Hammad Ather

Hammad Ather is a tenured and endowed professor of urology at Aga Khan University and a consultant urologist at the KSSH, Taif. He was head of Urology at the Aga Khan University for over 10 years and previously served as the Urology program director. He also chaired the ethics review committee at the Aga Khan University. He served on the editorial board of the African Journal of Urology, Türkiye Klinikleri, and is currently an editorial board member of Advances in Urology and Int J Urology. Actively involved in teaching and training. Trained over 30 urologists and are serving in academic positions around the world. He has over 140 indexed peer-reviewed publications, over 12 book Chapters, and has edited five books. His publications have a significant impact, with nearly 200,000 citations, an H index of 39, and an i10index of 93 (https://scholar.google.com/citations?hl=en&user=bmdzI-sAAAAJ) as accessed on 23rd April 2025. He is the director of “Conceptual basis of Urology course”, A monthly webinar on contemporary urological topics for trainees and urologists, so far, over 40 high-impact webinars (https://www.pauskarachi.org/CBC.htm ). Recently started a One-year certification course in uro oncology, the course, with over 30 leading experts in Uro cancer as faculty from around the world https://www.pauskarachi.org/uro.oncology.course.htm ). He was trained in Karachi and London and has had many short fellowships in Rotterdam (Prof Shroeder and Mickish), the UK (Michael Kallet and Prof Whitfield), Berne, Switzerland (Prof. Urs Studer and George Thalmann), India (Mahesh Desai), and Leuven (Prof Hein Van Poppel). His clinical interests include uro-oncology and endourology.

14th August 2025

Time Session
08:30
12:10
Management of UTUC and RIRS Updates
  • 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.
    Chen-Hsun HoTaiwan Moderator Laser Lithotripsy in RIRS: Choosing the Right Settings for Better Outcomes
  • Kay Seong NgooMalaysia Speaker Overview of UTUC: from Diagnosis to Treatment to SurveillanceUpper tract urothelial carcinoma (UTUC) accounts for approximately 5% to 10% of all urothelial carcinomas, with an annual incidence of about 2 per 100,000 population. It predominantly affects men, who are typically diagnosed at a younger age. At the time of diagnosis, approximately two-thirds of UTUC cases involve the intrarenal collecting system, 70% are high-grade, and around two-thirds are invasive. Established risk factors include cigarette smoking, exposure to aristolochic acid, and Lynch syndrome. The majority of patients present with locally advanced disease. Diagnostic workup typically includes contrast-enhanced computed tomography (CT) urography, ureteroscopy with tissue biopsy, and selective urinary cytology. Technological advancements in ureteroscopy, including the integration of optical coherence tomography and confocal laser endomicroscopy, have shown promise in improving in vivo tumour grading and staging. Treatment strategies are guided by risk stratification and the potential for disease progression. In low-risk cases—and in selected high-risk patients with imperative indications—nephron-sparing approaches such as endoscopic ablation, segmental ureterectomy, and chemoablation may be considered. Recent evidence suggests comparable oncologic outcomes between nephron-sparing surgery (NSS) and radical approaches. Advances in endoscopic techniques, including newer laser technologies, have further improved the feasibility and efficacy of NSS. Due to higher recurrence rates following NSS, adjuvant intraluminal therapy is recommended. For high-risk UTUC, radical nephroureterectomy with bladder cuff excision remains the gold standard, irrespective of surgical modality. This is typically followed by a single postoperative intravesical instillation of chemotherapy. Adjuvant platinum-based chemotherapy has demonstrated improved disease-free survival, and emerging data suggest a potential role for immunotherapy in the perioperative setting. Given the high risk of local recurrence, especially after nephron-sparing interventions, long-term and rigorous surveillance is essential. This includes periodic CT urography, cystoscopy, and urinary cytology. Surveillance protocols vary across guidelines, particularly in terms of recommended frequency and duration.
