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08:30
10:00
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Chun-Hou LiaoTaiwan
Moderator
Regeneration Medicine in Urology - A Promising Future or Hoax?Regenerative medicine comprises therapeutic strategies aimed at restoring tissue structure and function, rather than merely alleviating symptoms. By deploying cells, biomaterials, bioactive molecules, or combinations thereof, these interventions stimulate the body’s intrinsic repair mechanisms. This paradigm extends beyond traditional symptomatic treatment, offering the potential for true self-healing and organ reconstruction—ultimately prioritizing cure over chronic disease management.
Cell-based therapy has emerged as a promising intervention for various urogenital disorders, including erectile dysfunction (ED), bladder dysfunction, and male infertility. Current clinical research primarily focuses on mesenchymal stem cells (MSCs), investigating their safety, tolerability, and preliminary efficacy. Although early-phase studies suggest functional benefits—such as improved hemodynamics and tissue regeneration—most programs remain in preclinical or early clinical stages. A critical limitation remains the lack of standardization in MSC source, dose, and delivery route.
Among alternative sources, human amniotic fluid-derived stem cells (hAFSCs) have shown particular promise. In preclinical models of cavernous nerve injury, hAFSCs demonstrated prolonged retention in penile tissue and in-situ differentiation into α-smooth muscle actin-positive corporal smooth muscle cells, effectively replacing damaged tissue and restoring function. These findings represent an encouraging step toward curative therapy. However, the mechanisms governing their in vivo behavior—such as engraftment, differentiation, and immunogenicity—will ultimately determine their clinical translatability and therapeutic stability. Whether cell-based approaches can evolve from experimental platforms into routine clinical care remains a central question.
Platelet-Rich Plasma (PRP)
Platelet-rich plasma (PRP) is an autologous biologic product enriched with supraphysiologic levels of platelets, growth factors, chemokines, and extracellular vesicles. Upon activation, PRP releases a bioactive cocktail that promotes angiogenesis, neuroregeneration, and antifibrotic remodeling—key processes in the restoration of urogenital tissues.
In rodent models of cavernous nerve injury, PRP has been shown to preserve corporal sinusoidal endothelial cells and axonal scaffolds, while restoring erectile hemodynamics. Clinical studies further support PRP's safety in humans and report variable but promising improvements in IIEF scores following intracavernous injection. Nevertheless, the therapeutic response appears heterogeneous, likely influenced by patient factors, PRP preparation techniques, and injection protocols. Beyond ED, PRP has shown potential in other urologic indications such as stress urinary incontinence (SUI), interstitial cystitis/bladder pain syndrome (IC/BPS), and chronic pelvic pain, where it may contribute to tissue regeneration and symptom relief. However, broader adoption will require the establishment of individualized blood-quality metrics, standardized preparation methods, and randomized controlled trials demonstrating durable benefit.
Emerging Regenerative Strategies
Beyond cell-based and autologous biologics, a suite of innovative regenerative technologies is progressing from bench to bedside. These include:
Energy-based devices such as low-intensity extracorporeal shock wave therapy (Li-ESWT), which promotes neovascularization and tissue regeneration via mechanotransduction pathways.
Gene therapies, targeting dysfunctional or absent proteins in disorders like overactive bladder.
Smart biomaterials, capable of delivering cells or bioactive molecules in a controlled, responsive manner.
Extracellular vesicle (EV)-based therapeutics, which leverage cell-free vesicles derived from MSCs or urine-derived stem cells. These EVs carry signaling molecules (e.g., microRNAs, cytokines, growth factors) that mimic the paracrine effects of stem cells, offering a potentially safer and more scalable alternative to cell transplantation.
In preclinical models of ED and bladder dysfunction, EVs have demonstrated the capacity to promote smooth muscle regeneration, nerve sprouting, and fibrosis reduction, with functional improvements comparable to stem cell therapy.
