Industry Symposium 9 【YI CHENG】

16 Aug 2025 13:30 15:00
TICC - 1F 101B
Advancing Urologic Care Through Technology and Minimally Invasive Innovation

Topic: Tibial nerve stimulation for voiding dysfunction

Abstract:

This presentation details the evolution and clinical applications of Percutaneous Tibial Nerve Stimulation (PTNS) as a minimally invasive therapy for a range of bladder dysfunctions. Building upon the foundational work of McGuire et al. in 1983, who demonstrated that transcutaneous stimulation of the common peroneal or posterior tibial nerve could alleviate lower urinary tract symptoms (LUTS), Professor Stoller introduced a refined percutaneous technique in 1990, termed Stoller Afferent Nerve Stimulation (SANS). This method specifically targets the posterior tibial nerve to treat overactive bladder (OAB) syndrome.

Clinical results from an early cohort of 90 patients showed that 80% experienced at least a 50% reduction in symptoms, establishing PTNS as a promising alternative to pharmacologic or more invasive therapies. Over time, PTNS has been successfully applied to various bladder conditions, including neurogenic bladder, non-obstructive urinary retention (NOUR), pediatric voiding dysfunction, and chronic pelvic pain/painful bladder syndrome (CPP/PBS).

A systematic review of published studies on PTNS reports broad effectiveness across patient populations:

  • 37–100% symptom improvement in OAB patients
  • 41–100% effectiveness in NOUR patients
  • Up to 100% response rate in CPP/PBS and pediatric dysfunction cases

These findings underscore PTNS as a safe, effective, and non-pharmacological option for bladder control, although additional research is needed to confirm its long-term efficacy and expand its indications.

Professor Stoller will also highlight Tensi+, a state-of-the-art device developed by Stimuli Technology. Tensi+ employs transcutaneous electrical nerve stimulation (TENS) to activate the posterior tibial nerve non-invasively. The device is designed for daily 20-minute treatments over a minimum of 12 weeks, with some patients experiencing symptom relief as early as six weeks. Clinical studies from Europe and Canada validate Tensi+ for its safety and efficacy, making it an accessible, patient-friendly solution for managing OAB and related voiding dysfunctions.

This presentation will provide insights into PTNS’s clinical development, treatment protocols, and emerging technologies like Tensi+, offering valuable knowledge for clinicians and researchers focused on improving bladder dysfunction management.

 

Topic: Bridging Innovation and Evidence in Non-Surgical Phimosis Treatment: Novoglan Medical Device Clinical Outcomes and Real-World Data

Abstract:

Presenting an evidence-based, non-surgical approach to treating adult phimosis—an increasingly relevant issue in both public and private urology settings. The Novoglan Medical Device is a conservative, foreskin-preserving treatment that aligns with the growing demand for less invasive, more patient-centric care.

 

The Novoglan treatment is a Class 1 medical device designed for gentle, controlled foreskin expansion through topical mechanical action. It is user-directed, discreet, and engineered for safe at-home use. Developed with input from urologists and biomedical engineers, the Novoglan device offers motivated patients who wish to preserve their foreskin, an effective alternative to circumcision.

 

To date, over 55,000 treatments have been delivered globally with zero reported adverse events, despite being subject to mandatory reporting requirements. These safety outcomes are unmatched in the field and underscore the device's reliability and tolerability across diverse populations.

 

Published independent clinical papers report a 90% success rate in achieving full or functional foreskin retractability in selected patients—establishing Novoglan as a viable and validated first-line treatment option. Furthermore, clinical follow-up data, including two-year post-treatment surveillance, has shown zero surgical interventions required among compliant patients.

 

The implications are significant. Pathological phimosis, if left untreated, can progress to chronic inflammation, infection, and complications including severe penile scarring. Early intervention with conservative therapies like Novoglan, particularly in younger men, can reduce these risks and preserve anatomical integrity. Importantly, the treatment is non-traumatic and respects patients’ psychological and cultural preferences around foreskin retention.

 

From a systemic perspective, Novoglan offers practical benefits for health services. Reducing unnecessary surgical referrals can ease the burden on public hospital waiting lists, while also freeing up valuable time in private practice for more complex urological cases. This realignment of resources benefits clinicians, institutions, and patients alike.

 

We are witnessing a broader shift in urology toward minimally invasive, foreskin-preserving interventions. Novoglan is well-positioned within this movement—offering not just an alternative, but a proven, safe, and effective solution grounded in long-term evidence and global clinical use.

 

In summary, the Novoglan Medical Device presents an opportunity to improve outcomes, reduce surgical demand, and provide dignified, conservative care to adult men with phimosis. We encourage you all, as urologists to consider validated alternatives and deliver tailored treatment pathways that reflect both science and patient needs.

 

Topic: Robotic intraoperative surgeon controlled suction system

Abstract:

In this session, Prof. Simone Crivellaro introduces the Remotely Operated Suction Irrigation System (ROSI), a significant advancement in suction and irrigation technology for robot-assisted surgeries. ROSI enables the console surgeon to directly control both suction and irrigation, enhancing autonomy and procedural efficiency.

The ROSI system consists of a slim, flexible probe that can be inserted through standard 5mm ports, including both multiport and single-port robotic platforms. Its design allows it to remain in the surgical field and be manipulated using robotic instruments. Suction and irrigation functions are remotely controlled by a footswitch at the console, reducing the need for constant bedside assistance and improving response time during surgery.

An important enhancement to the system is ROSI with Exchangeable Tips (ROSI xT). This version enables seamless transfer of suction/irrigation control between the robotic surgeon and the bedside assistant. When more traditional rigid suction is needed, the assistant can take over, providing greater flexibility in complex cases.