  • Srinath K. ChandrasekeraSri Lanka Speaker Renal Preservation in UTUC
  • Hammad Ather Pakistan Speaker Current Evidence Supporting Adjuvant and Neo-Adjuvant TreatmentThe Upper Tract Urothelial Cancer (UTUC) is increasingly being considered as a genetic disorder. Following RNU, the IHC can detect a deficiency in mismatch repair proteins or microsatellite instability (MSI) using PCR. In the presence of MSI, it is necessary to undergo germline testing. High-grade UTUC is an aggressive cancer and is often associated with micrometastases, resulting in early recurrence and development of metastases. Risk classification and recognising more aggressive cancers in whom adjuvant or even neoadjuvant chemotherapy may be of benefit. One of the most crucial steps in considering patients for chemotherapy is the platinum eligibility, renal function (<30ml/min), functional status (ECOG >2) and comorbidities >2 grade are considered ineligible. There is good-quality evidence of improved survival for adjuvant chemotherapy in eligible patients following RNU for pT2–T4 and/or pN+ disease. The 2025 EAU guidelines recommend discussing adjuvant nivolumab with PD-L1-positive patients unfit for, or who declined, platinum-based adjuvant chemotherapy for ≥ pT3 and/or pN+ disease after previous RNU alone or ≥ypT2 and/or ypN+ disease after previous neoadjuvant chemotherapy, followed by RNU. However, the evidence supporting this recommendation is weak. Single intravesical chemotherapy is strongly recommended. There is currently no level 1 evidence supporting neo-adjuvant chemotherapy; however, non-randomised series have shown a decreased incidence of positive surgical margins, recurrence, and improved survival over RNU alone.Avoiding Complication in Orthotopic NeobladderIn most large series from Europe, approximately 1-2 of every 10 patients undergoing radical cystectomy have an orthotopic neobladder (ONB). Data is supporting ONB in terms of quality of life, cosmetics, and improved patient satisfaction. Early and late morbidity in up to 22% of patients is reported. The terminal ileum is the GI segment most often used for orthotopic bladder substitution. With ileo-ureteral anastomoses, there is UUT reflux, and renal functional deterioration is a concern. Various forms of UUT reflux protection, including a simple isoperistaltic tunnel, ileal intussusception, tapered ileal prolongation implanted subserosally, and direct (sub)mucosal or subserosal ureteral implantation, have been described. Superiority of one over the other is not proven. Urethral recurrence is a significant concern; therefore, patient selection must be optimal. Short-term complications are related to the GI tract, including atelectasis and metabolic acidosis. They are all preventable with standardised post-operative measures. The ERAS protocol is particularly useful in avoiding short-term complications and decreasing postoperative hospital stay, among other benefits. The key to success in preventing complications is meticulous patient selection and the implementation of preemptive measures to avoid common complications.Prostate Biopsy Technique: Current EvidenceOptimal prostate biopsy is critical in risk-stratifying patients for appropriate patient care. The traditional TRUS-guided biopsy is associated with UTI sepsis and other infectious complications. Recently, the use of the transperineal route has been advocated for the diagnosis of prostate cancer. Biopsy is either systematic or targeted. There is evidence supporting the notion that MRI-targeted biopsy without systematic biopsy significantly reduces the over-diagnosis of low-risk disease, compared to systematic biopsy. This seems true even when systematic biopsies are indicated after risk stratification with the Rotterdam Prostate Cancer Risk Calculator. EAU recommends performing prostate biopsy using the transperineal approach due to the low risk of infectious complications and better antibiotic stewardship. They also recommend using either target prophylaxis based on rectal swab or stool culture, or augmented prophylaxis (two or more different classes of antibiotics), for transrectal biopsy.