Regenerative medicine has propelled the field of urologic tissue repair from theoretical promise to an early clinical reality. While substantial challenges remain—including the need for deeper mechanistic insight, protocol standardization, and regulatory clarity—the field is advancing rapidly. The convergence of cell therapy, PRP, EVs, and device-based modalities is creating a multifaceted toolkit for urologic regeneration. With continued scientific rigor, large-scale clinical trials, and interdisciplinary collaboration, regenerative medicine holds the potential to shift urologic care from chronic symptomatic management to durable, tissue-level cure.Stem Cell Therapy: Advancements and Clinical Insights for Erectile Dysfunction Treatment Erectile dysfunction (ED)—defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity—affects over 150 million men worldwide. While phosphodiesterase-5 inhibitors (PDE5is) remain the first-line treatment, many patients, particularly those with diabetes, age-related vascular decline, or neuropathy following radical prostatectomy, show suboptimal responses. Consequently, regenerative medicine—particularly stem-cell therapy—has gained interest for its potential to address the root causes of ED rather than merely managing symptoms.
Stem-cell therapy offers a multifaceted approach to treating ED through neuroregeneration, angiogenesis, anti-apoptotic signaling, and fibrosis inhibition. Once introduced into the target tissue, stem cells can differentiate into specific cell types or exert paracrine effects via secretion of growth factors and extracellular vesicles. Among the various sources studied, bone marrow-derived mesenchymal stem cells (BM-MSCs), adipose-derived stem cells (ADSCs), and umbilical cord-derived MSCs (UC-MSCs) have been most extensively explored.
Preclinical studies consistently demonstrate that MSC-based therapies enhance cavernous nerve regeneration, suppress fibrosis, and preserve endothelial integrity. In rat models of diabetes- or nerve-injury-induced ED, intracavernosal injections of ADSCs or BM-MSCs significantly restore intracavernosal pressure (ICP) and improve corpus cavernosum histology. Phase I/II clinical trials also support the safety and preliminary efficacy of stem-cell approaches. For example, in men with diabetic ED treated with autologous BM-MSCs, significant improvements in International Index of Erectile Function-5 (IIEF-5) scores and penile arterial flow have been reported without major adverse events. Similarly, ADSC therapy in post-prostatectomy ED has shown encouraging short-term results. However, large-scale trials are needed to clarify long-term efficacy, immune responses, and safety profiles.
Human amniotic fluid stem cells (hAFSCs) represent a promising alternative, offering characteristics that bridge embryonic and adult stem-cell profiles. These include broad multipotency, high proliferation, and low immunogenicity—traits ideal for allogeneic use and neuroregenerative purposes. Notably, hAFSCs secrete potent regenerative mediators such as brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and insulin-like growth factor-1 (IGF-1), all of which support neurovascular repair and smooth muscle integrity. Our recent studies demonstrate, for the first time, that hAFSCs persist long-term in penile tissue and can differentiate into cavernous smooth-muscle cells, effectively replacing damaged tissue and improving erectile function even in chronic neurogenic ED models.
Despite these advantages, our findings did not reveal in-vivo homing of hAFSCs to nerve injury sites or differentiation into neural tissue. This suggests a need for future studies to identify the specific microenvironmental cues required to induce such responses. Additionally, combining hAFSCs with platelet-rich plasma (PRP) may provide synergistic benefits—enhancing stem-cell homing, paracrine signaling, and in-vivo differentiation—thereby advancing a more effective, scalable, and safe therapeutic strategy.
Hann-Chorng KuoTaiwan
Speaker
ACU Lecture: Videourodynamic Study for Precision Diagnosis and Management of Lower Urinary Tract DysfunctionVideourodynamic Study in the Precision Diagnosis and Management of Lower Urinary Tract Dysfunctions
Hann-Chorng Kuo, M.D.
