Jeff S. Chueh

Jeff Shih-Chieh Chueh, MD, PhD. is Professor and Chairman at Department of Urology, College of Medicine, National Taiwan University and also Attending staff and Director at Department of Urology, National Taiwan University Hospitals. Right before this position, he had been a Staff at Center for Robotic and Minimally Invasive Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic and Clinical Professor of Surgery (Urology) at Cleveland Clinic Lerner College of Medicine, Case Western Reserve University for 12 more years. Dr. Chueh joined Cleveland Clinic in 2009, and served as the primary kidney transplant surgeon and Medical Director of the kidney transplant program at Charleston Area Medical Center (CAMC), WV, which has been affiliated with Cleveland Clinic for more than 30 years. He practiced kidney transplantation and urology there for 4 years, and accomplished the 1000th kidney transplant case of the CAMC program, before he moved up to the greater Cleveland area; he continued to be the live donor laparoscopic nephrectomy surgeon for CAMC, WV until before he left CCF. Dr. Chueh earned a straight pre-med and medical degree from the Taipei Medical University, Taiwan in 1989. He performed his urology residency at National Taiwan University Hospital, and completed his kidney transplantation fellowship training under Professor Barry D. Kahan, PhD, MD at UT-Houston, Texas. He then earned his PhD degree from National Taiwan University with his thesis on the pharmacological studies of the alpha-blockers for hyperplastic prostate, and learned how to be a “physician scientist”. He was promoted to the full professorship at the Medical School of National Taiwan University, Taipei, Taiwan before he joined Cleveland Clinic. His main surgical/research interest includes urological laparoscopic and robotic minimally invasive surgery, voiding dysfunction in men, and innovative urological procedures. Along those years of his maturation, he had also paid many short-term visits and learned from many world-renown urological laparoscopic/robotic experts (including Drs. Ralph Clayman, Louise Kavoussi, Indiber Gill, Bertrand Guilloneau, Steve Jacobs, Thomas Arhling, Mark Kawachi, Jihad Kaouk, George Haber; Craig Roger, Simone Crivellaro, …etc.), and successfully mastered almost all urological laparoscopic/robotic operations. He was the first one in Taiwan to perform a successful laparoscopic donor nephrectomy, and then taught and spread his experience to other doctors in Taiwan, the Philippines and China. While he worked in WV, he also successfully accomplished many laparoendoscopic single site (LESS) living donor nephrectomy—the most cutting-edge smallest incision surgery for living donor nephrectomy. Through these years he developed several pioneer and innovative techniques in urological laparoscopy which were never reported before, including surgery involving adrenal gland, kidneys, and prostate. All the originalities and creativity have been attested by academic publications in highly-cited peer-reviewed journals. He had a good record of publications in the field of laparoscopic and robotic operations; there were 55 among his more than 250 published SCI papers related with laparoscopic and robotic surgery, and many of them were of ground-breaking initiatives in the field. As mentioned above, Dr. Chueh has published extensively with articles and chapters in peer-reviewed journals and books; and has authored a textbook entitled "Practical Guide to Urological Laparoscopic Surgery (in Chinese)". He has been serving as an Editorial Board member for Transplantation Proceedings, Transplantation Reports, Journal of Formosan Medical Association (JFMA), Urological Science and Asian Journal of Surgery and an Ad-hoc peer-reviewer for more than 20 highly-ranked SCI journals. He holds active membership in the American Urologic Association, the Society of Endourology, the Society of Robotic Surgeons, and the American Society for Transplant Surgeon. Dr. Chueh has been certified for injection of SpaceOAR biodegradable hydrogel for prostate cancer radiotherapy, and he was also granted as a center of excellence by the manufacturer of UroLift prostate urethral lifting and also privileged to perform Resum to treat lower urinary tract symptoms caused by the enlarged prostate. Throughout these years, Dr. Chueh has been granted by Taiwan National Science Council for many research protocols, including a current 3-year protocol from 2022~ 2025. Dr. Chueh also received research fund from SPARK for evaluating and modifying a novel urethral catheter. He is also involved in a study of AI interpretation for small renal masses, as supported jointly by Industrial Technology Investment Corporation (itri) and NTUH.

13th August 2025

Time	Session

08:00 17:00	Asian Urology Residents' Courses (AURC) Welcome Speeches Jeff S. ChuehTaiwan Moderator Welcome Speech from Chairman of Asian School of Urology Michael WongSingapore Speaker Introduction to Asia School of UrologyAsian School of Urology 2022-2026 – New initiatives Dr Michael YC Wong Principal Director of ASU 2022-2026 President Endourological Society and WCET 2026 Introduction Asian School of Urology (ASU) officially started in 1999 with the appointment of her first director Prof Pichai Bunyaratavej from Thailand (1999-2002) Subsequent directors were Dato Dr Rohan Malek from Malaysia (2002-2006) Prof Foo Keong Tatt from Singapore (2006-2010) Prof Rainy Umbas from Indonesia (2010-2014 ) and Prof Shin Egawa from Japan ( 2014-2022 ). One of the highlights of the ASU in the early days were the organization of several workshops outside of UAA congress by three active sub-specialty sections of UAA namely Asian society of Endourology (over 16 workshops held from 1998-2008), Asian Society of Female Urology and Asia-Pacific society of Uro-Oncology. Other subspecialty sections were subsequently introduced and have matured very well including Asian Society of UTI and STI, Asian-Pacific Society of Andrological and Reconstructive Urology Surgeons. In the last 8 years, ASU has seen tremendous growth under the steady leadership of Prof Shin Egawa with introduction of UAA lecturers at national Meetings and further maturation of the subspecialty sections of UAA e.g., Conversion of Asian society of endourology to Asian Robotic Urological Society to reflect the growth and development of UAA. During the past 8 years, ASU-South-East Asia section has also managed to organize 15 physical workshops and 4 webinars outside of UAA congress. The Growth Trajectory for the next 4 years 2022-2026 There are many areas where ASU can grow further. Bearing in mind our limited resources and our excellent relationships with the world urological leaders at this point in our history. There are three areas which I will focus on. Please remember that ASU is always open to other new initiatives as we must stay relevant to our Asian urological community. 1. Lasting and strong Relationships 1.1 AUA. Over a dish of chili crab with AUA secretary general Gopal Badlani, we explored the common desire to elevate Asian Urology and strengthen UAA Family. This led to our first joint UAA-AUA residency course at UAA Singapore 2016. After successful completion, a MOU was signed at AUA 2017 with Richard Babayan, Manoj Monga, Allen Chiu and myself in attendance. The AURC at UAA Hong Kong under Prof Eddie Chan was the result of this signed MOU. We are extremely grateful for the generosity of AUA for this program. What may not be obvious is that Gopal Badlani, Manoj Monga, John Denstedt and I served as faculty and board directors at WCE. We will sign the extension MOU in 2023 for another three years. 1.2 EAU. We have a very successful UAA-EAU Youth program since UAA Thailand 2012. This has been the work of several UAA senior members. From 2023, we are exploring joint webinars with EAU to build on this relationship. 1.3 SIU and WCE. We will further explore options based on available resources and manpower. Joint Webinar are planned for early 2026 2. Education Platform for Asian Urology Residents From 2023, we will continue to grow our relationship with BJUI. BJUI has developed a world class online learning platform with tremendous investments since 2013. This platform is called BJUI Knowledge. ASU will reach out to all Asian residents via their national urological association president and secretary to encourage every resident to sign up for a free access to more than 420 interactive 30-minute modules covering the whole urology syllabus suitable for learning, exit exams and recertification exams. I am personally involved in developing all modules under Endourology and urolithiasis Section and have been associate editor since May 2013. The modest aim is for at least 10 residents per country to sign up by UAA 2023. We will report progress at each UAA council meeting. Pls see attached information and if there are any questions pls email me personally at email@drmichaelwong.com 3. Re-Strategize Training cum fellowship sites for ASU. 3.1 In the past we have always talked about the possibility about training sites for UAA and ASU. It has always been a difficult task due to financial and multiple logistics issues. 3.2 What can we do that is possible? Let us consider two options in the next 4 years. 3.3 For the last 6 years a group of Asian urologists started AUGTEG to design and provide two-day surgical training which includes lectures as well as dry and wet lab to develop surgical skills. AUSTEG has direct access to physical training centres in Thailand, South Korea, and China. ASU will work with AUGTEC to pool resources since we are the same people working on both sides e.g., Anthony Ng (chairman of AUSTEG) Michael Wong (vice chairman) Eddie Chan (treasurer). AUGTEG is registered in HK. 3.4 The second option is to recognise elected university or training Asian centres to allow an attachment for young urologist post residency in a flexible format. ASU will recognise officially these sites as endorsed by UAA. At UAA 2025 , several potential ASU/UAA fellowship sites directors will be presenting their programmes to kickstart this initiative 4. In conclusion, ASU will continue to grow and serve the Asian Urological Community. The above initiatives are only the beginning of a next chapter. Can you contribute your ideas and current available resources for this purpose? If you can, Pls email me personally at email@drmichaelwong.com Which Position is the Best for PCNL in 2025?With tremendous advances in both technique and technology , the MIS approach to staghorn calculi has evolved significantly over the last 30 years. It is timely to review all the landmark articles on patient positioning as this ultimately determines renal access which in turn plays a major role in stone free rates. We will gain much insight as we debate and attempt to answer the question of which position is best in 2026! Welcome Speech from Chairman of AURC Samuel Vincent G. YrastorzaPhilippines Speaker Wrap-up from Day 1 Course Shu-Wen LiTaiwan Speaker Wrap-up from Day 1 Course Oncology-Kidney Cancer and Urothelial Carcinoma Michael WongSingapore Moderator Introduction to Asia School of UrologyAsian School of Urology 2022-2026 – New initiatives Dr Michael YC Wong Principal Director of ASU 2022-2026 President Endourological Society and WCET 2026 Introduction Asian School of Urology (ASU) officially started in 1999 with the appointment of her first director Prof Pichai Bunyaratavej from Thailand (1999-2002) Subsequent directors were Dato Dr Rohan Malek from Malaysia (2002-2006) Prof Foo Keong Tatt from Singapore (2006-2010) Prof Rainy Umbas from Indonesia (2010-2014 ) and Prof Shin Egawa from Japan ( 2014-2022 ). One of the highlights of the ASU in the early days were the organization of several workshops outside of UAA congress by three active sub-specialty sections of UAA namely Asian society of Endourology (over 16 workshops held from 1998-2008), Asian Society of Female Urology and Asia-Pacific society of Uro-Oncology. Other subspecialty sections were subsequently introduced and have matured very well including Asian Society of UTI and STI, Asian-Pacific Society of Andrological and Reconstructive Urology Surgeons. In the last 8 years, ASU has seen tremendous growth under the steady leadership of Prof Shin Egawa with introduction of UAA lecturers at national Meetings and further maturation of the subspecialty sections of UAA e.g., Conversion of Asian society of endourology to Asian Robotic Urological Society to reflect the growth and development of UAA. During the past 8 years, ASU-South-East Asia section has also managed to organize 15 physical workshops and 4 webinars outside of UAA congress. The Growth Trajectory for the next 4 years 2022-2026 There are many areas where ASU can grow further. Bearing in mind our limited resources and our excellent relationships with the world urological leaders at this point in our history. There are three areas which I will focus on. Please remember that ASU is always open to other new initiatives as we must stay relevant to our Asian urological community. 1. Lasting and strong Relationships 1.1 AUA. Over a dish of chili crab with AUA secretary general Gopal Badlani, we explored the common desire to elevate Asian Urology and strengthen UAA Family. This led to our first joint UAA-AUA residency course at UAA Singapore 2016. After successful completion, a MOU was signed at AUA 2017 with Richard Babayan, Manoj Monga, Allen Chiu and myself in attendance. The AURC at UAA Hong Kong under Prof Eddie Chan was the result of this signed MOU. We are extremely grateful for the generosity of AUA for this program. What may not be obvious is that Gopal Badlani, Manoj Monga, John Denstedt and I served as faculty and board directors at WCE. We will sign the extension MOU in 2023 for another three years. 1.2 EAU. We have a very successful UAA-EAU Youth program since UAA Thailand 2012. This has been the work of several UAA senior members. From 2023, we are exploring joint webinars with EAU to build on this relationship. 1.3 SIU and WCE. We will further explore options based on available resources and manpower. Joint Webinar are planned for early 2026 2. Education Platform for Asian Urology Residents From 2023, we will continue to grow our relationship with BJUI. BJUI has developed a world class online learning platform with tremendous investments since 2013. This platform is called BJUI Knowledge. ASU will reach out to all Asian residents via their national urological association president and secretary to encourage every resident to sign up for a free access to more than 420 interactive 30-minute modules covering the whole urology syllabus suitable for learning, exit exams and recertification exams. I am personally involved in developing all modules under Endourology and urolithiasis Section and have been associate editor since May 2013. The modest aim is for at least 10 residents per country to sign up by UAA 2023. We will report progress at each UAA council meeting. Pls see attached information and if there are any questions pls email me personally at email@drmichaelwong.com 3. Re-Strategize Training cum fellowship sites for ASU. 3.1 In the past we have always talked about the possibility about training sites for UAA and ASU. It has always been a difficult task due to financial and multiple logistics issues. 3.2 What can we do that is possible? Let us consider two options in the next 4 years. 3.3 For the last 6 years a group of Asian urologists started AUGTEG to design and provide two-day surgical training which includes lectures as well as dry and wet lab to develop surgical skills. AUSTEG has direct access to physical training centres in Thailand, South Korea, and China. ASU will work with AUGTEC to pool resources since we are the same people working on both sides e.g., Anthony Ng (chairman of AUSTEG) Michael Wong (vice chairman) Eddie Chan (treasurer). AUGTEG is registered in HK. 3.4 The second option is to recognise elected university or training Asian centres to allow an attachment for young urologist post residency in a flexible format. ASU will recognise officially these sites as endorsed by UAA. At UAA 2025 , several potential ASU/UAA fellowship sites directors will be presenting their programmes to kickstart this initiative 4. In conclusion, ASU will continue to grow and serve the Asian Urological Community. The above initiatives are only the beginning of a next chapter. Can you contribute your ideas and current available resources for this purpose? If you can, Pls email me personally at email@drmichaelwong.com Which Position is the Best for PCNL in 2025?With tremendous advances in both technique and technology , the MIS approach to staghorn calculi has evolved significantly over the last 30 years. It is timely to review all the landmark articles on patient positioning as this ultimately determines renal access which in turn plays a major role in stone free rates. We will gain much insight as we debate and attempt to answer the question of which position is best in 2026! From Bench to Bedside - A Comprehensive Overview of Kidney Cancer Stephen A. BoorjianUnited States Speaker AUA Lecture: 2025 Update of AUA and EAU NMIBC GuidelinesBoth the American Urological Association (AUA) and European Association of Urology (EAU) have developed guidelines for the management of non-muscle invasive bladder cancer (NMIBC). While subtle differences in several aspects of these guidelines exist which merit mentioning, both guidelines emphasis the concept of risk stratification. In particular, understanding the criteria which classifies patients with NMIBC as high risk avoids undertreatment of the patients most likely to experience disease progress. Likewise, recognizing the indications for cystectomy among high risk NMIBC patients is critical to optimize survival. Meanwhile, continued options emerge for patients classified as having BCG unresponsive NMIBC, such that knowledge of that definition as well as current management strategies for these patients facilitates contemporary practice.From Bench to Bedside - A Comprehensive Overview of Kidney CancerEvaluation of patients with a newly identified renal mass includes dedicated cross-sectional imaging for appropriate characterization. Genetic syndromes which include renal cell carcinoma (RCC) are increasingly understood, and indeed knowledge of the intracellular pathways of these conditions has facilitate rationale drug development for kidney cancer. Managing patients with a small renal mass involves a critical assessment of competing risks inherent to the tumor, the patient (underlying comorbidity status), and the proposed treatment. Renal mass biopsy may play a role in select cases for additional information/risk stratification. The safety of active surveillance is being increasingly demonstrated as longer-term follow-up matures. Meanwhile, select patients with high risk disease now have the option of adjuvant immunotherapy following surgical resection. In the setting of metastatic RCC, again risk stratification plays a critical role in the decision for – and timing of – cytoreductive nephrectomy, particularly in the contemporary era of checkpoint inhibitor therapies.Real World Experience in the Management of Upper Tract Urothelial CarcinomaThe biggest challenging in managing upper tract urothelial carcionma (UTUC) remains accurate staging of tumors at diagnosis. Given the limited ability of contemporary staging methods, clinical risk stratification models have been developed to assist in providing risk-based treatment recommendations. For example, endoscopic management (e.g., ablation) represents the recommended first line approach for patients with low risk disease. Importantly, follow-up for these patients should include endoscopic re-evaluation. The value of testing patients with UTUC for Lynch syndrome is also critical to recognize. A role for neoadjuvant chemotherapy is being increasing explored for patients classified with high-risk UTUC, while several options exist for adjuvant chemotherapy and immunotherapy for patients with adverse pathology at surgical resection. Continued investigation into prevention of postoperative intravesical recurrences in patients with UTUC is warranted given the frequency of metachronous tumor development in the bladder among these patients.Updates on MIBC and Advanced Bladder Cancer: Where do We Stand in 2025While neoadjuvant chemotherapy prior to radical cystectomy has been demonstrated with randomized trial data to improve survival for patients undergoing radical cystectomy, nevertheless utilization is often restricted by misunderstandings regarding patient eligibility factors. As such, defining eligibility criteria will facilitate increased adoption. Likewise, new data indicates a role for adjust immunotherapy in select patients following surgery as well. Moreover, important recent evidence on the role of extended lymph node dissection and the opportunities for preserving sexual function after cystectomy by modifying surgical technique are critical to review in order to optimize future patient outcomes. Further, recent advancements in systemic therapy options for patients with metastatic urothelial carcinoma have led to unprecedented survival rates.Revisit on Testicular Tumors-What we Learned from past and Prepared for the FutureGerm cell tumor (GCT) progression typically occurs in a predictable sequence of disease spread to the retroperitoneum first and then distant metastases. Understanding the role of serum tumor markers at various disease stages is critical for guideline-concordant management and to optimize patient outcomes, avoiding both undertreatment and overtreatment. For patients with seminoma, retroperitoneal lymph node dissection now represents an option for patients with low volume retroperitoneal lymph node disease, with the goal of avoiding the long-term toxicities associated with chemotherapy and radiotherapy. For patients with residual postchemotherapy masses in seminoma, increasing evidence suggests that PET scans should be utilized/interpreted with caution, and that in the absence of mass growth continued follow-up may be the strategy for most patients. Similarly, for patients with nonseminomatous GCTs (NSGCT) and equivocal retroperitoneal lymph nodes at presentation, re-scanning after an interval of approximately 6-8 weeks may be preferable to initial treatment, as many of these nodes represent benign processes and as such will resolve. Nevertheless, postchemotherapy retroperitoneal lymph node dissection remains a critical component of the management of patients with NSCGT and a residual mass. Risk Stratification and Contemporary Management of Biochemical RecurrenceBiochemical recurrence (BCR) has been reported in up to 35% of patients following radical prostatectomy. Understanding the natural history and clinicopathologic risk factors associated with disease progression is critical to facilitate an individualized treatment approach. Likewise, recognizing the details of treatment delivery with salvage radiotherapy is necessary to optimize outcomes. Further, as data emerge on the utilization of systemic therapy for non-metastatic BCR, being able to contextualize reported outcomes with patient age, comorbidity status, and disease risk will enhance appropriate care delivery. Real World Experience in the Management of Upper Tract Urothelial Carcinoma Stephen A. BoorjianUnited States Speaker AUA Lecture: 2025 Update of AUA and EAU NMIBC GuidelinesBoth the American Urological Association (AUA) and European Association of Urology (EAU) have developed guidelines for the management of non-muscle invasive bladder cancer (NMIBC). While subtle differences in several aspects of these guidelines exist which merit mentioning, both guidelines emphasis the concept of risk stratification. In particular, understanding the criteria which classifies patients with NMIBC as high risk avoids undertreatment of the patients most likely to experience disease progress. Likewise, recognizing the indications for cystectomy among high risk NMIBC patients is critical to optimize survival. Meanwhile, continued options emerge for patients classified as having BCG unresponsive NMIBC, such that knowledge of that definition as well as current management strategies for these patients facilitates contemporary practice.From Bench to Bedside - A Comprehensive Overview of Kidney CancerEvaluation of patients with a newly identified renal mass includes dedicated cross-sectional imaging for appropriate characterization. Genetic syndromes which include renal cell carcinoma (RCC) are increasingly understood, and indeed knowledge of the intracellular pathways of these conditions has facilitate rationale drug development for kidney cancer. Managing patients with a small renal mass involves a critical assessment of competing risks inherent to the tumor, the patient (underlying comorbidity status), and the proposed treatment. Renal mass biopsy may play a role in select cases for additional information/risk stratification. The safety of active surveillance is being increasingly demonstrated as longer-term follow-up matures. Meanwhile, select patients with high risk disease now have the option of adjuvant immunotherapy following surgical resection. In the setting of metastatic RCC, again risk stratification plays a critical role in the decision for – and timing of – cytoreductive nephrectomy, particularly in the contemporary era of checkpoint inhibitor therapies.Real World Experience in the Management of Upper Tract Urothelial CarcinomaThe biggest challenging in managing upper tract urothelial carcionma (UTUC) remains accurate staging of tumors at diagnosis. Given the limited ability of contemporary staging methods, clinical risk stratification models have been developed to assist in providing risk-based treatment recommendations. For example, endoscopic management (e.g., ablation) represents the recommended first line approach for patients with low risk disease. Importantly, follow-up for these patients should include endoscopic re-evaluation. The value of testing patients with UTUC for Lynch syndrome is also critical to recognize. A role for neoadjuvant chemotherapy is being increasing explored for patients classified with high-risk UTUC, while several options exist for adjuvant chemotherapy and immunotherapy for patients with adverse pathology at surgical resection. Continued investigation into prevention of postoperative intravesical recurrences in patients with UTUC is warranted given the frequency of metachronous tumor development in the bladder among these patients.Updates on MIBC and Advanced Bladder Cancer: Where do We Stand in 2025While neoadjuvant chemotherapy prior to radical cystectomy has been demonstrated with randomized trial data to improve survival for patients undergoing radical cystectomy, nevertheless utilization is often restricted by misunderstandings regarding patient eligibility factors. As such, defining eligibility criteria will facilitate increased adoption. Likewise, new data indicates a role for adjust immunotherapy in select patients following surgery as well. Moreover, important recent evidence on the role of extended lymph node dissection and the opportunities for preserving sexual function after cystectomy by modifying surgical technique are critical to review in order to optimize future patient outcomes. Further, recent advancements in systemic therapy options for patients with metastatic urothelial carcinoma have led to unprecedented survival rates.Revisit on Testicular Tumors-What we Learned from past and Prepared for the FutureGerm cell tumor (GCT) progression typically occurs in a predictable sequence of disease spread to the retroperitoneum first and then distant metastases. Understanding the role of serum tumor markers at various disease stages is critical for guideline-concordant management and to optimize patient outcomes, avoiding both undertreatment and overtreatment. For patients with seminoma, retroperitoneal lymph node dissection now represents an option for patients with low volume retroperitoneal lymph node disease, with the goal of avoiding the long-term toxicities associated with chemotherapy and radiotherapy. For patients with residual postchemotherapy masses in seminoma, increasing evidence suggests that PET scans should be utilized/interpreted with caution, and that in the absence of mass growth continued follow-up may be the strategy for most patients. Similarly, for patients with nonseminomatous GCTs (NSGCT) and equivocal retroperitoneal lymph nodes at presentation, re-scanning after an interval of approximately 6-8 weeks may be preferable to initial treatment, as many of these nodes represent benign processes and as such will resolve. Nevertheless, postchemotherapy retroperitoneal lymph node dissection remains a critical component of the management of patients with NSCGT and a residual mass. Risk Stratification and Contemporary Management of Biochemical RecurrenceBiochemical recurrence (BCR) has been reported in up to 35% of patients following radical prostatectomy. Understanding the natural history and clinicopathologic risk factors associated with disease progression is critical to facilitate an individualized treatment approach. Likewise, recognizing the details of treatment delivery with salvage radiotherapy is necessary to optimize outcomes. Further, as data emerge on the utilization of systemic therapy for non-metastatic BCR, being able to contextualize reported outcomes with patient age, comorbidity status, and disease risk will enhance appropriate care delivery. Updates on MIBC and Advanced Bladder Cancer: Where do We Stand in 2025 Stephen A. BoorjianUnited States Speaker AUA Lecture: 2025 Update of AUA and EAU NMIBC GuidelinesBoth the American Urological Association (AUA) and European Association of Urology (EAU) have developed guidelines for the management of non-muscle invasive bladder cancer (NMIBC). While subtle differences in several aspects of these guidelines exist which merit mentioning, both guidelines emphasis the concept of risk stratification. In particular, understanding the criteria which classifies patients with NMIBC as high risk avoids undertreatment of the patients most likely to experience disease progress. Likewise, recognizing the indications for cystectomy among high risk NMIBC patients is critical to optimize survival. Meanwhile, continued options emerge for patients classified as having BCG unresponsive NMIBC, such that knowledge of that definition as well as current management strategies for these patients facilitates contemporary practice.From Bench to Bedside - A Comprehensive Overview of Kidney CancerEvaluation of patients with a newly identified renal mass includes dedicated cross-sectional imaging for appropriate characterization. Genetic syndromes which include renal cell carcinoma (RCC) are increasingly understood, and indeed knowledge of the intracellular pathways of these conditions has facilitate rationale drug development for kidney cancer. Managing patients with a small renal mass involves a critical assessment of competing risks inherent to the tumor, the patient (underlying comorbidity status), and the proposed treatment. Renal mass biopsy may play a role in select cases for additional information/risk stratification. The safety of active surveillance is being increasingly demonstrated as longer-term follow-up matures. Meanwhile, select patients with high risk disease now have the option of adjuvant immunotherapy following surgical resection. In the setting of metastatic RCC, again risk stratification plays a critical role in the decision for – and timing of – cytoreductive nephrectomy, particularly in the contemporary era of checkpoint inhibitor therapies.Real World Experience in the Management of Upper Tract Urothelial CarcinomaThe biggest challenging in managing upper tract urothelial carcionma (UTUC) remains accurate staging of tumors at diagnosis. Given the limited ability of contemporary staging methods, clinical risk stratification models have been developed to assist in providing risk-based treatment recommendations. For example, endoscopic management (e.g., ablation) represents the recommended first line approach for patients with low risk disease. Importantly, follow-up for these patients should include endoscopic re-evaluation. The value of testing patients with UTUC for Lynch syndrome is also critical to recognize. A role for neoadjuvant chemotherapy is being increasing explored for patients classified with high-risk UTUC, while several options exist for adjuvant chemotherapy and immunotherapy for patients with adverse pathology at surgical resection. Continued investigation into prevention of postoperative intravesical recurrences in patients with UTUC is warranted given the frequency of metachronous tumor development in the bladder among these patients.Updates on MIBC and Advanced Bladder Cancer: Where do We Stand in 2025While neoadjuvant chemotherapy prior to radical cystectomy has been demonstrated with randomized trial data to improve survival for patients undergoing radical cystectomy, nevertheless utilization is often restricted by misunderstandings regarding patient eligibility factors. As such, defining eligibility criteria will facilitate increased adoption. Likewise, new data indicates a role for adjust immunotherapy in select patients following surgery as well. Moreover, important recent evidence on the role of extended lymph node dissection and the opportunities for preserving sexual function after cystectomy by modifying surgical technique are critical to review in order to optimize future patient outcomes. Further, recent advancements in systemic therapy options for patients with metastatic urothelial carcinoma have led to unprecedented survival rates.Revisit on Testicular Tumors-What we Learned from past and Prepared for the FutureGerm cell tumor (GCT) progression typically occurs in a predictable sequence of disease spread to the retroperitoneum first and then distant metastases. Understanding the role of serum tumor markers at various disease stages is critical for guideline-concordant management and to optimize patient outcomes, avoiding both undertreatment and overtreatment. For patients with seminoma, retroperitoneal lymph node dissection now represents an option for patients with low volume retroperitoneal lymph node disease, with the goal of avoiding the long-term toxicities associated with chemotherapy and radiotherapy. For patients with residual postchemotherapy masses in seminoma, increasing evidence suggests that PET scans should be utilized/interpreted with caution, and that in the absence of mass growth continued follow-up may be the strategy for most patients. Similarly, for patients with nonseminomatous GCTs (NSGCT) and equivocal retroperitoneal lymph nodes at presentation, re-scanning after an interval of approximately 6-8 weeks may be preferable to initial treatment, as many of these nodes represent benign processes and as such will resolve. Nevertheless, postchemotherapy retroperitoneal lymph node dissection remains a critical component of the management of patients with NSCGT and a residual mass. Risk Stratification and Contemporary Management of Biochemical RecurrenceBiochemical recurrence (BCR) has been reported in up to 35% of patients following radical prostatectomy. Understanding the natural history and clinicopathologic risk factors associated with disease progression is critical to facilitate an individualized treatment approach. Likewise, recognizing the details of treatment delivery with salvage radiotherapy is necessary to optimize outcomes. Further, as data emerge on the utilization of systemic therapy for non-metastatic BCR, being able to contextualize reported outcomes with patient age, comorbidity status, and disease risk will enhance appropriate care delivery. Case Presentation and Discussion Coffee Break Oncology-Prostate Cancer and Testicular Tumor Shin EgawaJapan Moderator Comparison of Various Treatment Options for Localized Prostate Cancer David PensonUnited States Speaker Comparison of Various Treatment Options for Localized Prostate CancerThere are numerous therapeutic strategies used to treat localized prostate cancer, each with unique advantages and disadvantages. Furthermore, prostate cancer itself is heterogeneous with some tumors being indolent and others being more aggressive. We will from the presentation by looking at outcomes separately in patients with favorable prognosis and those with unfavorable prognosis, based upon baseline clinical characteristics. We will first compare cancer control and mortality outcomes amongst the various options. We will then present data on patient-reported outcomes. At the conclusion of the presentation, attendees will have a better understanding of outcomes following treatment for localized prostate cancer and will be better prepared to counsel patients newly diagnosed with this common malignancy.Updates on Combination Therapy for Advanced Prostate CancerOver the past decade, there are have been significant advances in the treatment of metastatic prostate cancer. Randomized clinical trial data have demonstrated that combination therapies are superior to monotherapy in terms of cancer control and survival. Various treatment options will be discussed for metastatic castrate-sensitive and -resistant prostate cancer. These will be compared in terms of efficacy and side effect profiles to aid in treatment selection in this The Startup of An Academic Urologist - How to Build up Your Team in Clinical ResearchMany young academic urologists wish to perform clinical research at their institution. Often, however, this is challenging due to lack of resources or time. In this presentation, we will discuss how to build a clinical research program, including identifying what types of individuals need to be part of the team and what sort of resources are required for success. While American examples will often be used, information from this presentation will still be applicable globally.A Programmatic Approach to Prostate Cancer ScreeningProstate cancer screening has advanced beyond annual PSA testing. We now have numerous tools available to aid in identifying men at risk for harboring clinically significant prostate cancer, including MRI and various novel biomarkers. In this presentation, we will review these modalities and lay out a systematic approach to screening in 2025. Updates on Combination Therapy for Advanced Prostate Cancer David PensonUnited States Speaker Comparison of Various Treatment Options for Localized Prostate CancerThere are numerous therapeutic strategies used to treat localized prostate cancer, each with unique advantages and disadvantages. Furthermore, prostate cancer itself is heterogeneous with some tumors being indolent and others being more aggressive. We will from the presentation by looking at outcomes separately in patients with favorable prognosis and those with unfavorable prognosis, based upon baseline clinical characteristics. We will first compare cancer control and mortality outcomes amongst the various options. We will then present data on patient-reported outcomes. At the conclusion of the presentation, attendees will have a better understanding of outcomes following treatment for localized prostate cancer and will be better prepared to counsel patients newly diagnosed with this common malignancy.Updates on Combination Therapy for Advanced Prostate CancerOver the past decade, there are have been significant advances in the treatment of metastatic prostate cancer. Randomized clinical trial data have demonstrated that combination therapies are superior to monotherapy in terms of cancer control and survival. Various treatment options will be discussed for metastatic castrate-sensitive and -resistant prostate cancer. These will be compared in terms of efficacy and side effect profiles to aid in treatment selection in this The Startup of An Academic Urologist - How to Build up Your Team in Clinical ResearchMany young academic urologists wish to perform clinical research at their institution. Often, however, this is challenging due to lack of resources or time. In this presentation, we will discuss how to build a clinical research program, including identifying what types of individuals need to be part of the team and what sort of resources are required for success. While American examples will often be used, information from this presentation will still be applicable globally.A Programmatic Approach to Prostate Cancer ScreeningProstate cancer screening has advanced beyond annual PSA testing. We now have numerous tools available to aid in identifying men at risk for harboring clinically significant prostate cancer, including MRI and various novel biomarkers. In this presentation, we will review these modalities and lay out a systematic approach to screening in 2025. Revisit on Testicular Tumors-What we Learned from past and Prepared for the Future Stephen A. BoorjianUnited States Speaker AUA Lecture: 2025 Update of AUA and EAU NMIBC GuidelinesBoth the American Urological Association (AUA) and European Association of Urology (EAU) have developed guidelines for the management of non-muscle invasive bladder cancer (NMIBC). While subtle differences in several aspects of these guidelines exist which merit mentioning, both guidelines emphasis the concept of risk stratification. In particular, understanding the criteria which classifies patients with NMIBC as high risk avoids undertreatment of the patients most likely to experience disease progress. Likewise, recognizing the indications for cystectomy among high risk NMIBC patients is critical to optimize survival. Meanwhile, continued options emerge for patients classified as having BCG unresponsive NMIBC, such that knowledge of that definition as well as current management strategies for these patients facilitates contemporary practice.From Bench to Bedside - A Comprehensive Overview of Kidney CancerEvaluation of patients with a newly identified renal mass includes dedicated cross-sectional imaging for appropriate characterization. Genetic syndromes which include renal cell carcinoma (RCC) are increasingly understood, and indeed knowledge of the intracellular pathways of these conditions has facilitate rationale drug development for kidney cancer. Managing patients with a small renal mass involves a critical assessment of competing risks inherent to the tumor, the patient (underlying comorbidity status), and the proposed treatment. Renal mass biopsy may play a role in select cases for additional information/risk stratification. The safety of active surveillance is being increasingly demonstrated as longer-term follow-up matures. Meanwhile, select patients with high risk disease now have the option of adjuvant immunotherapy following surgical resection. In the setting of metastatic RCC, again risk stratification plays a critical role in the decision for – and timing of – cytoreductive nephrectomy, particularly in the contemporary era of checkpoint inhibitor therapies.Real World Experience in the Management of Upper Tract Urothelial CarcinomaThe biggest challenging in managing upper tract urothelial carcionma (UTUC) remains accurate staging of tumors at diagnosis. Given the limited ability of contemporary staging methods, clinical risk stratification models have been developed to assist in providing risk-based treatment recommendations. For example, endoscopic management (e.g., ablation) represents the recommended first line approach for patients with low risk disease. Importantly, follow-up for these patients should include endoscopic re-evaluation. The value of testing patients with UTUC for Lynch syndrome is also critical to recognize. A role for neoadjuvant chemotherapy is being increasing explored for patients classified with high-risk UTUC, while several options exist for adjuvant chemotherapy and immunotherapy for patients with adverse pathology at surgical resection. Continued investigation into prevention of postoperative intravesical recurrences in patients with UTUC is warranted given the frequency of metachronous tumor development in the bladder among these patients.Updates on MIBC and Advanced Bladder Cancer: Where do We Stand in 2025While neoadjuvant chemotherapy prior to radical cystectomy has been demonstrated with randomized trial data to improve survival for patients undergoing radical cystectomy, nevertheless utilization is often restricted by misunderstandings regarding patient eligibility factors. As such, defining eligibility criteria will facilitate increased adoption. Likewise, new data indicates a role for adjust immunotherapy in select patients following surgery as well. Moreover, important recent evidence on the role of extended lymph node dissection and the opportunities for preserving sexual function after cystectomy by modifying surgical technique are critical to review in order to optimize future patient outcomes. Further, recent advancements in systemic therapy options for patients with metastatic urothelial carcinoma have led to unprecedented survival rates.Revisit on Testicular Tumors-What we Learned from past and Prepared for the FutureGerm cell tumor (GCT) progression typically occurs in a predictable sequence of disease spread to the retroperitoneum first and then distant metastases. Understanding the role of serum tumor markers at various disease stages is critical for guideline-concordant management and to optimize patient outcomes, avoiding both undertreatment and overtreatment. For patients with seminoma, retroperitoneal lymph node dissection now represents an option for patients with low volume retroperitoneal lymph node disease, with the goal of avoiding the long-term toxicities associated with chemotherapy and radiotherapy. For patients with residual postchemotherapy masses in seminoma, increasing evidence suggests that PET scans should be utilized/interpreted with caution, and that in the absence of mass growth continued follow-up may be the strategy for most patients. Similarly, for patients with nonseminomatous GCTs (NSGCT) and equivocal retroperitoneal lymph nodes at presentation, re-scanning after an interval of approximately 6-8 weeks may be preferable to initial treatment, as many of these nodes represent benign processes and as such will resolve. Nevertheless, postchemotherapy retroperitoneal lymph node dissection remains a critical component of the management of patients with NSCGT and a residual mass. Risk Stratification and Contemporary Management of Biochemical RecurrenceBiochemical recurrence (BCR) has been reported in up to 35% of patients following radical prostatectomy. Understanding the natural history and clinicopathologic risk factors associated with disease progression is critical to facilitate an individualized treatment approach. Likewise, recognizing the details of treatment delivery with salvage radiotherapy is necessary to optimize outcomes. Further, as data emerge on the utilization of systemic therapy for non-metastatic BCR, being able to contextualize reported outcomes with patient age, comorbidity status, and disease risk will enhance appropriate care delivery. Case Presentation and Discussion Lunch Break Functional Urology 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. Overview on Female Urine Incontinence and Pelvic Organ Prolapse Jaspreet SandhuUnited States Speaker Overview on Female Urine Incontinence and Pelvic Organ ProlapseThis lecture will be about female stress urinary incontinence and pelvic organ prolapse, including current demographics and conservative and surgical management of both. Guidelines-based approach to management of female stress urinary incontinence will be emphasized, with particular attention to surgical management. Further, we will evaluate trends and current surgical management of pelvic organ prolapse.Multimodality Management of Male Bladder Outlet ObstructionMale Bladder Outlet Obstruction is usually due benign prostate hypertrophy (BPH), therefore we will focus on an evidence-based approach to management of lower urinary tract symptoms (LUTS) secondary to BPH. Attention will be given to medical management of this condition and the nuances with respect to bladder dysfunction (specifically concomitant overactive bladder). The audience will also understand the current state of surgical management of LUTS/BPH.Overview of Urodynamic Studies - A Must Learn Approach in Daily Clinical PracticeA practical review of urodynamics studies including how to perform a study, the mandatory variables required, and standard calculations for most studies. Multimodality Management of Male Bladder Outlet Obstruction Jaspreet SandhuUnited States Speaker Overview on Female Urine Incontinence and Pelvic Organ ProlapseThis lecture will be about female stress urinary incontinence and pelvic organ prolapse, including current demographics and conservative and surgical management of both. Guidelines-based approach to management of female stress urinary incontinence will be emphasized, with particular attention to surgical management. Further, we will evaluate trends and current surgical management of pelvic organ prolapse.Multimodality Management of Male Bladder Outlet ObstructionMale Bladder Outlet Obstruction is usually due benign prostate hypertrophy (BPH), therefore we will focus on an evidence-based approach to management of lower urinary tract symptoms (LUTS) secondary to BPH. Attention will be given to medical management of this condition and the nuances with respect to bladder dysfunction (specifically concomitant overactive bladder). The audience will also understand the current state of surgical management of LUTS/BPH.Overview of Urodynamic Studies - A Must Learn Approach in Daily Clinical PracticeA practical review of urodynamics studies including how to perform a study, the mandatory variables required, and standard calculations for most studies. Overview of Urodynamic Studies - A Must Learn Approach in Daily Clinical Practice Jaspreet SandhuUnited States Speaker Overview on Female Urine Incontinence and Pelvic Organ ProlapseThis lecture will be about female stress urinary incontinence and pelvic organ prolapse, including current demographics and conservative and surgical management of both. Guidelines-based approach to management of female stress urinary incontinence will be emphasized, with particular attention to surgical management. Further, we will evaluate trends and current surgical management of pelvic organ prolapse.Multimodality Management of Male Bladder Outlet ObstructionMale Bladder Outlet Obstruction is usually due benign prostate hypertrophy (BPH), therefore we will focus on an evidence-based approach to management of lower urinary tract symptoms (LUTS) secondary to BPH. Attention will be given to medical management of this condition and the nuances with respect to bladder dysfunction (specifically concomitant overactive bladder). The audience will also understand the current state of surgical management of LUTS/BPH.Overview of Urodynamic Studies - A Must Learn Approach in Daily Clinical PracticeA practical review of urodynamics studies including how to perform a study, the mandatory variables required, and standard calculations for most studies. Case Presentation and Discussion Coffee Break Research Trends William J. HuangTaiwan Moderator Male Infertility: Challenges and Opportunities in AsiaMale infertility contributes to nearly 50% of all infertility cases, with an increasing burden observed across Asia. In parallel, a dramatic decline in birth rates has emerged in several Asian countries—including South Korea, Japan, Taiwan, and Singapore—reaching historically low total fertility rates (TFRs) of under 1.0. While multifactorial in nature, this demographic crisis underscores the urgent need to address all aspects of reproductive health, including the often-overlooked role of male infertility. Epidemiological data reveal significant regional disparities in the prevalence, diagnosis, and treatment of male infertility. Cultural stigma, limited andrology training, fragmented referral systems, and inadequate coverage of assisted reproductive technologies (ART) have impeded timely diagnosis and intervention. Environmental exposures, endocrine-disrupting chemicals, occupational heat, and increased paternal age have all been linked to declining semen quality, as evidenced by longitudinal studies showing decreased sperm concentration and motility in several urban centers across Asia. Current diagnostic tools—including semen analysis, hormone profiling, genetic testing (e.g., Y-chromosome microdeletion, karyotyping), and imaging—enable better etiological categorization. Microsurgical sperm retrieval techniques such as mTESE have provided new hope for patients with non-obstructive azoospermia, while ICSI and sperm cryopreservation have become increasingly utilized where available. Nevertheless, access remains inconsistent, particularly outside metropolitan regions. Recent integration of AI-based systems for semen evaluation, patient triage, and digital counseling offers promising strategies to improve care delivery, especially in under-resourced settings. However, data privacy, regulatory standards, and user trust continue to pose barriers to widespread implementation. Opportunities for systemic improvement include the development of regional male infertility registries, integration of andrology into national reproductive health frameworks, expansion of insurance coverage for fertility services, and public awareness campaigns to destigmatize male infertility. In light of Asia’s fertility decline, repositioning male reproductive health as a public health and demographic priority is essential for sustainable population policy and long-term healthcare planning. The Peri-Operative Care of MIST For Prostate HyperplasiaMinimally invasive surgical therapies (MIST), particularly UroLift and Rezūm, have transformed the treatment landscape for benign prostatic hyperplasia (BPH), offering effective symptom relief with reduced morbidity and preservation of sexual function. However, optimal outcomes depend not only on procedural execution, but also on well-structured peri-operative care protocols encompassing pre-, intra-, and post-operative management. Pre-operative evaluation includes comprehensive assessment of prostate anatomy—especially size, shape, and presence of median lobe—via imaging (TRUS or cystoscopy) to determine candidacy. Careful patient selection is essential: UroLift is typically suited for prostates <80 cc without obstructive median lobes, while Rezūm accommodates broader anatomical variability but may have delayed symptom resolution. Baseline symptom scores (e.g., IPSS), uroflowmetry, and post-void residual volume establish functional benchmarks and guide patient counseling. Anesthesia planning must consider procedural setting and patient comorbidities. UroLift can often be performed under local anesthesia with light sedation, whereas Rezūm may require short general anesthesia or deeper sedation due to thermal discomfort. Appropriate selection reduces intraoperative stress and facilitates same-day discharge. Intraoperative care focuses on minimizing trauma and ensuring device precision. UroLift requires accurate deployment of implants to maintain lateral lobe retraction without compromising sphincter integrity. In Rezūm, the number and duration of vapor injections must be titrated based on lobe size and configuration to balance efficacy and tissue inflammation. Real-time visualization and standardized protocols reduce variability and improve safety. Post-operative management involves anticipating and controlling transient irritative symptoms, such as dysuria, urgency, and hematuria. Alpha-blockers and anti-inflammatory medications are commonly used for 3–7 days post-procedure. Catheterization strategies differ by technique: UroLift may avoid catheter use entirely, whereas Rezūm often requires 7-14 days of catheter drainage due to anticipated edema. Monitoring for urinary retention, UTI, or clot obstruction is critical during the early recovery phase. Follow-up care typically occurs at 2–4 weeks and includes reassessment of voiding function, symptom scores, and patient satisfaction. Reinforcement of realistic expectations is especially important with Rezūm, which may take 4–6 weeks to achieve peak efficacy. Longitudinal studies indicate sustained symptom relief and low retreatment rates when peri-operative care is standardized and patient education is emphasized. Adverse event profiles differ between techniques: UroLift is associated with less dysuria but higher retreatment rates in large prostates, while Rezūm presents higher rates of transient discomfort but favorable durability. Structured peri-operative care pathways—including patient education, standardized medication protocols, and clear complication management plans—enhance recovery, minimize adverse events, and improve overall clinical success. The Startup of An Academic Urologist - How to Build up Your Team in Clinical Research David PensonUnited States Speaker Comparison of Various Treatment Options for Localized Prostate CancerThere are numerous therapeutic strategies used to treat localized prostate cancer, each with unique advantages and disadvantages. Furthermore, prostate cancer itself is heterogeneous with some tumors being indolent and others being more aggressive. We will from the presentation by looking at outcomes separately in patients with favorable prognosis and those with unfavorable prognosis, based upon baseline clinical characteristics. We will first compare cancer control and mortality outcomes amongst the various options. We will then present data on patient-reported outcomes. At the conclusion of the presentation, attendees will have a better understanding of outcomes following treatment for localized prostate cancer and will be better prepared to counsel patients newly diagnosed with this common malignancy.Updates on Combination Therapy for Advanced Prostate CancerOver the past decade, there are have been significant advances in the treatment of metastatic prostate cancer. Randomized clinical trial data have demonstrated that combination therapies are superior to monotherapy in terms of cancer control and survival. Various treatment options will be discussed for metastatic castrate-sensitive and -resistant prostate cancer. These will be compared in terms of efficacy and side effect profiles to aid in treatment selection in this The Startup of An Academic Urologist - How to Build up Your Team in Clinical ResearchMany young academic urologists wish to perform clinical research at their institution. Often, however, this is challenging due to lack of resources or time. In this presentation, we will discuss how to build a clinical research program, including identifying what types of individuals need to be part of the team and what sort of resources are required for success. While American examples will often be used, information from this presentation will still be applicable globally.A Programmatic Approach to Prostate Cancer ScreeningProstate cancer screening has advanced beyond annual PSA testing. We now have numerous tools available to aid in identifying men at risk for harboring clinically significant prostate cancer, including MRI and various novel biomarkers. In this presentation, we will review these modalities and lay out a systematic approach to screening in 2025. How to Incorporate Simulation into Surgery Practice Thomas HsuehTaiwan Speaker Application of Big Data Research in Urology Thomas HsuehTaiwan Speaker Case Presentation and Discussion Semi-Live Surgery Presentation AURC Networking Dinner TWTC - 2F Conference Room 5