  • Lukman HakimIndonesia Speaker Multidisciplinary: Metastatic Disease
  • Hammad Ather Pakistan Speaker Current Evidence Supporting Adjuvant and Neo-Adjuvant TreatmentThe Upper Tract Urothelial Cancer (UTUC) is increasingly being considered as a genetic disorder. Following RNU, the IHC can detect a deficiency in mismatch repair proteins or microsatellite instability (MSI) using PCR. In the presence of MSI, it is necessary to undergo germline testing. High-grade UTUC is an aggressive cancer and is often associated with micrometastases, resulting in early recurrence and development of metastases. Risk classification and recognising more aggressive cancers in whom adjuvant or even neoadjuvant chemotherapy may be of benefit. One of the most crucial steps in considering patients for chemotherapy is the platinum eligibility, renal function (<30ml/min), functional status (ECOG >2) and comorbidities >2 grade are considered ineligible. There is good-quality evidence of improved survival for adjuvant chemotherapy in eligible patients following RNU for pT2–T4 and/or pN+ disease. The 2025 EAU guidelines recommend discussing adjuvant nivolumab with PD-L1-positive patients unfit for, or who declined, platinum-based adjuvant chemotherapy for ≥ pT3 and/or pN+ disease after previous RNU alone or ≥ypT2 and/or ypN+ disease after previous neoadjuvant chemotherapy, followed by RNU. However, the evidence supporting this recommendation is weak. Single intravesical chemotherapy is strongly recommended. There is currently no level 1 evidence supporting neo-adjuvant chemotherapy; however, non-randomised series have shown a decreased incidence of positive surgical margins, recurrence, and improved survival over RNU alone.Avoiding Complication in Orthotopic NeobladderIn most large series from Europe, approximately 1-2 of every 10 patients undergoing radical cystectomy have an orthotopic neobladder (ONB). Data is supporting ONB in terms of quality of life, cosmetics, and improved patient satisfaction. Early and late morbidity in up to 22% of patients is reported. The terminal ileum is the GI segment most often used for orthotopic bladder substitution. With ileo-ureteral anastomoses, there is UUT reflux, and renal functional deterioration is a concern. Various forms of UUT reflux protection, including a simple isoperistaltic tunnel, ileal intussusception, tapered ileal prolongation implanted subserosally, and direct (sub)mucosal or subserosal ureteral implantation, have been described. Superiority of one over the other is not proven. Urethral recurrence is a significant concern; therefore, patient selection must be optimal. Short-term complications are related to the GI tract, including atelectasis and metabolic acidosis. They are all preventable with standardised post-operative measures. The ERAS protocol is particularly useful in avoiding short-term complications and decreasing postoperative hospital stay, among other benefits. The key to success in preventing complications is meticulous patient selection and the implementation of preemptive measures to avoid common complications.Prostate Biopsy Technique: Current EvidenceOptimal prostate biopsy is critical in risk-stratifying patients for appropriate patient care. The traditional TRUS-guided biopsy is associated with UTI sepsis and other infectious complications. Recently, the use of the transperineal route has been advocated for the diagnosis of prostate cancer. Biopsy is either systematic or targeted. There is evidence supporting the notion that MRI-targeted biopsy without systematic biopsy significantly reduces the over-diagnosis of low-risk disease, compared to systematic biopsy. This seems true even when systematic biopsies are indicated after risk stratification with the Rotterdam Prostate Cancer Risk Calculator. EAU recommends performing prostate biopsy using the transperineal approach due to the low risk of infectious complications and better antibiotic stewardship. They also recommend using either target prophylaxis based on rectal swab or stool culture, or augmented prophylaxis (two or more different classes of antibiotics), for transrectal biopsy.
  • 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!