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
As a urologist, we are dealing with patients with lower urinary tract symptoms everyday. We did transurethral resection of the prostate (TURP) for elderly men with bothersome lower urinary tract symptoms (LUTS). We put a suburethral sling for women with stress urinary incontinence (SUI). We prescribed alpha-blocker for those who had difficulty in urination. We add antimuscarinics for patients with urgency urinary incontinence. Our seniors always told us these treatments are effective in treating patients with LUTS. However, patients still had LUTS after TURP, women still complained of urgency and dysuria after anti-incontinence surgery. Medication based on storage or emptying LUTS do not work all the time. Why? Because symptoms are not reliable, a large prostate does not indicate bladder outlet obstruction (BOO), and SUI is not solely a result of urethral incompetence. Therefore, in diagnosis and management of LUTS, we need precision medicine to direct an accurate pathophysiology of LUTS, and to guide an appropriate management based on the bladder and bladder outlet dysfunction. When we encounter patients who have LUTS refractory to the treatment based on our initial diagnosis, when we are treating patients who have complicated storage and emptying LUTS, when we are not sure patients could benefit from the invasive procedures for their LUTS, or patients who had both lower and upper urinary tract dysfunctions, videourodynamic study (VUDS) is an essential investigation for diagnosis and management of LUTS. In additional to benign prostate hyperplasia (BPH) and BOO, male patients with emptying LUTS might result from detrusor underactivity (DU), bladder neck dysfunction (BND), urethral sphincter dysfunction, or a hypersensitive bladder, which is not related with the prostate. Patients with BPH and LUTS might have latent neurogenic lesion, such as minor stroke, Parkinson's disease, or early dementia, causing LUTS. TURP without known the neurological disease might exacerbate LUTS after surgery. Mixed SUI comprises intrinsic sphincter deficiency (ISD) and detrusor overactivity (DO). The overactive bladder (OAB) symptoms may also result from an incompetent bladder outlet. Without comprehensive VUDS, we might cure the SUI, but OAB remains after placing a mid-urethral sling. Bladder pain is the cardinal symptoms of interstitial cystitis. However, bladder pain perceived by the patient might also originate from BOO or pelvic floor fascitis. VUDS can help in discrimination. DU and low compliant bladder and ISD could result in complicated storage and emptying LUTS. Large post-void residual (PVR) should alert us to investigate whether it is originated from low compliance or ISD. Dysfunctional voiding (DV) and BND in women with emptying LUTS. OAB symptoms are not always coming from the DO. BOO such as BND, DV, or urethral stricture might exist in men and women without voiding symptoms. Urinary difficulty in women is usually a result from low detrusor contractility, due to DU, or through inhibitory effect from a poorly relaxed pelvic floor or urethral sphincter. A simple bladder neck incision can effectively restore spontaneous voiding in men or women with dysuria due to DU or BND. However, a tight BN is necessary to predict a successful treatment outcome. Patients with central nervous system (CNS) disorders or spinal cord injury usually have complicated LUTD, including DO, BND, DV, detrusor sphincter dyssynergia (DSD), and vesicoureteral reflux (VUR). Management of LUTS in CNS disorders or SCI patients should know the current bladder and bladder outlet dysfunctions. Pediatric incontinence, children with myelomeningocele, DV, or recurrent urinary tract infection are complicated and need precision diagnosis before treatment. Especially when surgery is planned. Lower urinary tract dysfunctions is a dynamic condition. The bladder and bladder outlet dysfunction might change with time. Although VUDS is considered as an invasive investigation with radiation exposure, the advantages in accurate diagnosis and guiding management outweigh these disadvantages.
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Andrew HungUnited States
Speaker
Future Direction of AI Application in UrologyDr. Hung will share the contemporary applications of AI in Urology, and how it will be utilized in the near future.
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Mahendra BhandariUnited States
Speaker
Predictive Intelligence in Motion: Enabling Surgical Automation in Urologic RoboticsArtificial intelligence is rapidly transforming urologic robotic surgery, not by replacing the surgeon, but by enhancing anticipation, precision, and intraoperative decision-making. This talk focuses on how high-fidelity predictive models serve as the computational core of surgical automation enabling intelligent systems to respond to anatomical variation, predict surgical planes, and adapt in real time.
I will highlight the evolving landscape of AI-driven assistance in procedures like robotic prostatectomy and partial nephrectomy, where predictive analytics and multimodal data (vision, force, motion) converge to guide dissection and preserve function. A special emphasis will be placed on the emerging and underutilized concept of "no-fly zones “predefined anatomical areas digitally fenced off to prevent inadvertent damage. Widely applied in ophthalmology and orthopedic robotics, this concept has yet to be integrated into urologic surgical platforms, despite its potential to enhance safety during nerve-sparing or vascular dissection.