Time

Session

08:00

17:00

Asian Urology Residents' Courses (AURC)

Welcome Speeches

Jeff S. ChuehTaiwan Moderator
Welcome Speech from Chairman of Asian School of Urology

Michael WongSingapore Speaker Introduction to Asia School of UrologyAsian School of Urology 2022-2026 – New initiatives Dr Michael YC Wong Principal Director of ASU 2022-2026 President Endourological Society and WCET 2026 Introduction Asian School of Urology (ASU) officially started in 1999 with the appointment of her first director Prof Pichai Bunyaratavej from Thailand (1999-2002) Subsequent directors were Dato Dr Rohan Malek from Malaysia (2002-2006) Prof Foo Keong Tatt from Singapore (2006-2010) Prof Rainy Umbas from Indonesia (2010-2014 ) and Prof Shin Egawa from Japan ( 2014-2022 ). One of the highlights of the ASU in the early days were the organization of several workshops outside of UAA congress by three active sub-specialty sections of UAA namely Asian society of Endourology (over 16 workshops held from 1998-2008), Asian Society of Female Urology and Asia-Pacific society of Uro-Oncology. Other subspecialty sections were subsequently introduced and have matured very well including Asian Society of UTI and STI, Asian-Pacific Society of Andrological and Reconstructive Urology Surgeons. In the last 8 years, ASU has seen tremendous growth under the steady leadership of Prof Shin Egawa with introduction of UAA lecturers at national Meetings and further maturation of the subspecialty sections of UAA e.g., Conversion of Asian society of endourology to Asian Robotic Urological Society to reflect the growth and development of UAA. During the past 8 years, ASU-South-East Asia section has also managed to organize 15 physical workshops and 4 webinars outside of UAA congress. The Growth Trajectory for the next 4 years 2022-2026 There are many areas where ASU can grow further. Bearing in mind our limited resources and our excellent relationships with the world urological leaders at this point in our history. There are three areas which I will focus on. Please remember that ASU is always open to other new initiatives as we must stay relevant to our Asian urological community. 1. Lasting and strong Relationships 1.1 AUA. Over a dish of chili crab with AUA secretary general Gopal Badlani, we explored the common desire to elevate Asian Urology and strengthen UAA Family. This led to our first joint UAA-AUA residency course at UAA Singapore 2016. After successful completion, a MOU was signed at AUA 2017 with Richard Babayan, Manoj Monga, Allen Chiu and myself in attendance. The AURC at UAA Hong Kong under Prof Eddie Chan was the result of this signed MOU. We are extremely grateful for the generosity of AUA for this program. What may not be obvious is that Gopal Badlani, Manoj Monga, John Denstedt and I served as faculty and board directors at WCE. We will sign the extension MOU in 2023 for another three years. 1.2 EAU. We have a very successful UAA-EAU Youth program since UAA Thailand 2012. This has been the work of several UAA senior members. From 2023, we are exploring joint webinars with EAU to build on this relationship. 1.3 SIU and WCE. We will further explore options based on available resources and manpower. Joint Webinar are planned for early 2026 2. Education Platform for Asian Urology Residents From 2023, we will continue to grow our relationship with BJUI. BJUI has developed a world class online learning platform with tremendous investments since 2013. This platform is called BJUI Knowledge. ASU will reach out to all Asian residents via their national urological association president and secretary to encourage every resident to sign up for a free access to more than 420 interactive 30-minute modules covering the whole urology syllabus suitable for learning, exit exams and recertification exams. I am personally involved in developing all modules under Endourology and urolithiasis Section and have been associate editor since May 2013. The modest aim is for at least 10 residents per country to sign up by UAA 2023. We will report progress at each UAA council meeting. Pls see attached information and if there are any questions pls email me personally at email@drmichaelwong.com 3. Re-Strategize Training cum fellowship sites for ASU. 3.1 In the past we have always talked about the possibility about training sites for UAA and ASU. It has always been a difficult task due to financial and multiple logistics issues. 3.2 What can we do that is possible? Let us consider two options in the next 4 years. 3.3 For the last 6 years a group of Asian urologists started AUGTEG to design and provide two-day surgical training which includes lectures as well as dry and wet lab to develop surgical skills. AUSTEG has direct access to physical training centres in Thailand, South Korea, and China. ASU will work with AUGTEC to pool resources since we are the same people working on both sides e.g., Anthony Ng (chairman of AUSTEG) Michael Wong (vice chairman) Eddie Chan (treasurer). AUGTEG is registered in HK. 3.4 The second option is to recognise elected university or training Asian centres to allow an attachment for young urologist post residency in a flexible format. ASU will recognise officially these sites as endorsed by UAA. At UAA 2025 , several potential ASU/UAA fellowship sites directors will be presenting their programmes to kickstart this initiative 4. In conclusion, ASU will continue to grow and serve the Asian Urological Community. The above initiatives are only the beginning of a next chapter. Can you contribute your ideas and current available resources for this purpose? If you can, Pls email me personally at email@drmichaelwong.com Which Position is the Best for PCNL in 2025?With tremendous advances in both technique and technology , the MIS approach to staghorn calculi has evolved significantly over the last 30 years. It is timely to review all the landmark articles on patient positioning as this ultimately determines renal access which in turn plays a major role in stone free rates. We will gain much insight as we debate and attempt to answer the question of which position is best in 2026!
Welcome Speech from Chairman of AURC

Samuel Vincent G. YrastorzaPhilippines Speaker
Wrap-up from Day 1 Course

Shu-Wen LiTaiwan Speaker Wrap-up from Day 1 Course
Oncology-Kidney Cancer and Urothelial Carcinoma

Michael WongSingapore Moderator Introduction to Asia School of UrologyAsian School of Urology 2022-2026 – New initiatives Dr Michael YC Wong Principal Director of ASU 2022-2026 President Endourological Society and WCET 2026 Introduction Asian School of Urology (ASU) officially started in 1999 with the appointment of her first director Prof Pichai Bunyaratavej from Thailand (1999-2002) Subsequent directors were Dato Dr Rohan Malek from Malaysia (2002-2006) Prof Foo Keong Tatt from Singapore (2006-2010) Prof Rainy Umbas from Indonesia (2010-2014 ) and Prof Shin Egawa from Japan ( 2014-2022 ). One of the highlights of the ASU in the early days were the organization of several workshops outside of UAA congress by three active sub-specialty sections of UAA namely Asian society of Endourology (over 16 workshops held from 1998-2008), Asian Society of Female Urology and Asia-Pacific society of Uro-Oncology. Other subspecialty sections were subsequently introduced and have matured very well including Asian Society of UTI and STI, Asian-Pacific Society of Andrological and Reconstructive Urology Surgeons. In the last 8 years, ASU has seen tremendous growth under the steady leadership of Prof Shin Egawa with introduction of UAA lecturers at national Meetings and further maturation of the subspecialty sections of UAA e.g., Conversion of Asian society of endourology to Asian Robotic Urological Society to reflect the growth and development of UAA. During the past 8 years, ASU-South-East Asia section has also managed to organize 15 physical workshops and 4 webinars outside of UAA congress. The Growth Trajectory for the next 4 years 2022-2026 There are many areas where ASU can grow further. Bearing in mind our limited resources and our excellent relationships with the world urological leaders at this point in our history. There are three areas which I will focus on. Please remember that ASU is always open to other new initiatives as we must stay relevant to our Asian urological community. 1. Lasting and strong Relationships 1.1 AUA. Over a dish of chili crab with AUA secretary general Gopal Badlani, we explored the common desire to elevate Asian Urology and strengthen UAA Family. This led to our first joint UAA-AUA residency course at UAA Singapore 2016. After successful completion, a MOU was signed at AUA 2017 with Richard Babayan, Manoj Monga, Allen Chiu and myself in attendance. The AURC at UAA Hong Kong under Prof Eddie Chan was the result of this signed MOU. We are extremely grateful for the generosity of AUA for this program. What may not be obvious is that Gopal Badlani, Manoj Monga, John Denstedt and I served as faculty and board directors at WCE. We will sign the extension MOU in 2023 for another three years. 1.2 EAU. We have a very successful UAA-EAU Youth program since UAA Thailand 2012. This has been the work of several UAA senior members. From 2023, we are exploring joint webinars with EAU to build on this relationship. 1.3 SIU and WCE. We will further explore options based on available resources and manpower. Joint Webinar are planned for early 2026 2. Education Platform for Asian Urology Residents From 2023, we will continue to grow our relationship with BJUI. BJUI has developed a world class online learning platform with tremendous investments since 2013. This platform is called BJUI Knowledge. ASU will reach out to all Asian residents via their national urological association president and secretary to encourage every resident to sign up for a free access to more than 420 interactive 30-minute modules covering the whole urology syllabus suitable for learning, exit exams and recertification exams. I am personally involved in developing all modules under Endourology and urolithiasis Section and have been associate editor since May 2013. The modest aim is for at least 10 residents per country to sign up by UAA 2023. We will report progress at each UAA council meeting. Pls see attached information and if there are any questions pls email me personally at email@drmichaelwong.com 3. Re-Strategize Training cum fellowship sites for ASU. 3.1 In the past we have always talked about the possibility about training sites for UAA and ASU. It has always been a difficult task due to financial and multiple logistics issues. 3.2 What can we do that is possible? Let us consider two options in the next 4 years. 3.3 For the last 6 years a group of Asian urologists started AUGTEG to design and provide two-day surgical training which includes lectures as well as dry and wet lab to develop surgical skills. AUSTEG has direct access to physical training centres in Thailand, South Korea, and China. ASU will work with AUGTEC to pool resources since we are the same people working on both sides e.g., Anthony Ng (chairman of AUSTEG) Michael Wong (vice chairman) Eddie Chan (treasurer). AUGTEG is registered in HK. 3.4 The second option is to recognise elected university or training Asian centres to allow an attachment for young urologist post residency in a flexible format. ASU will recognise officially these sites as endorsed by UAA. At UAA 2025 , several potential ASU/UAA fellowship sites directors will be presenting their programmes to kickstart this initiative 4. In conclusion, ASU will continue to grow and serve the Asian Urological Community. The above initiatives are only the beginning of a next chapter. Can you contribute your ideas and current available resources for this purpose? If you can, Pls email me personally at email@drmichaelwong.com Which Position is the Best for PCNL in 2025?With tremendous advances in both technique and technology , the MIS approach to staghorn calculi has evolved significantly over the last 30 years. It is timely to review all the landmark articles on patient positioning as this ultimately determines renal access which in turn plays a major role in stone free rates. We will gain much insight as we debate and attempt to answer the question of which position is best in 2026!
From Bench to Bedside - A Comprehensive Overview of Kidney Cancer

Stephen A. BoorjianUnited States Speaker AUA Lecture: 2025 Update of AUA and EAU NMIBC GuidelinesBoth the American Urological Association (AUA) and European Association of Urology (EAU) have developed guidelines for the management of non-muscle invasive bladder cancer (NMIBC). While subtle differences in several aspects of these guidelines exist which merit mentioning, both guidelines emphasis the concept of risk stratification. In particular, understanding the criteria which classifies patients with NMIBC as high risk avoids undertreatment of the patients most likely to experience disease progress. Likewise, recognizing the indications for cystectomy among high risk NMIBC patients is critical to optimize survival. Meanwhile, continued options emerge for patients classified as having BCG unresponsive NMIBC, such that knowledge of that definition as well as current management strategies for these patients facilitates contemporary practice.From Bench to Bedside - A Comprehensive Overview of Kidney CancerEvaluation of patients with a newly identified renal mass includes dedicated cross-sectional imaging for appropriate characterization. Genetic syndromes which include renal cell carcinoma (RCC) are increasingly understood, and indeed knowledge of the intracellular pathways of these conditions has facilitate rationale drug development for kidney cancer. Managing patients with a small renal mass involves a critical assessment of competing risks inherent to the tumor, the patient (underlying comorbidity status), and the proposed treatment. Renal mass biopsy may play a role in select cases for additional information/risk stratification. The safety of active surveillance is being increasingly demonstrated as longer-term follow-up matures. Meanwhile, select patients with high risk disease now have the option of adjuvant immunotherapy following surgical resection. In the setting of metastatic RCC, again risk stratification plays a critical role in the decision for – and timing of – cytoreductive nephrectomy, particularly in the contemporary era of checkpoint inhibitor therapies.Real World Experience in the Management of Upper Tract Urothelial CarcinomaThe biggest challenging in managing upper tract urothelial carcionma (UTUC) remains accurate staging of tumors at diagnosis. Given the limited ability of contemporary staging methods, clinical risk stratification models have been developed to assist in providing risk-based treatment recommendations. For example, endoscopic management (e.g., ablation) represents the recommended first line approach for patients with low risk disease. Importantly, follow-up for these patients should include endoscopic re-evaluation. The value of testing patients with UTUC for Lynch syndrome is also critical to recognize. A role for neoadjuvant chemotherapy is being increasing explored for patients classified with high-risk UTUC, while several options exist for adjuvant chemotherapy and immunotherapy for patients with adverse pathology at surgical resection. Continued investigation into prevention of postoperative intravesical recurrences in patients with UTUC is warranted given the frequency of metachronous tumor development in the bladder among these patients.Updates on MIBC and Advanced Bladder Cancer: Where do We Stand in 2025While neoadjuvant chemotherapy prior to radical cystectomy has been demonstrated with randomized trial data to improve survival for patients undergoing radical cystectomy, nevertheless utilization is often restricted by misunderstandings regarding patient eligibility factors. As such, defining eligibility criteria will facilitate increased adoption. Likewise, new data indicates a role for adjust immunotherapy in select patients following surgery as well. Moreover, important recent evidence on the role of extended lymph node dissection and the opportunities for preserving sexual function after cystectomy by modifying surgical technique are critical to review in order to optimize future patient outcomes. Further, recent advancements in systemic therapy options for patients with metastatic urothelial carcinoma have led to unprecedented survival rates.Revisit on Testicular Tumors-What we Learned from past and Prepared for the FutureGerm cell tumor (GCT) progression typically occurs in a predictable sequence of disease spread to the retroperitoneum first and then distant metastases. Understanding the role of serum tumor markers at various disease stages is critical for guideline-concordant management and to optimize patient outcomes, avoiding both undertreatment and overtreatment. For patients with seminoma, retroperitoneal lymph node dissection now represents an option for patients with low volume retroperitoneal lymph node disease, with the goal of avoiding the long-term toxicities associated with chemotherapy and radiotherapy. For patients with residual postchemotherapy masses in seminoma, increasing evidence suggests that PET scans should be utilized/interpreted with caution, and that in the absence of mass growth continued follow-up may be the strategy for most patients. Similarly, for patients with nonseminomatous GCTs (NSGCT) and equivocal retroperitoneal lymph nodes at presentation, re-scanning after an interval of approximately 6-8 weeks may be preferable to initial treatment, as many of these nodes represent benign processes and as such will resolve. Nevertheless, postchemotherapy retroperitoneal lymph node dissection remains a critical component of the management of patients with NSCGT and a residual mass. Risk Stratification and Contemporary Management of Biochemical RecurrenceBiochemical recurrence (BCR) has been reported in up to 35% of patients following radical prostatectomy. Understanding the natural history and clinicopathologic risk factors associated with disease progression is critical to facilitate an individualized treatment approach. Likewise, recognizing the details of treatment delivery with salvage radiotherapy is necessary to optimize outcomes. Further, as data emerge on the utilization of systemic therapy for non-metastatic BCR, being able to contextualize reported outcomes with patient age, comorbidity status, and disease risk will enhance appropriate care delivery.
Real World Experience in the Management of Upper Tract Urothelial Carcinoma

