improving testosterone production, mitigating hypogonadism, and enhancing overall testicular function. Additionally, varicocelectomy has been demonstrated to significantly improve sperm DNA integrity and reduce oxidative stress levels, thus positively impacting assisted reproductive technology (ART) outcomes.
Furthermore, contemporary research suggests that varicocelectomy may provide systemic health benefits by reducing chronic inflammation and oxidative damage, conditions associated with metabolic and cardiovascular disorders. This evolving understanding positions varicocelectomy not merely as a fertility treatment but as an integral part of comprehensive male reproductive health management. These insights prompt a proactive approach, encouraging clinicians to recognize varicocelectomy’s extended potential in enhancing male reproductive longevity and general health.
In conclusion, the evolution of varicocelectomy, characterized by advancements in surgical techniques and expanded clinical indications, underscores its significant role in modern andrology. An integrated appreciation of its multifaceted therapeutic benefits facilitates informed clinical decision-making, ultimately enhancing patient care and outcomes in andrological practice.
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Hui-Ying LiuTaiwan
Speaker
Recent Advances in Fertility Preservation for Young Male Cancer SurvivorsTesticular cancer (TC) is the most common malignancy in men of reproductive age and significantly impacts fertility through both direct tumor effects and subsequent gonadotoxic treatments. Tumor-related factors such as testicular parenchymal destruction, intratesticular obstruction, elevated β-HCG levels, oxidative stress, and disruption of the hypothalamic–pituitary–gonadal axis contribute to impaired spermatogenesis and sperm DNA fragmentation. Cancer treatments including orchiectomy, chemotherapy (especially cisplatin-based regimens), retroperitoneal lymph node dissection, and radiotherapy further increase the risk of oligo- or azoospermia, with long-term recovery of spermatogenesis often taking up to 2–4 years. Despite these risks, less than one-third of patients undergo sperm cryopreservation before treatment, even though up to 50% present with abnormal semen parameters at diagnosis. Onco-TESE and electroejaculation serve as viable alternatives in select patients, while emerging evidence supports the use of testis-sparing strategies and real-time sperm retrieval in appropriate cases. Current data emphasize the necessity of early fertility counseling and preservation planning for all men diagnosed with TC. Given the high cure rate and young patient demographic, optimizing reproductive outcomes is a key component of survivorship care.
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So InamuraJapan
Speaker
Chronic Pelvic Pain Syndrome (CPPS): New Insights and Therapeutic Approaches Chronic Pelvic Pain Syndrome (CP/CPPS) is a complex condition characterized by a combination of pelvic pain or discomfort and lower urinary tract symptoms (LUTS), including both storage and voiding issues. The pathophysiology is multifaceted, often originating from prostatic inflammation which contributes to both LUTS and pelvic pain. The condition is frequently exacerbated by the involvement of neurogenic inflammation and central sensitization, which can cause pain to spread and amplify, creating a negative spiral of symptoms that significantly impairs patients' quality of life (QOL).
This presentation reviews the current understanding of CP/CPPS pathophysiology and outlines therapeutic options. In general, treatment primarily relies on conventional drug therapies such as α1 blockers, anti-inflammatory agents, neuropathic medications, phosphodiesterase 5 inhibitors (PDE5 inhibitors), and phytotherapeutics. These treatments aim to manage symptoms by improving bladder outlet obstruction (BOO), suppressing inflammation, enhancing pelvic blood flow, and modulating pain signals.
While various treatment options exist, their effectiveness varies significantly among individuals, underscoring the need for a patient and individualized approach to find a suitable regimen. Furthermore, emerging treatments such as Extracorporeal Shockwave Therapy (ESWT) have shown significant promise in improving pain and QOL and are recommended in international guidelines.
In conclusion, effective management of CP/CPPS requires consideration of its complex mechanisms, including prostatic inflammation, neurogenic inflammation, and central sensitization. A patient, trial-and-error approach is essential to identify the most effective treatment for each individual.
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Hyun Jun Park Korea (Republic of)
Speaker
The Evolutionary Role of Varicocelectomy in Andrology Varicocelectomy is among the most commonly performed surgical procedures in contemporary andrological practice. Historically, varicocele management focused primarily on alleviating symptomatic discomfort and addressing infertility characterized by impaired semen parameters. However, the conceptual framework and indications for varicocelectomy have evolved significantly over recent decades, reshaping its clinical implications and expanding its therapeutic potential.
Initially, open surgical approaches such as retroperitoneal and inguinal varicocelectomy were predominant, yet they carried considerable risks, including recurrence, hydrocele formation, and potential damage to testicular arteries. With the advent of microsurgical techniques, particularly subinguinal microsurgical varicocelectomy, procedural efficacy and safety have markedly improved. This has resulted in reduced complication rates and enhanced fertility outcomes, positioning microsurgical varicocelectomy as the current gold standard.
Modern andrological literature emphasizes varicocelectomy’s broader physiological benefits beyond fertility. Recent studies highlight its role in improving testosterone production, mitigating hypogonadism, and enhancing overall testicular function. Additionally, varicocelectomy has been demonstrated to significantly improve sperm DNA integrity and reduce oxidative stress levels, thus positively impacting assisted reproductive technology (ART) outcomes.
Furthermore, contemporary research suggests that varicocelectomy may provide systemic health benefits by reducing chronic inflammation and oxidative damage, conditions associated with metabolic and cardiovascular disorders. This evolving understanding positions varicocelectomy not merely as a fertility treatment but as an integral part of comprehensive male reproductive health management. These insights prompt a proactive approach, encouraging clinicians to recognize varicocelectomy’s extended potential in enhancing male reproductive longevity and general health.