    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
  • Chen-Hsun HoTaiwan Speaker Laser Lithotripsy in RIRS: Choosing the Right Settings for Better Outcomes
  • Shuji IsotaniJapan Speaker ECIRS in Daily Practice: How to Achieve Better Stone-Free Rates with Fewer Complications
  • Joseph LiHong Kong, China Speaker Troubleshooting in Endoscopic Stone Surgery: How to Handle Unexpected Challenges in RIRS and ECIRS
  • 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
  • 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
TICC - 1F 102

15th August 2025

Time Session
10:30
12:00
  • Hammad Ather Pakistan Speaker Current Evidence Supporting Adjuvant and Neo-Adjuvant TreatmentThe Upper Tract Urothelial Cancer (UTUC) is increasingly being considered as a genetic disorder. Following RNU, the IHC can detect a deficiency in mismatch repair proteins or microsatellite instability (MSI) using PCR. In the presence of MSI, it is necessary to undergo germline testing. High-grade UTUC is an aggressive cancer and is often associated with micrometastases, resulting in early recurrence and development of metastases. Risk classification and recognising more aggressive cancers in whom adjuvant or even neoadjuvant chemotherapy may be of benefit. One of the most crucial steps in considering patients for chemotherapy is the platinum eligibility, renal function (<30ml/min), functional status (ECOG >2) and comorbidities >2 grade are considered ineligible. There is good-quality evidence of improved survival for adjuvant chemotherapy in eligible patients following RNU for pT2–T4 and/or pN+ disease. The 2025 EAU guidelines recommend discussing adjuvant nivolumab with PD-L1-positive patients unfit for, or who declined, platinum-based adjuvant chemotherapy for ≥ pT3 and/or pN+ disease after previous RNU alone or ≥ypT2 and/or ypN+ disease after previous neoadjuvant chemotherapy, followed by RNU. However, the evidence supporting this recommendation is weak. Single intravesical chemotherapy is strongly recommended. There is currently no level 1 evidence supporting neo-adjuvant chemotherapy; however, non-randomised series have shown a decreased incidence of positive surgical margins, recurrence, and improved survival over RNU alone.Avoiding Complication in Orthotopic NeobladderIn most large series from Europe, approximately 1-2 of every 10 patients undergoing radical cystectomy have an orthotopic neobladder (ONB). Data is supporting ONB in terms of quality of life, cosmetics, and improved patient satisfaction. Early and late morbidity in up to 22% of patients is reported. The terminal ileum is the GI segment most often used for orthotopic bladder substitution. With ileo-ureteral anastomoses, there is UUT reflux, and renal functional deterioration is a concern. Various forms of UUT reflux protection, including a simple isoperistaltic tunnel, ileal intussusception, tapered ileal prolongation implanted subserosally, and direct (sub)mucosal or subserosal ureteral implantation, have been described. Superiority of one over the other is not proven. Urethral recurrence is a significant concern; therefore, patient selection must be optimal. Short-term complications are related to the GI tract, including atelectasis and metabolic acidosis. They are all preventable with standardised post-operative measures. The ERAS protocol is particularly useful in avoiding short-term complications and decreasing postoperative hospital stay, among other benefits. The key to success in preventing complications is meticulous patient selection and the implementation of preemptive measures to avoid common complications.Prostate Biopsy Technique: Current EvidenceOptimal prostate biopsy is critical in risk-stratifying patients for appropriate patient care. The traditional TRUS-guided biopsy is associated with UTI sepsis and other infectious complications. Recently, the use of the transperineal route has been advocated for the diagnosis of prostate cancer. Biopsy is either systematic or targeted. There is evidence supporting the notion that MRI-targeted biopsy without systematic biopsy significantly reduces the over-diagnosis of low-risk disease, compared to systematic biopsy. This seems true even when systematic biopsies are indicated after risk stratification with the Rotterdam Prostate Cancer Risk Calculator. EAU recommends performing prostate biopsy using the transperineal approach due to the low risk of infectious complications and better antibiotic stewardship. They also recommend using either target prophylaxis based on rectal swab or stool culture, or augmented prophylaxis (two or more different classes of antibiotics), for transrectal biopsy.
  • Vinod K.VIndia Moderator Testosterone Therapy: Implications for Cardiovascular Health Sexual Function Preservation in MIS for BPH
  • Sarbartha Kumar PratiharIndia Speaker Retroperitoneal vs. Transperitoneal Robot Assisted Partial Nephrectomy for RCC
  • Mahesh Bahadur AdhikariNepal Speaker Infectious Complications after Endourological Procedures
  • M. SivashankarSri Lanka Speaker Management of NMIBC during BCG Shortage EraDuring periods of Bacillus Calmette–Guérin (BCG) shortage, management of non muscle invasive bladder cancer (NMIBC) must be guided by risk stratification and resource optimization. Recent evidence supports reduced dosing (one third to half) rather than abbreviated schedules, with induction prioritized for high risk and carcinoma in situ cases. Alternative intravesical agents—mitomycin C (especially with chemohyperthermia or EMDA), gemcitabine, epirubicin, or sequential gemcitabine/docetaxel—are recommended when BCG is unavailable. In cases of incomplete BCG followed by chemotherapy, outcomes may be superior to chemotherapy alone. For high risk patients, upfront radical cystectomy should be considered when BCG is wholly unavailable. Future trials and supply diversification remain vital.