Stephen A. BoorjianUnited States Speaker AUA Lecture: 2025 Update of AUA and EAU NMIBC GuidelinesBoth the American Urological Association (AUA) and European Association of Urology (EAU) have developed guidelines for the management of non-muscle invasive bladder cancer (NMIBC). While subtle differences in several aspects of these guidelines exist which merit mentioning, both guidelines emphasis the concept of risk stratification. In particular, understanding the criteria which classifies patients with NMIBC as high risk avoids undertreatment of the patients most likely to experience disease progress. Likewise, recognizing the indications for cystectomy among high risk NMIBC patients is critical to optimize survival. Meanwhile, continued options emerge for patients classified as having BCG unresponsive NMIBC, such that knowledge of that definition as well as current management strategies for these patients facilitates contemporary practice.From Bench to Bedside - A Comprehensive Overview of Kidney CancerEvaluation of patients with a newly identified renal mass includes dedicated cross-sectional imaging for appropriate characterization. Genetic syndromes which include renal cell carcinoma (RCC) are increasingly understood, and indeed knowledge of the intracellular pathways of these conditions has facilitate rationale drug development for kidney cancer. Managing patients with a small renal mass involves a critical assessment of competing risks inherent to the tumor, the patient (underlying comorbidity status), and the proposed treatment. Renal mass biopsy may play a role in select cases for additional information/risk stratification. The safety of active surveillance is being increasingly demonstrated as longer-term follow-up matures. Meanwhile, select patients with high risk disease now have the option of adjuvant immunotherapy following surgical resection. In the setting of metastatic RCC, again risk stratification plays a critical role in the decision for – and timing of – cytoreductive nephrectomy, particularly in the contemporary era of checkpoint inhibitor therapies.Real World Experience in the Management of Upper Tract Urothelial CarcinomaThe biggest challenging in managing upper tract urothelial carcionma (UTUC) remains accurate staging of tumors at diagnosis. Given the limited ability of contemporary staging methods, clinical risk stratification models have been developed to assist in providing risk-based treatment recommendations. For example, endoscopic management (e.g., ablation) represents the recommended first line approach for patients with low risk disease. Importantly, follow-up for these patients should include endoscopic re-evaluation. The value of testing patients with UTUC for Lynch syndrome is also critical to recognize. A role for neoadjuvant chemotherapy is being increasing explored for patients classified with high-risk UTUC, while several options exist for adjuvant chemotherapy and immunotherapy for patients with adverse pathology at surgical resection. Continued investigation into prevention of postoperative intravesical recurrences in patients with UTUC is warranted given the frequency of metachronous tumor development in the bladder among these patients.Updates on MIBC and Advanced Bladder Cancer: Where do We Stand in 2025While neoadjuvant chemotherapy prior to radical cystectomy has been demonstrated with randomized trial data to improve survival for patients undergoing radical cystectomy, nevertheless utilization is often restricted by misunderstandings regarding patient eligibility factors. As such, defining eligibility criteria will facilitate increased adoption. Likewise, new data indicates a role for adjust immunotherapy in select patients following surgery as well. Moreover, important recent evidence on the role of extended lymph node dissection and the opportunities for preserving sexual function after cystectomy by modifying surgical technique are critical to review in order to optimize future patient outcomes. Further, recent advancements in systemic therapy options for patients with metastatic urothelial carcinoma have led to unprecedented survival rates.Revisit on Testicular Tumors-What we Learned from past and Prepared for the FutureGerm cell tumor (GCT) progression typically occurs in a predictable sequence of disease spread to the retroperitoneum first and then distant metastases. Understanding the role of serum tumor markers at various disease stages is critical for guideline-concordant management and to optimize patient outcomes, avoiding both undertreatment and overtreatment. For patients with seminoma, retroperitoneal lymph node dissection now represents an option for patients with low volume retroperitoneal lymph node disease, with the goal of avoiding the long-term toxicities associated with chemotherapy and radiotherapy. For patients with residual postchemotherapy masses in seminoma, increasing evidence suggests that PET scans should be utilized/interpreted with caution, and that in the absence of mass growth continued follow-up may be the strategy for most patients. Similarly, for patients with nonseminomatous GCTs (NSGCT) and equivocal retroperitoneal lymph nodes at presentation, re-scanning after an interval of approximately 6-8 weeks may be preferable to initial treatment, as many of these nodes represent benign processes and as such will resolve. Nevertheless, postchemotherapy retroperitoneal lymph node dissection remains a critical component of the management of patients with NSCGT and a residual mass. Risk Stratification and Contemporary Management of Biochemical RecurrenceBiochemical recurrence (BCR) has been reported in up to 35% of patients following radical prostatectomy. Understanding the natural history and clinicopathologic risk factors associated with disease progression is critical to facilitate an individualized treatment approach. Likewise, recognizing the details of treatment delivery with salvage radiotherapy is necessary to optimize outcomes. Further, as data emerge on the utilization of systemic therapy for non-metastatic BCR, being able to contextualize reported outcomes with patient age, comorbidity status, and disease risk will enhance appropriate care delivery.
Updates on MIBC and Advanced Bladder Cancer: Where do We Stand in 2025

Stephen A. BoorjianUnited States Speaker AUA Lecture: 2025 Update of AUA and EAU NMIBC GuidelinesBoth the American Urological Association (AUA) and European Association of Urology (EAU) have developed guidelines for the management of non-muscle invasive bladder cancer (NMIBC). While subtle differences in several aspects of these guidelines exist which merit mentioning, both guidelines emphasis the concept of risk stratification. In particular, understanding the criteria which classifies patients with NMIBC as high risk avoids undertreatment of the patients most likely to experience disease progress. Likewise, recognizing the indications for cystectomy among high risk NMIBC patients is critical to optimize survival. Meanwhile, continued options emerge for patients classified as having BCG unresponsive NMIBC, such that knowledge of that definition as well as current management strategies for these patients facilitates contemporary practice.From Bench to Bedside - A Comprehensive Overview of Kidney CancerEvaluation of patients with a newly identified renal mass includes dedicated cross-sectional imaging for appropriate characterization. Genetic syndromes which include renal cell carcinoma (RCC) are increasingly understood, and indeed knowledge of the intracellular pathways of these conditions has facilitate rationale drug development for kidney cancer. Managing patients with a small renal mass involves a critical assessment of competing risks inherent to the tumor, the patient (underlying comorbidity status), and the proposed treatment. Renal mass biopsy may play a role in select cases for additional information/risk stratification. The safety of active surveillance is being increasingly demonstrated as longer-term follow-up matures. Meanwhile, select patients with high risk disease now have the option of adjuvant immunotherapy following surgical resection. In the setting of metastatic RCC, again risk stratification plays a critical role in the decision for – and timing of – cytoreductive nephrectomy, particularly in the contemporary era of checkpoint inhibitor therapies.Real World Experience in the Management of Upper Tract Urothelial CarcinomaThe biggest challenging in managing upper tract urothelial carcionma (UTUC) remains accurate staging of tumors at diagnosis. Given the limited ability of contemporary staging methods, clinical risk stratification models have been developed to assist in providing risk-based treatment recommendations. For example, endoscopic management (e.g., ablation) represents the recommended first line approach for patients with low risk disease. Importantly, follow-up for these patients should include endoscopic re-evaluation. The value of testing patients with UTUC for Lynch syndrome is also critical to recognize. A role for neoadjuvant chemotherapy is being increasing explored for patients classified with high-risk UTUC, while several options exist for adjuvant chemotherapy and immunotherapy for patients with adverse pathology at surgical resection. Continued investigation into prevention of postoperative intravesical recurrences in patients with UTUC is warranted given the frequency of metachronous tumor development in the bladder among these patients.Updates on MIBC and Advanced Bladder Cancer: Where do We Stand in 2025While neoadjuvant chemotherapy prior to radical cystectomy has been demonstrated with randomized trial data to improve survival for patients undergoing radical cystectomy, nevertheless utilization is often restricted by misunderstandings regarding patient eligibility factors. As such, defining eligibility criteria will facilitate increased adoption. Likewise, new data indicates a role for adjust immunotherapy in select patients following surgery as well. Moreover, important recent evidence on the role of extended lymph node dissection and the opportunities for preserving sexual function after cystectomy by modifying surgical technique are critical to review in order to optimize future patient outcomes. Further, recent advancements in systemic therapy options for patients with metastatic urothelial carcinoma have led to unprecedented survival rates.Revisit on Testicular Tumors-What we Learned from past and Prepared for the FutureGerm cell tumor (GCT) progression typically occurs in a predictable sequence of disease spread to the retroperitoneum first and then distant metastases. Understanding the role of serum tumor markers at various disease stages is critical for guideline-concordant management and to optimize patient outcomes, avoiding both undertreatment and overtreatment. For patients with seminoma, retroperitoneal lymph node dissection now represents an option for patients with low volume retroperitoneal lymph node disease, with the goal of avoiding the long-term toxicities associated with chemotherapy and radiotherapy. For patients with residual postchemotherapy masses in seminoma, increasing evidence suggests that PET scans should be utilized/interpreted with caution, and that in the absence of mass growth continued follow-up may be the strategy for most patients. Similarly, for patients with nonseminomatous GCTs (NSGCT) and equivocal retroperitoneal lymph nodes at presentation, re-scanning after an interval of approximately 6-8 weeks may be preferable to initial treatment, as many of these nodes represent benign processes and as such will resolve. Nevertheless, postchemotherapy retroperitoneal lymph node dissection remains a critical component of the management of patients with NSCGT and a residual mass. Risk Stratification and Contemporary Management of Biochemical RecurrenceBiochemical recurrence (BCR) has been reported in up to 35% of patients following radical prostatectomy. Understanding the natural history and clinicopathologic risk factors associated with disease progression is critical to facilitate an individualized treatment approach. Likewise, recognizing the details of treatment delivery with salvage radiotherapy is necessary to optimize outcomes. Further, as data emerge on the utilization of systemic therapy for non-metastatic BCR, being able to contextualize reported outcomes with patient age, comorbidity status, and disease risk will enhance appropriate care delivery.
Case Presentation and Discussion
Coffee Break
Oncology-Prostate Cancer and Testicular Tumor

Shin EgawaJapan Moderator
Comparison of Various Treatment Options for Localized Prostate Cancer

David PensonUnited States Speaker Comparison of Various Treatment Options for Localized Prostate CancerThere are numerous therapeutic strategies used to treat localized prostate cancer, each with unique advantages and disadvantages. Furthermore, prostate cancer itself is heterogeneous with some tumors being indolent and others being more aggressive. We will from the presentation by looking at outcomes separately in patients with favorable prognosis and those with unfavorable prognosis, based upon baseline clinical characteristics. We will first compare cancer control and mortality outcomes amongst the various options. We will then present data on patient-reported outcomes. At the conclusion of the presentation, attendees will have a better understanding of outcomes following treatment for localized prostate cancer and will be better prepared to counsel patients newly diagnosed with this common malignancy.Updates on Combination Therapy for Advanced Prostate CancerOver the past decade, there are have been significant advances in the treatment of metastatic prostate cancer. Randomized clinical trial data have demonstrated that combination therapies are superior to monotherapy in terms of cancer control and survival. Various treatment options will be discussed for metastatic castrate-sensitive and -resistant prostate cancer. These will be compared in terms of efficacy and side effect profiles to aid in treatment selection in this The Startup of An Academic Urologist - How to Build up Your Team in Clinical ResearchMany young academic urologists wish to perform clinical research at their institution. Often, however, this is challenging due to lack of resources or time. In this presentation, we will discuss how to build a clinical research program, including identifying what types of individuals need to be part of the team and what sort of resources are required for success. While American examples will often be used, information from this presentation will still be applicable globally.A Programmatic Approach to Prostate Cancer ScreeningProstate cancer screening has advanced beyond annual PSA testing. We now have numerous tools available to aid in identifying men at risk for harboring clinically significant prostate cancer, including MRI and various novel biomarkers. In this presentation, we will review these modalities and lay out a systematic approach to screening in 2025.
Updates on Combination Therapy for Advanced Prostate Cancer

David PensonUnited States Speaker Comparison of Various Treatment Options for Localized Prostate CancerThere are numerous therapeutic strategies used to treat localized prostate cancer, each with unique advantages and disadvantages. Furthermore, prostate cancer itself is heterogeneous with some tumors being indolent and others being more aggressive. We will from the presentation by looking at outcomes separately in patients with favorable prognosis and those with unfavorable prognosis, based upon baseline clinical characteristics. We will first compare cancer control and mortality outcomes amongst the various options. We will then present data on patient-reported outcomes. At the conclusion of the presentation, attendees will have a better understanding of outcomes following treatment for localized prostate cancer and will be better prepared to counsel patients newly diagnosed with this common malignancy.Updates on Combination Therapy for Advanced Prostate CancerOver the past decade, there are have been significant advances in the treatment of metastatic prostate cancer. Randomized clinical trial data have demonstrated that combination therapies are superior to monotherapy in terms of cancer control and survival. Various treatment options will be discussed for metastatic castrate-sensitive and -resistant prostate cancer. These will be compared in terms of efficacy and side effect profiles to aid in treatment selection in this The Startup of An Academic Urologist - How to Build up Your Team in Clinical ResearchMany young academic urologists wish to perform clinical research at their institution. Often, however, this is challenging due to lack of resources or time. In this presentation, we will discuss how to build a clinical research program, including identifying what types of individuals need to be part of the team and what sort of resources are required for success. While American examples will often be used, information from this presentation will still be applicable globally.A Programmatic Approach to Prostate Cancer ScreeningProstate cancer screening has advanced beyond annual PSA testing. We now have numerous tools available to aid in identifying men at risk for harboring clinically significant prostate cancer, including MRI and various novel biomarkers. In this presentation, we will review these modalities and lay out a systematic approach to screening in 2025.
Revisit on Testicular Tumors-What we Learned from past and Prepared for the Future

Stephen A. BoorjianUnited States Speaker AUA Lecture: 2025 Update of AUA and EAU NMIBC GuidelinesBoth the American Urological Association (AUA) and European Association of Urology (EAU) have developed guidelines for the management of non-muscle invasive bladder cancer (NMIBC). While subtle differences in several aspects of these guidelines exist which merit mentioning, both guidelines emphasis the concept of risk stratification. In particular, understanding the criteria which classifies patients with NMIBC as high risk avoids undertreatment of the patients most likely to experience disease progress. Likewise, recognizing the indications for cystectomy among high risk NMIBC patients is critical to optimize survival. Meanwhile, continued options emerge for patients classified as having BCG unresponsive NMIBC, such that knowledge of that definition as well as current management strategies for these patients facilitates contemporary practice.From Bench to Bedside - A Comprehensive Overview of Kidney CancerEvaluation of patients with a newly identified renal mass includes dedicated cross-sectional imaging for appropriate characterization. Genetic syndromes which include renal cell carcinoma (RCC) are increasingly understood, and indeed knowledge of the intracellular pathways of these conditions has facilitate rationale drug development for kidney cancer. Managing patients with a small renal mass involves a critical assessment of competing risks inherent to the tumor, the patient (underlying comorbidity status), and the proposed treatment. Renal mass biopsy may play a role in select cases for additional information/risk stratification. The safety of active surveillance is being increasingly demonstrated as longer-term follow-up matures. Meanwhile, select patients with high risk disease now have the option of adjuvant immunotherapy following surgical resection. In the setting of metastatic RCC, again risk stratification plays a critical role in the decision for – and timing of – cytoreductive nephrectomy, particularly in the contemporary era of checkpoint inhibitor therapies.Real World Experience in the Management of Upper Tract Urothelial CarcinomaThe biggest challenging in managing upper tract urothelial carcionma (UTUC) remains accurate staging of tumors at diagnosis. Given the limited ability of contemporary staging methods, clinical risk stratification models have been developed to assist in providing risk-based treatment recommendations. For example, endoscopic management (e.g., ablation) represents the recommended first line approach for patients with low risk disease. Importantly, follow-up for these patients should include endoscopic re-evaluation. The value of testing patients with UTUC for Lynch syndrome is also critical to recognize. A role for neoadjuvant chemotherapy is being increasing explored for patients classified with high-risk UTUC, while several options exist for adjuvant chemotherapy and immunotherapy for patients with adverse pathology at surgical resection. Continued investigation into prevention of postoperative intravesical recurrences in patients with UTUC is warranted given the frequency of metachronous tumor development in the bladder among these patients.Updates on MIBC and Advanced Bladder Cancer: Where do We Stand in 2025While neoadjuvant chemotherapy prior to radical cystectomy has been demonstrated with randomized trial data to improve survival for patients undergoing radical cystectomy, nevertheless utilization is often restricted by misunderstandings regarding patient eligibility factors. As such, defining eligibility criteria will facilitate increased adoption. Likewise, new data indicates a role for adjust immunotherapy in select patients following surgery as well. Moreover, important recent evidence on the role of extended lymph node dissection and the opportunities for preserving sexual function after cystectomy by modifying surgical technique are critical to review in order to optimize future patient outcomes. Further, recent advancements in systemic therapy options for patients with metastatic urothelial carcinoma have led to unprecedented survival rates.Revisit on Testicular Tumors-What we Learned from past and Prepared for the FutureGerm cell tumor (GCT) progression typically occurs in a predictable sequence of disease spread to the retroperitoneum first and then distant metastases. Understanding the role of serum tumor markers at various disease stages is critical for guideline-concordant management and to optimize patient outcomes, avoiding both undertreatment and overtreatment. For patients with seminoma, retroperitoneal lymph node dissection now represents an option for patients with low volume retroperitoneal lymph node disease, with the goal of avoiding the long-term toxicities associated with chemotherapy and radiotherapy. For patients with residual postchemotherapy masses in seminoma, increasing evidence suggests that PET scans should be utilized/interpreted with caution, and that in the absence of mass growth continued follow-up may be the strategy for most patients. Similarly, for patients with nonseminomatous GCTs (NSGCT) and equivocal retroperitoneal lymph nodes at presentation, re-scanning after an interval of approximately 6-8 weeks may be preferable to initial treatment, as many of these nodes represent benign processes and as such will resolve. Nevertheless, postchemotherapy retroperitoneal lymph node dissection remains a critical component of the management of patients with NSCGT and a residual mass. Risk Stratification and Contemporary Management of Biochemical RecurrenceBiochemical recurrence (BCR) has been reported in up to 35% of patients following radical prostatectomy. Understanding the natural history and clinicopathologic risk factors associated with disease progression is critical to facilitate an individualized treatment approach. Likewise, recognizing the details of treatment delivery with salvage radiotherapy is necessary to optimize outcomes. Further, as data emerge on the utilization of systemic therapy for non-metastatic BCR, being able to contextualize reported outcomes with patient age, comorbidity status, and disease risk will enhance appropriate care delivery.
Case Presentation and Discussion
Lunch Break
Functional Urology

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.
Overview on Female Urine Incontinence and Pelvic Organ Prolapse

Jaspreet SandhuUnited States Speaker Overview on Female Urine Incontinence and Pelvic Organ ProlapseThis lecture will be about female stress urinary incontinence and pelvic organ prolapse, including current demographics and conservative and surgical management of both. Guidelines-based approach to management of female stress urinary incontinence will be emphasized, with particular attention to surgical management. Further, we will evaluate trends and current surgical management of pelvic organ prolapse.Multimodality Management of Male Bladder Outlet ObstructionMale Bladder Outlet Obstruction is usually due benign prostate hypertrophy (BPH), therefore we will focus on an evidence-based approach to management of lower urinary tract symptoms (LUTS) secondary to BPH. Attention will be given to medical management of this condition and the nuances with respect to bladder dysfunction (specifically concomitant overactive bladder). The audience will also understand the current state of surgical management of LUTS/BPH.Overview of Urodynamic Studies - A Must Learn Approach in Daily Clinical PracticeA practical review of urodynamics studies including how to perform a study, the mandatory variables required, and standard calculations for most studies.
Multimodality Management of Male Bladder Outlet Obstruction

Jaspreet SandhuUnited States Speaker Overview on Female Urine Incontinence and Pelvic Organ ProlapseThis lecture will be about female stress urinary incontinence and pelvic organ prolapse, including current demographics and conservative and surgical management of both. Guidelines-based approach to management of female stress urinary incontinence will be emphasized, with particular attention to surgical management. Further, we will evaluate trends and current surgical management of pelvic organ prolapse.Multimodality Management of Male Bladder Outlet ObstructionMale Bladder Outlet Obstruction is usually due benign prostate hypertrophy (BPH), therefore we will focus on an evidence-based approach to management of lower urinary tract symptoms (LUTS) secondary to BPH. Attention will be given to medical management of this condition and the nuances with respect to bladder dysfunction (specifically concomitant overactive bladder). The audience will also understand the current state of surgical management of LUTS/BPH.Overview of Urodynamic Studies - A Must Learn Approach in Daily Clinical PracticeA practical review of urodynamics studies including how to perform a study, the mandatory variables required, and standard calculations for most studies.
Overview of Urodynamic Studies - A Must Learn Approach in Daily Clinical Practice

Jaspreet SandhuUnited States Speaker Overview on Female Urine Incontinence and Pelvic Organ ProlapseThis lecture will be about female stress urinary incontinence and pelvic organ prolapse, including current demographics and conservative and surgical management of both. Guidelines-based approach to management of female stress urinary incontinence will be emphasized, with particular attention to surgical management. Further, we will evaluate trends and current surgical management of pelvic organ prolapse.Multimodality Management of Male Bladder Outlet ObstructionMale Bladder Outlet Obstruction is usually due benign prostate hypertrophy (BPH), therefore we will focus on an evidence-based approach to management of lower urinary tract symptoms (LUTS) secondary to BPH. Attention will be given to medical management of this condition and the nuances with respect to bladder dysfunction (specifically concomitant overactive bladder). The audience will also understand the current state of surgical management of LUTS/BPH.Overview of Urodynamic Studies - A Must Learn Approach in Daily Clinical PracticeA practical review of urodynamics studies including how to perform a study, the mandatory variables required, and standard calculations for most studies.
Case Presentation and Discussion
Coffee Break
Research Trends

William J. HuangTaiwan Moderator Male Infertility: Challenges and Opportunities in AsiaMale infertility contributes to nearly 50% of all infertility cases, with an increasing burden observed across Asia. In parallel, a dramatic decline in birth rates has emerged in several Asian countries—including South Korea, Japan, Taiwan, and Singapore—reaching historically low total fertility rates (TFRs) of under 1.0. While multifactorial in nature, this demographic crisis underscores the urgent need to address all aspects of reproductive health, including the often-overlooked role of male infertility. Epidemiological data reveal significant regional disparities in the prevalence, diagnosis, and treatment of male infertility. Cultural stigma, limited andrology training, fragmented referral systems, and inadequate coverage of assisted reproductive technologies (ART) have impeded timely diagnosis and intervention. Environmental exposures, endocrine-disrupting chemicals, occupational heat, and increased paternal age have all been linked to declining semen quality, as evidenced by longitudinal studies showing decreased sperm concentration and motility in several urban centers across Asia. Current diagnostic tools—including semen analysis, hormone profiling, genetic testing (e.g., Y-chromosome microdeletion, karyotyping), and imaging—enable better etiological categorization. Microsurgical sperm retrieval techniques such as mTESE have provided new hope for patients with non-obstructive azoospermia, while ICSI and sperm cryopreservation have become increasingly utilized where available. Nevertheless, access remains inconsistent, particularly outside metropolitan regions. Recent integration of AI-based systems for semen evaluation, patient triage, and digital counseling offers promising strategies to improve care delivery, especially in under-resourced settings. However, data privacy, regulatory standards, and user trust continue to pose barriers to widespread implementation. Opportunities for systemic improvement include the development of regional male infertility registries, integration of andrology into national reproductive health frameworks, expansion of insurance coverage for fertility services, and public awareness campaigns to destigmatize male infertility. In light of Asia’s fertility decline, repositioning male reproductive health as a public health and demographic priority is essential for sustainable population policy and long-term healthcare planning. The Peri-Operative Care of MIST For Prostate HyperplasiaMinimally invasive surgical therapies (MIST), particularly UroLift and Rezūm, have transformed the treatment landscape for benign prostatic hyperplasia (BPH), offering effective symptom relief with reduced morbidity and preservation of sexual function. However, optimal outcomes depend not only on procedural execution, but also on well-structured peri-operative care protocols encompassing pre-, intra-, and post-operative management. Pre-operative evaluation includes comprehensive assessment of prostate anatomy—especially size, shape, and presence of median lobe—via imaging (TRUS or cystoscopy) to determine candidacy. Careful patient selection is essential: UroLift is typically suited for prostates <80 cc without obstructive median lobes, while Rezūm accommodates broader anatomical variability but may have delayed symptom resolution. Baseline symptom scores (e.g., IPSS), uroflowmetry, and post-void residual volume establish functional benchmarks and guide patient counseling. Anesthesia planning must consider procedural setting and patient comorbidities. UroLift can often be performed under local anesthesia with light sedation, whereas Rezūm may require short general anesthesia or deeper sedation due to thermal discomfort. Appropriate selection reduces intraoperative stress and facilitates same-day discharge. Intraoperative care focuses on minimizing trauma and ensuring device precision. UroLift requires accurate deployment of implants to maintain lateral lobe retraction without compromising sphincter integrity. In Rezūm, the number and duration of vapor injections must be titrated based on lobe size and configuration to balance efficacy and tissue inflammation. Real-time visualization and standardized protocols reduce variability and improve safety. Post-operative management involves anticipating and controlling transient irritative symptoms, such as dysuria, urgency, and hematuria. Alpha-blockers and anti-inflammatory medications are commonly used for 3–7 days post-procedure. Catheterization strategies differ by technique: UroLift may avoid catheter use entirely, whereas Rezūm often requires 7-14 days of catheter drainage due to anticipated edema. Monitoring for urinary retention, UTI, or clot obstruction is critical during the early recovery phase. Follow-up care typically occurs at 2–4 weeks and includes reassessment of voiding function, symptom scores, and patient satisfaction. Reinforcement of realistic expectations is especially important with Rezūm, which may take 4–6 weeks to achieve peak efficacy. Longitudinal studies indicate sustained symptom relief and low retreatment rates when peri-operative care is standardized and patient education is emphasized. Adverse event profiles differ between techniques: UroLift is associated with less dysuria but higher retreatment rates in large prostates, while Rezūm presents higher rates of transient discomfort but favorable durability. Structured peri-operative care pathways—including patient education, standardized medication protocols, and clear complication management plans—enhance recovery, minimize adverse events, and improve overall clinical success.
The Startup of An Academic Urologist - How to Build up Your Team in Clinical Research

David PensonUnited States Speaker Comparison of Various Treatment Options for Localized Prostate CancerThere are numerous therapeutic strategies used to treat localized prostate cancer, each with unique advantages and disadvantages. Furthermore, prostate cancer itself is heterogeneous with some tumors being indolent and others being more aggressive. We will from the presentation by looking at outcomes separately in patients with favorable prognosis and those with unfavorable prognosis, based upon baseline clinical characteristics. We will first compare cancer control and mortality outcomes amongst the various options. We will then present data on patient-reported outcomes. At the conclusion of the presentation, attendees will have a better understanding of outcomes following treatment for localized prostate cancer and will be better prepared to counsel patients newly diagnosed with this common malignancy.Updates on Combination Therapy for Advanced Prostate CancerOver the past decade, there are have been significant advances in the treatment of metastatic prostate cancer. Randomized clinical trial data have demonstrated that combination therapies are superior to monotherapy in terms of cancer control and survival. Various treatment options will be discussed for metastatic castrate-sensitive and -resistant prostate cancer. These will be compared in terms of efficacy and side effect profiles to aid in treatment selection in this The Startup of An Academic Urologist - How to Build up Your Team in Clinical ResearchMany young academic urologists wish to perform clinical research at their institution. Often, however, this is challenging due to lack of resources or time. In this presentation, we will discuss how to build a clinical research program, including identifying what types of individuals need to be part of the team and what sort of resources are required for success. While American examples will often be used, information from this presentation will still be applicable globally.A Programmatic Approach to Prostate Cancer ScreeningProstate cancer screening has advanced beyond annual PSA testing. We now have numerous tools available to aid in identifying men at risk for harboring clinically significant prostate cancer, including MRI and various novel biomarkers. In this presentation, we will review these modalities and lay out a systematic approach to screening in 2025.
How to Incorporate Simulation into Surgery Practice

Thomas HsuehTaiwan Speaker
Application of Big Data Research in Urology

Thomas HsuehTaiwan Speaker
Case Presentation and Discussion
Semi-Live Surgery Presentation
AURC Networking Dinner