The presentation will explore:
• AI-based risk prediction and intraoperative guidance
• Learning from large, annotated video and sensor datasets
• A proposed roadmap to introduce “no-fly zones” in urologic procedures
Ultimately, the talk advocates for a future where predictive AI not only guides the hand but safeguards the intent, making surgery smarter, safer, and more consistent.
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Isaac KimUnited States
Speaker
Update on the Apa Neoadjuvant TrialIn patients with high-risk prostate cancer (PCa), neoadjuvant androgen deprivation therapy (ADT) is not an accepted standard of care. However, we hypothesize that neoadjuvant ADT may result in improved quality of life by down-staging prostate cancer and thereby, permitting a better quality of nerve sparing. has demonstrated benefit in surgical outcomes after radical prostatectomy (RP). To test this hypothesis, we conducted a prospective randomized trial evaluating the effect of neoadjuvant Apalutamide (Apa) +/- abiraterone acetate/prednisone (AAP) and a gonadotropin-releasing hormone (GnRH) agonist on nerve sparing during RP in men with high-risk PCa. Update on the Results of SIMCAP StudyApproximately 7% of new prostate cancer (PCa) patients in the US will be diagnosed with metastatic disease. The role of surgery in this population remains unclear. To investigate the therapeutic value of radical prostatectomy in men with de novo metastatic prostate cancer, we are conducting the phase 2.5 randomized clinical trial SIMCAP (NCT03456843).
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John YuenSingapore
Speaker
Technical Pearls: Total Extraperitoneal TechniquePractice-Changing Development in RaLRP
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Vipul R. PatelUnited States
Speaker
Lessons from 20,000 Robotic Prostatectomies: A Global Expert’s PerspectiveTechnical Considerations for Large Prostates over 100gmsTelesurgery: The Future of Surgery
TICC - 3F Plenary Hall
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10:30
12:00
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Robotic Surgery
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Jian-Ri LiTaiwan
Moderator
Applying Vision Augmentation in Robotic Surgery: Reality or FictionApplying Vision Augmentation in Robotic Surgery: Reality or Fiction
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Ketan BadaniUnited States
Speaker
Expanding horizons: SP for complex RAPNThe Future of Urological Robotic SurgerySingle-Port Robotic Partial Nephrectomy for Multiple or Large Renal TumorsHow to Standardize Training by AI-Learning from The Best Practice of Urological Robotic SurgerySP Partial Nephrectomy
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Allen W. ChiuTaiwan
Speaker
Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques.
This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system.
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Steven L. ChangUnited States
Speaker
The Progression Landscape of Diagnostic and Treatment Options for Kidney CancerPros and Cons in the daVinci SP System Applications in Urological Surgeries
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TICC - 2F 201DE
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12:00
13:00
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Role of Da Vinci SP in Urology
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Allen W. ChiuTaiwan
Speaker
Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques.
This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system.
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Allen W. ChiuTaiwan
Moderator
Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques.
This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system.