  • Athanasios PapatsorisGreece Speaker BCG Refractory Cancer: Current Status of Intravesical TreatmentRecommendations in Laser Use for the Treatment of Upper Tract Urothelial Carcinoma
  • Mahesh Bahadur AdhikariNepal Moderator Infectious Complications after Endourological Procedures
    Rajeev TPIndia Moderator Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith
  • Md Jahangir KabirBangladesh Speaker Quality of Life Issues with Androgen Blockade in Prostate Cancer
  • Hammad Ather Pakistan Speaker Current Evidence Supporting Adjuvant and Neo-Adjuvant TreatmentThe Upper Tract Urothelial Cancer (UTUC) is increasingly being considered as a genetic disorder. Following RNU, the IHC can detect a deficiency in mismatch repair proteins or microsatellite instability (MSI) using PCR. In the presence of MSI, it is necessary to undergo germline testing. High-grade UTUC is an aggressive cancer and is often associated with micrometastases, resulting in early recurrence and development of metastases. Risk classification and recognising more aggressive cancers in whom adjuvant or even neoadjuvant chemotherapy may be of benefit. One of the most crucial steps in considering patients for chemotherapy is the platinum eligibility, renal function (<30ml/min), functional status (ECOG >2) and comorbidities >2 grade are considered ineligible. There is good-quality evidence of improved survival for adjuvant chemotherapy in eligible patients following RNU for pT2–T4 and/or pN+ disease. The 2025 EAU guidelines recommend discussing adjuvant nivolumab with PD-L1-positive patients unfit for, or who declined, platinum-based adjuvant chemotherapy for ≥ pT3 and/or pN+ disease after previous RNU alone or ≥ypT2 and/or ypN+ disease after previous neoadjuvant chemotherapy, followed by RNU. However, the evidence supporting this recommendation is weak. Single intravesical chemotherapy is strongly recommended. There is currently no level 1 evidence supporting neo-adjuvant chemotherapy; however, non-randomised series have shown a decreased incidence of positive surgical margins, recurrence, and improved survival over RNU alone.Avoiding Complication in Orthotopic NeobladderIn most large series from Europe, approximately 1-2 of every 10 patients undergoing radical cystectomy have an orthotopic neobladder (ONB). Data is supporting ONB in terms of quality of life, cosmetics, and improved patient satisfaction. Early and late morbidity in up to 22% of patients is reported. The terminal ileum is the GI segment most often used for orthotopic bladder substitution. With ileo-ureteral anastomoses, there is UUT reflux, and renal functional deterioration is a concern. Various forms of UUT reflux protection, including a simple isoperistaltic tunnel, ileal intussusception, tapered ileal prolongation implanted subserosally, and direct (sub)mucosal or subserosal ureteral implantation, have been described. Superiority of one over the other is not proven. Urethral recurrence is a significant concern; therefore, patient selection must be optimal. Short-term complications are related to the GI tract, including atelectasis and metabolic acidosis. They are all preventable with standardised post-operative measures. The ERAS protocol is particularly useful in avoiding short-term complications and decreasing postoperative hospital stay, among other benefits. The key to success in preventing complications is meticulous patient selection and the implementation of preemptive measures to avoid common complications.Prostate Biopsy Technique: Current EvidenceOptimal prostate biopsy is critical in risk-stratifying patients for appropriate patient care. The traditional TRUS-guided biopsy is associated with UTI sepsis and other infectious complications. Recently, the use of the transperineal route has been advocated for the diagnosis of prostate cancer. Biopsy is either systematic or targeted. There is evidence supporting the notion that MRI-targeted biopsy without systematic biopsy significantly reduces the over-diagnosis of low-risk disease, compared to systematic biopsy. This seems true even when systematic biopsies are indicated after risk stratification with the Rotterdam Prostate Cancer Risk Calculator. EAU recommends performing prostate biopsy using the transperineal approach due to the low risk of infectious complications and better antibiotic stewardship. They also recommend using either target prophylaxis based on rectal swab or stool culture, or augmented prophylaxis (two or more different classes of antibiotics), for transrectal biopsy.