TWTC - 2F Conference Room 5

14th August 2025

Time	Session

08:00 16:50	Asian Urological Society of Endoluminal Surgery & Technology (AUSET) Part I: Urolithiasis & Technology (Fundamental) Opening Remarks & Congratulatory Remarks from Experts Sung Yong Cho Korea (Republic of) Speaker Robotic URS: Can It Really Improve Precision and Reduce Surgeon Fatigue?Use of AI and Robots in Endourology Welcome ETS 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 Session: Reshaping Upper Tract Endourology Intervention Abhay MahajanIndia Moderator Cheng-Chia LinTaiwan Moderator 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 Chong-Tsung WenSingapore Moderator Infection Complications after Stone Surgery How Suction Changed My Hospital Practice of Flexible Ureteroscopy Yi Quan TanSingapore Speaker How Suction Changed My Hospital Practice of Flexible UreteroscopySuction in Endourology has truly been a gamechanger in recent years. In this talk, Dr Yi Quan Tan discusses how rapid technological advancements have evolved his hospital's practice of performing RIRS. Working alongside Dr Vineet Gauhar in the Endourology unit at Ng Teng Fong General Hospital in Singapore, Dr Tan provides a glimpse of how early adoption of new technology and concepts have helped push boundaries and improved RIRS outcomes for their patients. Digitalization in Suction PCNL Can Change Practice Jaisukh KalathiaIndia Speaker Digitalization in Suction PCNL Can Change Practice Endoscopic Combined Intra Renal Surgery: New Frontiers Han Kyu ChaeKorea (Republic of) Speaker Endoscopic Combined Intra Renal Surgery: New FrontiersBackground: Endoscopic Combined Intra Renal Surgery (ECIRS) has evolved as a versatile approach that combines the strengths of percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS), allowing for simultaneous anterograde and retrograde access. This dual approach has shown advantages in treating large or complex renal stones, including full or partial staghorn calculi, particularly in cases where monotherapy may be suboptimal. Objectives: This lecture will explore recent advancements in ECIRS, highlight regional practices in Asia, and propose future directions that may redefine the standard of care in endourology. Key Topics Covered: Technical evolution: From prone to modified supine position; advancement in ultra-mini PCNL and flexible ureteroscopy integration. Instrument synergy: Role of suction PCNL systems and navigable ureteroscopes in optimizing stone clearance and reducing operative time. Asian perspective: Surgical position, tract size, and imaging modality preferences vary across countries, reflecting diverse adaptations and innovations in ECIRS techniques. Clinical outcomes: Review of recent multicenter data showing ECIRS's impact on stone-free rates, complication reduction, and postoperative recovery. Future frontiers: Integration of AI-guided navigation, pressure-controlled irrigation systems, and 3D intraoperative imaging to refine intrarenal surgery. Conclusion: As endourological technology advances, ECIRS stands at the intersection of innovation and practicality. The next frontier lies not only in technical refinement but also in tailoring approaches to anatomical and cultural variability across Asia. This session aims to foster collaboration and knowledge sharing to drive further evolution in combined intrarenal stone surgery. Navigating the Complex Renal Anatomy with FANS? Chu Ann Chai Malaysia Speaker Navigating the Complex Renal Anatomy with FANS? Suction PCNL vs Suction RIRS? Do We Have a Winner Boyke SoebhaliIndonesia Speaker Updates on Pharmacological Therapy for UrolithiasisUrolithiasis, a prevalent and recurrent urological condition, requires a multifaceted approach combining pharmacological, dietary, and surgical interventions. Recent advancements in pharmacological therapy emphasize personalized treatment based on stone composition, metabolic profiles, and patient-specific risk factors. For calcium oxalate stones, the most common type, thiazide diuretics remain first-line therapy to reduce urinary calcium excretion, while potassium citrate is recommended to increase urinary citrate levels, inhibiting stone formation. Dietary modifications, such as reduced oxalate intake and adequate calcium consumption, are adjunctive measures. In primary hyperoxaluria (PH), novel RNA interference (RNAi) agents like lumasiran and nedosiran significantly lower urinary oxalate levels, offering promising alternatives for patients unresponsive to pyridoxine. Uric acid stones are managed with urinary alkalinization using potassium citrate or sodium bicarbonate to maintain a pH >6.0, enhancing uric acid solubility. Xanthine oxidase inhibitors (allopurinol, febuxostat) are reserved for hyperuricemic patients. Cystine stones, though rare, require alkalinization and thiol-based drugs (tiopronin) to improve cystine solubility. Struvite stones, associated with urease-producing infections, necessitate antibiotics and urinary acidification (e.g., L-methionine) alongside surgical removal. Emerging therapies like theobromine show potential in inhibiting uric acid crystallization, while phytate demonstrates inhibitory effects on calcium salt aggregation. Medical expulsive therapy (MET) with alpha-blockers (tamsulosin) remains effective for distal ureteral stones (5–10 mm), reducing time to expulsion and need for surgery. However, MET efficacy diminishes for proximal stones or those >10 mm, necessitating surgical intervention. Future directions include optimizing RNAi therapies for hereditary stone diseases and integrating smartphone apps to enhance treatment adherence. A tailored, evidence-based approach combining pharmacological and lifestyle interventions is crucial for reducing recurrence and improving patient outcomes.Suction PCNL vs Suction RIRS? Do We Have a WinnerThe management of renal stones has evolved with the introduction of suction-assisted techniques in both percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). Suction PCNL, including mini-PCNL and flexible mini-PCNL (F-mPCNL), utilizes negative pressure to improve stone clearance and reduce intrarenal pressure, while suction RIRS employs vacuum-assisted ureteral access sheaths (V-UAS) or direct in-scope suction (DISS) to enhance fragment removal and minimize infectious complications. Recent studies highlight that suction PCNL achieves superior stone-free rates (SFRs) in a single session, particularly for stones >2 cm, with SFRs ranging from 93.8% to 95.1% compared to 77.8%–87.9% for suction RIRS. However, suction RIRS offers advantages in reduced invasiveness, shorter hospital stays (1–3 days vs. 2–5 days for PCNL), and lower complication rates (e.g., bleeding, transfusion needs). For infectious stones, suction RIRS with V-UAS demonstrates lower postoperative infection markers (CRP, PCT) and fewer febrile complications than PCNL . Operative times vary, with suction PCNL often being faster for large stones (47–82 min) but requiring fluoroscopy, while suction RIRS avoids tract-related risks but may necessitate staged procedures for stones >2 cm. Cost-effectiveness analyses favor suction PCNL due to fewer retreatments, though RIRS reduces radiation exposure. Q&A Session: Global Leaders Share the Evidence Anil ShresthaNepal Moderator Clearpetra the Sheath of Choice for Lower Pole StonesSFR Assessment: Timing and Modalities Chinnakhet Ketsuwan Thailand Moderator Intra Renal Pressure Defines Outcomes: Current EvidenceIntrarenal pressure (IRP) is a crucial physiological parameter during endourological interventions, as elevated IRP is closely linked to increased fluid absorption, intrarenal backflow, compromised renal perfusion, and postoperative complications. Experimental studies in animal models have consistently demonstrated a correlation between increased IRP and augmented irrigation fluid absorption, renal parenchymal backflow, and reductions in renal blood flow. Clinical studies have reported baseline IRP values ranging from 14 to 17 mmHg, with transient peristaltic peaks reaching up to 25 mmHg. Notably, IRP frequently surpassed 60 mmHg during endoscopic procedures, particularly when utilizing manual hand-pump irrigation or employing ureteral access sheaths (UAS) with smaller diameters. Significant risk factors identified for sustained elevations of IRP include non-prestented ureters, Asian ethnicity, and omission of UAS placement. Furthermore, elevated IRPs have demonstrated a direct association with infectious adverse events, notably postoperative sepsis. Randomized controlled trials have established that manual hand-pump irrigation generates substantially higher IRPs compared to pressurized irrigation bags. Additionally, serial manual irrigation boluses have been shown to produce prolonged IRP elevations, with maximum peaks exceeding 100 mmHg and durations surpassing 40 seconds. Collectively, both preclinical and clinical evidence underscores the necessity of meticulous intraoperative IRP management during endourological procedures. Strategic optimization of irrigation techniques and appropriate UAS selection are imperative to effectively maintain IRP within safe physiological limits, thereby minimizing the risk of complicationsRole of VR/AR/MR in Endourology and Urolithiasis Renal stone disease is a common urological condition affecting diverse patient populations. Percutaneous nephrolithotomy (PCNL) is widely recognized as the primary treatment for large or complex renal calculi, offering high stone-free rates with low complication profiles. Nevertheless, achieving accurate percutaneous renal access (PCA) remains technically challenging due to anatomical proximity to vital structures and insufficient hands-on training opportunities for urologists. Virtual reality (VR) simulators, such as the PERC Mentor and Uro Mentor, have demonstrated significant improvements in PCA proficiency, operative efficiency, and complication reduction, establishing their validity as effective training platforms. Additionally, mixed reality (MR) and 3D holographic technologies, exemplified by HoloLens, enhance surgical planning and procedural accuracy, particularly in calyceal targeting during PCNL. Recent nationwide training needs assessments have further advocated for the integration of these advanced simulation technologies into urological education curricula. Ultimately, systematic incorporation of VR and MR simulation into residency training holds substantial promise in bridging existing skill gaps, refining surgical competencies, and circumventing ethical concerns associated with traditional methods of surgical education. Jeff S. ChuehTaiwan Moderator Thullium Fibre Laser: A Unique Laser for Urological Use Mohamad Afzal Bin Farikhullah KhanMalaysia Speaker Thullium Fibre Laser: A Unique Laser for Urological Use Do We Need Augmented Reality for Renal Stone Management? Takaaki InoueJapan Speaker New Advancement on Retrograde Intrarenal SurgeryRetrograde intrarenal surgery (RIRS) has dramatically grown up around world for stone management. Why has RIRS been getting popullar and increasing nowadays?. The reaseon are absoulutely "Technological development with collaborated engineering comapny" and " Global communicaton and collaboration in Endourology". Endourology has still been improving and expanding more and more. Thereby, many novel devices and machine are launching faster. We, urologists should catch up this faster trend and acquire these knowledge for our clinical use. However, most of urologists can not catch up it. Therefore, I will share you all these novel chage of mind and tech-knowledge of stone field in this session. Do We Need Augmented Reality for Renal Stone Management?What is Augmented reality and Vertual reality in medicine?. The paradigm shift of medicine which includes AI, Robotics, VR, and AR etc named Digital transformation has been still emerging. Of course, these shift is gradually permeating in stone field. Especially, in terms of VR, AR, we wonder if this kind of DX is useful in stone management. if so, how do we use it in clinical practice? Today, I will talk these future role in stone management, and expectation. Which Laser for RIRS: Pulsed Thulium YAG Laser We can use three kind of laser such as Holumium YAG, Thulium YAG, and Thulium fiber laser for stone management. Which lase are best option for stone patients? I will talk about featurs and advantage of pulsed-Thulium YAG laser. There are two kinds of p-Tm;YAG laser machine nowadays. P^Tm;YAG has unique characteristics as laser wave. Therefore, this laser would be able to use Stone, BPH, UTUC. Especially, p-Tm YAG laser can utilize for Stone ablation, fragmentingand and UTUC ablation, shock wave. We will share our experoence and thoughts. New Advancement on Retrograde Intrarenal Surgery Battle of the Robots in Flexible Ureteroscopy: What's the Verdict? Albert El HajjLebanon Speaker Battle of the Robots in Flexible Ureteroscopy: What's the Verdict?AAU Lecture: Robotic Flexible Ureterorenoscopy— Gimmick or a True Helper? What’s It Cost Performance Value? Transurethral En Bloc Resection of Bladder Tumor: Where Are We Now? 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?) Best Laser for UTUC Hsiang-Ying LeeTaiwan Speaker Best Laser for UTUCManagement of Total Ureteral Avulsion during Ureteroscopy Q&A Session: Surgical Advancement of Asia for Stone Management: ECIRS Nguyen Ngoc ChauVietnam Moderator Jia-Lun Kwok Singapore Moderator Albert El HajjLebanon Moderator Battle of the Robots in Flexible Ureteroscopy: What's the Verdict?AAU Lecture: Robotic Flexible Ureterorenoscopy— Gimmick or a True Helper? What’s It Cost Performance Value? Impact of Ureteral Access Sheath on Kidney Stones before and after FANS Anggie N. RahwantoIndonesia Speaker Impact of Ureteral Access Sheath on Kidney Stones before and after FANS How to Perform Supine PCNL in Pediatrics? Is It Different from Adults? Azimjon TursunkulovUzbekistan Speaker How to Perform Supine PCNL in Pediatrics? Is It Different from Adults?Percutaneous nephrolithotomy (PCNL) is increasingly favored as a minimally invasive method for treating kidney stones, especially in the supine position, due to its benefits for anesthesia, ergonomics, and overall patient safety. However, when performing supine PCNL in children, urologists encounter distinct challenges that differ significantly from adult patients. In this presentation, we will discuss the key differences and specialized techniques required to successfully and safely perform supine PCNL in pediatric cases. Important considerations in pediatric patients include their smaller anatomical size, larger stone-to-kidney size ratios, increased sensitivity to fluid overload, and greater vulnerability to radiation exposure. Particular care is needed in patient positioning due to fewer clear anatomical landmarks, making precise ultrasound-guided kidney access crucial to minimize radiation and enhance accuracy. The use of specially designed miniaturized instruments is essential for pediatric procedures, alongside careful management of fluid to prevent complications. Drawing from extensive personal experience and evidence-based practices, this presentation will cover practical adjustments, such as optimal patient positioning, precise kidney puncture techniques, careful tract dilation, nephroscopic approaches, effective stone removal strategies, and tailored postoperative care. This presentation aims to provide attendees with practical insights and techniques to enhance their approach to supine PCNL in pediatric patients, supporting outcomes comparable to those achieved in adult cases. ESWL for Ureteric Stones: Art of Achieving 100% Stone Free Rate Shemeem Kachereente VitaQatar Speaker ESWL for Ureteric Stones: Art of Achieving 100% Stone Free RateExtracorporeal Shock Wave Lithotripsy (ESWL) remains a valuable, non-invasive option for managing ureteric stones, despite growing preference for endoscopic approaches. In this talk, I will share insights from over 40,000 ESWL procedures performed at our center, with a focus on optimizing technique, patient selection, and procedural nuances that have allowed us to consistently achieve near-complete clearance rates—even for distal and impacted stones. Key points include: Understanding anatomical and technical factors that influence ESWL success Strategies to overcome limitations traditionally associated with ureteric stone location The role of stenting, pain control, and imaging in maximizing outcomes Real-world evidence demonstrating ESWL’s continued relevance in modern stone management This session aims to reignite interest in ESWL by presenting practical, reproducible methods that can raise clearance rates close to 100%, when done with precision and experience. Discussion Part II: Endoluminal Technology Symposium (ETS), Advance Course of Urolithiasis & Technology, Company Sponsored Symposium 1st Company Session: Luncheon Symposium Hsiang-Ying LeeTaiwan Facilitator Best Laser for UTUCManagement of Total Ureteral Avulsion during Ureteroscopy Majed AlharthiSaudi Arabia Facilitator Single-Use Cysto-Nephro Scope in ECIRS/ PCNL Yasser FarahatUnited Arab Emirates Speaker Single-Use Cysto-Nephro Scope in ECIRS/ PCNL Experimental and Real World Take Away Messages on DISS Vineet GauharSingapore Speaker Experimental and Real World Take Away Messages on DISSSuction in Renal Stone Treatment: DISS, FANS or Combined Procedure?Need of Future EndourologyChoosing the Correct Laser and Flex Scope Combination in Suction Ureteroscopy Can Be the Deal Breaker Q & A 2nd Company Session Jia-Lun Kwok Singapore Moderator Karl Marvin TanPhilippines Moderator Which Laser for RIRS: Holmium YAG Laser The Power of Magneto and Vapour Tunnel in Holep Giorgio BozziniItaly Speaker The Power of Magneto and Vapour Tunnel in Holep Take Home Messages to Prevent Bladder Neck Contracture in Enucleation Sarvajit Biligere Singapore Speaker Take Home Messages to Prevent Bladder Neck Contracture in Enucleation Q & A 3rd Company Session Joy CastilloPhilippines Moderator Advance Course of Urolithiasis & Technology, Company Sponsored SymposiumWith continuous innovations in endourology, particularly in the field of retrograde intrarenal surgery (RIRS), the role of intrarenal pressure (IRP) has emerged as a key factor influencing surgical outcomes. This session will delve into the growing body of evidence linking elevated IRP to complications such as postoperative infections, renal injury, and reduced stone-free rates. The symposium will also introduce a focused discussion on pressure management strategies during RIRS, highlighting the Tidor System—an advanced platform designed to monitor and regulate IRP in real time. By combining current evidence with practical solutions, this session aims to equip urologists with a deeper understanding of IRP’s clinical impact and how emerging technologies can enhance safety and efficacy in stone surgery. Steffi YuenHong Kong, China Moderator The Power of Powerbend in Management of Lower Pole and Complex StonesThe management of lower pole stones (LPS) and complex renal calculi remains one of the most challenging aspects of contemporary urolithiasis treatment, with the deflection capability of flexible ureteroscopes serving as the critical determinant of surgical success. Modern flexible ureteroscopes achieve impressive bidirectional deflection angles of 270° or even more, representing a significant advancement from earlier generation instruments. However, this “working deflection” capacity becomes substantially compromised when therapeutic instruments, such as laser fibers or stone baskets, are inserted through the working channel. The anatomical challenges of lower pole access, particularly steep infundibulopelvic angles, necessitate prolonged maximal deflection during lithotrispy that significantly increases the risk of ureteroscope damage and surgeon fatigability. Deflection deterioration is also directly proportional to instrument usage, with newer single-use scopes coming to the rescue. The introduction of flexible and navigable suction access sheaths (FANS) has revolutionized lower pole stone management allowing direct access to performing lithotriopsy and stone fragments retrieval, reducing the need for stone basket in stone relocation and fragment retrieval. Recent multicenter studies demonstrate comparable stone-free rates (<2mm) between lower pole and non-lower pole locations (96.6% vs 98.4%) when using FANS, with minimal complications and low reintervention rates. With current technological advancements, combined with improved surgical techniques and the strategic choice of single-use ureteroscopes with good deflection power, one can significantly achieve high stone-free rates with low infectious complications and reinterventions with FANS flexible ureteroscopy in the treatment of complex lower pole stones. FANs in Endourology: Finding the Best Combination with Lasers and Scopes for Optimal Outcomes Intra Renal Pressure Defines Outcomes: Current Evidence Chinnakhet Ketsuwan Thailand Speaker Intra Renal Pressure Defines Outcomes: Current EvidenceIntrarenal pressure (IRP) is a crucial physiological parameter during endourological interventions, as elevated IRP is closely linked to increased fluid absorption, intrarenal backflow, compromised renal perfusion, and postoperative complications. Experimental studies in animal models have consistently demonstrated a correlation between increased IRP and augmented irrigation fluid absorption, renal parenchymal backflow, and reductions in renal blood flow. Clinical studies have reported baseline IRP values ranging from 14 to 17 mmHg, with transient peristaltic peaks reaching up to 25 mmHg. Notably, IRP frequently surpassed 60 mmHg during endoscopic procedures, particularly when utilizing manual hand-pump irrigation or employing ureteral access sheaths (UAS) with smaller diameters. Significant risk factors identified for sustained elevations of IRP include non-prestented ureters, Asian ethnicity, and omission of UAS placement. Furthermore, elevated IRPs have demonstrated a direct association with infectious adverse events, notably postoperative sepsis. Randomized controlled trials have established that manual hand-pump irrigation generates substantially higher IRPs compared to pressurized irrigation bags. Additionally, serial manual irrigation boluses have been shown to produce prolonged IRP elevations, with maximum peaks exceeding 100 mmHg and durations surpassing 40 seconds. Collectively, both preclinical and clinical evidence underscores the necessity of meticulous intraoperative IRP management during endourological procedures. Strategic optimization of irrigation techniques and appropriate UAS selection are imperative to effectively maintain IRP within safe physiological limits, thereby minimizing the risk of complicationsRole of VR/AR/MR in Endourology and Urolithiasis Renal stone disease is a common urological condition affecting diverse patient populations. Percutaneous nephrolithotomy (PCNL) is widely recognized as the primary treatment for large or complex renal calculi, offering high stone-free rates with low complication profiles. Nevertheless, achieving accurate percutaneous renal access (PCA) remains technically challenging due to anatomical proximity to vital structures and insufficient hands-on training opportunities for urologists. Virtual reality (VR) simulators, such as the PERC Mentor and Uro Mentor, have demonstrated significant improvements in PCA proficiency, operative efficiency, and complication reduction, establishing their validity as effective training platforms. Additionally, mixed reality (MR) and 3D holographic technologies, exemplified by HoloLens, enhance surgical planning and procedural accuracy, particularly in calyceal targeting during PCNL. Recent nationwide training needs assessments have further advocated for the integration of these advanced simulation technologies into urological education curricula. Ultimately, systematic incorporation of VR and MR simulation into residency training holds substantial promise in bridging existing skill gaps, refining surgical competencies, and circumventing ethical concerns associated with traditional methods of surgical education. Pressure Management Strategy in RIRS using Tidor System Ponco BirowoIndonesia Speaker Pressure Management Strategy in RIRS using Tidor System Q & A 4th Company Session Sung Yong Cho Korea (Republic of) Moderator Robotic URS: Can It Really Improve Precision and Reduce Surgeon Fatigue?Use of AI and Robots in Endourology Vineet GauharSingapore Moderator Experimental and Real World Take Away Messages on DISSSuction in Renal Stone Treatment: DISS, FANS or Combined Procedure?Need of Future EndourologyChoosing the Correct Laser and Flex Scope Combination in Suction Ureteroscopy Can Be the Deal Breaker The Power of Powerbend in Management of Lower Pole and Complex Stones. Steffi YuenHong Kong, China Speaker The Power of Powerbend in Management of Lower Pole and Complex StonesThe management of lower pole stones (LPS) and complex renal calculi remains one of the most challenging aspects of contemporary urolithiasis treatment, with the deflection capability of flexible ureteroscopes serving as the critical determinant of surgical success. Modern flexible ureteroscopes achieve impressive bidirectional deflection angles of 270° or even more, representing a significant advancement from earlier generation instruments. However, this “working deflection” capacity becomes substantially compromised when therapeutic instruments, such as laser fibers or stone baskets, are inserted through the working channel. The anatomical challenges of lower pole access, particularly steep infundibulopelvic angles, necessitate prolonged maximal deflection during lithotrispy that significantly increases the risk of ureteroscope damage and surgeon fatigability. Deflection deterioration is also directly proportional to instrument usage, with newer single-use scopes coming to the rescue. The introduction of flexible and navigable suction access sheaths (FANS) has revolutionized lower pole stone management allowing direct access to performing lithotriopsy and stone fragments retrieval, reducing the need for stone basket in stone relocation and fragment retrieval. Recent multicenter studies demonstrate comparable stone-free rates (<2mm) between lower pole and non-lower pole locations (96.6% vs 98.4%) when using FANS, with minimal complications and low reintervention rates. With current technological advancements, combined with improved surgical techniques and the strategic choice of single-use ureteroscopes with good deflection power, one can significantly achieve high stone-free rates with low infectious complications and reinterventions with FANS flexible ureteroscopy in the treatment of complex lower pole stones. FANs in Endourology: Finding the Best Combination with Lasers and Scopes for Optimal Outcomes What I Need as a Clinician in Single Use Scopes Manint UsawachintachitThailand Speaker What I Need as a Clinician in Single Use ScopesSpecial Consideration in Pediatric Endourology Q & A 5th Company Session Boyke SoebhaliIndonesia Moderator Updates on Pharmacological Therapy for UrolithiasisUrolithiasis, a prevalent and recurrent urological condition, requires a multifaceted approach combining pharmacological, dietary, and surgical interventions. Recent advancements in pharmacological therapy emphasize personalized treatment based on stone composition, metabolic profiles, and patient-specific risk factors. For calcium oxalate stones, the most common type, thiazide diuretics remain first-line therapy to reduce urinary calcium excretion, while potassium citrate is recommended to increase urinary citrate levels, inhibiting stone formation. Dietary modifications, such as reduced oxalate intake and adequate calcium consumption, are adjunctive measures. In primary hyperoxaluria (PH), novel RNA interference (RNAi) agents like lumasiran and nedosiran significantly lower urinary oxalate levels, offering promising alternatives for patients unresponsive to pyridoxine. Uric acid stones are managed with urinary alkalinization using potassium citrate or sodium bicarbonate to maintain a pH >6.0, enhancing uric acid solubility. Xanthine oxidase inhibitors (allopurinol, febuxostat) are reserved for hyperuricemic patients. Cystine stones, though rare, require alkalinization and thiol-based drugs (tiopronin) to improve cystine solubility. Struvite stones, associated with urease-producing infections, necessitate antibiotics and urinary acidification (e.g., L-methionine) alongside surgical removal. Emerging therapies like theobromine show potential in inhibiting uric acid crystallization, while phytate demonstrates inhibitory effects on calcium salt aggregation. Medical expulsive therapy (MET) with alpha-blockers (tamsulosin) remains effective for distal ureteral stones (5–10 mm), reducing time to expulsion and need for surgery. However, MET efficacy diminishes for proximal stones or those >10 mm, necessitating surgical intervention. Future directions include optimizing RNAi therapies for hereditary stone diseases and integrating smartphone apps to enhance treatment adherence. A tailored, evidence-based approach combining pharmacological and lifestyle interventions is crucial for reducing recurrence and improving patient outcomes.Suction PCNL vs Suction RIRS? Do We Have a WinnerThe management of renal stones has evolved with the introduction of suction-assisted techniques in both percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). Suction PCNL, including mini-PCNL and flexible mini-PCNL (F-mPCNL), utilizes negative pressure to improve stone clearance and reduce intrarenal pressure, while suction RIRS employs vacuum-assisted ureteral access sheaths (V-UAS) or direct in-scope suction (DISS) to enhance fragment removal and minimize infectious complications. Recent studies highlight that suction PCNL achieves superior stone-free rates (SFRs) in a single session, particularly for stones >2 cm, with SFRs ranging from 93.8% to 95.1% compared to 77.8%–87.9% for suction RIRS. However, suction RIRS offers advantages in reduced invasiveness, shorter hospital stays (1–3 days vs. 2–5 days for PCNL), and lower complication rates (e.g., bleeding, transfusion needs). For infectious stones, suction RIRS with V-UAS demonstrates lower postoperative infection markers (CRP, PCT) and fewer febrile complications than PCNL . Operative times vary, with suction PCNL often being faster for large stones (47–82 min) but requiring fluoroscopy, while suction RIRS avoids tract-related risks but may necessitate staged procedures for stones >2 cm. Cost-effectiveness analyses favor suction PCNL due to fewer retreatments, though RIRS reduces radiation exposure. Takaaki InoueJapan Moderator New Advancement on Retrograde Intrarenal SurgeryRetrograde intrarenal surgery (RIRS) has dramatically grown up around world for stone management. Why has RIRS been getting popullar and increasing nowadays?. The reaseon are absoulutely "Technological development with collaborated engineering comapny" and " Global communicaton and collaboration in Endourology". Endourology has still been improving and expanding more and more. Thereby, many novel devices and machine are launching faster. We, urologists should catch up this faster trend and acquire these knowledge for our clinical use. However, most of urologists can not catch up it. Therefore, I will share you all these novel chage of mind and tech-knowledge of stone field in this session. Do We Need Augmented Reality for Renal Stone Management?What is Augmented reality and Vertual reality in medicine?. The paradigm shift of medicine which includes AI, Robotics, VR, and AR etc named Digital transformation has been still emerging. Of course, these shift is gradually permeating in stone field. Especially, in terms of VR, AR, we wonder if this kind of DX is useful in stone management. if so, how do we use it in clinical practice? Today, I will talk these future role in stone management, and expectation. Which Laser for RIRS: Pulsed Thulium YAG Laser We can use three kind of laser such as Holumium YAG, Thulium YAG, and Thulium fiber laser for stone management. Which lase are best option for stone patients? I will talk about featurs and advantage of pulsed-Thulium YAG laser. There are two kinds of p-Tm;YAG laser machine nowadays. P^Tm;YAG has unique characteristics as laser wave. Therefore, this laser would be able to use Stone, BPH, UTUC. Especially, p-Tm YAG laser can utilize for Stone ablation, fragmentingand and UTUC ablation, shock wave. We will share our experoence and thoughts. New Advancement on Retrograde Intrarenal Surgery Clearpetra the Sheath of Choice for Lower Pole Stones Anil ShresthaNepal Speaker Clearpetra the Sheath of Choice for Lower Pole StonesSFR Assessment: Timing and Modalities How to Use Clearpetra Shetah to Minimize Post Operative Stenting after FANS Deepak Ragoori India Speaker How to Use Clearpetra Shetah to Minimize Post Operative Stenting after FANS Q & A TICC - 2F 201DE