In conclusion, the evolution of varicocelectomy, characterized by advancements in surgical techniques and expanded clinical indications, underscores its significant role in modern andrology. An integrated appreciation of its multifaceted therapeutic benefits facilitates informed clinical decision-making, ultimately enhancing patient care and outcomes in andrological practice.
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I-Shen HuangTaiwan
Speaker
New Horizons in Clinical Predictors for Sperm Retrieval in Non-Obstructive Azoospermia Patients
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Yu-Sheng ChengTaiwan
Speaker
DNA Fragmentation’s Impact on Male Infertility: Advanced molecular approaches in male infertility diagnosis Semen analysis remains the cornerstone to accessing male fertility potential despite many drawbacks and fails to predict the male fertility potential with high sensitivity and specificity. The integrity of sperm DNA is crucial for successful fertilization, embryo growth, and the precise transmission of genetic information to progeny. Increasing research suggests that higher sperm DNA fragmentation (SDF) may correlate with clinical varicocele, unexplained infertility, recurrent pregnancy loss, and offspring health. Currently, several tests are available to assess sperm DNA fragmentation in clinical settings. The degree of sperm DNA damage can be measured using the sperm DNA fragmentation index (DFI), which provides more insight into the quality of sperm. Recently, several laboratories have integrated SDF testing into routine semen analysis for the assessment of male infertility. Nonetheless, several aspects of SDF remain unresolved.
This presentation will provide an introduction to existing SDF assays, including recent innovative tests for double-strand breaks (DSBs) in human ejaculated sperm, as well as a discussion on the clinical indications for SDF testing based on recent scientific findings.
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Vincent FS TsaiTaiwan
Speaker
The Role of Artificial Intelligence in Male Infertility: Innovations in Diagnosis and Treatment Optimization Artificial Intelligence (AI) is reshaping the landscape of reproductive medicine by offering unprecedented precision, personalization, and predictive power. This presentation introduces some current AI-integrated fertility projects, designed to enhance outcomes across both pre- and post-fertilization stages.
We begin with a brief overview of AI’s transformative role in healthcare, before delving into the scope. In the pre-fertilization phase, we leverage AI tools for semen analysis, enabling rapid and objective assessment of sperm quality---a home semen test. Advanced image recognition aids in tissue classification, while robotic precision enhances microsurgical interventions. Additionally, machine learning algorithms provide nuanced risk prediction to support clinical decision-making.
Post-fertilization, some systems apply AI-driven models for embryo selection and manipulation, optimizing implantation potential. Predictive analytics further extend to embryonic development, offering clinicians early insights that support successful pregnancies.
Together, these innovations illustrate how AI can augment every stage of the fertility journey—offering not only efficiency but also a hopeful future for prospective parents.
TICC - 2F 201DE
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倫理與法律: 人工智慧衝擊醫療衍生的倫理與糾紛如何應對 (中文)
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Chung-You TsaiTaiwan
Moderator
Bridging AI Frontiers and Urology: How Multimodal and Agentic AI Will Shape 20251. **Evolution of AI: From LLM to Agentic AI**
AI has progressed rapidly from basic language models (LLMs) to multimodal and agentic systems capable of autonomous decision-making and task execution.
2. **General vs. Domain-Specific LLMs**
General-purpose LLMs offer versatility, while domain-specific LLMs (e.g., medical models) provide higher accuracy in specialized fields like urology.
3. **AI Applications in Medical Practice**
LLMs and AI agents assist in research, academic writing, and clinical decision-making—transforming how urologists access and apply medical knowledge.
4. **Agentic AI & Multi-Agent Systems**
AI agents can orchestrate tools, reason through complex problems, and automate workflows without human input—enhancing productivity in healthcare.
5. **Benchmarking AI vs. Human Experts**
In prostate cancer risk assessment, top-tier LLMs demonstrated competitive or superior performance compared to human experts, indicating clinical potential.
How to Make AI as the Most Powerful Assistance for the Treatment of GU Cancer?
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Fu-Chang TsaiTaiwan
Speaker
AI 醫療應用的倫理問題與挑戰人工智慧（AI）是當今科技發展的主流與大趨勢，其範疇幾乎無所不在，所將帶給人類的影響亦將是全面、本質性且不可逆轉。本演講將探討AI於醫院、醫療照護、醫學研究等應用發展現況，並從個人資訊的隱私保護與知情同意、資料管理與使用、建立社會信任三方面來分析其所涉倫理議題，並將進一步探討生成式AI於醫學研究與應用所衍生倫理法律問題。
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Kai-Hsin ChangTaiwan
Speaker
智慧醫療衍生的醫療糾紛—人工智慧誤診怎麼辦？該如何看待與應對？本研究報告深入分析了人工智慧（AI）在醫療診斷中潛在的誤診與誤判問題，並從技術成因、臨床影響、法律責任歸屬及監管應對等多面向進行了探討。
本報告發現，AI誤診的根源在於其「黑箱」特性、訓練數據的偏差與不足，以及模型可能隨時間發生的性能退化。在臨床實踐中，儘管AI被定位為輔助工具，但其介入對醫師的判斷力帶來了新的挑戰，並持續重塑醫療照護的標準。現行侵權法原則（如醫療過失、轉承責任、產品責任）在AI情境下適用困難，尤其在因果關係證明以及AI軟體「產品」與「服務」的法律界定上存在模糊性。
為應對這些挑戰，本文擬提出下列建議：