Jian-Ri LiTaiwan
Speaker
Applying Vision Augmentation in Robotic Surgery: Reality or FictionApplying Vision Augmentation in Robotic Surgery: Reality or Fiction
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Allen W. ChiuTaiwan
Moderator
Reflecting on the Past, Shaping the Present, and Envisioning the Future of UAASince 1990, the Urological Association of Asia (UAA) has stood as a beacon of collaboration, innovation, and advancement in urology in Asia. As we reflect on its evolution, acknowledge its current impact, and envision its future, it becomes clear that the UAA has played - and will continue to play - a pivotal role in shaping urological care, education, and research throughout Asia. Reflecting on the path we’ve traveled together from 16 member associations and 1,000 individual members in 2014 to 28 member associations and over 4,500 individual members today - I see more than growth. I see unity, commitment, and a shared belief in something bigger than ourselves. A defining milestone was enrolling the Urological Society of Australia and New Zealand into the UAA, further enriching our diversity and strengthening our position as a truly Asia-Pacific organization. The UAA proudly supports several journals, including the International Journal of Urology, the Indian Journal of Urology, Asian Urology, which continue to shape the academic discourse. The Asian Urological Resident Course (AURC) started in 2014, in collaboration with the American Urological Association, has become a cornerstone in nurturing clinical excellence among young urologists. The Young Leadership Forum, since 2012, developed in partnership with the European Urological Association, has fostered cross-continental mentorship and exchange. These initiatives symbolize our commitment to creating a future shared across borders. We have faced challenges under the impact of COVID-19, but conquered it with resilience and shared purpose. As healthcare needs evolve and patient expectations rise, the UAA aims to: 1. Promote regional research 2. Enhance training and education 3. Strengthen partnerships 4. Champion equity in healthcare.Complex Robotic Assisted Surgery for Urinary Fistula RepairRobotic-assisted (da Vinci) surgery is increasingly used for repair of urinary fistulas, including vesicovaginal, ureterovaginal, and enterovesical fistula. It offers a minimally invasive alternative to open surgery. A case report described using the da Vinci X system to fix a vesicovaginal fistula (VVF) post-hysterectomy in 105 min with no complications, a 2 day hospital stay, and excellent patient reported quality-of-life at 12 months. A literature review including 30 cases showed robotic repair of VVF reduced blood loss and shortened hospital stays by 2 days compared to open repair. A review found that robotic repair of complex urinary fistulas is technically feasible in expert hands, with good early outcomes and less morbidity than open techniques.
This presentation illustrated the key operative procedures, inlcuding ureteral catheter placement to identify the ureteral tract, anchoring stitches on opened urinary bladder wall, robotic excision of the fistula tract, layered closure of bladder wall and adjacent organ (vagina or colon), with or without Interposition of tissue flaps (e.g. omentum or peritoneal flaps) to reinforce repair. The robot provides precise and secure ileal isolation with ICG technique for the ileal isolation, and and intracorporeal anastomosis to ureter and urinary bladder are safe. Intracorporeal bowel re-anastomosis and accessibility of the da Vinci platform is becoming more popular. The isolated ileal technique provides good urinary reconstruction (e.g., Neobladder, Augmentation Cystoplasty Ileal conduit (Bricker’s procedure), Orthotopic neobladder (Studer, Hautmann, etc.) The Role of the robot to harvestest, detubularize, and fold ileum to form bladder substitute. Suture to urethra and ureters. It is often performed entirely intracorporeally with the da Vinci Xi system.
Simone CrivellaroUnited States
Speaker
Single-Port vs. Multi-Port Robotic Prostatectomy: Balancing Innovation, Precision, and OutcomesThe Application & Limitation of Urological SP SurgerySingle Port Retroperitoneal Partial NephrectomySingle Port Prostate Surgery
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TICC - 2F 201BC
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13:30
15:00
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Yao-Chi ChuangTaiwan
Moderator
Road to Excellent ResearchYao Chi Chuang, Professor of Urology, Kaohsiung Chang Gung Memorial Hospital, and National Sun Yat-sen University Taiwan.
Medical research is what allows doctors to explore unmet medical need and decide how to best treat patients. It is what makes the development of new diagnostic tools, new biomarkers, new medicines, and new procedures. Without medical research, we would not be able to creative new knowledge and decide if new treatments are better than our current treatments.
There are some Tips on what to do about what research is and how to get into it:
1. Ask a good question from your daily practice, what is unmet medical need?
2. Search the old literature of your research interests- what is known? What is unknown?
3. Find a new method to solve your question or an old method but applying to a new field.
4. Start from jointing a pre-planned research project, and join a research collaborative.
5. Try to be an independent researcher from a small project without funding support, retrospective study.
6. Try to get funding support from your institute, national grant, or industry.
As a young doctor, it’s important to look after yourself and maintain a healthy balance between daily practice and research work. There is a range of options for doctors interested in research, from smaller time commitments as a co-investigator to longer-term projects and experience as chief investigator. Research works are all optional activities, so do what you can but don’t overwhelm yourself. Road to Excellent Research
Po-Ming ChowTaiwan
Speaker
Conventional Artificial Urinary Sphincter ImplantationA step-by-step video of a standard approach of AUS implatation is shown in this semi-live session.