08:30 17:00	Asian Robotic Urology Society (ARUS) Opening Remarks Jacob See-Tong PangTaiwan Speaker Tai-Lung ChaTaiwan Speaker 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. Ponco BirowoIndonesia Speaker Pressure Management Strategy in RIRS using Tidor System Allen W. ChiuTaiwan Speaker Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques. This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system. Yen-Chuan OuTaiwan Speaker ARUS–PRUS Partnership Ceremony: A New Chapter in Asia Robotic Urology CollaborationDear colleagues and friends, It’s a great honor to witness the signing of this partnership between the Asian Robotic Urology Society (ARUS) and the Philippines Robotic Urology Society (PRUS). This marks the beginning of a new chapter in regional collaboration—one that emphasizes shared training, joint research, and mutual support to advance robotic urology across Asia. PRUS brings energy, expertise, and vision to this partnership, and ARUS is proud to walk alongside you as we work toward higher standards and better outcomes for our patients. Let us move forward together—with unity, purpose, and innovation. Congratulations to both ARUS and PRUS!Aquablation Revolutionizing BPH Treatment: A New Era of Minimally Invasive Therapy-Tungs' Taichung Metroharbor Hospital ExperienceIntroduction Aquablation is a waterjet ablation therapy for benign prostatic hyperplasia (BPH) that has gained significant attention. While its efficacy, durability, and safety have been established across various prostate sizes (30–150 mL), local data on its efficacy, safety, and learning curve in Taiwan remain limited. Our team have been performed 85 cases between March 2024 and July 2025. This lecture presents the learning curve observed in the first 50 patients who underwent Aquablation for BPH, highlighting its role in revolutionizing BPH treatment. Materials and Methods We conducted a retrospective review of 50 consecutive patients who underwent Aquablation between March 2024 and February 2025, dividing them into two groups: Group I (first 25 cases) and Group II (subsequent 25 cases). Assessments included IPSS, QoL, uroflowmetry parameters (voiding volume, Qmax, Qmean, PVR), operative time, hemoglobin drop, Clavien-Dindo grade ≥2 complications, hospital stay, and urethral catheter duration. Results Patients in Group II were younger and had smaller prostates. Aquablation was successfully performed in all cases. IPSS, QoL, voiding volume, Qmax, and Qmean improved significantly and were sustained for three months, while PVR improved only in Group I. Operative time was significantly shorter in Group II, and hemoglobin drop was greater in Group I. Complication rates, hospital stay, and catheter duration were similar between groups. Conclusions Aquablation provided significant and immediate improvements in voiding parameters and symptoms, with sustained PVR benefits in larger prostates. Surgeon proficiency improved after 25 cases. Overall, Aquablation proved safe and effective, even in an unselected patient population. Aquablation represents a promising advancement that could transform the therapeutic landscape for BPH—particularly if costs are reduced.Experience of 100 Consecutive Hugo Robotic Radical ProstatectomiesIntroduction and background: Dr. Ou’ surgical team of Tungs’ Taichung MetroHarbor Hospital performed the first Hugo robotic radical prostatectomy on May 9, 2023. In 2023, we published the results of the first series of 12 Hugo robotic radical prostatectomies performed. In 2024, we published a comparison of 30 Hugo robotic radical prostatectomies and 30 Da Vinci robotic radical prostatectomies. Professor Ou is the Hugo robotic arm instructor recognized by Medtronic. Many Southeast Asian doctors come to this Hospital to observe the surgery and learn. Material and Methods: We prospectively collected data for retrospective analysis and statistics from May 9, 2023 to April 30, 2025, performing 100 consecutive Hugo robotic radical prostatectomies. We compared the surgical results of 1-50 cases (group 1) and 51-100 cases (group 2). The data analyzed included basic information, age, risk of anesthesia, BMI , prostate-specific antigen, clinical stage, and Gleason score grade. The two groups were compared in terms of surgical difficulty, receipt of neoadjuvant hormonal therapy, obesity, prostate volume >70 g, prostate protrusion more than 1 cm into the bladder neck, previous transurethral resection of prostate, history of abdominal surgery, extensive pelvic lymphadenectomy, salvage radical prostatectomy, and time from biopsy to radical prostatectomy less than 6 weeks. The two groups were compared in terms of robotic console time, blood loss, blood transfusion rate, and surgical complications. We compared the two groups in terms of postoperative pathological staging and grade, the proportion of tumor, and the proportion of urinary control at one month and three months. Results: The study showed that the age of patients in the second group was slightly higher, but the statistical p value was 0.058, which did not reach statistical difference. The second group of patients had significantly higher rates of stage III, stage IV, lymph node and bone oligometastasis, with a p value of 0.021. The rate of neoadjuvant hormonal therapy received by the second group was 16 percent, which was statistically significant compared with 2 percent of the first group (p = 0.021). The rates of other surgical difficulty factors were the same between the two groups. The average blood loss of patients in the second group was 156 CC, which was significantly less than the 208 CC in the first group. The operation time and surgical complications were comparable between the two groups. The cancer volume of the second group of patients was significantly reduced compared with that of the first group (3.30±2.93 versus 5.09±5.24, p value=0.049). The reason was that more patients in the second group received neoadjuvant hormonal therapy, which significantly reduced the cancer. Both groups of patients had very good urinary control after surgery. Conclusion: We conclude that Hugo robotic radical prostatectomy is an effective and feasible method with extremely low complications and good recovery of urinary control function after surgery. After the experience of the first 50 operations, the surgeon will choose patients with higher difficulty, especially those receiving neoadjuvant hormone therapy, to perform the operation.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical ProstatectomyBackground: Robotic-assisted radical prostatectomy (RARP) has become a preferred surgical approach for localized prostate cancer due to its minimally invasive nature and precision. However, the preservation of urinary continence and sexual function remains a significant postoperative challenge. Traditional outcomes have focused heavily on oncological safety. Yet, contemporary perspectives emphasize a more holistic view—embodied in the concept of the “Pentafecta,” which includes continence, potency, negative surgical margins, biochemical recurrence-free survival, and absence of perioperative complications. Objective: This presentation introduces a comprehensive and integrative approach aimed at maximizing functional outcomes—particularly urinary continence and erectile function—through a modified pubovesical complex-sparing RARP under regional hypothermia, supplemented with real-time nerve imaging, neurovascular preservation strategies, and biological enhancement techniques. Methods: We present data and experience from Tungs’ Taichung MetroHarbor Hospital (TTMHH), including a series of 3780 robotic procedures performed between December 2005 and July 2025. Among these, 100 cases were completed using the Hugo™ RAS system and 21 with the da Vinci SP™ platform. Our modified technique builds upon Dr. Richard Gaston’s pubovesical complex-sparing method, with the addition of localized hypothermia (24°C), near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG), and application of dehydrated human amnion/chorion membrane (dHACM). In selected cases, nerve grafting with Axogen® technology was applied. Results: Initial results indicate a significantly improved early return of continence (95% by 16 weeks) and promising erectile function recovery, particularly in patients who received adjunctive therapies such as phosphodiesterase inhibitors or vacuum erection devices. The precision afforded by robotic technology enabled preservation of prostate capsular arteries and accessory pudendal arteries. Localized hypothermia contributed to reduced tissue edema, minimized neural trauma, and improved nerve recovery. The use of ICG-NIRF allowed real-time identification of critical vascular landmarks, enhancing nerve-sparing accuracy. Preliminary analysis suggests our technique is both feasible and reproducible. Conclusion: The modified pubovesical complex-sparing RARP under hypothermia, augmented with vascular imaging and biologic materials, offers a promising paradigm for functional preservation in prostate cancer surgery. This total solution approach not only protects neurovascular integrity but also accelerates recovery of continence and potency. Continued accumulation of clinical cases and controlled comparative studies are warranted to further validate the efficacy and long-term benefits of these techniques. Significance: This strategy reflects a patient-centered evolution in robotic prostate surgery, merging surgical innovation with anatomical preservation and technological augmentation. It represents an epic collaboration of surgical precision, team-based care, and thoughtful application of biomedical advances to improve quality of life outcomes in prostate cancer patients.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical Prostatectomy ARUS–PRUS Partnership Ceremony: A New Chapter in Asia Robotic Urology Collaboration Jason Lui LetranPhilippines Speaker ARUS–PRUS Partnership Ceremony: A New Chapter in Asia Robotic Urology Collaboration Yen-Chuan OuTaiwan Speaker ARUS–PRUS Partnership Ceremony: A New Chapter in Asia Robotic Urology CollaborationDear colleagues and friends, It’s a great honor to witness the signing of this partnership between the Asian Robotic Urology Society (ARUS) and the Philippines Robotic Urology Society (PRUS). This marks the beginning of a new chapter in regional collaboration—one that emphasizes shared training, joint research, and mutual support to advance robotic urology across Asia. PRUS brings energy, expertise, and vision to this partnership, and ARUS is proud to walk alongside you as we work toward higher standards and better outcomes for our patients. Let us move forward together—with unity, purpose, and innovation. Congratulations to both ARUS and PRUS!Aquablation Revolutionizing BPH Treatment: A New Era of Minimally Invasive Therapy-Tungs' Taichung Metroharbor Hospital ExperienceIntroduction Aquablation is a waterjet ablation therapy for benign prostatic hyperplasia (BPH) that has gained significant attention. While its efficacy, durability, and safety have been established across various prostate sizes (30–150 mL), local data on its efficacy, safety, and learning curve in Taiwan remain limited. Our team have been performed 85 cases between March 2024 and July 2025. This lecture presents the learning curve observed in the first 50 patients who underwent Aquablation for BPH, highlighting its role in revolutionizing BPH treatment. Materials and Methods We conducted a retrospective review of 50 consecutive patients who underwent Aquablation between March 2024 and February 2025, dividing them into two groups: Group I (first 25 cases) and Group II (subsequent 25 cases). Assessments included IPSS, QoL, uroflowmetry parameters (voiding volume, Qmax, Qmean, PVR), operative time, hemoglobin drop, Clavien-Dindo grade ≥2 complications, hospital stay, and urethral catheter duration. Results Patients in Group II were younger and had smaller prostates. Aquablation was successfully performed in all cases. IPSS, QoL, voiding volume, Qmax, and Qmean improved significantly and were sustained for three months, while PVR improved only in Group I. Operative time was significantly shorter in Group II, and hemoglobin drop was greater in Group I. Complication rates, hospital stay, and catheter duration were similar between groups. Conclusions Aquablation provided significant and immediate improvements in voiding parameters and symptoms, with sustained PVR benefits in larger prostates. Surgeon proficiency improved after 25 cases. Overall, Aquablation proved safe and effective, even in an unselected patient population. Aquablation represents a promising advancement that could transform the therapeutic landscape for BPH—particularly if costs are reduced.Experience of 100 Consecutive Hugo Robotic Radical ProstatectomiesIntroduction and background: Dr. Ou’ surgical team of Tungs’ Taichung MetroHarbor Hospital performed the first Hugo robotic radical prostatectomy on May 9, 2023. In 2023, we published the results of the first series of 12 Hugo robotic radical prostatectomies performed. In 2024, we published a comparison of 30 Hugo robotic radical prostatectomies and 30 Da Vinci robotic radical prostatectomies. Professor Ou is the Hugo robotic arm instructor recognized by Medtronic. Many Southeast Asian doctors come to this Hospital to observe the surgery and learn. Material and Methods: We prospectively collected data for retrospective analysis and statistics from May 9, 2023 to April 30, 2025, performing 100 consecutive Hugo robotic radical prostatectomies. We compared the surgical results of 1-50 cases (group 1) and 51-100 cases (group 2). The data analyzed included basic information, age, risk of anesthesia, BMI , prostate-specific antigen, clinical stage, and Gleason score grade. The two groups were compared in terms of surgical difficulty, receipt of neoadjuvant hormonal therapy, obesity, prostate volume >70 g, prostate protrusion more than 1 cm into the bladder neck, previous transurethral resection of prostate, history of abdominal surgery, extensive pelvic lymphadenectomy, salvage radical prostatectomy, and time from biopsy to radical prostatectomy less than 6 weeks. The two groups were compared in terms of robotic console time, blood loss, blood transfusion rate, and surgical complications. We compared the two groups in terms of postoperative pathological staging and grade, the proportion of tumor, and the proportion of urinary control at one month and three months. Results: The study showed that the age of patients in the second group was slightly higher, but the statistical p value was 0.058, which did not reach statistical difference. The second group of patients had significantly higher rates of stage III, stage IV, lymph node and bone oligometastasis, with a p value of 0.021. The rate of neoadjuvant hormonal therapy received by the second group was 16 percent, which was statistically significant compared with 2 percent of the first group (p = 0.021). The rates of other surgical difficulty factors were the same between the two groups. The average blood loss of patients in the second group was 156 CC, which was significantly less than the 208 CC in the first group. The operation time and surgical complications were comparable between the two groups. The cancer volume of the second group of patients was significantly reduced compared with that of the first group (3.30±2.93 versus 5.09±5.24, p value=0.049). The reason was that more patients in the second group received neoadjuvant hormonal therapy, which significantly reduced the cancer. Both groups of patients had very good urinary control after surgery. Conclusion: We conclude that Hugo robotic radical prostatectomy is an effective and feasible method with extremely low complications and good recovery of urinary control function after surgery. After the experience of the first 50 operations, the surgeon will choose patients with higher difficulty, especially those receiving neoadjuvant hormone therapy, to perform the operation.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical ProstatectomyBackground: Robotic-assisted radical prostatectomy (RARP) has become a preferred surgical approach for localized prostate cancer due to its minimally invasive nature and precision. However, the preservation of urinary continence and sexual function remains a significant postoperative challenge. Traditional outcomes have focused heavily on oncological safety. Yet, contemporary perspectives emphasize a more holistic view—embodied in the concept of the “Pentafecta,” which includes continence, potency, negative surgical margins, biochemical recurrence-free survival, and absence of perioperative complications. Objective: This presentation introduces a comprehensive and integrative approach aimed at maximizing functional outcomes—particularly urinary continence and erectile function—through a modified pubovesical complex-sparing RARP under regional hypothermia, supplemented with real-time nerve imaging, neurovascular preservation strategies, and biological enhancement techniques. Methods: We present data and experience from Tungs’ Taichung MetroHarbor Hospital (TTMHH), including a series of 3780 robotic procedures performed between December 2005 and July 2025. Among these, 100 cases were completed using the Hugo™ RAS system and 21 with the da Vinci SP™ platform. Our modified technique builds upon Dr. Richard Gaston’s pubovesical complex-sparing method, with the addition of localized hypothermia (24°C), near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG), and application of dehydrated human amnion/chorion membrane (dHACM). In selected cases, nerve grafting with Axogen® technology was applied. Results: Initial results indicate a significantly improved early return of continence (95% by 16 weeks) and promising erectile function recovery, particularly in patients who received adjunctive therapies such as phosphodiesterase inhibitors or vacuum erection devices. The precision afforded by robotic technology enabled preservation of prostate capsular arteries and accessory pudendal arteries. Localized hypothermia contributed to reduced tissue edema, minimized neural trauma, and improved nerve recovery. The use of ICG-NIRF allowed real-time identification of critical vascular landmarks, enhancing nerve-sparing accuracy. Preliminary analysis suggests our technique is both feasible and reproducible. Conclusion: The modified pubovesical complex-sparing RARP under hypothermia, augmented with vascular imaging and biologic materials, offers a promising paradigm for functional preservation in prostate cancer surgery. This total solution approach not only protects neurovascular integrity but also accelerates recovery of continence and potency. Continued accumulation of clinical cases and controlled comparative studies are warranted to further validate the efficacy and long-term benefits of these techniques. Significance: This strategy reflects a patient-centered evolution in robotic prostate surgery, merging surgical innovation with anatomical preservation and technological augmentation. It represents an epic collaboration of surgical precision, team-based care, and thoughtful application of biomedical advances to improve quality of life outcomes in prostate cancer patients.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical Prostatectomy Session 1: Advances in Robotic Surgery Allen W. ChiuTaiwan Moderator Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques. This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system. Yen-Chuan OuTaiwan Moderator ARUS–PRUS Partnership Ceremony: A New Chapter in Asia Robotic Urology CollaborationDear colleagues and friends, It’s a great honor to witness the signing of this partnership between the Asian Robotic Urology Society (ARUS) and the Philippines Robotic Urology Society (PRUS). This marks the beginning of a new chapter in regional collaboration—one that emphasizes shared training, joint research, and mutual support to advance robotic urology across Asia. PRUS brings energy, expertise, and vision to this partnership, and ARUS is proud to walk alongside you as we work toward higher standards and better outcomes for our patients. Let us move forward together—with unity, purpose, and innovation. Congratulations to both ARUS and PRUS!Aquablation Revolutionizing BPH Treatment: A New Era of Minimally Invasive Therapy-Tungs' Taichung Metroharbor Hospital ExperienceIntroduction Aquablation is a waterjet ablation therapy for benign prostatic hyperplasia (BPH) that has gained significant attention. While its efficacy, durability, and safety have been established across various prostate sizes (30–150 mL), local data on its efficacy, safety, and learning curve in Taiwan remain limited. Our team have been performed 85 cases between March 2024 and July 2025. This lecture presents the learning curve observed in the first 50 patients who underwent Aquablation for BPH, highlighting its role in revolutionizing BPH treatment. Materials and Methods We conducted a retrospective review of 50 consecutive patients who underwent Aquablation between March 2024 and February 2025, dividing them into two groups: Group I (first 25 cases) and Group II (subsequent 25 cases). Assessments included IPSS, QoL, uroflowmetry parameters (voiding volume, Qmax, Qmean, PVR), operative time, hemoglobin drop, Clavien-Dindo grade ≥2 complications, hospital stay, and urethral catheter duration. Results Patients in Group II were younger and had smaller prostates. Aquablation was successfully performed in all cases. IPSS, QoL, voiding volume, Qmax, and Qmean improved significantly and were sustained for three months, while PVR improved only in Group I. Operative time was significantly shorter in Group II, and hemoglobin drop was greater in Group I. Complication rates, hospital stay, and catheter duration were similar between groups. Conclusions Aquablation provided significant and immediate improvements in voiding parameters and symptoms, with sustained PVR benefits in larger prostates. Surgeon proficiency improved after 25 cases. Overall, Aquablation proved safe and effective, even in an unselected patient population. Aquablation represents a promising advancement that could transform the therapeutic landscape for BPH—particularly if costs are reduced.Experience of 100 Consecutive Hugo Robotic Radical ProstatectomiesIntroduction and background: Dr. Ou’ surgical team of Tungs’ Taichung MetroHarbor Hospital performed the first Hugo robotic radical prostatectomy on May 9, 2023. In 2023, we published the results of the first series of 12 Hugo robotic radical prostatectomies performed. In 2024, we published a comparison of 30 Hugo robotic radical prostatectomies and 30 Da Vinci robotic radical prostatectomies. Professor Ou is the Hugo robotic arm instructor recognized by Medtronic. Many Southeast Asian doctors come to this Hospital to observe the surgery and learn. Material and Methods: We prospectively collected data for retrospective analysis and statistics from May 9, 2023 to April 30, 2025, performing 100 consecutive Hugo robotic radical prostatectomies. We compared the surgical results of 1-50 cases (group 1) and 51-100 cases (group 2). The data analyzed included basic information, age, risk of anesthesia, BMI , prostate-specific antigen, clinical stage, and Gleason score grade. The two groups were compared in terms of surgical difficulty, receipt of neoadjuvant hormonal therapy, obesity, prostate volume >70 g, prostate protrusion more than 1 cm into the bladder neck, previous transurethral resection of prostate, history of abdominal surgery, extensive pelvic lymphadenectomy, salvage radical prostatectomy, and time from biopsy to radical prostatectomy less than 6 weeks. The two groups were compared in terms of robotic console time, blood loss, blood transfusion rate, and surgical complications. We compared the two groups in terms of postoperative pathological staging and grade, the proportion of tumor, and the proportion of urinary control at one month and three months. Results: The study showed that the age of patients in the second group was slightly higher, but the statistical p value was 0.058, which did not reach statistical difference. The second group of patients had significantly higher rates of stage III, stage IV, lymph node and bone oligometastasis, with a p value of 0.021. The rate of neoadjuvant hormonal therapy received by the second group was 16 percent, which was statistically significant compared with 2 percent of the first group (p = 0.021). The rates of other surgical difficulty factors were the same between the two groups. The average blood loss of patients in the second group was 156 CC, which was significantly less than the 208 CC in the first group. The operation time and surgical complications were comparable between the two groups. The cancer volume of the second group of patients was significantly reduced compared with that of the first group (3.30±2.93 versus 5.09±5.24, p value=0.049). The reason was that more patients in the second group received neoadjuvant hormonal therapy, which significantly reduced the cancer. Both groups of patients had very good urinary control after surgery. Conclusion: We conclude that Hugo robotic radical prostatectomy is an effective and feasible method with extremely low complications and good recovery of urinary control function after surgery. After the experience of the first 50 operations, the surgeon will choose patients with higher difficulty, especially those receiving neoadjuvant hormone therapy, to perform the operation.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical ProstatectomyBackground: Robotic-assisted radical prostatectomy (RARP) has become a preferred surgical approach for localized prostate cancer due to its minimally invasive nature and precision. However, the preservation of urinary continence and sexual function remains a significant postoperative challenge. Traditional outcomes have focused heavily on oncological safety. Yet, contemporary perspectives emphasize a more holistic view—embodied in the concept of the “Pentafecta,” which includes continence, potency, negative surgical margins, biochemical recurrence-free survival, and absence of perioperative complications. Objective: This presentation introduces a comprehensive and integrative approach aimed at maximizing functional outcomes—particularly urinary continence and erectile function—through a modified pubovesical complex-sparing RARP under regional hypothermia, supplemented with real-time nerve imaging, neurovascular preservation strategies, and biological enhancement techniques. Methods: We present data and experience from Tungs’ Taichung MetroHarbor Hospital (TTMHH), including a series of 3780 robotic procedures performed between December 2005 and July 2025. Among these, 100 cases were completed using the Hugo™ RAS system and 21 with the da Vinci SP™ platform. Our modified technique builds upon Dr. Richard Gaston’s pubovesical complex-sparing method, with the addition of localized hypothermia (24°C), near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG), and application of dehydrated human amnion/chorion membrane (dHACM). In selected cases, nerve grafting with Axogen® technology was applied. Results: Initial results indicate a significantly improved early return of continence (95% by 16 weeks) and promising erectile function recovery, particularly in patients who received adjunctive therapies such as phosphodiesterase inhibitors or vacuum erection devices. The precision afforded by robotic technology enabled preservation of prostate capsular arteries and accessory pudendal arteries. Localized hypothermia contributed to reduced tissue edema, minimized neural trauma, and improved nerve recovery. The use of ICG-NIRF allowed real-time identification of critical vascular landmarks, enhancing nerve-sparing accuracy. Preliminary analysis suggests our technique is both feasible and reproducible. Conclusion: The modified pubovesical complex-sparing RARP under hypothermia, augmented with vascular imaging and biologic materials, offers a promising paradigm for functional preservation in prostate cancer surgery. This total solution approach not only protects neurovascular integrity but also accelerates recovery of continence and potency. Continued accumulation of clinical cases and controlled comparative studies are warranted to further validate the efficacy and long-term benefits of these techniques. Significance: This strategy reflects a patient-centered evolution in robotic prostate surgery, merging surgical innovation with anatomical preservation and technological augmentation. It represents an epic collaboration of surgical precision, team-based care, and thoughtful application of biomedical advances to improve quality of life outcomes in prostate cancer patients.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical Prostatectomy Chi-Fai NgHong Kong, China Moderator Novel Robotic Surgery PlatformsOver the past decades, robotic surgery has become an essential approach in urological care. The recent blooming of different robotic platforms, in particular in Asian countries, has helped popularize robotic surgery in less developed countries. The introduction of robotic technology in endoluminal surgery has also helped to open up opportunities to further improve endourology. In the future, the incorporation of AI in robotic systems will help upgrade the standard of care in urology. Enhancing Robotic Surgery with AI and Imaging Navigation: Bridging Precision and Efficiency Gang ZhuChina Speaker Enhancing Robotic Surgery with AI and Imaging Navigation: Bridging Precision and EfficiencyBackground: Robotic surgery faces persistent challenges in real-time anatomical navigation during complex procedures like partial nephrectomy (PN), where millimeter-scale precision impacts oncological and functional outcomes. Objective: This review explores the integration of artificial intelligence (AI) and augmented reality (AR)-based holographic imaging to overcome these limitations, synergistically advancing surgical precision and operational efficiency. Design, setting and participants: Holographic imaging, an AR technique reconstructed from CT/MRI via surface rendering, provides detailed 3D anatomical models for preoperative planning, patient counseling, surgical training, and intraoperative navigation. These models enable precise tumor localization, super-selective vascular clamping, and parenchymal preservation, in particular the PN. Results: Clinical outcomes demonstrate significant improvements. AI-automated modeling cuts 3D model reconstruction time while improving segmentation accuracy. AI enhanced holographic imaging in patient consultation, education and training, surgical planning, and surgical navigation have demonstrated value. Holographic imaging navigation overlays virtual models onto endoscopic views, reducing collecting system injury and increasing enucleation rates for endophytic tumors. AI-based holographic imaging visualization alters surgical strategy for complex cases, reducing conversion from partial to radical nephrectomy. Challenges persist in tracking robustness due to intraoperative organ deformation. Future directions include multimodal Integration: Combining holographic imaging and PET CT to define the metastatic lymph nodes, enabling personalized complete resection; Full-Cycle Coverage: Extending from preoperative assessment to postoperative recovery (e.g., recurrence prediction, customized rehabilitation plans); Telesurgery Empowerment: 5G + holographic imaging to support telesurgical guidance, promoting the decentralization of medical resources. Conclusions: AI-powered holographic imaging navigation bridges critical gaps in robotic surgery by transforming static anatomical data into dynamic, real-time guidance. This synergy enhances precision in tumor resection and vascular management while streamlining workflows—ultimately improving patient outcomes through reduced ischemia, fewer complications, and greater nephron preservation, enhancing survival and quality of life for cancer patients. Real-time navigation integrating “anatomy-function-metabolism”, advancing MIS from “precision resection” to “personalized treatment” and "functional preservation”. From Console to Cloud: The Evolution of Robotic Telesurgery in Urology – Innovations, Trials, and Ethical Frontiers Xu Zhang China Speaker From Console to Cloud: The Evolution of Robotic Telesurgery in Urology – Innovations, Trials, and Ethical FrontiersTelesurgery is an emerging branch of surgery that utilizes telecommunication technology and surgical robots to perform operations. It breaks the spatial constraints on the conduct of surgical procedures and represents a systematic innovation brought about by the intersection of new technologies and concepts such as robotic surgery, telecommunication, and artificial intelligence. It holds promise as a potential solution to the uneven distribution of medical resources. Currently, China's research in telesurgery has reached the forefront of the international stage. Building a high-quality disciplinary development ecosystem and a regional collaborative system for remote surgery will be the inevitable path to maintaining a leading position. Providing national-level project support for telesurgery, establishing a national-level joint innovation group, creating a regional medical consortium for remote surgery, and formulating legal norms and treatment guidelines will pave the way for the sustainable development of telesurgery in China. It is believed that with the strong support of the state, Chinese surgeons will seize the opportunity, lead the new wave of surgical development, integrate new telesurgery technologies into the national universal healthcare system, and benefit a large number of patients. Open Surgery Training: Is It Necessary in the Era of Robotics? John DavisUnited States Speaker Open Surgery Training: Is It Necessary in the Era of Robotics?Open surgery training in the era of robotics may or may not be a training environment that urology has control of, given worldwide access to robotic or at least laparoscopic techniques and strong patient preference. There may be some applications where a given experienced urologist can prefer open over minimally invasive surgery (MIS), such as radical cystectomy, or indications possibly outside of MIS feasibility such as large renal tumors with caval thrombus. Specific to training and expertise, there are 3 principle features of surgical skills desired: 1) knowing ideal exposure, 2) recognition of surgical planes, and 3) knowing anatomy before it can be seen. Although some trainees may only see MIS for certain indications, open surgery may expedite the process. There are no human studies identified on the topic, but a skills lab study was instructive (Farah, J Surgical Education 2023) showing that interns with open and MIS training performed higher comparing pre-intern to post intern bootcamp skills. The benefits of a solid training pathway including open experience are to move trainees towards the faster-to-progress part of the learning curve such that the attending can offer a safe training environment while moving the case along efficiently.The Future of Surgical Skills Evaluation: What Is on Your Wish List?Surgical skills training vary significantly by region with some systems putting trainees on a timed set of years, while others apprentice trainees until meeting a threshold for skills. Early training assessments were basic timed events with qualitative scores (subject to strong attending selection for success). Trainees should experience and/or study the key pitfalls to avoid and performance goals. Surgical simulation can be highly useful, but tend to improve only certain skills and not full case needs. Updated simulation moves from digital to hands on surgical models and may move the needle towards human experience. Training can be augmented with descriptors of surgical gestures and measuring which ones are most effective. The experience for the trainee is often depicted as an "autonomy gap" whereby the training desires to have case control, possibly before they are ready. Progression can be measured by descriptors of performance from assistance through full performance