1. 增強技術穩健性與數據品質：強調使用多樣化、高品質的「黃金標準」數據集，並實施持續監測與反饋循環，同時優先發展可解釋AI（XAI）技術，以提升模型透明度和可理解性。
2. 強化人類監督與培訓：明確AI應作為輔助工具，並強制對醫療專業人員進行全面的AI應用培訓，建立清晰的內部治理政策與跨學科AI委員會，並實施健全的文檔記錄實踐。
3. 發展健全的法律與監管框架：比較美國FDA與歐盟《AI法案》等不同監管模式，指出歐盟採取更為全面的立法途徑，將醫療AI歸類為「高風險」系統，並透過產品責任指令（PLD）與AI責任指令（AILD）減輕受害者舉證責任。報告建議立法應明確各方責任，並參考國際經驗平衡創新與安全。
4. 推動保險解決方案的演進：分析現有醫療專業責任保險（MPLI）在AI時代面臨的覆蓋範圍空白與除外條款問題，建議保險業應開發AI特定保險產品，並調整承保趨勢以適應AI整合帶來的風險變化。
本研究強調，醫療AI的負責任部署需透過技術、培訓、法規和保險等多層次、協同一致的策略，方能平衡創新潛力與患者安全，確保AI真正為人類健康福祉服務。
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TICC - 2F 201AF
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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
TICC - 1F 101A
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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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Hui-Ying LiuTaiwan
Speaker
Recent Advances in Fertility Preservation for Young Male Cancer SurvivorsTesticular cancer (TC) is the most common malignancy in men of reproductive age and significantly impacts fertility through both direct tumor effects and subsequent gonadotoxic treatments. Tumor-related factors such as testicular parenchymal destruction, intratesticular obstruction, elevated β-HCG levels, oxidative stress, and disruption of the hypothalamic–pituitary–gonadal axis contribute to impaired spermatogenesis and sperm DNA fragmentation. Cancer treatments including orchiectomy, chemotherapy (especially cisplatin-based regimens), retroperitoneal lymph node dissection, and radiotherapy further increase the risk of oligo- or azoospermia, with long-term recovery of spermatogenesis often taking up to 2–4 years. Despite these risks, less than one-third of patients undergo sperm cryopreservation before treatment, even though up to 50% present with abnormal semen parameters at diagnosis. Onco-TESE and electroejaculation serve as viable alternatives in select patients, while emerging evidence supports the use of testis-sparing strategies and real-time sperm retrieval in appropriate cases. Current data emphasize the necessity of early fertility counseling and preservation planning for all men diagnosed with TC. Given the high cure rate and young patient demographic, optimizing reproductive outcomes is a key component of survivorship care.
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TICC - 1F 101B
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10:30
12:00
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BPH & Novel Advances (B)
Po-Ming ChowTaiwan
Moderator
Conventional Artificial Urinary Sphincter ImplantationA step-by-step video of a standard approach of AUS implatation is shown in this semi-live session.
TICC - 1F 101C
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Oncology Prostate (F)
TICC - 1F 101D
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Oncology Bladder (B)
TICC - 3F South Lounge
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12:00
13:00
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Global Impact and Transforming HIV Prevention of Shang Ring Male Circumcision
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Philip S. LiUnited States
Speaker
Global Impact and Transforming HIV Prevention of ShangRing Male Circumcision: A Journey from Clinical Trials to Policy Making (2008–2025)n/a
TICC - 3F Banquet Hall
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A New Era in Precision Diagnosis and Localized Therapy in PCa with Micro-Ultrasound (ExactVu) and Focal One Robotic HIFU
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Tai-Lung ChaTaiwan
Moderator
Novel Target for GU Cancer Metastasis and TherapeuticsCancer progression is shaped by both cell-intrinsic adaptations and complex extrinsic interactions within the tumor microenvironment (TME). Here, we identify a transmembrane protein, Meta1, as a shared therapeutic target that exhibits a Janus-like role: promoting malignant phenotypes in cancer cells while restraining tumor-supportive functions in non-cancerous stromal and immune cells. Meta1 is expressed in both compartments of the TME, orchestrating a dual program that supports metastasis and immune evasion. Mechanistically, we uncovered a malignancy-promoting factor (MPF) that acts as a functional ligand for Meta1, selectively enhancing pro-invasive signaling in cancer cells. We further identify Meta1 as an unconventional G protein–coupled receptor (GPCR) that plays as an accelerator in cancer cells of the TME. Meta1 interacts with Rho-GDI and Gαq to activate RhoA-mediated cytoskeletal remodeling and amoeboid migration, facilitating metastatic dissemination. We further identify MPF binding to Meta1 initiates Gβγ signaling, elevating intracellular cAMP and activating Rap1, thereby amplifying cell motility and metastatic potential. Leveraging the Meta1–MPF interaction, we designed MPF-derived peptides that specifically bind Meta1 and serve as the basis for a novel peptide-based PROTAC, which efficiently induces degradation of Meta1 and abrogates its pro-metastatic functions. Our study unveils Meta1 as an atypical GPCR with canonical signaling capacity and topological divergence, representing a shared and targetable vulnerability that bridges cancer cell-intrinsic adaptation with extrinsic TME communication. These findings establish the Meta1–MPF axis as a compelling therapeutic target for suppressing metastasis and reprogramming the TME.