Key features and benefits include:

  • Improved Surgeon Autonomy: Direct console control enhances precision and independence.
  • Dual Operation Mode: Can be controlled by either the surgeon or assistant.
  • Wide Compatibility: Passes through most 5mm ports and single-port platforms like GelPoint.
  • Enhanced Access: Long, flexible probe offers better reach and maneuverability.
  • Eco-friendly Design: No powered or battery components, potentially reducing OR waste.
  • Cost Efficiency: May reduce overall operating room costs.
  • Adaptable Irrigation: Compatible with hospital compressed nitrogen or manual infusor cuffs for pressurized irrigation.

Prof. Crivellaro shares his extensive hands-on experience with ROSI in various robotic procedures, offering practical tips for integration and use. His insights highlight ROSI’s role in enhancing surgical efficiency, adaptability, and sustainability.

This talk provides a comprehensive overview of how ROSI can be successfully implemented in robotic surgery to improve workflow, reduce dependence on bedside staff, and enhance overall surgical outcomes.

Time Session
13:30
14:00
Hann-Chorng KuoTaiwan Moderator ACU Lecture: Videourodynamic Study for Precision Diagnosis and Management of Lower Urinary Tract DysfunctionVideourodynamic Study in the Precision Diagnosis and Management of Lower Urinary Tract Dysfunctions Hann-Chorng Kuo, M.D. Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan As a urologist, we are dealing with patients with lower urinary tract symptoms everyday. We did transurethral resection of the prostate (TURP) for elderly men with bothersome lower urinary tract symptoms (LUTS). We put a suburethral sling for women with stress urinary incontinence (SUI). We prescribed alpha-blocker for those who had difficulty in urination. We add antimuscarinics for patients with urgency urinary incontinence. Our seniors always told us these treatments are effective in treating patients with LUTS. However, patients still had LUTS after TURP, women still complained of urgency and dysuria after anti-incontinence surgery. Medication based on storage or emptying LUTS do not work all the time. Why? Because symptoms are not reliable, a large prostate does not indicate bladder outlet obstruction (BOO), and SUI is not solely a result of urethral incompetence. Therefore, in diagnosis and management of LUTS, we need precision medicine to direct an accurate pathophysiology of LUTS, and to guide an appropriate management based on the bladder and bladder outlet dysfunction. When we encounter patients who have LUTS refractory to the treatment based on our initial diagnosis, when we are treating patients who have complicated storage and emptying LUTS, when we are not sure patients could benefit from the invasive procedures for their LUTS, or patients who had both lower and upper urinary tract dysfunctions, videourodynamic study (VUDS) is an essential investigation for diagnosis and management of LUTS. In additional to benign prostate hyperplasia (BPH) and BOO, male patients with emptying LUTS might result from detrusor underactivity (DU), bladder neck dysfunction (BND), urethral sphincter dysfunction, or a hypersensitive bladder, which is not related with the prostate. Patients with BPH and LUTS might have latent neurogenic lesion, such as minor stroke, Parkinson's disease, or early dementia, causing LUTS. TURP without known the neurological disease might exacerbate LUTS after surgery. Mixed SUI comprises intrinsic sphincter deficiency (ISD) and detrusor overactivity (DO). The overactive bladder (OAB) symptoms may also result from an incompetent bladder outlet. Without comprehensive VUDS, we might cure the SUI, but OAB remains after placing a mid-urethral sling. Bladder pain is the cardinal symptoms of interstitial cystitis. However, bladder pain perceived by the patient might also originate from BOO or pelvic floor fascitis. VUDS can help in discrimination. DU and low compliant bladder and ISD could result in complicated storage and emptying LUTS. Large post-void residual (PVR) should alert us to investigate whether it is originated from low compliance or ISD. Dysfunctional voiding (DV) and BND in women with emptying LUTS. OAB symptoms are not always coming from the DO. BOO such as BND, DV, or urethral stricture might exist in men and women without voiding symptoms. Urinary difficulty in women is usually a result from low detrusor contractility, due to DU, or through inhibitory effect from a poorly relaxed pelvic floor or urethral sphincter. A simple bladder neck incision can effectively restore spontaneous voiding in men or women with dysuria due to DU or BND. However, a tight BN is necessary to predict a successful treatment outcome. Patients with central nervous system (CNS) disorders or spinal cord injury usually have complicated LUTD, including DO, BND, DV, detrusor sphincter dyssynergia (DSD), and vesicoureteral reflux (VUR). Management of LUTS in CNS disorders or SCI patients should know the current bladder and bladder outlet dysfunctions. Pediatric incontinence, children with myelomeningocele, DV, or recurrent urinary tract infection are complicated and need precision diagnosis before treatment. Especially when surgery is planned. Lower urinary tract dysfunctions is a dynamic condition. The bladder and bladder outlet dysfunction might change with time. Although VUDS is considered as an invasive investigation with radiation exposure, the advantages in accurate diagnosis and guiding management outweigh these disadvantages.
Marshall StollerUnited States Speaker Normothermic Ex Vivo Kidney Perfusion for Urologic Discovery
14:00
14:30
14:30
15:00
Chun-Te WuTaiwan Moderator 健保各領域審查共識及討論-泌尿腫瘤
Simone CrivellaroUnited States Speaker Single-Port vs. Multi-Port Robotic Prostatectomy: Balancing Innovation, Precision, and OutcomesThe Application & Limitation of Urological SP SurgerySingle Port Retroperitoneal Partial NephrectomySingle Port Prostate Surgery