without coaching. The next frontier will be artificial intelligence guided measurement where specific performances can be characterized and diagnosed for success. My ultimate wishlist would be for methods to correlate skills to outcomes, optimized curricula, and a specific pathway to correct underperformance.Tips and Tricks in Challenging Cases of Robotic Radical ProstatectomyThere are many specific challenges with robotic radical prostatectomy (RARP) that can be described and illustrated--the most 5 common are 1) difficulty access, 2) obesity, 3) pubic arch interference, 4) anatomic challenges, and 5) reconstruction challenges. In this video sample, we demonstrate 2 challenges: obesity requiring a pelvic lymph node dissection and significant pelvic de-fatting to identify the proper surgical landmarks. Next a massive sized prostate that has had a partial transurethral resection--together presenting challenges with landmarks, a difficult bladder neck to diagnose, and final reconstruction challenges. Hinotori Robotic System in Urological Surgery: Clinical Applications and Future Potential Ryoichi Shiroki Japan Speaker Surgical Robot-System hinotori in Urological Surgery: Clinical Applications and Future PotentialThe hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has been designed to reduce interference between arms and the surgeon at bedside. Equipped with four 8-axis robotic arms, providing smooth, highly articulated movements that mimic the human hand. In addition, docking-free design allows for a wide operative field around trocars, ensuring smooth workflows for surgeons and assistants. As a made-in-Japan system, it offers high adaptability to local clinical needs and faster implementation of user feedback. Since the first launch, more 90 systems have been installed for the clinical use, not only inside Japan but foreign countries such as Singapore and Malaysia. The first one was performed in December 2020 on prostatectomy. Since then, more than 100,000 cases performed, including urology GI surgery, gynecology and thoracic fields. In urological surgery, robot-assisted surgery has been widely and promptly accepted as a standard approach for the majority of major surgeries, including robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), radical nephrectomy (RARN), radical nephroureterectomy (RANU), and radical cystectomy (RARC), and has generally shown findings superior to those of conventional open and laparoscopic surgeries In conclusion, hinotori is a cutting-edge Japanese surgical robot already in use at many medical institutions. With strong performance across various surgical specialties and growing insurance coverage, it is expected to benefit even more patients as its technology continues to evolve and its global presence expands.Comparison of Various Current Surgical Robotic Systems - Nuances, Advantages, & DrawbacksIn the field of urology, robotic surgery has gained rapid and wide acceptance as a standard surgical care in the majority of surgeries over the last decade. To date, the da Vinci surgical system has been the dominant platform in robotic surgery; however, several newly developed robotic systems have recently been introduced in routine clinical practice. We, Fujita, installed the four different kinds of robotic platform for clinical usage such as, daVinci Xi, SP, hinotori and Hugo. In this study, we want to analyze the perioperative outcomes of robotic radical prostatectomy (RARP) and characterize the differences between four platforms. hinotori : The hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has a compact operation arm with eight axes of motion, one more than the DaVinci, leading to reduce interference between arms and the surgeon at bedside. DaVinci SP : The characteristic of the SP system can operate one 3D flexible camera and three forceps through a single port, and various surgical access is possible without the external interference of the arms. The various complicated procedures have been feasible such as NOTES or transoral surgery through the narrow space without the large wound, and retroperitoneal approach like the prostatectomy and partial nephrectomy. SP system is expected to contribute to develop the high quality surgery with minimal invasiveness. Hugo : Hugo system (Medtronic) consists of an open-site console with two arm-controllers that are operated with a grip similar to a pistol. It also has a footswitch that controls the camera, energy source, and reserve arm. The system includes four separate arm carts, each with six joints to increase the range of motion. Additionally, it uses specific 3D glasses for head tracking technology. Despite a small case series, there seemed to need learning-curve to get familiar with systems in setting-up and surgical procedures in introductory-phase. However, all the surgical procedures were efficaciously and safely performed, resulting in the achievement of favorable perioperative outcomes surgically as well as oncologically. In conclusion, these new robots will lead to competition and reduce the costs of RAS and will contribute to an increase in use. Robotic-assisted surgery will become more common than laparoscopic surgery especially in the field of urology. What's Next in Urologic Robotics in Asia: Future Perspectives Mario Gyung-Tak SungKorea (Republic of) Speaker What's Next in Urologic Robotics in Asia: Future PerspectivesAdvancement of Novel Instruments/Gadgets in Urological Robotic Surgery Panel Discussion Coffee Break Session 2: Robotic Prostate Surgery Edmund ChiongSingapore Moderator Debate: Bladder Preservation Should Be Considered for All Cases of MIBC KoonHo RhaKorea (Republic of) Moderator Trend in Healthcare AI Jian-Ri LiTaiwan Moderator Applying Vision Augmentation in Robotic Surgery: Reality or FictionApplying Vision Augmentation in Robotic Surgery: Reality or Fiction Lessons from 20,000 Robotic Prostatectomies: A Global Expert’s Perspective Vipul R. PatelUnited States Speaker Lessons from 20,000 Robotic Prostatectomies: A Global Expert’s PerspectiveTechnical Considerations for Large Prostates over 100gmsTelesurgery: The Future of Surgery Aquablation Revolutionizing BPH Treatment: A New Era of Minimally Invasive Therapy-Tungs' Taichung Metroharbor Hospital Experience Yen-Chuan OuTaiwan Speaker ARUS–PRUS Partnership Ceremony: A New Chapter in Asia Robotic Urology CollaborationDear colleagues and friends, It’s a great honor to witness the signing of this partnership between the Asian Robotic Urology Society (ARUS) and the Philippines Robotic Urology Society (PRUS). This marks the beginning of a new chapter in regional collaboration—one that emphasizes shared training, joint research, and mutual support to advance robotic urology across Asia. PRUS brings energy, expertise, and vision to this partnership, and ARUS is proud to walk alongside you as we work toward higher standards and better outcomes for our patients. Let us move forward together—with unity, purpose, and innovation. Congratulations to both ARUS and PRUS!Aquablation Revolutionizing BPH Treatment: A New Era of Minimally Invasive Therapy-Tungs' Taichung Metroharbor Hospital ExperienceIntroduction Aquablation is a waterjet ablation therapy for benign prostatic hyperplasia (BPH) that has gained significant attention. While its efficacy, durability, and safety have been established across various prostate sizes (30–150 mL), local data on its efficacy, safety, and learning curve in Taiwan remain limited. Our team have been performed 85 cases between March 2024 and July 2025. This lecture presents the learning curve observed in the first 50 patients who underwent Aquablation for BPH, highlighting its role in revolutionizing BPH treatment. Materials and Methods We conducted a retrospective review of 50 consecutive patients who underwent Aquablation between March 2024 and February 2025, dividing them into two groups: Group I (first 25 cases) and Group II (subsequent 25 cases). Assessments included IPSS, QoL, uroflowmetry parameters (voiding volume, Qmax, Qmean, PVR), operative time, hemoglobin drop, Clavien-Dindo grade ≥2 complications, hospital stay, and urethral catheter duration. Results Patients in Group II were younger and had smaller prostates. Aquablation was successfully performed in all cases. IPSS, QoL, voiding volume, Qmax, and Qmean improved significantly and were sustained for three months, while PVR improved only in Group I. Operative time was significantly shorter in Group II, and hemoglobin drop was greater in Group I. Complication rates, hospital stay, and catheter duration were similar between groups. Conclusions Aquablation provided significant and immediate improvements in voiding parameters and symptoms, with sustained PVR benefits in larger prostates. Surgeon proficiency improved after 25 cases. Overall, Aquablation proved safe and effective, even in an unselected patient population. Aquablation represents a promising advancement that could transform the therapeutic landscape for BPH—particularly if costs are reduced.Experience of 100 Consecutive Hugo Robotic Radical ProstatectomiesIntroduction and background: Dr. Ou’ surgical team of Tungs’ Taichung MetroHarbor Hospital performed the first Hugo robotic radical prostatectomy on May 9, 2023. In 2023, we published the results of the first series of 12 Hugo robotic radical prostatectomies performed. In 2024, we published a comparison of 30 Hugo robotic radical prostatectomies and 30 Da Vinci robotic radical prostatectomies. Professor Ou is the Hugo robotic arm instructor recognized by Medtronic. Many Southeast Asian doctors come to this Hospital to observe the surgery and learn. Material and Methods: We prospectively collected data for retrospective analysis and statistics from May 9, 2023 to April 30, 2025, performing 100 consecutive Hugo robotic radical prostatectomies. We compared the surgical results of 1-50 cases (group 1) and 51-100 cases (group 2). The data analyzed included basic information, age, risk of anesthesia, BMI , prostate-specific antigen, clinical stage, and Gleason score grade. The two groups were compared in terms of surgical difficulty, receipt of neoadjuvant hormonal therapy, obesity, prostate volume >70 g, prostate protrusion more than 1 cm into the bladder neck, previous transurethral resection of prostate, history of abdominal surgery, extensive pelvic lymphadenectomy, salvage radical prostatectomy, and time from biopsy to radical prostatectomy less than 6 weeks. The two groups were compared in terms of robotic console time, blood loss, blood transfusion rate, and surgical complications. We compared the two groups in terms of postoperative pathological staging and grade, the proportion of tumor, and the proportion of urinary control at one month and three months. Results: The study showed that the age of patients in the second group was slightly higher, but the statistical p value was 0.058, which did not reach statistical difference. The second group of patients had significantly higher rates of stage III, stage IV, lymph node and bone oligometastasis, with a p value of 0.021. The rate of neoadjuvant hormonal therapy received by the second group was 16 percent, which was statistically significant compared with 2 percent of the first group (p = 0.021). The rates of other surgical difficulty factors were the same between the two groups. The average blood loss of patients in the second group was 156 CC, which was significantly less than the 208 CC in the first group. The operation time and surgical complications were comparable between the two groups. The cancer volume of the second group of patients was significantly reduced compared with that of the first group (3.30±2.93 versus 5.09±5.24, p value=0.049). The reason was that more patients in the second group received neoadjuvant hormonal therapy, which significantly reduced the cancer. Both groups of patients had very good urinary control after surgery. Conclusion: We conclude that Hugo robotic radical prostatectomy is an effective and feasible method with extremely low complications and good recovery of urinary control function after surgery. After the experience of the first 50 operations, the surgeon will choose patients with higher difficulty, especially those receiving neoadjuvant hormone therapy, to perform the operation.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical ProstatectomyBackground: Robotic-assisted radical prostatectomy (RARP) has become a preferred surgical approach for localized prostate cancer due to its minimally invasive nature and precision. However, the preservation of urinary continence and sexual function remains a significant postoperative challenge. Traditional outcomes have focused heavily on oncological safety. Yet, contemporary perspectives emphasize a more holistic view—embodied in the concept of the “Pentafecta,” which includes continence, potency, negative surgical margins, biochemical recurrence-free survival, and absence of perioperative complications. Objective: This presentation introduces a comprehensive and integrative approach aimed at maximizing functional outcomes—particularly urinary continence and erectile function—through a modified pubovesical complex-sparing RARP under regional hypothermia, supplemented with real-time nerve imaging, neurovascular preservation strategies, and biological enhancement techniques. Methods: We present data and experience from Tungs’ Taichung MetroHarbor Hospital (TTMHH), including a series of 3780 robotic procedures performed between December 2005 and July 2025. Among these, 100 cases were completed using the Hugo™ RAS system and 21 with the da Vinci SP™ platform. Our modified technique builds upon Dr. Richard Gaston’s pubovesical complex-sparing method, with the addition of localized hypothermia (24°C), near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG), and application of dehydrated human amnion/chorion membrane (dHACM). In selected cases, nerve grafting with Axogen® technology was applied. Results: Initial results indicate a significantly improved early return of continence (95% by 16 weeks) and promising erectile function recovery, particularly in patients who received adjunctive therapies such as phosphodiesterase inhibitors or vacuum erection devices. The precision afforded by robotic technology enabled preservation of prostate capsular arteries and accessory pudendal arteries. Localized hypothermia contributed to reduced tissue edema, minimized neural trauma, and improved nerve recovery. The use of ICG-NIRF allowed real-time identification of critical vascular landmarks, enhancing nerve-sparing accuracy. Preliminary analysis suggests our technique is both feasible and reproducible. Conclusion: The modified pubovesical complex-sparing RARP under hypothermia, augmented with vascular imaging and biologic materials, offers a promising paradigm for functional preservation in prostate cancer surgery. This total solution approach not only protects neurovascular integrity but also accelerates recovery of continence and potency. Continued accumulation of clinical cases and controlled comparative studies are warranted to further validate the efficacy and long-term benefits of these techniques. Significance: This strategy reflects a patient-centered evolution in robotic prostate surgery, merging surgical innovation with anatomical preservation and technological augmentation. It represents an epic collaboration of surgical precision, team-based care, and thoughtful application of biomedical advances to improve quality of life outcomes in prostate cancer patients.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical Prostatectomy Update on the Apa Neoadjuvant Trial Isaac KimUnited States Speaker Update on the Apa Neoadjuvant TrialIn patients with high-risk prostate cancer (PCa), neoadjuvant androgen deprivation therapy (ADT) is not an accepted standard of care. However, we hypothesize that neoadjuvant ADT may result in improved quality of life by down-staging prostate cancer and thereby, permitting a better quality of nerve sparing. has demonstrated benefit in surgical outcomes after radical prostatectomy (RP). To test this hypothesis, we conducted a prospective randomized trial evaluating the effect of neoadjuvant Apalutamide (Apa) +/- abiraterone acetate/prednisone (AAP) and a gonadotropin-releasing hormone (GnRH) agonist on nerve sparing during RP in men with high-risk PCa. Update on the Results of SIMCAP StudyApproximately 7% of new prostate cancer (PCa) patients in the US will be diagnosed with metastatic disease. The role of surgery in this population remains unclear. To investigate the therapeutic value of radical prostatectomy in men with de novo metastatic prostate cancer, we are conducting the phase 2.5 randomized clinical trial SIMCAP (NCT03456843). Robotic Radical Prostatectomy: Trying to Fit the Right Surgery to the Right Patient Cheng-Kuang YangTaiwan Speaker Robotic Radical Prostatectomy: Trying to Fit the Right Surgery to the Right PatientDefinitive treatment for localized prostate cancer included radical prostatectomy and radiation. Successful criteria of radical prostatectomy have to meet oncology control, not persistent PSA after surgery without salvage therapy. MRI imaging stage and PSA density are predictors for short‐term BCR after prostatectomy. NCCN‐defined high‐risk patients with a high initial PSA 28 density, imaging stage (T3aN0M0 and T3bN0M0), and 29 pathologic stage (any N1) had a higher risk of BCR when 30 compared with other patients with undetectable PSA, while 31 those with pathologic stage (T3bN0M0 or any N1) displayed 32 a higher risk of postoperatively detectable PSA. These find‐ 33 ings may help urologists to identify patients for whom active 34 therapeutic protocols are necessary. Single-Port vs. Multi-Port Robotic Prostatectomy: Balancing Innovation, Precision, and Outcomes 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 Comparison of Hood technique vs Retzius sparing RARP: Beijing Hospital Experience. Ming LiuChina Speaker Comparison of Hood technique vs Retzius sparing RARP: Beijing Hospital Experience. Panel Discussion Lunch Break Session 3: Robotic Kidney and Vascular Surgery Eddie ChanHong Kong, China Moderator How to Escape Surgical ComplicationsSurgical complications can significantly impact patient outcomes and healthcare resources. This talk will focus on practical strategies to minimize complications in urologic surgery, tailored specifically for urology fellows. Real-life case examples will illustrate how thoughtful preparation and proactive communication can prevent or mitigate complications. Additionally, we will discuss structured approaches to managing complications when they arise, including communication with the patient and team, documentation, and timely intervention. Through real-life case examples, this session aims to enhance surgical judgment, promote patient safety, and build confidence in complication management. Bannakij LojanapiwatThailand Moderator PSA Kinetics Following PADT in mHSPC. Is It a Real-World Tool for Predicting Oncologic Outcome?PSA Kinetics following Primary Androgen Deprivation Therapy (PADT) in mHSPC. Is it a Real-world Tool for Prediction Oncologic Outcome? Bannakij Lojanapiwat, M.D. Professor of Urology, Chiang Mai University, Thailand. Of recent guidelines, upfront primary androgen deprivation monotherapy or combination therapy (PADT) is recommended for the treatment of metastatic hormone sensitive prostate cancer (mHSPC). Limitation of real-world treatment such as culture difference, financial barrier, geographic access to treatment and high operation/ radiation risks associated with medical comorbidity led to underutilization of combination therapy as the standard guideline. Prognostic factors are important in clinical practice which can predict the clinical outcome that offer the pre-treatment counseling for patients to select the optimal treatment. Prostate specific antigen (PSA) levels is one of the important key prognostic markers. PSA kinetics of nadir PSA level and time to nadir PSA following the treatment are the important role for progression to CRPC and oncologic outcome. Our study and the previous studies reported better oncologic outcome especially overall survival, cancer specific survival and time to developed CRPC in mHSPC patients received upfront PADT who decline PSA≥95% (deep responder), PSA nadir ≤ 0.2 ng/ml (low PSA nadir level), time to PSA nadir ≥ 6 month and PSA decline velocity <11 ng/ml/month. PSA Kinetics following Primary Androgen Deprivation Therapy (PADT) is one of a real-world tool for prediction oncologic outcome in the treatment of mHSPC. Jeff S. ChuehTaiwan Moderator Expanding Horizons: SP for Complex RAPN Ketan BadaniUnited States Speaker Expanding horizons: SP for complex RAPNThe Future of Urological Robotic SurgerySingle-Port Robotic Partial Nephrectomy for Multiple or Large Renal TumorsHow to Standardize Training by AI-Learning from The Best Practice of Urological Robotic SurgerySP Partial Nephrectomy Partial Nephrectomy: Managing Complications and Challenging Cases Hsiao-Jen ChungTaiwan Speaker Partial Nephrectomy: Managing Complications and Challenging Cases Robotic IVC Thrombectomy: Expanding the Role of Robotics in Vascular Involvement Xuepei ZhangChina Speaker Robotic IVC Thrombectomy: Expanding the Role of Robotics in Vascular Involvement Panel Discussion Session 4: Robotic Reconstructive Surgery Jason Lui LetranPhilippines Moderator ARUS–PRUS Partnership Ceremony: A New Chapter in Asia Robotic Urology Collaboration Pai-Fu WangTaiwan Moderator Teng-Aik OngMalaysia Moderator Robotic Sacrocolpopexy: Techniques, Challenges, and Long-Term Outcomes Jimmy NomuraJapan Speaker Robotic Sacrocolpopexy: Techniques, Challenges, and Long-Term Outcomes Robotic Vesico-Rectal and Vesico-Vaginal Repair: Innovations in Complex Fistula Management Narasimhan RagavanIndia Speaker Robotic Vesico-Rectal and Vesico-Vaginal Repair: Innovations in Complex Fistula ManagementWe will be presenting our work on Vesicle vaginal fistula . We have described this as Chennai technique . Robotic Ureteral Reconstruction: Managing Strictures and Injuries Xuesong LiChina Speaker Robotic Ureteral Reconstruction: Managing Strictures and Injuries Panel Discussion Coffee Break Session 5: Robotic Bladder Surgery Masatoshi EtoJapan Moderator Current Status & Future Perspective of Surgical Navigation in Robotic SurgeryRobot-assisted partial nephrectomy (RAPN) is a standard treatment for small renal cancer, however, the number of reports on the development of the image supported system and its effectiveness is small. The key point in the procedure of RAPN is to reliably identify renal artery in a space with few landmarks and to resect a tumor. To performe RAPN safely and reliably, we have already developed a surgical navigation specialized for RAPN, and published its usefulness in daVinci surgical systems. In this lecture, I would like to talk our recent projects updating our current navigation system. The first project focuses on 3D navigation using real-time forceps tracking. The second project is to develop an AI-based autonomous registration method for surgical navigation in RAPN. I hope that these 2 projects will further enhance the usefulness of our navigation system in RAPN. Jeremy TeohHong Kong, China Moderator Transurethral En Bloc Resection of Bladder Tumor: Where Are We Now?There is increasing evidence that transurethral en bloc resection of bladder tumour (ERBT) could lead to better peri-operative and oncological outcomes in patients with non-muscle-invasive bladder cancer. Modified approaches of ERBT have also been proposed to expand its indications for larger bladder tumours. The quality of resection is also the key for bladder-sparing treatment for muscle-invasive bladder cancer. We foresee an exciting journey ahead for ERBT, and as a urologist, we must embrace this novel technique for the best interest of our bladder cancer patients. To Publish or not to Publish? Navigating the path to academia in urologyDoing good science is the basis for technological advancement in healthcare. However, pursuing a path to academic in urology is often tough, stressful and frustrating. In this talk, I will share with you what I have learnt throughout my 15 years of research work. I will let you know what's the best and fastest way to become a globally renowned and successful researcher. Most importantly, I will explain what it takes to develop a great team and create a positive impact in people's lives. Believe in yourself! If I can do it, so can you.SIU Lecture: Role of MISTs in Male LUTS Surgical Management (Will TUR-P/ Laser Prostatectomy be Replaced?)Transurethral resection of prostate (TURP) is the current gold standard in treating patients with benign prostatic hyperplasia. Laser prostatectomy has also been used widely especially in patients who are on anticoagulants. However, both TURP and laser prostatectomy are associated with several problems including the need of spinal / general anaesthesia and the risk of male sexual dysfunction. In the past decade, we have witnessed the introduction of multiple new technologies including Rezum, Urolift, iTind and Aquablation. in this SIU lecture, we will discuss about the technical details, as well as the pros and cons of every new technology. We will also invite you to be our jury and decide whether TURP and laser prostatectomy will be replaced in the future. Novel Intravesical Therapeutics in the Evolving Landscape of NMIBCNon-muscle-invasive bladder cancer (NMIBC) is well known to be a difficult disease to manage, with a 1-year recurrence rate of up to 61% and 5-year recurrence rate of 78%. Despite the use of intravesical BCG therapy, NMIBC patients may still experience recurrence and develop what we call BCG-unresponsive NMIBC. Conventionally, we offer upfront radical cystectomy for patients with BCG-unresponsive NMIBC, however, this is an ultra-major surgery with significant risk of complications and could also lead to significant deterioration in quality of life in the long run. We are in urgent need for novel therapies to manage this difficult condition. In this lecture, we will discuss the evidence on the different novel intravesical therapies in treating BCG-unresponsive NMIBC. SIU Lecture: Role of MISTs in Male LUTS Surgical Management (Will TUR-P/ Laser Prostatectomy be Replaced?) 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 Mastering the Details: Tips and Tricks on Robotic Radical Cystectomy Kittinut KijvikaiThailand Speaker Robotic Surgery: Past, Present and Future PerspectivesMastering the Details: Tips and Tricks on Robotic Radical Cystectomy Step-by-Step: Intra-Corporeal Orthotopic Bladder Creation Wei-Yu LinTaiwan Speaker Step-by-Step: Intra-Corporeal Orthotopic Bladder CreationIntra-corporeal orthotopic neobladder creation is a technically demanding yet feasible procedure performed following robotic radical cystectomy. Using a 40–50 cm segment of ileum, the bowel is isolated, detubularized along the antimesenteric border, and configured into a low-pressure reservoir. Urethro-ileal anastomosis is carefully performed to ensure a tension-free, watertight connection, followed by uretero-ileal anastomoses using the Wallace technique with ureteral stent placement. The intra-corporeal approach minimizes bowel handling, facilitates faster recovery, and preserves pelvic anatomy, offering potential advantages in continence and postoperative outcomes when performed by experienced robotic surgeons. Robotic Pelvic LN Dissection: A critical Component of Bladder Cancer Surgery Noor Ashani Md YusoffMalaysia Speaker Technical Pearls: Node Dissection in Robotic CystectomyHighlight and Limitation in Urology Service in MalaysiaRobotic Pelvic LN Dissection: A critical Component of Bladder Cancer Surgery Panel Discussion Honoring the Past, Embracing the Future: ARUS Business Session and Presidential Handover Yen-Chuan OuTaiwan Speaker ARUS–PRUS Partnership Ceremony: A New Chapter in Asia Robotic Urology CollaborationDear colleagues and friends, It’s a great honor to witness the signing of this partnership between the Asian Robotic Urology Society (ARUS) and the Philippines Robotic Urology Society (PRUS). This marks the beginning of a new chapter in regional collaboration—one that emphasizes shared training, joint research, and mutual support to advance robotic urology across Asia. PRUS brings energy, expertise, and vision to this partnership, and ARUS is proud to walk alongside you as we work toward higher standards and better outcomes for our patients. Let us move forward together—with unity, purpose, and innovation. Congratulations to both ARUS and PRUS!Aquablation Revolutionizing BPH Treatment: A New Era of Minimally Invasive Therapy-Tungs' Taichung Metroharbor Hospital ExperienceIntroduction Aquablation is a waterjet ablation therapy for benign prostatic hyperplasia (BPH) that has gained significant attention. While its efficacy, durability, and safety have been established across various prostate sizes (30–150 mL), local data on its efficacy, safety, and learning curve in Taiwan remain limited. Our team have been performed 85 cases between March 2024 and July 2025. This lecture presents the learning curve observed in the first 50 patients who underwent Aquablation for BPH, highlighting its role in revolutionizing BPH treatment. Materials and Methods We conducted a retrospective review of 50 consecutive patients who underwent Aquablation between March 2024 and February 2025, dividing them into two groups: Group I (first 25 cases) and Group II (subsequent 25 cases). Assessments included IPSS, QoL, uroflowmetry parameters (voiding volume, Qmax, Qmean, PVR), operative time, hemoglobin drop, Clavien-Dindo grade ≥2 complications, hospital stay, and urethral catheter duration. Results Patients in Group II were younger and had smaller prostates. Aquablation was successfully performed in all cases. IPSS, QoL, voiding volume, Qmax, and Qmean improved significantly and were sustained for three months, while PVR improved only in Group I. Operative time was significantly shorter in Group II, and hemoglobin drop was greater in Group I. Complication rates, hospital stay, and catheter duration were similar between groups. Conclusions Aquablation provided significant and immediate improvements in voiding parameters and symptoms, with sustained PVR benefits in larger prostates. Surgeon proficiency improved after 25 cases. Overall, Aquablation proved safe and effective, even in an unselected patient population. Aquablation represents a promising advancement that could transform the therapeutic landscape for BPH—particularly if costs are reduced.Experience of 100 Consecutive Hugo Robotic Radical ProstatectomiesIntroduction and background: Dr. Ou’ surgical team of Tungs’ Taichung MetroHarbor Hospital performed the first Hugo robotic radical prostatectomy on May 9, 2023. In 2023, we published the results of the first series of 12 Hugo robotic radical prostatectomies performed. In 2024, we published a comparison of 30 Hugo robotic radical prostatectomies and 30 Da Vinci robotic radical prostatectomies. Professor Ou is the Hugo robotic arm instructor recognized by Medtronic. Many Southeast Asian doctors come to this Hospital to observe the surgery and learn. Material and Methods: We prospectively collected data for retrospective analysis and statistics from May 9, 2023 to April 30, 2025, performing 100 consecutive Hugo robotic radical prostatectomies. We compared the surgical results of 1-50 cases (group 1) and 51-100 cases (group 2). The data analyzed included basic information, age, risk of anesthesia, BMI , prostate-specific antigen, clinical stage, and Gleason score grade. The two groups were compared in terms of surgical difficulty, receipt of neoadjuvant hormonal therapy, obesity, prostate volume >70 g, prostate protrusion more than 1 cm into the bladder neck, previous transurethral resection of prostate, history of abdominal surgery, extensive pelvic lymphadenectomy, salvage radical prostatectomy, and time from biopsy to radical prostatectomy less than 6 weeks. The two groups were compared in terms of robotic console time, blood loss, blood transfusion rate, and surgical complications. We compared the two groups in terms of postoperative pathological staging and grade, the proportion of tumor, and the proportion of urinary control at one month and three months. Results: The study showed that the age of patients in the second group was slightly higher, but the statistical p value was 0.058, which did not reach statistical difference. The second group of patients had significantly higher rates of stage III, stage IV, lymph node and bone oligometastasis, with a p value of 0.021. The rate of neoadjuvant hormonal therapy received by the second group was 16 percent, which was statistically significant compared with 2 percent of the first group (p = 0.021). The rates of other surgical difficulty factors were the same between the two groups. The average blood loss of patients in the second group was 156 CC, which was significantly less than the 208 CC in the first group. The operation time and surgical complications were comparable between the two groups. The cancer volume of the second group of patients was significantly reduced compared with that of the first group (3.30±2.93 versus 5.09±5.24, p value=0.049). The reason was that more patients in the second group received neoadjuvant hormonal therapy, which significantly reduced the cancer. Both groups of patients had very good urinary control after surgery. Conclusion: We conclude that Hugo robotic radical prostatectomy is an effective and feasible method with extremely low complications and good recovery of urinary control function after surgery. After the experience of the first 50 operations, the surgeon will choose patients with higher difficulty, especially those receiving neoadjuvant hormone therapy, to perform the operation.