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Tai-Lung ChaTaiwan
Moderator
Novel Target for GU Cancer Metastasis and TherapeuticsCancer progression is shaped by both cell-intrinsic adaptations and complex extrinsic interactions within the tumor microenvironment (TME). Here, we identify a transmembrane protein, Meta1, as a shared therapeutic target that exhibits a Janus-like role: promoting malignant phenotypes in cancer cells while restraining tumor-supportive functions in non-cancerous stromal and immune cells. Meta1 is expressed in both compartments of the TME, orchestrating a dual program that supports metastasis and immune evasion. Mechanistically, we uncovered a malignancy-promoting factor (MPF) that acts as a functional ligand for Meta1, selectively enhancing pro-invasive signaling in cancer cells. We further identify Meta1 as an unconventional G protein–coupled receptor (GPCR) that plays as an accelerator in cancer cells of the TME. Meta1 interacts with Rho-GDI and Gαq to activate RhoA-mediated cytoskeletal remodeling and amoeboid migration, facilitating metastatic dissemination. We further identify MPF binding to Meta1 initiates Gβγ signaling, elevating intracellular cAMP and activating Rap1, thereby amplifying cell motility and metastatic potential. Leveraging the Meta1–MPF interaction, we designed MPF-derived peptides that specifically bind Meta1 and serve as the basis for a novel peptide-based PROTAC, which efficiently induces degradation of Meta1 and abrogates its pro-metastatic functions. Our study unveils Meta1 as an atypical GPCR with canonical signaling capacity and topological divergence, representing a shared and targetable vulnerability that bridges cancer cell-intrinsic adaptation with extrinsic TME communication. These findings establish the Meta1–MPF axis as a compelling therapeutic target for suppressing metastasis and reprogramming the TME.
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Cary Nobles RobertsonUnited States
Speaker
Latest Clinical Data and Operative Technique on Focal One Robotic HIFU Therapy for Prostate CancerThe lecture will cover the latest clinical data and operative advancements in Focal One Robotic High-Intensity Focused Ultrasound (HIFU) therapy for the treatment of prostate cancer.
Focal One marks a significant advancement in minimally invasive, organ-sparing treatment. This technology integrates real-time MRI and ultrasound imaging with robotic precision to deliver highly focused ultrasound energy directly to cancerous prostate tissue—while minimizing damage to surrounding healthy structures.
Tai-Lung ChaTaiwan
Moderator
Novel Target for GU Cancer Metastasis and TherapeuticsCancer progression is shaped by both cell-intrinsic adaptations and complex extrinsic interactions within the tumor microenvironment (TME). Here, we identify a transmembrane protein, Meta1, as a shared therapeutic target that exhibits a Janus-like role: promoting malignant phenotypes in cancer cells while restraining tumor-supportive functions in non-cancerous stromal and immune cells. Meta1 is expressed in both compartments of the TME, orchestrating a dual program that supports metastasis and immune evasion. Mechanistically, we uncovered a malignancy-promoting factor (MPF) that acts as a functional ligand for Meta1, selectively enhancing pro-invasive signaling in cancer cells. We further identify Meta1 as an unconventional G protein–coupled receptor (GPCR) that plays as an accelerator in cancer cells of the TME. Meta1 interacts with Rho-GDI and Gαq to activate RhoA-mediated cytoskeletal remodeling and amoeboid migration, facilitating metastatic dissemination. We further identify MPF binding to Meta1 initiates Gβγ signaling, elevating intracellular cAMP and activating Rap1, thereby amplifying cell motility and metastatic potential. Leveraging the Meta1–MPF interaction, we designed MPF-derived peptides that specifically bind Meta1 and serve as the basis for a novel peptide-based PROTAC, which efficiently induces degradation of Meta1 and abrogates its pro-metastatic functions. Our study unveils Meta1 as an atypical GPCR with canonical signaling capacity and topological divergence, representing a shared and targetable vulnerability that bridges cancer cell-intrinsic adaptation with extrinsic TME communication. These findings establish the Meta1–MPF axis as a compelling therapeutic target for suppressing metastasis and reprogramming the TME.
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Tai-Lung ChaTaiwan
Moderator
Novel Target for GU Cancer Metastasis and TherapeuticsCancer progression is shaped by both cell-intrinsic adaptations and complex extrinsic interactions within the tumor microenvironment (TME). Here, we identify a transmembrane protein, Meta1, as a shared therapeutic target that exhibits a Janus-like role: promoting malignant phenotypes in cancer cells while restraining tumor-supportive functions in non-cancerous stromal and immune cells. Meta1 is expressed in both compartments of the TME, orchestrating a dual program that supports metastasis and immune evasion. Mechanistically, we uncovered a malignancy-promoting factor (MPF) that acts as a functional ligand for Meta1, selectively enhancing pro-invasive signaling in cancer cells. We further identify Meta1 as an unconventional G protein–coupled receptor (GPCR) that plays as an accelerator in cancer cells of the TME. Meta1 interacts with Rho-GDI and Gαq to activate RhoA-mediated cytoskeletal remodeling and amoeboid migration, facilitating metastatic dissemination. We further identify MPF binding to Meta1 initiates Gβγ signaling, elevating intracellular cAMP and activating Rap1, thereby amplifying cell motility and metastatic potential. Leveraging the Meta1–MPF interaction, we designed MPF-derived peptides that specifically bind Meta1 and serve as the basis for a novel peptide-based PROTAC, which efficiently induces degradation of Meta1 and abrogates its pro-metastatic functions. Our study unveils Meta1 as an atypical GPCR with canonical signaling capacity and topological divergence, representing a shared and targetable vulnerability that bridges cancer cell-intrinsic adaptation with extrinsic TME communication. These findings establish the Meta1–MPF axis as a compelling therapeutic target for suppressing metastasis and reprogramming the TME.
Cary Nobles RobertsonUnited States
Speaker
Latest Clinical Data and Operative Technique on Focal One Robotic HIFU Therapy for Prostate CancerThe lecture will cover the latest clinical data and operative advancements in Focal One Robotic High-Intensity Focused Ultrasound (HIFU) therapy for the treatment of prostate cancer.
Focal One marks a significant advancement in minimally invasive, organ-sparing treatment. This technology integrates real-time MRI and ultrasound imaging with robotic precision to deliver highly focused ultrasound energy directly to cancerous prostate tissue—while minimizing damage to surrounding healthy structures.