  • Keval PatelIndia Speaker Radical Prostatectomy without Biopsy: Are We There?
TICC - 1F 101D
13:30
15:00
  • Hammad Ather Pakistan Moderator Current Evidence Supporting Adjuvant and Neo-Adjuvant TreatmentThe Upper Tract Urothelial Cancer (UTUC) is increasingly being considered as a genetic disorder. Following RNU, the IHC can detect a deficiency in mismatch repair proteins or microsatellite instability (MSI) using PCR. In the presence of MSI, it is necessary to undergo germline testing. High-grade UTUC is an aggressive cancer and is often associated with micrometastases, resulting in early recurrence and development of metastases. Risk classification and recognising more aggressive cancers in whom adjuvant or even neoadjuvant chemotherapy may be of benefit. One of the most crucial steps in considering patients for chemotherapy is the platinum eligibility, renal function (<30ml/min), functional status (ECOG >2) and comorbidities >2 grade are considered ineligible. There is good-quality evidence of improved survival for adjuvant chemotherapy in eligible patients following RNU for pT2–T4 and/or pN+ disease. The 2025 EAU guidelines recommend discussing adjuvant nivolumab with PD-L1-positive patients unfit for, or who declined, platinum-based adjuvant chemotherapy for ≥ pT3 and/or pN+ disease after previous RNU alone or ≥ypT2 and/or ypN+ disease after previous neoadjuvant chemotherapy, followed by RNU. However, the evidence supporting this recommendation is weak. Single intravesical chemotherapy is strongly recommended. There is currently no level 1 evidence supporting neo-adjuvant chemotherapy; however, non-randomised series have shown a decreased incidence of positive surgical margins, recurrence, and improved survival over RNU alone.Avoiding Complication in Orthotopic NeobladderIn most large series from Europe, approximately 1-2 of every 10 patients undergoing radical cystectomy have an orthotopic neobladder (ONB). Data is supporting ONB in terms of quality of life, cosmetics, and improved patient satisfaction. Early and late morbidity in up to 22% of patients is reported. The terminal ileum is the GI segment most often used for orthotopic bladder substitution. With ileo-ureteral anastomoses, there is UUT reflux, and renal functional deterioration is a concern. Various forms of UUT reflux protection, including a simple isoperistaltic tunnel, ileal intussusception, tapered ileal prolongation implanted subserosally, and direct (sub)mucosal or subserosal ureteral implantation, have been described. Superiority of one over the other is not proven. Urethral recurrence is a significant concern; therefore, patient selection must be optimal. Short-term complications are related to the GI tract, including atelectasis and metabolic acidosis. They are all preventable with standardised post-operative measures. The ERAS protocol is particularly useful in avoiding short-term complications and decreasing postoperative hospital stay, among other benefits. The key to success in preventing complications is meticulous patient selection and the implementation of preemptive measures to avoid common complications.Prostate Biopsy Technique: Current EvidenceOptimal prostate biopsy is critical in risk-stratifying patients for appropriate patient care. The traditional TRUS-guided biopsy is associated with UTI sepsis and other infectious complications. Recently, the use of the transperineal route has been advocated for the diagnosis of prostate cancer. Biopsy is either systematic or targeted. There is evidence supporting the notion that MRI-targeted biopsy without systematic biopsy significantly reduces the over-diagnosis of low-risk disease, compared to systematic biopsy. This seems true even when systematic biopsies are indicated after risk stratification with the Rotterdam Prostate Cancer Risk Calculator. EAU recommends performing prostate biopsy using the transperineal approach due to the low risk of infectious complications and better antibiotic stewardship. They also recommend using either target prophylaxis based on rectal swab or stool culture, or augmented prophylaxis (two or more different classes of antibiotics), for transrectal biopsy.