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical ProstatectomyBackground: Robotic-assisted radical prostatectomy (RARP) has become a preferred surgical approach for localized prostate cancer due to its minimally invasive nature and precision. However, the preservation of urinary continence and sexual function remains a significant postoperative challenge. Traditional outcomes have focused heavily on oncological safety. Yet, contemporary perspectives emphasize a more holistic view—embodied in the concept of the “Pentafecta,” which includes continence, potency, negative surgical margins, biochemical recurrence-free survival, and absence of perioperative complications. Objective: This presentation introduces a comprehensive and integrative approach aimed at maximizing functional outcomes—particularly urinary continence and erectile function—through a modified pubovesical complex-sparing RARP under regional hypothermia, supplemented with real-time nerve imaging, neurovascular preservation strategies, and biological enhancement techniques. Methods: We present data and experience from Tungs’ Taichung MetroHarbor Hospital (TTMHH), including a series of 3780 robotic procedures performed between December 2005 and July 2025. Among these, 100 cases were completed using the Hugo™ RAS system and 21 with the da Vinci SP™ platform. Our modified technique builds upon Dr. Richard Gaston’s pubovesical complex-sparing method, with the addition of localized hypothermia (24°C), near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG), and application of dehydrated human amnion/chorion membrane (dHACM). In selected cases, nerve grafting with Axogen® technology was applied. Results: Initial results indicate a significantly improved early return of continence (95% by 16 weeks) and promising erectile function recovery, particularly in patients who received adjunctive therapies such as phosphodiesterase inhibitors or vacuum erection devices. The precision afforded by robotic technology enabled preservation of prostate capsular arteries and accessory pudendal arteries. Localized hypothermia contributed to reduced tissue edema, minimized neural trauma, and improved nerve recovery. The use of ICG-NIRF allowed real-time identification of critical vascular landmarks, enhancing nerve-sparing accuracy. Preliminary analysis suggests our technique is both feasible and reproducible. Conclusion: The modified pubovesical complex-sparing RARP under hypothermia, augmented with vascular imaging and biologic materials, offers a promising paradigm for functional preservation in prostate cancer surgery. This total solution approach not only protects neurovascular integrity but also accelerates recovery of continence and potency. Continued accumulation of clinical cases and controlled comparative studies are warranted to further validate the efficacy and long-term benefits of these techniques. Significance: This strategy reflects a patient-centered evolution in robotic prostate surgery, merging surgical innovation with anatomical preservation and technological augmentation. It represents an epic collaboration of surgical precision, team-based care, and thoughtful application of biomedical advances to improve quality of life outcomes in prostate cancer patients.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical Prostatectomy Gang ZhuChina Speaker Enhancing Robotic Surgery with AI and Imaging Navigation: Bridging Precision and EfficiencyBackground: Robotic surgery faces persistent challenges in real-time anatomical navigation during complex procedures like partial nephrectomy (PN), where millimeter-scale precision impacts oncological and functional outcomes. Objective: This review explores the integration of artificial intelligence (AI) and augmented reality (AR)-based holographic imaging to overcome these limitations, synergistically advancing surgical precision and operational efficiency. Design, setting and participants: Holographic imaging, an AR technique reconstructed from CT/MRI via surface rendering, provides detailed 3D anatomical models for preoperative planning, patient counseling, surgical training, and intraoperative navigation. These models enable precise tumor localization, super-selective vascular clamping, and parenchymal preservation, in particular the PN. Results: Clinical outcomes demonstrate significant improvements. AI-automated modeling cuts 3D model reconstruction time while improving segmentation accuracy. AI enhanced holographic imaging in patient consultation, education and training, surgical planning, and surgical navigation have demonstrated value. Holographic imaging navigation overlays virtual models onto endoscopic views, reducing collecting system injury and increasing enucleation rates for endophytic tumors. AI-based holographic imaging visualization alters surgical strategy for complex cases, reducing conversion from partial to radical nephrectomy. Challenges persist in tracking robustness due to intraoperative organ deformation. Future directions include multimodal Integration: Combining holographic imaging and PET CT to define the metastatic lymph nodes, enabling personalized complete resection; Full-Cycle Coverage: Extending from preoperative assessment to postoperative recovery (e.g., recurrence prediction, customized rehabilitation plans); Telesurgery Empowerment: 5G + holographic imaging to support telesurgical guidance, promoting the decentralization of medical resources. Conclusions: AI-powered holographic imaging navigation bridges critical gaps in robotic surgery by transforming static anatomical data into dynamic, real-time guidance. This synergy enhances precision in tumor resection and vascular management while streamlining workflows—ultimately improving patient outcomes through reduced ischemia, fewer complications, and greater nephron preservation, enhancing survival and quality of life for cancer patients. Real-time navigation integrating “anatomy-function-metabolism”, advancing MIS from “precision resection” to “personalized treatment” and "functional preservation”. Xu Zhang China Speaker From Console to Cloud: The Evolution of Robotic Telesurgery in Urology – Innovations, Trials, and Ethical FrontiersTelesurgery is an emerging branch of surgery that utilizes telecommunication technology and surgical robots to perform operations. It breaks the spatial constraints on the conduct of surgical procedures and represents a systematic innovation brought about by the intersection of new technologies and concepts such as robotic surgery, telecommunication, and artificial intelligence. It holds promise as a potential solution to the uneven distribution of medical resources. Currently, China's research in telesurgery has reached the forefront of the international stage. Building a high-quality disciplinary development ecosystem and a regional collaborative system for remote surgery will be the inevitable path to maintaining a leading position. Providing national-level project support for telesurgery, establishing a national-level joint innovation group, creating a regional medical consortium for remote surgery, and formulating legal norms and treatment guidelines will pave the way for the sustainable development of telesurgery in China. It is believed that with the strong support of the state, Chinese surgeons will seize the opportunity, lead the new wave of surgical development, integrate new telesurgery technologies into the national universal healthcare system, and benefit a large number of patients. ARUS Closing Remarks Ryoichi Shiroki Japan Speaker Surgical Robot-System hinotori in Urological Surgery: Clinical Applications and Future PotentialThe hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has been designed to reduce interference between arms and the surgeon at bedside. Equipped with four 8-axis robotic arms, providing smooth, highly articulated movements that mimic the human hand. In addition, docking-free design allows for a wide operative field around trocars, ensuring smooth workflows for surgeons and assistants. As a made-in-Japan system, it offers high adaptability to local clinical needs and faster implementation of user feedback. Since the first launch, more 90 systems have been installed for the clinical use, not only inside Japan but foreign countries such as Singapore and Malaysia. The first one was performed in December 2020 on prostatectomy. Since then, more than 100,000 cases performed, including urology GI surgery, gynecology and thoracic fields. In urological surgery, robot-assisted surgery has been widely and promptly accepted as a standard approach for the majority of major surgeries, including robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), radical nephrectomy (RARN), radical nephroureterectomy (RANU), and radical cystectomy (RARC), and has generally shown findings superior to those of conventional open and laparoscopic surgeries In conclusion, hinotori is a cutting-edge Japanese surgical robot already in use at many medical institutions. With strong performance across various surgical specialties and growing insurance coverage, it is expected to benefit even more patients as its technology continues to evolve and its global presence expands.Comparison of Various Current Surgical Robotic Systems - Nuances, Advantages, & DrawbacksIn the field of urology, robotic surgery has gained rapid and wide acceptance as a standard surgical care in the majority of surgeries over the last decade. To date, the da Vinci surgical system has been the dominant platform in robotic surgery; however, several newly developed robotic systems have recently been introduced in routine clinical practice. We, Fujita, installed the four different kinds of robotic platform for clinical usage such as, daVinci Xi, SP, hinotori and Hugo. In this study, we want to analyze the perioperative outcomes of robotic radical prostatectomy (RARP) and characterize the differences between four platforms. hinotori : The hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has a compact operation arm with eight axes of motion, one more than the DaVinci, leading to reduce interference between arms and the surgeon at bedside. DaVinci SP : The characteristic of the SP system can operate one 3D flexible camera and three forceps through a single port, and various surgical access is possible without the external interference of the arms. The various complicated procedures have been feasible such as NOTES or transoral surgery through the narrow space without the large wound, and retroperitoneal approach like the prostatectomy and partial nephrectomy. SP system is expected to contribute to develop the high quality surgery with minimal invasiveness. Hugo : Hugo system (Medtronic) consists of an open-site console with two arm-controllers that are operated with a grip similar to a pistol. It also has a footswitch that controls the camera, energy source, and reserve arm. The system includes four separate arm carts, each with six joints to increase the range of motion. Additionally, it uses specific 3D glasses for head tracking technology. Despite a small case series, there seemed to need learning-curve to get familiar with systems in setting-up and surgical procedures in introductory-phase. However, all the surgical procedures were efficaciously and safely performed, resulting in the achievement of favorable perioperative outcomes surgically as well as oncologically. In conclusion, these new robots will lead to competition and reduce the costs of RAS and will contribute to an increase in use. Robotic-assisted surgery will become more common than laparoscopic surgery especially in the field of urology. Gang ZhuChina Speaker Enhancing Robotic Surgery with AI and Imaging Navigation: Bridging Precision and EfficiencyBackground: Robotic surgery faces persistent challenges in real-time anatomical navigation during complex procedures like partial nephrectomy (PN), where millimeter-scale precision impacts oncological and functional outcomes. Objective: This review explores the integration of artificial intelligence (AI) and augmented reality (AR)-based holographic imaging to overcome these limitations, synergistically advancing surgical precision and operational efficiency. Design, setting and participants: Holographic imaging, an AR technique reconstructed from CT/MRI via surface rendering, provides detailed 3D anatomical models for preoperative planning, patient counseling, surgical training, and intraoperative navigation. These models enable precise tumor localization, super-selective vascular clamping, and parenchymal preservation, in particular the PN. Results: Clinical outcomes demonstrate significant improvements. AI-automated modeling cuts 3D model reconstruction time while improving segmentation accuracy. AI enhanced holographic imaging in patient consultation, education and training, surgical planning, and surgical navigation have demonstrated value. Holographic imaging navigation overlays virtual models onto endoscopic views, reducing collecting system injury and increasing enucleation rates for endophytic tumors. AI-based holographic imaging visualization alters surgical strategy for complex cases, reducing conversion from partial to radical nephrectomy. Challenges persist in tracking robustness due to intraoperative organ deformation. Future directions include multimodal Integration: Combining holographic imaging and PET CT to define the metastatic lymph nodes, enabling personalized complete resection; Full-Cycle Coverage: Extending from preoperative assessment to postoperative recovery (e.g., recurrence prediction, customized rehabilitation plans); Telesurgery Empowerment: 5G + holographic imaging to support telesurgical guidance, promoting the decentralization of medical resources. Conclusions: AI-powered holographic imaging navigation bridges critical gaps in robotic surgery by transforming static anatomical data into dynamic, real-time guidance. This synergy enhances precision in tumor resection and vascular management while streamlining workflows—ultimately improving patient outcomes through reduced ischemia, fewer complications, and greater nephron preservation, enhancing survival and quality of life for cancer patients. Real-time navigation integrating “anatomy-function-metabolism”, advancing MIS from “precision resection” to “personalized treatment” and "functional preservation”. TICC - 1F 101D
18:30 20:40	Industry Symposium 1 【Minimal Invasive Surgery Medical Foundation】 Da Vinci SP Experience Sharing Session How Shall We Start? Opening Jeff S. ChuehTaiwan Speaker How to Start SP Application in Urology? Ryoichi Shiroki Japan Moderator Surgical Robot-System hinotori in Urological Surgery: Clinical Applications and Future PotentialThe hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has been designed to reduce interference between arms and the surgeon at bedside. Equipped with four 8-axis robotic arms, providing smooth, highly articulated movements that mimic the human hand. In addition, docking-free design allows for a wide operative field around trocars, ensuring smooth workflows for surgeons and assistants. As a made-in-Japan system, it offers high adaptability to local clinical needs and faster implementation of user feedback. Since the first launch, more 90 systems have been installed for the clinical use, not only inside Japan but foreign countries such as Singapore and Malaysia. The first one was performed in December 2020 on prostatectomy. Since then, more than 100,000 cases performed, including urology GI surgery, gynecology and thoracic fields. In urological surgery, robot-assisted surgery has been widely and promptly accepted as a standard approach for the majority of major surgeries, including robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), radical nephrectomy (RARN), radical nephroureterectomy (RANU), and radical cystectomy (RARC), and has generally shown findings superior to those of conventional open and laparoscopic surgeries In conclusion, hinotori is a cutting-edge Japanese surgical robot already in use at many medical institutions. With strong performance across various surgical specialties and growing insurance coverage, it is expected to benefit even more patients as its technology continues to evolve and its global presence expands.Comparison of Various Current Surgical Robotic Systems - Nuances, Advantages, & DrawbacksIn the field of urology, robotic surgery has gained rapid and wide acceptance as a standard surgical care in the majority of surgeries over the last decade. To date, the da Vinci surgical system has been the dominant platform in robotic surgery; however, several newly developed robotic systems have recently been introduced in routine clinical practice. We, Fujita, installed the four different kinds of robotic platform for clinical usage such as, daVinci Xi, SP, hinotori and Hugo. In this study, we want to analyze the perioperative outcomes of robotic radical prostatectomy (RARP) and characterize the differences between four platforms. hinotori : The hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has a compact operation arm with eight axes of motion, one more than the DaVinci, leading to reduce interference between arms and the surgeon at bedside. DaVinci SP : The characteristic of the SP system can operate one 3D flexible camera and three forceps through a single port, and various surgical access is possible without the external interference of the arms. The various complicated procedures have been feasible such as NOTES or transoral surgery through the narrow space without the large wound, and retroperitoneal approach like the prostatectomy and partial nephrectomy. SP system is expected to contribute to develop the high quality surgery with minimal invasiveness. Hugo : Hugo system (Medtronic) consists of an open-site console with two arm-controllers that are operated with a grip similar to a pistol. It also has a footswitch that controls the camera, energy source, and reserve arm. The system includes four separate arm carts, each with six joints to increase the range of motion. Additionally, it uses specific 3D glasses for head tracking technology. Despite a small case series, there seemed to need learning-curve to get familiar with systems in setting-up and surgical procedures in introductory-phase. However, all the surgical procedures were efficaciously and safely performed, resulting in the achievement of favorable perioperative outcomes surgically as well as oncologically. In conclusion, these new robots will lead to competition and reduce the costs of RAS and will contribute to an increase in use. Robotic-assisted surgery will become more common than laparoscopic surgery especially in the field of urology. Jeff S. ChuehTaiwan Moderator Steven L. ChangUnited States Speaker The Progression Landscape of Diagnostic and Treatment Options for Kidney CancerPros and Cons in the daVinci SP System Applications in Urological Surgeries What Are Patient Selection Criterion for SP in Early Phase? Jeff S. ChuehTaiwan Moderator Ryoichi Shiroki Japan Moderator Surgical Robot-System hinotori in Urological Surgery: Clinical Applications and Future PotentialThe hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has been designed to reduce interference between arms and the surgeon at bedside. Equipped with four 8-axis robotic arms, providing smooth, highly articulated movements that mimic the human hand. In addition, docking-free design allows for a wide operative field around trocars, ensuring smooth workflows for surgeons and assistants. As a made-in-Japan system, it offers high adaptability to local clinical needs and faster implementation of user feedback. Since the first launch, more 90 systems have been installed for the clinical use, not only inside Japan but foreign countries such as Singapore and Malaysia. The first one was performed in December 2020 on prostatectomy. Since then, more than 100,000 cases performed, including urology GI surgery, gynecology and thoracic fields. In urological surgery, robot-assisted surgery has been widely and promptly accepted as a standard approach for the majority of major surgeries, including robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), radical nephrectomy (RARN), radical nephroureterectomy (RANU), and radical cystectomy (RARC), and has generally shown findings superior to those of conventional open and laparoscopic surgeries In conclusion, hinotori is a cutting-edge Japanese surgical robot already in use at many medical institutions. With strong performance across various surgical specialties and growing insurance coverage, it is expected to benefit even more patients as its technology continues to evolve and its global presence expands.Comparison of Various Current Surgical Robotic Systems - Nuances, Advantages, & DrawbacksIn the field of urology, robotic surgery has gained rapid and wide acceptance as a standard surgical care in the majority of surgeries over the last decade. To date, the da Vinci surgical system has been the dominant platform in robotic surgery; however, several newly developed robotic systems have recently been introduced in routine clinical practice. We, Fujita, installed the four different kinds of robotic platform for clinical usage such as, daVinci Xi, SP, hinotori and Hugo. In this study, we want to analyze the perioperative outcomes of robotic radical prostatectomy (RARP) and characterize the differences between four platforms. hinotori : The hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has a compact operation arm with eight axes of motion, one more than the DaVinci, leading to reduce interference between arms and the surgeon at bedside. DaVinci SP : The characteristic of the SP system can operate one 3D flexible camera and three forceps through a single port, and various surgical access is possible without the external interference of the arms. The various complicated procedures have been feasible such as NOTES or transoral surgery through the narrow space without the large wound, and retroperitoneal approach like the prostatectomy and partial nephrectomy. SP system is expected to contribute to develop the high quality surgery with minimal invasiveness. Hugo : Hugo system (Medtronic) consists of an open-site console with two arm-controllers that are operated with a grip similar to a pistol. It also has a footswitch that controls the camera, energy source, and reserve arm. The system includes four separate arm carts, each with six joints to increase the range of motion. Additionally, it uses specific 3D glasses for head tracking technology. Despite a small case series, there seemed to need learning-curve to get familiar with systems in setting-up and surgical procedures in introductory-phase. However, all the surgical procedures were efficaciously and safely performed, resulting in the achievement of favorable perioperative outcomes surgically as well as oncologically. In conclusion, these new robots will lead to competition and reduce the costs of RAS and will contribute to an increase in use. Robotic-assisted surgery will become more common than laparoscopic surgery especially in the field of urology. John DavisUnited States Speaker Open Surgery Training: Is It Necessary in the Era of Robotics?Open surgery training in the era of robotics may or may not be a training environment that urology has control of, given worldwide access to robotic or at least laparoscopic techniques and strong patient preference. There may be some applications where a given experienced urologist can prefer open over minimally invasive surgery (MIS), such as radical cystectomy, or indications possibly outside of MIS feasibility such as large renal tumors with caval thrombus. Specific to training and expertise, there are 3 principle features of surgical skills desired: 1) knowing ideal exposure, 2) recognition of surgical planes, and 3) knowing anatomy before it can be seen. Although some trainees may only see MIS for certain indications, open surgery may expedite the process. There are no human studies identified on the topic, but a skills lab study was instructive (Farah, J Surgical Education 2023) showing that interns with open and MIS training performed higher comparing pre-intern to post intern bootcamp skills. The benefits of a solid training pathway including open experience are to move trainees towards the faster-to-progress part of the learning curve such that the attending can offer a safe training environment while moving the case along efficiently.The Future of Surgical Skills Evaluation: What Is on Your Wish List?Surgical skills training vary significantly by region with some systems putting trainees on a timed set of years, while others apprentice trainees until meeting a threshold for skills. Early training assessments were basic timed events with qualitative scores (subject to strong attending selection for success). Trainees should experience and/or study the key pitfalls to avoid and performance goals. Surgical simulation can be highly useful, but tend to improve only certain skills and not full case needs. Updated simulation moves from digital to hands on surgical models and may move the needle towards human experience. Training can be augmented with descriptors of surgical gestures and measuring which ones are most effective. The experience for the trainee is often depicted as an "autonomy gap" whereby the training desires to have case control, possibly before they are ready. Progression can be measured by descriptors of performance from assistance through full performance without coaching. The next frontier will be artificial intelligence guided measurement where specific performances can be characterized and diagnosed for success. My ultimate wishlist would be for methods to correlate skills to outcomes, optimized curricula, and a specific pathway to correct underperformance.Tips and Tricks in Challenging Cases of Robotic Radical ProstatectomyThere are many specific challenges with robotic radical prostatectomy (RARP) that can be described and illustrated--the most 5 common are 1) difficulty access, 2) obesity, 3) pubic arch interference, 4) anatomic challenges, and 5) reconstruction challenges. In this video sample, we demonstrate 2 challenges: obesity requiring a pelvic lymph node dissection and significant pelvic de-fatting to identify the proper surgical landmarks. Next a massive sized prostate that has had a partial transurethral resection--together presenting challenges with landmarks, a difficult bladder neck to diagnose, and final reconstruction challenges. Q&A and Discussion Tea Break Pivoting Your Procedure to Broader Range New Approach and Application with SP Jeff S. ChuehTaiwan Moderator Ryoichi Shiroki Japan Moderator Surgical Robot-System hinotori in Urological Surgery: Clinical Applications and Future PotentialThe hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has been designed to reduce interference between arms and the surgeon at bedside. Equipped with four 8-axis robotic arms, providing smooth, highly articulated movements that mimic the human hand. In addition, docking-free design allows for a wide operative field around trocars, ensuring smooth workflows for surgeons and assistants. As a made-in-Japan system, it offers high adaptability to local clinical needs and faster implementation of user feedback. Since the first launch, more 90 systems have been installed for the clinical use, not only inside Japan but foreign countries such as Singapore and Malaysia. The first one was performed in December 2020 on prostatectomy. Since then, more than 100,000 cases performed, including urology GI surgery, gynecology and thoracic fields. In urological surgery, robot-assisted surgery has been widely and promptly accepted as a standard approach for the majority of major surgeries, including robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), radical nephrectomy (RARN), radical nephroureterectomy (RANU), and radical cystectomy (RARC), and has generally shown findings superior to those of conventional open and laparoscopic surgeries In conclusion, hinotori is a cutting-edge Japanese surgical robot already in use at many medical institutions. With strong performance across various surgical specialties and growing insurance coverage, it is expected to benefit even more patients as its technology continues to evolve and its global presence expands.Comparison of Various Current Surgical Robotic Systems - Nuances, Advantages, & DrawbacksIn the field of urology, robotic surgery has gained rapid and wide acceptance as a standard surgical care in the majority of surgeries over the last decade. To date, the da Vinci surgical system has been the dominant platform in robotic surgery; however, several newly developed robotic systems have recently been introduced in routine clinical practice. We, Fujita, installed the four different kinds of robotic platform for clinical usage such as, daVinci Xi, SP, hinotori and Hugo. In this study, we want to analyze the perioperative outcomes of robotic radical prostatectomy (RARP) and characterize the differences between four platforms. hinotori : The hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has a compact operation arm with eight axes of motion, one more than the DaVinci, leading to reduce interference between arms and the surgeon at bedside. DaVinci SP : The characteristic of the SP system can operate one 3D flexible camera and three forceps through a single port, and various surgical access is possible without the external interference of the arms. The various complicated procedures have been feasible such as NOTES or transoral surgery through the narrow space without the large wound, and retroperitoneal approach like the prostatectomy and partial nephrectomy. SP system is expected to contribute to develop the high quality surgery with minimal invasiveness. Hugo : Hugo system (Medtronic) consists of an open-site console with two arm-controllers that are operated with a grip similar to a pistol. It also has a footswitch that controls the camera, energy source, and reserve arm. The system includes four separate arm carts, each with six joints to increase the range of motion. Additionally, it uses specific 3D glasses for head tracking technology. Despite a small case series, there seemed to need learning-curve to get familiar with systems in setting-up and surgical procedures in introductory-phase. However, all the surgical procedures were efficaciously and safely performed, resulting in the achievement of favorable perioperative outcomes surgically as well as oncologically. In conclusion, these new robots will lead to competition and reduce the costs of RAS and will contribute to an increase in use. Robotic-assisted surgery will become more common than laparoscopic surgery especially in the field of urology. 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 Things Need to Know Tips and Tricks from Setup to Surgery Jeff S. ChuehTaiwan Moderator Ryoichi Shiroki Japan Moderator Surgical Robot-System hinotori in Urological Surgery: Clinical Applications and Future PotentialThe hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has been designed to reduce interference between arms and the surgeon at bedside. Equipped with four 8-axis robotic arms, providing smooth, highly articulated movements that mimic the human hand. In addition, docking-free design allows for a wide operative field around trocars, ensuring smooth workflows for surgeons and assistants. As a made-in-Japan system, it offers high adaptability to local clinical needs and faster implementation of user feedback. Since the first launch, more 90 systems have been installed for the clinical use, not only inside Japan but foreign countries such as Singapore and Malaysia. The first one was performed in December 2020 on prostatectomy. Since then, more than 100,000 cases performed, including urology GI surgery, gynecology and thoracic fields. In urological surgery, robot-assisted surgery has been widely and promptly accepted as a standard approach for the majority of major surgeries, including robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), radical nephrectomy (RARN), radical nephroureterectomy (RANU), and radical cystectomy (RARC), and has generally shown findings superior to those of conventional open and laparoscopic surgeries In conclusion, hinotori is a cutting-edge Japanese surgical robot already in use at many medical institutions. With strong performance across various surgical specialties and growing insurance coverage, it is expected to benefit even more patients as its technology continues to evolve and its global presence expands.Comparison of Various Current Surgical Robotic Systems - Nuances, Advantages, & DrawbacksIn the field of urology, robotic surgery has gained rapid and wide acceptance as a standard surgical care in the majority of surgeries over the last decade. To date, the da Vinci surgical system has been the dominant platform in robotic surgery; however, several newly developed robotic systems have recently been introduced in routine clinical practice. We, Fujita, installed the four different kinds of robotic platform for clinical usage such as, daVinci Xi, SP, hinotori and Hugo. In this study, we want to analyze the perioperative outcomes of robotic radical prostatectomy (RARP) and characterize the differences between four platforms. hinotori : The hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has a compact operation arm with eight axes of motion, one more than the DaVinci, leading to reduce interference between arms and the surgeon at bedside. DaVinci SP : The characteristic of the SP system can operate one 3D flexible camera and three forceps through a single port, and various surgical access is possible without the external interference of the arms. The various complicated procedures have been feasible such as NOTES or transoral surgery through the narrow space without the large wound, and retroperitoneal approach like the prostatectomy and partial nephrectomy. SP system is expected to contribute to develop the high quality surgery with minimal invasiveness. Hugo : Hugo system (Medtronic) consists of an open-site console with two arm-controllers that are operated with a grip similar to a pistol. It also has a footswitch that controls the camera, energy source, and reserve arm. The system includes four separate arm carts, each with six joints to increase the range of motion. Additionally, it uses specific 3D glasses for head tracking technology. Despite a small case series, there seemed to need learning-curve to get familiar with systems in setting-up and surgical procedures in introductory-phase. However, all the surgical procedures were efficaciously and safely performed, resulting in the achievement of favorable perioperative outcomes surgically as well as oncologically. In conclusion, these new robots will lead to competition and reduce the costs of RAS and will contribute to an increase in use. Robotic-assisted surgery will become more common than laparoscopic surgery especially in the field of urology. Ketan BadaniUnited States Speaker Expanding horizons: SP for complex RAPNThe Future of Urological Robotic SurgerySingle-Port Robotic Partial Nephrectomy for Multiple or Large Renal TumorsHow to Standardize Training by AI-Learning from The Best Practice of Urological Robotic SurgerySP Partial Nephrectomy Q&A and discussion (Panel discussion) TICC - 1F 101B