TICC - 2F 201BC
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The Role of Immunotherapy in adj./mRCC, Updated Evidence and Clinical Practice
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Jian-Ri LiTaiwan
Speaker
Applying Vision Augmentation in Robotic Surgery: Reality or FictionApplying Vision Augmentation in Robotic Surgery: Reality or Fiction
TICC - 2F 201DE
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Breaking New Ground: PARPi + ARPi Combination Therapy in mCRPC
TICC - 2F 201AF
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Offers an Optimized Solution for MIUC Patients with Nivolumab
TICC - 1F 101A
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12:00
13:00
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Optimizing Treatment and The Role of PARPi and ARPi in PC
TICC - 1F 101B
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Maximizing Treatment Outcomes in Advanced Prostate Cancer: Strategies for Optimal Patient Care
TICC - 1F 101C
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The Japanese Surveillance and JAID/JSC Guidelines 2023: The Usefulness of the Urinary Flow Cytometry Method (uFCM)
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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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Shang-Jen ChangTaiwan
Moderator
Which Surgical Treatment is Best for UPJO in Infants: Open, Laparoscopic, Robotic AssistedAbstract
Ureteropelvic junction obstruction (UPJO) in infants is a condition that can significantly impair renal function and requires timely surgical intervention when certain criteria are met, such as decreased split renal function, poor drainage on diuretic renography, or recurrent urinary tract infections. The three main surgical approaches for treating UPJO are open pyeloplasty (OP), laparoscopic pyeloplasty (LP), and robot-assisted laparoscopic pyeloplasty (RALP). Each technique has its own benefits and limitations, especially when applied to infants.
Minimally invasive surgery (MIS), including LP and RALP, has gained popularity in pediatric urology due to advantages such as shorter hospital stays, reduced postoperative pain, faster recovery, and better cosmetic outcomes. However, the small working space in infants, the steep learning curve, and higher costs are significant limitations. In particular, the utility of MIS in infants remains controversial due to undefined benefits and technical challenges, including limited space for trocar placement and difficulty in intracorporeal suturing.
Current guidelines from the European Association of Urology (EAU) indicate that while RALP is considered the gold standard for older pediatric patients, its role in infants remains less defined due to anatomical and logistical constraints. Open surgery continues to be the mainstay for infantile UPJO due to its well-established success rate and lower cost.
Several studies have addressed the learning curve associated with these techniques. Laparoscopic pyeloplasty requires about 30 cases for a surgeon to achieve proficiency, while RALP demands approximately 18–31 cases depending on the metrics used. Simulation-based training, dry labs, and multicenter collaboration are proposed solutions to accelerate skill acquisition and ensure patient safety.
Cost is another critical consideration. Although RALP generally incurs higher upfront costs, especially in low-volume centers, innovations such as magnetic stents have helped offset some of these expenses by eliminating the need for anesthesia during stent removal. Moreover, the availability of pediatric-specific robotic instruments remains limited and necessitates ongoing development to fully support MIS in smaller patients.
In conclusion, while RALP is increasingly recognized as the standard for pediatric UPJO, its application in infants should be considered selectively, depending on surgeon experience, institutional resources, and patient anatomy. Open pyeloplasty remains a safe and effective option, particularly in very young children. Advances in surgical training, cost reduction strategies, and instrument development will be key to expanding the use of minimally invasive techniques in this population.
Koichiro WadaJapan
Speaker
Antimicrobial Resistance on Neisseria Gonorrhoeae and Mycoplasma GenitaliumSexually transmitted diseases, in which Neisseria gonorrhoeae and Mycoplasma genitalium are the pathogenic microorganisms, have become a social problem also in Japan. Drug resistance has been increasing, especially among penicillins, macrolides, and fluoroquinolones in Neisseria gonorrhoeae. Mycoplasma genitalium was originally not highly susceptible to tetracyclines, but has recently become resistant to macrolides and fluoroquinolones. N. gonorrhea can be treated with a 1g single-dose of ceftriaxone, but urethritis caused by M. genitalium sometimes requires sequential/combination therapy, and many cases are difficult to treat. In my presentation, I would like to discuss diagnosis and treatment, especially drug resistance in Japan.
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Shang-Jen ChangTaiwan
Moderator
Which Surgical Treatment is Best for UPJO in Infants: Open, Laparoscopic, Robotic AssistedAbstract
Ureteropelvic junction obstruction (UPJO) in infants is a condition that can significantly impair renal function and requires timely surgical intervention when certain criteria are met, such as decreased split renal function, poor drainage on diuretic renography, or recurrent urinary tract infections. The three main surgical approaches for treating UPJO are open pyeloplasty (OP), laparoscopic pyeloplasty (LP), and robot-assisted laparoscopic pyeloplasty (RALP). Each technique has its own benefits and limitations, especially when applied to infants.
Minimally invasive surgery (MIS), including LP and RALP, has gained popularity in pediatric urology due to advantages such as shorter hospital stays, reduced postoperative pain, faster recovery, and better cosmetic outcomes. However, the small working space in infants, the steep learning curve, and higher costs are significant limitations. In particular, the utility of MIS in infants remains controversial due to undefined benefits and technical challenges, including limited space for trocar placement and difficulty in intracorporeal suturing.
Current guidelines from the European Association of Urology (EAU) indicate that while RALP is considered the gold standard for older pediatric patients, its role in infants remains less defined due to anatomical and logistical constraints. Open surgery continues to be the mainstay for infantile UPJO due to its well-established success rate and lower cost.