    Parash Mani ShresthaNepal Moderator Post RNU Adjuvant Treatment in UTUC- Recent Update
    Ponco BirowoIndonesia Moderator Pressure Management Strategy in RIRS using Tidor System
  • Jaisukh KalathiaIndia Speaker Digitalization in Suction PCNL Can Change Practice
  • Vinod K.VIndia Speaker Testosterone Therapy: Implications for Cardiovascular Health Sexual Function Preservation in MIS for BPH
  • Md. Nasir UddinBangladesh Speaker Two Stages versus Single Stage Repair of Obliterative Long Anterior Urethral Stricture
  • Suman ChapagainNepal Speaker Management of Bulbar Urethral Necrosis: Flap Vs Graft
  • 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!
    Srinath K. ChandrasekeraSri Lanka Moderator Renal Preservation in UTUC
    Suman ChapagainNepal Moderator Management of Bulbar Urethral Necrosis: Flap Vs Graft
  • Aziz AbdullahPakistan Speaker MIS in the Management of Urethral Stricture
  • Sasikumar SubramaniamSri Lanka Speaker Post Priapism Penile Prosthesis: What and WhenIschemic priapism remains a urological emergency with devastating consequences when not promptly and effectively managed. Among its most feared sequelae is corporal fibrosis leading to irreversible erectile dysfunction. In such cases, timely insertion of a penile prosthesis is often the only viable option to restore sexual function and preserve penile length. This presentation explores the complex decision-making framework surrounding penile prosthesis implantation following priapism. We will review the current evidence on timing—emergent versus delayed insertion—highlighting the anatomical and surgical challenges posed by fibrotic corporal bodies. The discussion will cover prosthesis type selection, intraoperative considerations, and outcomes data from recent case series and cohort studies. Additionally, we will examine the risks of infection, erosion, and mechanical failure in the post-priapism cohort, comparing them to standard ED populations.
  • Sanjay KulkarniIndia Speaker 12 cm Peno-Bulbar Stricture due to Lichen SclerosusPan Urethroplasty with Kulkarni technique, bilateral buccaneers mucosa grafts or spiral prepucial graft technique.Oral Mucosa and Beyond: Tissue Substitutes in Urethroplasty
  • Rajeev TPIndia Speaker Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith
TICC - 1F 101D

16th August 2025

Time Session
13:30
15:00
Urothelial Cancer
  • Chi-Hang YeeHong Kong, China Moderator Robotic Total Intracorporeal Urinary Diversion – from Ileal Conduit to Neobladder to Ileal Interposition Prostate Cancer Focal Therapy: Ready for Prime Time?
  • Tsu-Ming ChienTaiwan Speaker How to Deal with High-Risk NMIBC with BCG-Refractory Status?
  • Hammad Ather Pakistan Speaker Current Evidence Supporting Adjuvant and Neo-Adjuvant TreatmentThe Upper Tract Urothelial Cancer (UTUC) is increasingly being considered as a genetic disorder. Following RNU, the IHC can detect a deficiency in mismatch repair proteins or microsatellite instability (MSI) using PCR. In the presence of MSI, it is necessary to undergo germline testing. High-grade UTUC is an aggressive cancer and is often associated with micrometastases, resulting in early recurrence and development of metastases. Risk classification and recognising more aggressive cancers in whom adjuvant or even neoadjuvant chemotherapy may be of benefit. One of the most crucial steps in considering patients for chemotherapy is the platinum eligibility, renal function (<30ml/min), functional status (ECOG >2) and comorbidities >2 grade are considered ineligible. There is good-quality evidence of improved survival for adjuvant chemotherapy in eligible patients following RNU for pT2–T4 and/or pN+ disease. The 2025 EAU guidelines recommend discussing adjuvant nivolumab with PD-L1-positive patients unfit for, or who declined, platinum-based adjuvant chemotherapy for ≥ pT3 and/or pN+ disease after previous RNU alone or ≥ypT2 and/or ypN+ disease after previous neoadjuvant chemotherapy, followed by RNU. However, the evidence supporting this recommendation is weak. Single intravesical chemotherapy is strongly recommended. There is currently no level 1 evidence supporting neo-adjuvant chemotherapy; however, non-randomised series have shown a decreased incidence of positive surgical margins, recurrence, and improved survival over RNU alone.Avoiding Complication in Orthotopic NeobladderIn most large series from Europe, approximately 1-2 of every 10 patients undergoing radical cystectomy have an orthotopic neobladder (ONB). Data is supporting ONB in terms of quality of life, cosmetics, and improved patient satisfaction. Early and late morbidity in up to 22% of patients is reported. The terminal ileum is the GI segment most often used for orthotopic bladder substitution. With ileo-ureteral anastomoses, there is UUT reflux, and renal functional deterioration is a concern. Various forms of UUT reflux protection, including a simple isoperistaltic tunnel, ileal intussusception, tapered ileal prolongation implanted subserosally, and direct (sub)mucosal or subserosal ureteral implantation, have been described. Superiority of one over the other is not proven. Urethral recurrence is a significant concern; therefore, patient selection must be optimal. Short-term complications are related to the GI tract, including atelectasis and metabolic acidosis. They are all preventable with standardised post-operative measures. The ERAS protocol is particularly useful in avoiding short-term complications and decreasing postoperative hospital stay, among other benefits. The key to success in preventing complications is meticulous patient selection and the implementation of preemptive measures to avoid common complications.Prostate Biopsy Technique: Current EvidenceOptimal prostate biopsy is critical in risk-stratifying patients for appropriate patient care. The traditional TRUS-guided biopsy is associated with UTI sepsis and other infectious complications. Recently, the use of the transperineal route has been advocated for the diagnosis of prostate cancer. Biopsy is either systematic or targeted. There is evidence supporting the notion that MRI-targeted biopsy without systematic biopsy significantly reduces the over-diagnosis of low-risk disease, compared to systematic biopsy. This seems true even when systematic biopsies are indicated after risk stratification with the Rotterdam Prostate Cancer Risk Calculator. EAU recommends performing prostate biopsy using the transperineal approach due to the low risk of infectious complications and better antibiotic stewardship. They also recommend using either target prophylaxis based on rectal swab or stool culture, or augmented prophylaxis (two or more different classes of antibiotics), for transrectal biopsy.
  • Chi-Hang YeeHong Kong, China Speaker Robotic Total Intracorporeal Urinary Diversion – from Ileal Conduit to Neobladder to Ileal Interposition Prostate Cancer Focal Therapy: Ready for Prime Time?
  • Ali Hamidi MadaniIran Speaker Changing Treatment Landscape of Urothelial Cancers in New Era of Immunotherapy
  • Khurram Mutahir SiddiquiOman Speaker Kidney Preservation Strategies for Upper Tract Urothelial CancerAbstract: Upper tract urothelial carcinoma (UTUC) is a rare but aggressive malignancy that affects the renal pelvis and ureter, often leading to significant challenges in treatment and kidney preservation. This lecture provides a comprehensive overview of the state-of-the-art kidney preservation techniques employed in the management of UTUC, with a focus on preserving renal function while ensuring oncological control. Surgical approaches, including nephron-sparing surgery (NSS) and minimally invasive techniques, such as endoscopic resections and robotic-assisted procedures, are discussed, highlighting their role in achieving optimal outcomes with reduced morbidity. In addition, the importance of careful patient selection based on tumor characteristics, location, and stage is emphasized, as these factors significantly influence the decision-making process regarding kidney preservation versus radical nephroureterectomy. The lecture further explores the evolving role of neoadjuvant and adjuvant therapies, including chemotherapy and immunotherapy, in conjunction with surgical intervention, to improve survival rates while maintaining renal function. Recent advancements in genetic profiling and molecular diagnostics are also addressed, as these innovations may lead to more personalized treatment strategies that preserve the kidney while effectively targeting the malignancy. Lastly, the challenges of balancing oncological safety with renal preservation are discussed, and future directions in research, including potential breakthroughs in regenerative medicine and advanced surgical techniques, are explored. This lecture aims to provide a current and thorough understanding of the multidisciplinary approaches to kidney preservation in UTUC, offering insights into best practices and emerging trends in the field.
TICC - 2F 201BC