15th August 2025

Time	Session

10:30 12:00	Plenary Session 1-2 Comparison of Various Current Surgical Robotic Systems - Nuances, Advantages, & Drawbacks Jeff S. ChuehTaiwan Moderator Ryoichi Shiroki Japan Speaker Surgical Robot-System hinotori in Urological Surgery: Clinical Applications and Future PotentialThe hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has been designed to reduce interference between arms and the surgeon at bedside. Equipped with four 8-axis robotic arms, providing smooth, highly articulated movements that mimic the human hand. In addition, docking-free design allows for a wide operative field around trocars, ensuring smooth workflows for surgeons and assistants. As a made-in-Japan system, it offers high adaptability to local clinical needs and faster implementation of user feedback. Since the first launch, more 90 systems have been installed for the clinical use, not only inside Japan but foreign countries such as Singapore and Malaysia. The first one was performed in December 2020 on prostatectomy. Since then, more than 100,000 cases performed, including urology GI surgery, gynecology and thoracic fields. In urological surgery, robot-assisted surgery has been widely and promptly accepted as a standard approach for the majority of major surgeries, including robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), radical nephrectomy (RARN), radical nephroureterectomy (RANU), and radical cystectomy (RARC), and has generally shown findings superior to those of conventional open and laparoscopic surgeries In conclusion, hinotori is a cutting-edge Japanese surgical robot already in use at many medical institutions. With strong performance across various surgical specialties and growing insurance coverage, it is expected to benefit even more patients as its technology continues to evolve and its global presence expands.Comparison of Various Current Surgical Robotic Systems - Nuances, Advantages, & DrawbacksIn the field of urology, robotic surgery has gained rapid and wide acceptance as a standard surgical care in the majority of surgeries over the last decade. To date, the da Vinci surgical system has been the dominant platform in robotic surgery; however, several newly developed robotic systems have recently been introduced in routine clinical practice. We, Fujita, installed the four different kinds of robotic platform for clinical usage such as, daVinci Xi, SP, hinotori and Hugo. In this study, we want to analyze the perioperative outcomes of robotic radical prostatectomy (RARP) and characterize the differences between four platforms. hinotori : The hinotori system was developed by Medicaroid, the partnership between Kawasaki, a leader in the industrial robots, and Sysmex, with its abundant expertise and networks in advanced medicine, released the first made-in-Japan RAS in 2020. The hinotori has a compact operation arm with eight axes of motion, one more than the DaVinci, leading to reduce interference between arms and the surgeon at bedside. DaVinci SP : The characteristic of the SP system can operate one 3D flexible camera and three forceps through a single port, and various surgical access is possible without the external interference of the arms. The various complicated procedures have been feasible such as NOTES or transoral surgery through the narrow space without the large wound, and retroperitoneal approach like the prostatectomy and partial nephrectomy. SP system is expected to contribute to develop the high quality surgery with minimal invasiveness. Hugo : Hugo system (Medtronic) consists of an open-site console with two arm-controllers that are operated with a grip similar to a pistol. It also has a footswitch that controls the camera, energy source, and reserve arm. The system includes four separate arm carts, each with six joints to increase the range of motion. Additionally, it uses specific 3D glasses for head tracking technology. Despite a small case series, there seemed to need learning-curve to get familiar with systems in setting-up and surgical procedures in introductory-phase. However, all the surgical procedures were efficaciously and safely performed, resulting in the achievement of favorable perioperative outcomes surgically as well as oncologically. In conclusion, these new robots will lead to competition and reduce the costs of RAS and will contribute to an increase in use. Robotic-assisted surgery will become more common than laparoscopic surgery especially in the field of urology. The Future of Urological Robotic Surgery Michael WongSingapore Moderator Introduction to Asia School of UrologyAsian School of Urology 2022-2026 – New initiatives Dr Michael YC Wong Principal Director of ASU 2022-2026 President Endourological Society and WCET 2026 Introduction Asian School of Urology (ASU) officially started in 1999 with the appointment of her first director Prof Pichai Bunyaratavej from Thailand (1999-2002) Subsequent directors were Dato Dr Rohan Malek from Malaysia (2002-2006) Prof Foo Keong Tatt from Singapore (2006-2010) Prof Rainy Umbas from Indonesia (2010-2014 ) and Prof Shin Egawa from Japan ( 2014-2022 ). One of the highlights of the ASU in the early days were the organization of several workshops outside of UAA congress by three active sub-specialty sections of UAA namely Asian society of Endourology (over 16 workshops held from 1998-2008), Asian Society of Female Urology and Asia-Pacific society of Uro-Oncology. Other subspecialty sections were subsequently introduced and have matured very well including Asian Society of UTI and STI, Asian-Pacific Society of Andrological and Reconstructive Urology Surgeons. In the last 8 years, ASU has seen tremendous growth under the steady leadership of Prof Shin Egawa with introduction of UAA lecturers at national Meetings and further maturation of the subspecialty sections of UAA e.g., Conversion of Asian society of endourology to Asian Robotic Urological Society to reflect the growth and development of UAA. During the past 8 years, ASU-South-East Asia section has also managed to organize 15 physical workshops and 4 webinars outside of UAA congress. The Growth Trajectory for the next 4 years 2022-2026 There are many areas where ASU can grow further. Bearing in mind our limited resources and our excellent relationships with the world urological leaders at this point in our history. There are three areas which I will focus on. Please remember that ASU is always open to other new initiatives as we must stay relevant to our Asian urological community. 1. Lasting and strong Relationships 1.1 AUA. Over a dish of chili crab with AUA secretary general Gopal Badlani, we explored the common desire to elevate Asian Urology and strengthen UAA Family. This led to our first joint UAA-AUA residency course at UAA Singapore 2016. After successful completion, a MOU was signed at AUA 2017 with Richard Babayan, Manoj Monga, Allen Chiu and myself in attendance. The AURC at UAA Hong Kong under Prof Eddie Chan was the result of this signed MOU. We are extremely grateful for the generosity of AUA for this program. What may not be obvious is that Gopal Badlani, Manoj Monga, John Denstedt and I served as faculty and board directors at WCE. We will sign the extension MOU in 2023 for another three years. 1.2 EAU. We have a very successful UAA-EAU Youth program since UAA Thailand 2012. This has been the work of several UAA senior members. From 2023, we are exploring joint webinars with EAU to build on this relationship. 1.3 SIU and WCE. We will further explore options based on available resources and manpower. Joint Webinar are planned for early 2026 2. Education Platform for Asian Urology Residents From 2023, we will continue to grow our relationship with BJUI. BJUI has developed a world class online learning platform with tremendous investments since 2013. This platform is called BJUI Knowledge. ASU will reach out to all Asian residents via their national urological association president and secretary to encourage every resident to sign up for a free access to more than 420 interactive 30-minute modules covering the whole urology syllabus suitable for learning, exit exams and recertification exams. I am personally involved in developing all modules under Endourology and urolithiasis Section and have been associate editor since May 2013. The modest aim is for at least 10 residents per country to sign up by UAA 2023. We will report progress at each UAA council meeting. Pls see attached information and if there are any questions pls email me personally at email@drmichaelwong.com 3. Re-Strategize Training cum fellowship sites for ASU. 3.1 In the past we have always talked about the possibility about training sites for UAA and ASU. It has always been a difficult task due to financial and multiple logistics issues. 3.2 What can we do that is possible? Let us consider two options in the next 4 years. 3.3 For the last 6 years a group of Asian urologists started AUGTEG to design and provide two-day surgical training which includes lectures as well as dry and wet lab to develop surgical skills. AUSTEG has direct access to physical training centres in Thailand, South Korea, and China. ASU will work with AUGTEC to pool resources since we are the same people working on both sides e.g., Anthony Ng (chairman of AUSTEG) Michael Wong (vice chairman) Eddie Chan (treasurer). AUGTEG is registered in HK. 3.4 The second option is to recognise elected university or training Asian centres to allow an attachment for young urologist post residency in a flexible format. ASU will recognise officially these sites as endorsed by UAA. At UAA 2025 , several potential ASU/UAA fellowship sites directors will be presenting their programmes to kickstart this initiative 4. In conclusion, ASU will continue to grow and serve the Asian Urological Community. The above initiatives are only the beginning of a next chapter. Can you contribute your ideas and current available resources for this purpose? If you can, Pls email me personally at email@drmichaelwong.com Which Position is the Best for PCNL in 2025?With tremendous advances in both technique and technology , the MIS approach to staghorn calculi has evolved significantly over the last 30 years. It is timely to review all the landmark articles on patient positioning as this ultimately determines renal access which in turn plays a major role in stone free rates. We will gain much insight as we debate and attempt to answer the question of which position is best in 2026! Ketan BadaniUnited States Speaker Expanding horizons: SP for complex RAPNThe Future of Urological Robotic SurgerySingle-Port Robotic Partial Nephrectomy for Multiple or Large Renal TumorsHow to Standardize Training by AI-Learning from The Best Practice of Urological Robotic SurgerySP Partial Nephrectomy The Application & Limitation of Urological SP Surgery 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 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 Current Status & Future Perspective of Surgery Navigation in Robotic Surgery Khalil ArmachLebanon Moderator Masatoshi EtoJapan Speaker Current Status & Future Perspective of Surgical Navigation in Robotic SurgeryRobot-assisted partial nephrectomy (RAPN) is a standard treatment for small renal cancer, however, the number of reports on the development of the image supported system and its effectiveness is small. The key point in the procedure of RAPN is to reliably identify renal artery in a space with few landmarks and to resect a tumor. To performe RAPN safely and reliably, we have already developed a surgical navigation specialized for RAPN, and published its usefulness in daVinci surgical systems. In this lecture, I would like to talk our recent projects updating our current navigation system. The first project focuses on 3D navigation using real-time forceps tracking. The second project is to develop an AI-based autonomous registration method for surgical navigation in RAPN. I hope that these 2 projects will further enhance the usefulness of our navigation system in RAPN. Novel Robotic Surgery Platforms Rainy UmbasIndonesia Moderator Chi-Fai NgHong Kong, China Speaker Novel Robotic Surgery PlatformsOver the past decades, robotic surgery has become an essential approach in urological care. The recent blooming of different robotic platforms, in particular in Asian countries, has helped popularize robotic surgery in less developed countries. The introduction of robotic technology in endoluminal surgery has also helped to open up opportunities to further improve endourology. In the future, the incorporation of AI in robotic systems will help upgrade the standard of care in urology. Advancement of Novel Instruments/Gadgets in Urological Robotic Surgery Hong Gee SimSingapore Moderator Mario Gyung-Tak SungKorea (Republic of) Speaker What's Next in Urologic Robotics in Asia: Future PerspectivesAdvancement of Novel Instruments/Gadgets in Urological Robotic Surgery TICC - 3F Plenary Hall
12:00 13:00	Luncheon Symposium 9【PUSEN, QUANTA】 Mastering Suction Ureteroscopy: How the Right Laser and Scope Combination Makes the Difference Role of Single-Use Flexible Cysto-Nephro Scope in ECIRS and PCNL Jeff S. ChuehTaiwan Moderator Ponco BirowoIndonesia Speaker Pressure Management Strategy in RIRS using Tidor System HoLEP – The New Advancement Using Magneto Technology Jeff S. ChuehTaiwan Moderator Giorgio BozziniItaly Speaker The Power of Magneto and Vapour Tunnel in Holep Choosing the Correct Laser and Flex Scope Combination in Suction Ureteroscopy Can Be the Deal Breaker Cheng-Chia LinTaiwan Moderator 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 Vineet GauharSingapore Speaker Experimental and Real World Take Away Messages on DISSSuction in Renal Stone Treatment: DISS, FANS or Combined Procedure?Need of Future EndourologyChoosing the Correct Laser and Flex Scope Combination in Suction Ureteroscopy Can Be the Deal Breaker TICC - 3F Banquet Hall
13:30 15:00	Semi-Live Surgery 1 Tips and Tricks in Challenging Cases of Robotic Radical Prostatectomy Thomas HsuehTaiwan Moderator John DavisUnited States Speaker Open Surgery Training: Is It Necessary in the Era of Robotics?Open surgery training in the era of robotics may or may not be a training environment that urology has control of, given worldwide access to robotic or at least laparoscopic techniques and strong patient preference. There may be some applications where a given experienced urologist can prefer open over minimally invasive surgery (MIS), such as radical cystectomy, or indications possibly outside of MIS feasibility such as large renal tumors with caval thrombus. Specific to training and expertise, there are 3 principle features of surgical skills desired: 1) knowing ideal exposure, 2) recognition of surgical planes, and 3) knowing anatomy before it can be seen. Although some trainees may only see MIS for certain indications, open surgery may expedite the process. There are no human studies identified on the topic, but a skills lab study was instructive (Farah, J Surgical Education 2023) showing that interns with open and MIS training performed higher comparing pre-intern to post intern bootcamp skills. The benefits of a solid training pathway including open experience are to move trainees towards the faster-to-progress part of the learning curve such that the attending can offer a safe training environment while moving the case along efficiently.The Future of Surgical Skills Evaluation: What Is on Your Wish List?Surgical skills training vary significantly by region with some systems putting trainees on a timed set of years, while others apprentice trainees until meeting a threshold for skills. Early training assessments were basic timed events with qualitative scores (subject to strong attending selection for success). Trainees should experience and/or study the key pitfalls to avoid and performance goals. Surgical simulation can be highly useful, but tend to improve only certain skills and not full case needs. Updated simulation moves from digital to hands on surgical models and may move the needle towards human experience. Training can be augmented with descriptors of surgical gestures and measuring which ones are most effective. The experience for the trainee is often depicted as an "autonomy gap" whereby the training desires to have case control, possibly before they are ready. Progression can be measured by descriptors of performance from assistance through full performance without coaching. The next frontier will be artificial intelligence guided measurement where specific performances can be characterized and diagnosed for success. My ultimate wishlist would be for methods to correlate skills to outcomes, optimized curricula, and a specific pathway to correct underperformance.Tips and Tricks in Challenging Cases of Robotic Radical ProstatectomyThere are many specific challenges with robotic radical prostatectomy (RARP) that can be described and illustrated--the most 5 common are 1) difficulty access, 2) obesity, 3) pubic arch interference, 4) anatomic challenges, and 5) reconstruction challenges. In this video sample, we demonstrate 2 challenges: obesity requiring a pelvic lymph node dissection and significant pelvic de-fatting to identify the proper surgical landmarks. Next a massive sized prostate that has had a partial transurethral resection--together presenting challenges with landmarks, a difficult bladder neck to diagnose, and final reconstruction challenges. Technical Considerations for Large Prostates over 100gms Hiroshi KitamuraJapan Moderator Vipul R. PatelUnited States Speaker Lessons from 20,000 Robotic Prostatectomies: A Global Expert’s PerspectiveTechnical Considerations for Large Prostates over 100gmsTelesurgery: The Future of Surgery Single Port Retroperitoneal Partial Nephrectomy Satoru TaguchiJapan Moderator 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 Single-Port Robotic Partial Nephrectomy for Multiple or Large Renal Tumors Teng-Aik OngMalaysia Moderator Ketan BadaniUnited States Speaker Expanding horizons: SP for complex RAPNThe Future of Urological Robotic SurgerySingle-Port Robotic Partial Nephrectomy for Multiple or Large Renal TumorsHow to Standardize Training by AI-Learning from The Best Practice of Urological Robotic SurgerySP Partial Nephrectomy Emergency Undocking in Robotic Urology Surgery - Preparedness, Protocols, and Practice Jeff S. ChuehTaiwan Moderator Wenjie ZhongAustralia Speaker Emergency Undocking in Robotic Urology Surgery - Preparedness, Protocols, and PracticeIntroduction: Robotic surgery has revolutionized urologic procedures, offering precision and minimally invasive benefits. However, the complexity of the robotic interface introduces the rare but potentially catastrophic need for emergency undocking - a rapid disengagement of the robotic system in response to patient or technical emergencies. Objective: To review the current best practices, protocols, and preparedness strategies for emergency undocking during robotic urologic surgery, with a focus on multidisciplinary coordination, training, and outcome optimization. Methods: A structured review of the literature was conducted, including case reports, institutional protocols, and guideline recommendations from leading urological societies (AUA, EAU). In addition, procedural algorithms and simulation-based training approaches were analyzed to assess their impact on team performance and patient safety. Results: Emergency undocking occurs in fewer than 0.1% of robotic cases but is associated with high morbidity if delays occur. Key indications include sudden hemodynamic collapse, cardiac arrest, airway compromise, and robotic system malfunction. Simulation training has been shown to improve undocking times by up to 35%. Effective response hinges on predefined roles, verbal cues, and practiced protocols. Institutions with regular team drills report faster response times and better outcomes in high-acuity scenarios. Conclusion: Although infrequent, emergency undocking represents a critical moment in robotic surgery that demands rapid, coordinated team action. Implementing standardized protocols, reinforcing multidisciplinary simulations, and fostering a culture of readiness can significantly improve patient safety and surgical outcomes. Experience of 100 Consecutive Hugo Robotic Radical Prostatectomies Uttam Kumar MeteIndia Moderator Yen-Chuan OuTaiwan Speaker ARUS–PRUS Partnership Ceremony: A New Chapter in Asia Robotic Urology CollaborationDear colleagues and friends, It’s a great honor to witness the signing of this partnership between the Asian Robotic Urology Society (ARUS) and the Philippines Robotic Urology Society (PRUS). This marks the beginning of a new chapter in regional collaboration—one that emphasizes shared training, joint research, and mutual support to advance robotic urology across Asia. PRUS brings energy, expertise, and vision to this partnership, and ARUS is proud to walk alongside you as we work toward higher standards and better outcomes for our patients. Let us move forward together—with unity, purpose, and innovation. Congratulations to both ARUS and PRUS!Aquablation Revolutionizing BPH Treatment: A New Era of Minimally Invasive Therapy-Tungs' Taichung Metroharbor Hospital ExperienceIntroduction Aquablation is a waterjet ablation therapy for benign prostatic hyperplasia (BPH) that has gained significant attention. While its efficacy, durability, and safety have been established across various prostate sizes (30–150 mL), local data on its efficacy, safety, and learning curve in Taiwan remain limited. Our team have been performed 85 cases between March 2024 and July 2025. This lecture presents the learning curve observed in the first 50 patients who underwent Aquablation for BPH, highlighting its role in revolutionizing BPH treatment. Materials and Methods We conducted a retrospective review of 50 consecutive patients who underwent Aquablation between March 2024 and February 2025, dividing them into two groups: Group I (first 25 cases) and Group II (subsequent 25 cases). Assessments included IPSS, QoL, uroflowmetry parameters (voiding volume, Qmax, Qmean, PVR), operative time, hemoglobin drop, Clavien-Dindo grade ≥2 complications, hospital stay, and urethral catheter duration. Results Patients in Group II were younger and had smaller prostates. Aquablation was successfully performed in all cases. IPSS, QoL, voiding volume, Qmax, and Qmean improved significantly and were sustained for three months, while PVR improved only in Group I. Operative time was significantly shorter in Group II, and hemoglobin drop was greater in Group I. Complication rates, hospital stay, and catheter duration were similar between groups. Conclusions Aquablation provided significant and immediate improvements in voiding parameters and symptoms, with sustained PVR benefits in larger prostates. Surgeon proficiency improved after 25 cases. Overall, Aquablation proved safe and effective, even in an unselected patient population. Aquablation represents a promising advancement that could transform the therapeutic landscape for BPH—particularly if costs are reduced.Experience of 100 Consecutive Hugo Robotic Radical ProstatectomiesIntroduction and background: Dr. Ou’ surgical team of Tungs’ Taichung MetroHarbor Hospital performed the first Hugo robotic radical prostatectomy on May 9, 2023. In 2023, we published the results of the first series of 12 Hugo robotic radical prostatectomies performed. In 2024, we published a comparison of 30 Hugo robotic radical prostatectomies and 30 Da Vinci robotic radical prostatectomies. Professor Ou is the Hugo robotic arm instructor recognized by Medtronic. Many Southeast Asian doctors come to this Hospital to observe the surgery and learn. Material and Methods: We prospectively collected data for retrospective analysis and statistics from May 9, 2023 to April 30, 2025, performing 100 consecutive Hugo robotic radical prostatectomies. We compared the surgical results of 1-50 cases (group 1) and 51-100 cases (group 2). The data analyzed included basic information, age, risk of anesthesia, BMI , prostate-specific antigen, clinical stage, and Gleason score grade. The two groups were compared in terms of surgical difficulty, receipt of neoadjuvant hormonal therapy, obesity, prostate volume >70 g, prostate protrusion more than 1 cm into the bladder neck, previous transurethral resection of prostate, history of abdominal surgery, extensive pelvic lymphadenectomy, salvage radical prostatectomy, and time from biopsy to radical prostatectomy less than 6 weeks. The two groups were compared in terms of robotic console time, blood loss, blood transfusion rate, and surgical complications. We compared the two groups in terms of postoperative pathological staging and grade, the proportion of tumor, and the proportion of urinary control at one month and three months. Results: The study showed that the age of patients in the second group was slightly higher, but the statistical p value was 0.058, which did not reach statistical difference. The second group of patients had significantly higher rates of stage III, stage IV, lymph node and bone oligometastasis, with a p value of 0.021. The rate of neoadjuvant hormonal therapy received by the second group was 16 percent, which was statistically significant compared with 2 percent of the first group (p = 0.021). The rates of other surgical difficulty factors were the same between the two groups. The average blood loss of patients in the second group was 156 CC, which was significantly less than the 208 CC in the first group. The operation time and surgical complications were comparable between the two groups. The cancer volume of the second group of patients was significantly reduced compared with that of the first group (3.30±2.93 versus 5.09±5.24, p value=0.049). The reason was that more patients in the second group received neoadjuvant hormonal therapy, which significantly reduced the cancer. Both groups of patients had very good urinary control after surgery. Conclusion: We conclude that Hugo robotic radical prostatectomy is an effective and feasible method with extremely low complications and good recovery of urinary control function after surgery. After the experience of the first 50 operations, the surgeon will choose patients with higher difficulty, especially those receiving neoadjuvant hormone therapy, to perform the operation.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical ProstatectomyBackground: Robotic-assisted radical prostatectomy (RARP) has become a preferred surgical approach for localized prostate cancer due to its minimally invasive nature and precision. However, the preservation of urinary continence and sexual function remains a significant postoperative challenge. Traditional outcomes have focused heavily on oncological safety. Yet, contemporary perspectives emphasize a more holistic view—embodied in the concept of the “Pentafecta,” which includes continence, potency, negative surgical margins, biochemical recurrence-free survival, and absence of perioperative complications. Objective: This presentation introduces a comprehensive and integrative approach aimed at maximizing functional outcomes—particularly urinary continence and erectile function—through a modified pubovesical complex-sparing RARP under regional hypothermia, supplemented with real-time nerve imaging, neurovascular preservation strategies, and biological enhancement techniques. Methods: We present data and experience from Tungs’ Taichung MetroHarbor Hospital (TTMHH), including a series of 3780 robotic procedures performed between December 2005 and July 2025. Among these, 100 cases were completed using the Hugo™ RAS system and 21 with the da Vinci SP™ platform. Our modified technique builds upon Dr. Richard Gaston’s pubovesical complex-sparing method, with the addition of localized hypothermia (24°C), near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG), and application of dehydrated human amnion/chorion membrane (dHACM). In selected cases, nerve grafting with Axogen® technology was applied. Results: Initial results indicate a significantly improved early return of continence (95% by 16 weeks) and promising erectile function recovery, particularly in patients who received adjunctive therapies such as phosphodiesterase inhibitors or vacuum erection devices. The precision afforded by robotic technology enabled preservation of prostate capsular arteries and accessory pudendal arteries. Localized hypothermia contributed to reduced tissue edema, minimized neural trauma, and improved nerve recovery. The use of ICG-NIRF allowed real-time identification of critical vascular landmarks, enhancing nerve-sparing accuracy. Preliminary analysis suggests our technique is both feasible and reproducible. Conclusion: The modified pubovesical complex-sparing RARP under hypothermia, augmented with vascular imaging and biologic materials, offers a promising paradigm for functional preservation in prostate cancer surgery. This total solution approach not only protects neurovascular integrity but also accelerates recovery of continence and potency. Continued accumulation of clinical cases and controlled comparative studies are warranted to further validate the efficacy and long-term benefits of these techniques. Significance: This strategy reflects a patient-centered evolution in robotic prostate surgery, merging surgical innovation with anatomical preservation and technological augmentation. It represents an epic collaboration of surgical precision, team-based care, and thoughtful application of biomedical advances to improve quality of life outcomes in prostate cancer patients.Total Solution of Maintenance of Urinary and Sex Function during Robotic Radical Prostatectomy TICC - 3F Plenary Hall
15:30 17:00	Semi-Live Surgery 2 Robotic Partial Nephrectomy in Complex and Difficult Tumor Location Hideki EnokidaJapan Moderator Siros JitpraphaiThailand Speaker RCC and IVC ThrombectomyRCC and IVC thrombus Siros Jitpraphai Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, THAILAND Abstract Renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombus represents a complex surgical challenge, with an incidence of venous involvement in 4-10% of cases. This case report demonstrates the successful surgical management of a 58-year-old female patient with a large left-sided renal mass and IVC thrombus. The patient presented with gross hematuria and was diagnosed with a 10 cm clear cell renal cell carcinoma (Fuhrman nuclear grade 3) extending into the renal vein and IVC. Recognizing the complexity of the case, a multidisciplinary approach was employed, involving urological and hepatobiliary surgical teams. The comprehensive treatment strategy included an open radical nephrectomy with IVC thrombectomy. The surgical technique was meticulously planned and executed, with several key considerations. Preoperative imaging was crucial in determining the exact level of thrombus, allowing for precise surgical planning. The procedure emphasized careful vascular control and en-bloc tumor removal, with intraoperative ultrasound used to ensure accurate thrombus localization. Surgical teams worked collaboratively to minimize potential complications and maximize surgical success. Operatively, the procedure was substantial, with an estimated blood loss of 900 mL and a total operative time of 5 hours. The patient required two days of postoperative intensive care and was discharged from the hospital seven days after the surgery. Pathological examination confirmed the diagnosis of clear cell renal cell carcinoma, with no lymph node metastasis detected and positive tumor thrombus. Importantly, surgical margins were found to be free of tumor. Follow-up evaluations have been encouraging, with no signs of tumor recurrence observed during regular intervals. This case illustrates the critical importance of a systematic surgical approach, precise technical execution, and comprehensive multidisciplinary management in successfully treating RCC with IVC thrombus. It provides valuable insights into the complex surgical management of this challenging condition, potentially offering guidance for similar cases in the future. Keyword: RCC (Renal Cell Carcinoma), IVC Thrombus, Thrombectomy, Surgical Technique, Multidisciplinary Management Highlight: RCC with IVC thrombus is a complex surgical challenge affecting 4-10% of cases. Successful management requires meticulous preoperative imaging, multidisciplinary team approach, and precise surgical technique. With careful planning and execution, 45-70% of patients can be cured through radical nephrectomy and IVC thrombectomy. Robotic Partial Nephrectomy in Complex and Difficult Tumor Location Robotic Partial Nephrectomy in Tumors with High Renal Score Katsumi ShigemuraJapan Moderator Surya Prakash VaddiIndia Speaker Cytoreductive Nephrectomy in the Era of Immune TherapyRobotic Partial Nephrectomy in Tumors with High Renal Score Zero Ischemia Laparoscopic Partial Nephrectomy John YuenSingapore Moderator Technical Pearls: Total Extraperitoneal TechniquePractice-Changing Development in RaLRP Andrew Kennedy SmithNew Zealand Speaker Zero Ischemia Laparoscopic Partial NephrectomyNephron preservation with complete tumour excision and without complications remain the goals of surgery for early-stage kidney tumours. This surgery remains technically challenging using a minimally invasive platform, and there remain variations of technique. We present what is now an established approach within our centre, but has been enhanced by progressive improvements in the specific surgical instrumentation. The technique is achievable in a smaller centre with lower surgical volumes. We perform a laparoscopic partial nephrectomy using waterjet and advanced bipolar energy without vascular clamping and without renorrhaphy, supplemented with topical hemostatic agents, reliably achieving the stated goals of this surgery. Ischaemia and delayed complications are minimised by avoiding renorrhaphy and vascular clamping during dissection.Zero Ischemia Laparoscopic Partial Nephrectomy for Hilar TumorsOur technique for hilar tumours remains similar to that for peripheral tumours, again using waterjet and advanced bipolar energy without vascular clamping and without renorrhaphy, supplemented with topical hemostatic agents. Waterjet may be safely used directly on major vessels and collecting system structures, and directly on the tumour capsule, to perform either conventional partial nephrectomy with parenchymal margin or tumour enucleation. With hilar dissection, it is possible to visualise and control arterial supply directly to the tumour, reducing the potential for blood loss. The stated goals of this surgery are achieved. The technique which avoids renorrhaphy is particularly relevant in hilar tumours where renorrhaphy may not be technically achievable. Zero Ischemia Laparoscopic Partial Nephrectomy for Hilar Tumors Takashi SaikaJapan Moderator Andrew Kennedy SmithNew Zealand Speaker Zero Ischemia Laparoscopic Partial NephrectomyNephron preservation with complete tumour excision and without complications remain the goals of surgery for early-stage kidney tumours. This surgery remains technically challenging using a minimally invasive platform, and there remain variations of technique. We present what is now an established approach within our centre, but has been enhanced by progressive improvements in the specific surgical instrumentation. The technique is achievable in a smaller centre with lower surgical volumes. We perform a laparoscopic partial nephrectomy using waterjet and advanced bipolar energy without vascular clamping and without renorrhaphy, supplemented with topical hemostatic agents, reliably achieving the stated goals of this surgery. Ischaemia and delayed complications are minimised by avoiding renorrhaphy and vascular clamping during dissection.Zero Ischemia Laparoscopic Partial Nephrectomy for Hilar TumorsOur technique for hilar tumours remains similar to that for peripheral tumours, again using waterjet and advanced bipolar energy without vascular clamping and without renorrhaphy, supplemented with topical hemostatic agents. Waterjet may be safely used directly on major vessels and collecting system structures, and directly on the tumour capsule, to perform either conventional partial nephrectomy with parenchymal margin or tumour enucleation. With hilar dissection, it is possible to visualise and control arterial supply directly to the tumour, reducing the potential for blood loss. The stated goals of this surgery are achieved. The technique which avoids renorrhaphy is particularly relevant in hilar tumours where renorrhaphy may not be technically achievable. Robot-Assisted Radical Cystectomy and Intracorporeal Neobladder Formation Steven K. HuangTaiwan Moderator Arnulf StenzlGermany Speaker EAU Lecture: AI to Support Informed Decision Making (INSIDE) for Improved Literature Analysis in Oncology.Robot-Assisted Radical Cystectomy and Intracorporeal Neobladder Formation Technical Modifications Facilitate Robotic-Assisted Nephroureterectomy and Bladder Cuff Resection Chit Sin LohMalaysia Moderator Jeff S. ChuehTaiwan Speaker TICC - 3F Plenary Hall

16th August 2025

Time	Session

10:30 12:00	BPH/MIST Crossfire (1): < 100g BPH/MIST Crossfire (1): < 100g Jeff S. ChuehTaiwan Moderator John Jang Hwan KimKorea (Republic of) Moderator Ju-Chuan HuTaiwan Facilitator Trans-Vaginal Repair for VV Fistula Jian-Hua HongTaiwan Facilitator Oeng MengleangCambodia Commenter Chung-Cheng WangTaiwan Commenter Ureteral Stent and SelectionUreteral stents are widely used in urology for the management of obstructive uropathies, including urologic or non-urologic malignancy, radiation therapy, ureteral calculus, infection, surgical or nonsurgical trauma, or congenital factors. An untreated ureteral obstruction could result in urinary tract infection, abdominal or flank pain, and a deterioration of renal function. Despite their widespread utility, the selection of an appropriate ureteral stent remains a complex clinical decision involving multiple variables including patient-specific factors, disease pathology, duration of stenting, and the desired balance between drainage efficacy and patient comfort. Advancements in stent technology have led to the development of a variety of stent types, distinguished by their material composition (e.g., polyurethane, silicone, and hydrophilic-coated polymers), design features (e.g., double-J, multi-length, tail stents), drug-eluting capabilities, reinforced metallic stent, and biodegradable stents. Each design aims to optimize certain aspects of performance such as resistance to encrustation, migration, infection, and stent-related symptoms. Key considerations in stent selection include indwelling time, risk of infection or encrustation, patient anatomy, and comorbidities or prior urologic surgery. For short-term use, polyurethane or co-polymer stents are often preferred due to their balance of flexibility and cost-effectiveness. In contrast, silicone stents may be more appropriate for long-term indwelling due to their superior biocompatibility and reduced encrustation rates. Drug-eluting stents are emerging as promising options in cases of recurrent infection or tumor-associated obstruction. Softer materials, tapered tips, and biodegradable stents aim to reduce stent-related lower urinary tract symptoms. Recently, we reported the efficacy and safety of Allium metallic ureteral stents in treating 13 patients with refractory ureteral strictures. The median (IQR) age of the patients was 63 (46–76) years. The median (IQR) follow-up was 15 (13.5–21) months. Treatment success and improvement were noted in 9 (69.2%) and 3 (23.1%) patients, respectively. Compared to the preoperative levels, the median (IQR) serum creatinine levels were significantly improved at 3 months after the operation [1.6 (1.25–2.85) vs. 1.2 (1.05–2.05), p = 0.02] and at the last visit [1.6 (1.25–2.85) vs. 1.2 (1.05–1.8), p = 0.02]. Stent migration and encrustation were noted in three (23.1%) and one (7.7%) patients, respectively. The preliminary results showed that Allium ureteral stents were safe and effective for patients with refractory ureteral strictures. In conclusion, as technology continues to evolve, the future of ureteral stenting lies in personalized device selection based on real-time patient feedback, predictive analytics, and enhanced biomaterials. Further clinical trials and comparative studies are essential to establish evidence-based guidelines that can assist clinicians in making the most appropriate stent choices for optimal outcomes Fixed and Adjustable Male Slings: Key Techniques for Primary Implantation and Troubleshooting in Challenging CasesMale slings have emerged as an effective surgical solution for stress urinary incontinence (SUI) following radical prostatectomy, offering an alternative to artificial urinary sphincters, particularly in patients with mild to moderate incontinence. Among the available options, fixed and adjustable male slings represent two major categories, each with distinct mechanisms of action, implantation techniques, and postoperative management considerations. Fixed male slings work by repositioning and compressing the bulbar urethra against the pubic ramus to restore continence. These slings rely on proper patient selection—typically individuals with preserved sphincter function, low-volume leakage, and no prior pelvic radiation. Key technical considerations include precise dissection of the perineal space, adequate urethral mobilization, tension-free sling placement, and symmetric anchoring of the arms. Avoidance of over-tensioning is crucial to prevent postoperative urinary retention and perineal discomfort. Adjustable male slings offer intraoperative or postoperative modification of sling tension to accommodate varying degrees of incontinence or suboptimal initial outcomes. These slings are particularly useful in patients with higher degrees of incontinence, previous pelvic surgery, or radiation. The implantation techniques vary but generally involve positioning a cushion or compressive element under the urethra, with external or subcutaneous access ports for saline adjustment. Mastery of device calibration, port placement, and infection prevention are critical to long-term success. Challenging cases—such as those involving prior sling failure, prior pelvic radiation, fibrosis, or altered anatomy—require tailored strategies. In irradiated patients, tissue integrity and healing potential are compromised, often necessitating the use of adjustable systems with minimal tissue dissection or the combination of sling and bulking agents. In reoperative fields, precise identification of tissue planes and modified dissection techniques are required to prevent urethral injury or inadequate compression. Troubleshooting sling failure involves assessing continence status, sling positioning via imaging or endoscopy, and determining whether revision, adjustment, or conversion to an artificial urinary sphincter is most appropriate. Postoperative complications including infection, urethral erosion, urinary retention, and persistent incontinence can be mitigated by proper surgical technique, patient education, and regular follow-up. Management of these complications should be proactive and individualized, balancing intervention timing with patient expectations and functional goals. In this topic, we will share our experiences to avoid these complications and increase the successful outcome. Dean EltermanCanada Speaker Henry WooAustralia Speaker Peter ChinAustralia Speaker Steffi YuenHong Kong, China Speaker The Power of Powerbend in Management of Lower Pole and Complex StonesThe management of lower pole stones (LPS) and complex renal calculi remains one of the most challenging aspects of contemporary urolithiasis treatment, with the deflection capability of flexible ureteroscopes serving as the critical determinant of surgical success. Modern flexible ureteroscopes achieve impressive bidirectional deflection angles of 270° or even more, representing a significant advancement from earlier generation instruments. However, this “working deflection” capacity becomes substantially compromised when therapeutic instruments, such as laser fibers or stone baskets, are inserted through the working channel. The anatomical challenges of lower pole access, particularly steep infundibulopelvic angles, necessitate prolonged maximal deflection during lithotrispy that significantly increases the risk of ureteroscope damage and surgeon fatigability. Deflection deterioration is also directly proportional to instrument usage, with newer single-use scopes coming to the rescue. The introduction of flexible and navigable suction access sheaths (FANS) has revolutionized lower pole stone management allowing direct access to performing lithotriopsy and stone fragments retrieval, reducing the need for stone basket in stone relocation and fragment retrieval. Recent multicenter studies demonstrate comparable stone-free rates (<2mm) between lower pole and non-lower pole locations (96.6% vs 98.4%) when using FANS, with minimal complications and low reintervention rates. With current technological advancements, combined with improved surgical techniques and the strategic choice of single-use ureteroscopes with good deflection power, one can significantly achieve high stone-free rates with low infectious complications and reinterventions with FANS flexible ureteroscopy in the treatment of complex lower pole stones. FANs in Endourology: Finding the Best Combination with Lasers and Scopes for Optimal Outcomes Christopher NetschGermany Speaker TICC - 1F 102
12:00 13:00	Luncheon Symposium 17【Intuitive】 Role of Da Vinci SP in Urology Opening Allen W. ChiuTaiwan Speaker Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques. This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system. New Frontiers Explored with SP Allen W. ChiuTaiwan Moderator Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques. This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system. Jeff S. ChuehTaiwan Moderator Jian-Ri LiTaiwan Speaker Applying Vision Augmentation in Robotic Surgery: Reality or FictionApplying Vision Augmentation in Robotic Surgery: Reality or Fiction Single Port Prostate Surgery Allen W. ChiuTaiwan Moderator Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques. This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system. Jeff S. ChuehTaiwan Moderator 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 Q&A Jeff S. ChuehTaiwan Speaker TICC - 2F 201BC
13:30 15:00	BPH/MIST Crossfire (2): > 100g BPH/MIST Crossfire (2): > 100g Jeff S. ChuehTaiwan Moderator Jeremy TeohHong Kong, China Moderator Transurethral En Bloc Resection of Bladder Tumor: Where Are We Now?There is increasing evidence that transurethral en bloc resection of bladder tumour (ERBT) could lead to better peri-operative and oncological outcomes in patients with non-muscle-invasive bladder cancer. Modified approaches of ERBT have also been proposed to expand its indications for larger bladder tumours. The quality of resection is also the key for bladder-sparing treatment for muscle-invasive bladder cancer. We foresee an exciting journey ahead for ERBT, and as a urologist, we must embrace this novel technique for the best interest of our bladder cancer patients. To Publish or not to Publish? Navigating the path to academia in urologyDoing good science is the basis for technological advancement in healthcare. However, pursuing a path to academic in urology is often tough, stressful and frustrating. In this talk, I will share with you what I have learnt throughout my 15 years of research work. I will let you know what's the best and fastest way to become a globally renowned and successful researcher. Most importantly, I will explain what it takes to develop a great team and create a positive impact in people's lives. Believe in yourself! If I can do it, so can you.SIU Lecture: Role of MISTs in Male LUTS Surgical Management (Will TUR-P/ Laser Prostatectomy be Replaced?)Transurethral resection of prostate (TURP) is the current gold standard in treating patients with benign prostatic hyperplasia. Laser prostatectomy has also been used widely especially in patients who are on anticoagulants. However, both TURP and laser prostatectomy are associated with several problems including the need of spinal / general anaesthesia and the risk of male sexual dysfunction. In the past decade, we have witnessed the introduction of multiple new technologies including Rezum, Urolift, iTind and Aquablation. in this SIU lecture, we will discuss about the technical details, as well as the pros and cons of every new technology. We will also invite you to be our jury and decide whether TURP and laser prostatectomy will be replaced in the future. Novel Intravesical Therapeutics in the Evolving Landscape of NMIBCNon-muscle-invasive bladder cancer (NMIBC) is well known to be a difficult disease to manage, with a 1-year recurrence rate of up to 61% and 5-year recurrence rate of 78%. Despite the use of intravesical BCG therapy, NMIBC patients may still experience recurrence and develop what we call BCG-unresponsive NMIBC. Conventionally, we offer upfront radical cystectomy for patients with BCG-unresponsive NMIBC, however, this is an ultra-major surgery with significant risk of complications and could also lead to significant deterioration in quality of life in the long run. We are in urgent need for novel therapies to manage this difficult condition. In this lecture, we will discuss the evidence on the different novel intravesical therapies in treating BCG-unresponsive NMIBC. SIU Lecture: Role of MISTs in Male LUTS Surgical Management (Will TUR-P/ Laser Prostatectomy be Replaced?) Mitsui TakahikoJapan Commenter Chi-Shin TsengTaiwan Commenter Chih-Chieh LinTaiwan Facilitator Vesico-Vaginal Fistula: General Concept and Patient Preparation健保各領域審查共識及討論－功能性 Shih-Ting ChiuTaiwan Facilitator Giorgio BozziniItaly Speaker The Power of Magneto and Vapour Tunnel in Holep Steven L. ChangUnited States Speaker The Progression Landscape of Diagnostic and Treatment Options for Kidney CancerPros and Cons in the daVinci SP System Applications in Urological Surgeries Simone CrivellaroUnited States Speaker Single-Port vs. Multi-Port Robotic Prostatectomy: Balancing Innovation, Precision, and OutcomesThe Application & Limitation of Urological SP SurgerySingle Port Retroperitoneal Partial NephrectomySingle Port Prostate Surgery Dean EltermanCanada Speaker Christopher NetschGermany Speaker TICC - 1F 102
15:30 17:00	Industry Symposium 12 【Bayer】 Advancing Precision Medicine in Advanced PC: From Patient-Specific Factors to Real-World Evidence Advancing Precision Medicine in Advanced PC: From Patient-Specific Factors to Real-World Evidence Jeff S. ChuehTaiwan Moderator Ian VelaAustralia Speaker Shian-Shiang WangTaiwan Speaker How to Optimize BPH Treatment: From Evidence to Practice TICC - 1F 101C

17th August 2025

Time	Session

12:00 13:00	Luncheon Symposium 25【Jianhe-Biomedical】 A New Era in Precision Diagnosis and Localized Therapy in PCa with Micro-Ultrasound (ExactVu) and Focal One Robotic HIFU Opening Jeff S. ChuehTaiwan Moderator 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. Micro-Ultrasound in Prostate Cancer Diagnosis: A New Era in Real-Time High-Resolution Imaging (Initial experience of NTUH) Jeff S. ChuehTaiwan Moderator 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. Shih-Ting ChiuTaiwan Speaker Latest Clinical Data and Operative Technique on Focal One Robotic HIFU Therapy for Prostate Cancer 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. Jeff S. ChuehTaiwan Moderator 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. Panel Discussion Jeff S. ChuehTaiwan Moderator 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. Shih-Ting ChiuTaiwan Speaker TICC - 2F 201BC

Time

Session

12:00

13:00

Luncheon Symposium 25【Jianhe-Biomedical】

A New Era in Precision Diagnosis and Localized Therapy in PCa with Micro-Ultrasound (ExactVu) and Focal One Robotic HIFU

Opening

Jeff S. ChuehTaiwan Moderator

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.
Micro-Ultrasound in Prostate Cancer Diagnosis: A New Era in Real-Time High-Resolution Imaging (Initial experience of NTUH)

Jeff S. ChuehTaiwan Moderator

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.

Shih-Ting ChiuTaiwan Speaker
Latest Clinical Data and Operative Technique on Focal One Robotic HIFU Therapy for Prostate Cancer

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.

Jeff S. ChuehTaiwan Moderator

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.
Panel Discussion

Jeff S. ChuehTaiwan Moderator

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.

Shih-Ting ChiuTaiwan Speaker

TICC - 2F 201BC