Several studies have addressed the learning curve associated with these techniques. Laparoscopic pyeloplasty requires about 30 cases for a surgeon to achieve proficiency, while RALP demands approximately 18–31 cases depending on the metrics used. Simulation-based training, dry labs, and multicenter collaboration are proposed solutions to accelerate skill acquisition and ensure patient safety.
Cost is another critical consideration. Although RALP generally incurs higher upfront costs, especially in low-volume centers, innovations such as magnetic stents have helped offset some of these expenses by eliminating the need for anesthesia during stent removal. Moreover, the availability of pediatric-specific robotic instruments remains limited and necessitates ongoing development to fully support MIS in smaller patients.
In conclusion, while RALP is increasingly recognized as the standard for pediatric UPJO, its application in infants should be considered selectively, depending on surgeon experience, institutional resources, and patient anatomy. Open pyeloplasty remains a safe and effective option, particularly in very young children. Advances in surgical training, cost reduction strategies, and instrument development will be key to expanding the use of minimally invasive techniques in this population.
Sang-Rak BaeKorea (Republic of)
Speaker
HPV Vaccination in Men, Asia and the WorldHPV Vaccination in Men: Status in Asia and the World
Human papillomavirus (HPV) comprises a group of over 200 virus types, among which certain high-risk types are known to cause genital warts and various cancers. Persistent infection with high-risk HPV types is a leading cause of cervical cancer and is also associated with vulvar, vaginal, oral/oropharyngeal, penile, and anal cancers. Approximately 5.2% of all cancers globally—amounting to around 600,000 new cases annually—are attributed to HPV infection. Prophylactic vaccination remains the most effective method to prevent these HPV-related malignancies. In the case of cervical cancer, HPV screening and treatment of precancerous lesions are also recognized as effective preventive strategies. However, due to the absence of reliable screening methods for HPV-related conditions in men, the burden of male HPV infection has often been overlooked.
As of 2025, around 149 countries have implemented national HPV vaccination programs, of which 82 offer gender-neutral vaccination (GNV). In Asia, Mongolia, Bhutan, the UAE, Qatar, and Kuwait have adopted GNV, and Taiwan is scheduled to expand vaccination to males starting September 2025. This study aims to emphasize the necessity of expanding HPV vaccination for males in Asia, based on global comparisons and the rationale for male vaccination.
1. History of HPV and HPV Vaccination
In the 1970s, HPV infection was first identified as a cause of female genital malignancies. In 1985, HPV DNA was detected in head and neck cancer tissues, and in 1995, HPV types 16 and 18 were officially classified as carcinogenic for genital cancers. The first HPV vaccine was developed in 2006, and in 2007, HPV-16 was acknowledged as a carcinogen for head and neck cancers. As of July 2025, 37 out of 38 OECD countries (excluding Türkiye) have implemented national vaccination programs. Japan and Korea currently only provide government-supported vaccination for females. In Asia, Mongolia, Bhutan, UAE, Qatar, and Kuwait offer vaccination for both sexes, with Taiwan including males starting in September 2025.
2. Global Status of HPV-Related Cancers
To reduce the incidence of cervical cancer to fewer than 4 cases per 100,000 women by 2030, the WHO has launched the "A World Without Cervical Cancer" initiative, targeting 90% vaccination coverage, 70% screening uptake, and 90% treatment rates. Globally, 87–96% of cervical cancers are HPV-related, with 92% in Asia alone. Additionally, head and neck cancers—the fifth most common cancer—are associated with HPV in 20–40% of cases. Penile cancer is linked to HPV in up to 90% of HGSIL cases and approximately 33% of invasive penile cancers. In total, HPV is associated with over 730,000 cancers worldwide, representing over 5% of all malignancies.
3. Rationale for HPV Vaccination in Males
HPV vaccination in males is often underprioritized, as the burden of prevention is traditionally placed on females. Unlike cervical cancer in females, there is no organized screening program for HPV-related non-cervical cancers in men, limiting secondary prevention benefits. Men also show lower awareness of HPV-related diseases, increasing their vulnerability to infection. Due to insufficient vaccine coverage, populations such as MSM and unvaccinated females remain inadequately protected despite herd immunity. Males act as a significant reservoir of HPV. Transmission from female to male occurs at a rate of 5.6 per 100 person-months, while male-to-female transmission is also substantial at 3.5. HPV-infected sperm demonstrates reduced motility and increased DNA fragmentation, potentially affecting fertility. In the U.S., the incidence of HPV-related oropharyngeal cancer in men has surpassed that of cervical cancer in women since the mid-2010s.
4. HPV Vaccination for Males in Asia
Asia is home to approximately 60% of the global population. However, the two most populous countries—China and India—do not include HPV vaccination in their national immunization programs. Among the Asian countries offering vaccination, only Mongolia, Bhutan, UAE, Qatar, Kuwait, and now Taiwan (from September 2025) provide GNV. There is significant variability in vaccination coverage across nations. According to GLOBOCAN data, 58% of global cervical cancer cases—around 352,000 new diagnoses—occur in Asia. Given Asia’s population size and disease burden, expanding HPV vaccination programs, particularly for males, is a critical public health priority.
5. Recommendations
To prevent HPV-related diseases—including cervical cancer, oropharyngeal cancer, and benign HPV-related conditions—HPV vaccination is recommended for both males and females aged 9–26.
Individuals aged 9–14 should receive two doses at 0 and 6 months; those aged 15–26 should receive three doses at 0, 1, and 6 months.
The optimal age for vaccination is 11–12 years.
Women aged 27 and above may receive the vaccine based on individual clinical decision-making.
6. Conclusion
HPV affects both sexes, contributing significantly to disease burden in males through cancers and anogenital warts. The lack of organized screening for HPV-related diseases in men makes gender-neutral vaccination (GNV) a fair and effective public health strategy. GNV may also accelerate cervical cancer elimination and increase program resilience against future disruptions. In particular, the high burden of HPV-related diseases in Asia underscores the urgency and importance of expanding vaccination coverage across the region.
TICC - 1F 101D
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Shaping a New Era: IO Perioperative Therapy in MIBC
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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.
TICC - 3F South Lounge
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13:30
15:30
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Cary Nobles RobertsonUnited States
Speaker
Latest Clinical Data and Operative Technique on Focal One Robotic HIFU Therapy for Prostate CancerThe lecture will cover the latest clinical data and operative advancements in Focal One Robotic High-Intensity Focused Ultrasound (HIFU) therapy for the treatment of prostate cancer.
Focal One marks a significant advancement in minimally invasive, organ-sparing treatment. This technology integrates real-time MRI and ultrasound imaging with robotic precision to deliver highly focused ultrasound energy directly to cancerous prostate tissue—while minimizing damage to surrounding healthy structures.
Peter Ka-Fung ChiuHong Kong, China
Speaker
Minimal Invasive Therapy: Where do We Stand in 2025Endourological, Laparoscopic and robotic surgeries have replaced most open surgeries in Urology. Emergence of new robotic platforms have provided urologists with new opportunities. Both boom-type and module-type robots have been used, and they each have their strengths in practice. Tele-surgeries have provided a new paradigm of long-distance robotic surgeries to facilitate new surgical possibilities and proctorship. State of the art robotic surgeries in retrograde intrarenal surgeries and enbloc resection MDT Discussion: Personalizing Treatment in High Volume CSPCN/ADebate: Should We Only Offer Consolidative Cytoreductive Nephrectomy in Metastatic RCC?N/AFocal Therapy in Asia – Is It Prime Time?The increase in incidence of Prostate cancer has been rapid in Asia in the past 10 years. While Robotic radical prostatectomy and Radiotherapy has been the commonest treatments for localized prostate cancer, significant long-term morbidities are observed after surgery or radiotherapy including incontinence, erectile dysfunction and irradiation injury to the bladder and rectum. In the current era of MRI-guided prostate biopsy, focal diseases can be targeted and diagnosed, and image-guided focal therapy emerged as an alternative treatment. Although Focal therapy has a relatively higher rate of local recurrence, it has the advantages of minimal or no long-term complication after treatment, and it is possible to perform retreatment with focal therapy, prostatectomy or radiotherapy. In properly selected patients, the need for salvage prostatectomy or radiotherapy after focal therapy is less than 20% at 8 years, and patients’ quality of life could be preserved. In well-selected patients, focal therapy is an attractive option. Current focal therapy for prostate cancer available in Asia includes HIFU, Cryotherapy, Targeted Microwave Ablation (TMA), irreversible electroporation (IRE) and TULSA.
TICC - 2F 201BC
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Novel Advances (C)
Hsiang-Ying LeeTaiwan
Moderator
Best Laser for UTUCManagement of Total Ureteral Avulsion during Ureteroscopy
Osamu UkimuraJapan
Moderator
A Fully Automated Artificial Intelligence System to Assist Pathologists' Diagnosis to Predict Histologically High-Grade Urothelial Carcinoma from Digitized Urine CytologyBackground: Urine cytology, although a useful screening method for urothelial carcinoma, lacks sensitivity. As an emerging technology, artificial intelligence (AI) improved image analysis accuracy significantly.
Objective: To develop a fully automated AI system to assist pathologists in the histological prediction of high-grade urothelial carcinoma (HGUC) from digitized urine cytology slides.
Design, setting, and participants: We digitized 535 consecutive urine cytology slides for AI use. Among these slides, 181 were used for AI development, 39 were used as AI test data to identify HGUC by cell-level classification, and 315 were used as AI test data for slide-level classification.
Outcome measurements and statistical analysis: Out of the 315 slides, 171 were collected immediately prior to bladder biopsy or transurethral resection of bladder tumor, and then outcomes were compared with the histological presence of HGUC in the surgical specimen. The primary aim was to compare AI prediction of the histological presence of HGUC with the pathologist's histological diagnosis of HGUC. Secondary aims were to compare the time required for AI evaluation and concordance between the AI's classification and pathologist's cytology diagnosis.
Results and limitations: The AI capability for predicting the histological presence of HGUC was 0.78 for the area under the curve. Comparing the AI predictive performance with pathologists' diagnosis, the AI sensitivity of 63% for histological HGUC prediction was superior to a pathologists' cytology sensitivity of 46% (p = 0.0037). On the contrary, there was no significant difference between the AI specificity of 83% and pathologists' specificity of 89% (p = 0.13), and AI accuracy of 74% and pathologists' accuracy of 68% (p = 0.08). The time required for AI evaluation was 139 s. With respect to the concordance between the AI prediction and pathologist's cytology diagnosis, the accuracy was 86%. Agreements with positive and negative findings were 92% and 84%, respectively.
Conclusions: We developed a fully automated AI system to assist pathologists' histological diagnosis of HGUC using digitized slides. This AI system showed significantly higher sensitivity than a board-certified cytopathologist and may assist pathologists in making urine cytology diagnoses, reducing their workload.
Patient summary: In this study, we present a deep learning-based artificial intelligence (AI) system that classifies urine cytology slides according to the Paris system. An automated AI system was developed and validated with 535 consecutive urine cytology slides. The AI predicted histological high-grade urothelial carcinoma from digitized urine cytology slides with superior sensitivity than pathologists, while maintaining comparable specificity and accuracy.
Keywords: Artificial intelligence; Deep learning; The Paris System; Urine cytology; Urothelial carcinoma.
TICC - 2F 201DE
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Functional Urology (D)
TICC - 2F 201AF
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Oncology Prostate (F)
TICC - 1F 101A
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13:30
15:00
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Oncology Miscellaneous & Endourology (C)
TICC - 1F 101B
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Novel Advances (D) & Andrology & Transplantation
TICC - 1F 101C
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Andrology (D)
Chuan-Shu ChenTaiwan
Moderator
Severity of sexual dysfunction in Taiwanese patients with and without type 2 diabetes mellitus.introduction
Patients with type 2 diabetes are at a higher risk of developing sexual dysfunction. This study aims to investigate the current prevalence of sexual dysfunction in Taiwanese patients with and without type 2 diabetes mellitus(DM) and to explore patterns in how affected individuals seek management or treatment for this condition.
Materials and Methods
Between June 2023 and October 2024, a total of 450 patients visiting our urology outpatient department were invited to complete a questionnaire comprising the Men's Sexual Health Questionnaire (MSHQ) and supplementary questions assessing patterns of seeking management for sexual dysfunction.
Results
Of the 402 subjects who completed the questionnaire, 28.1% (113/402) had type 2 diabetes mellitus (DM). Among patients with varying degrees of sexual dysfunction, those in the DM group reported significantly greater severity across all domains of the MSHQ—erection, ejaculation, satisfaction, frequency of sexual activity, and sexual desire—compared to the non-DM group.
After applying propensity score matching for age and comorbid chronic diseases, the scores in each domain were as follows (DM group vs. non-DM group): erection (9.55 vs. 10.94, p = 0.028), ejaculation (25.87 vs. 28.26, p = 0.012), sexual desire (12.38 vs. 13.34, p = 0.020), satisfaction (20.51 vs. 21.64, p = 0.112), and frequency of sexual activity (10.29 vs. 10.58, p = 0.465).
Notably, 73% of patients with DM expressed a desire to discuss sexual health issues with their physicians. However, only 10% reported that their doctors had initiated such conversations. The most commonly cited reason for not discussing sexual problems was feeling embarrassed. Additionally, 54% of DM patients with sexual dysfunction reported receiving no form of management, despite 57% expressing interest in treatment.
Conclusions
The prevalence of sexual dysfunction and related concerns was high among diabetic patients; however, only a small proportion had sought professional help. Routine screening for sexual dysfunction in patients with diabetes is therefore recommended.
Hyun Jun Park Korea (Republic of)
Moderator
The Evolutionary Role of Varicocelectomy in Andrology Varicocelectomy is among the most commonly performed surgical procedures in contemporary andrological practice. Historically, varicocele management focused primarily on alleviating symptomatic discomfort and addressing infertility characterized by impaired semen parameters. However, the conceptual framework and indications for varicocelectomy have evolved significantly over recent decades, reshaping its clinical implications and expanding its therapeutic potential.
Initially, open surgical approaches such as retroperitoneal and inguinal varicocelectomy were predominant, yet they carried considerable risks, including recurrence, hydrocele formation, and potential damage to testicular arteries. With the advent of microsurgical techniques, particularly subinguinal microsurgical varicocelectomy, procedural efficacy and safety have markedly improved. This has resulted in reduced complication rates and enhanced fertility outcomes, positioning microsurgical varicocelectomy as the current gold standard.
Modern andrological literature emphasizes varicocelectomy’s broader physiological benefits beyond fertility. Recent studies highlight its role in improving testosterone production, mitigating hypogonadism, and enhancing overall testicular function. Additionally, varicocelectomy has been demonstrated to significantly improve sperm DNA integrity and reduce oxidative stress levels, thus positively impacting assisted reproductive technology (ART) outcomes.
Furthermore, contemporary research suggests that varicocelectomy may provide systemic health benefits by reducing chronic inflammation and oxidative damage, conditions associated with metabolic and cardiovascular disorders. This evolving understanding positions varicocelectomy not merely as a fertility treatment but as an integral part of comprehensive male reproductive health management. These insights prompt a proactive approach, encouraging clinicians to recognize varicocelectomy’s extended potential in enhancing male reproductive longevity and general health.
In conclusion, the evolution of varicocelectomy, characterized by advancements in surgical techniques and expanded clinical indications, underscores its significant role in modern andrology. An integrated appreciation of its multifaceted therapeutic benefits facilitates informed clinical decision-making, ultimately enhancing patient care and outcomes in andrological practice.
Yu-Sheng ChengTaiwan
Moderator
DNA Fragmentation’s Impact on Male Infertility: Advanced molecular approaches in male infertility diagnosis Semen analysis remains the cornerstone to accessing male fertility potential despite many drawbacks and fails to predict the male fertility potential with high sensitivity and specificity. The integrity of sperm DNA is crucial for successful fertilization, embryo growth, and the precise transmission of genetic information to progeny. Increasing research suggests that higher sperm DNA fragmentation (SDF) may correlate with clinical varicocele, unexplained infertility, recurrent pregnancy loss, and offspring health. Currently, several tests are available to assess sperm DNA fragmentation in clinical settings. The degree of sperm DNA damage can be measured using the sperm DNA fragmentation index (DFI), which provides more insight into the quality of sperm. Recently, several laboratories have integrated SDF testing into routine semen analysis for the assessment of male infertility. Nonetheless, several aspects of SDF remain unresolved.
This presentation will provide an introduction to existing SDF assays, including recent innovative tests for double-strand breaks (DSBs) in human ejaculated sperm, as well as a discussion on the clinical indications for SDF testing based on recent scientific findings.
TICC - 1F 101D
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13:30-14:30
TICC - 1F 102
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Oncology & Transplantation
TICC - 3F South Lounge
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15:30
16:00
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