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Yao-Chi ChuangTaiwan
Moderator
Road to Excellent ResearchYao Chi Chuang, Professor of Urology, Kaohsiung Chang Gung Memorial Hospital, and National Sun Yat-sen University Taiwan.
Medical research is what allows doctors to explore unmet medical need and decide how to best treat patients. It is what makes the development of new diagnostic tools, new biomarkers, new medicines, and new procedures. Without medical research, we would not be able to creative new knowledge and decide if new treatments are better than our current treatments.
There are some Tips on what to do about what research is and how to get into it:
1. Ask a good question from your daily practice, what is unmet medical need?
2. Search the old literature of your research interests- what is known? What is unknown?
3. Find a new method to solve your question or an old method but applying to a new field.
4. Start from jointing a pre-planned research project, and join a research collaborative.
5. Try to be an independent researcher from a small project without funding support, retrospective study.
6. Try to get funding support from your institute, national grant, or industry.
As a young doctor, it’s important to look after yourself and maintain a healthy balance between daily practice and research work. There is a range of options for doctors interested in research, from smaller time commitments as a co-investigator to longer-term projects and experience as chief investigator. Research works are all optional activities, so do what you can but don’t overwhelm yourself. Road to Excellent Research
Véronique PhéFrance
Speaker
New Artificial Urinary SphinterStress urinary incontinence remains a major quality-of-life concern, particularly following pelvic surgery. Despite being the gold standard, the AMS 800 artificial urinary sphincter (AUS) presents significant limitations, including mechanical failure, urethral atrophy, and challenges for elderly or disabled patients. Recent innovations in AUS design now incorporate mechatronics, remote control, adaptive pressure systems, and miniaturized components aimed at improving usability, autonomy, and continence outcomes. This presentation reviews the current landscape of next-generation AUS, focusing on ARTUS, UroActive®, and other devices under clinical evaluation. We discuss preclinical and first-in-human data, regulatory pathways, patient-reported preferences, and remaining barriers such as infection risks and training requirements. Intelligent, connected AUS devices hold promise to transform continence care after decades of technological stagnation.Choosing between Laparoscopic Sacrocolpopexy and Lateral Suspension: Weighing the Pros and ConsPelvic organ prolapse (POP) is a common condition requiring surgical intervention to restore apical support. Among minimally invasive options, laparoscopic sacrocolpopexy (LSCP) remains the gold standard, while laparoscopic lateral suspension (LLS) is gaining renewed interest for its reduced invasiveness and simplified technique. This presentation compares LSCP and LLS across multiple dimensions: anatomical restoration, functional outcomes, complication profiles, patient selection, and surgical learning curves. LSCP offers robust long-term results and better posterior compartment support but carries increased operative complexity. LLS provides effective anterior/apical correction with fewer vascular risks and a shorter learning curve. Both techniques have comparable mesh exposure rates and subjective success. Individualized decision-making based on patient anatomy, comorbidities, and surgeon expertise remains key. Emerging technologies and robotic assistance may further refine these approaches in the future.Robotic Novel Artificial Urinary Sphincter ImplantationThis video shows a step by step robotic artificial urinary sphincter implantation in women using AMS800 and Artus devices.First robot-assisted implantation of ARTUS (Affluent Medical) electromechanical artificial urinary sphincter in a female cadaverIntroduction
Artificial urinary sphincters (AUS) are effective tools for the treatment of female stress urinary incontinence. Nonetheless, hydraulic sphincters present with some limitations: complex and time-consuming preparation, need for preserved manual dexterity and constant pressure exertion on the bladder neck. The ARTUS® Artificial Urinary Sphincter is a novel electro-mechanical device designed to overcome these limitations thanks to its rapid and straight-forward implantation, intuitive remotely controlled manipulation and continuously adjustable cuff pressure.
Materials and methods
The ARTUS® system is currently under pre-market investigation in men, in an interventional, prospective, single arm, multicentric, international study. A cadaver lab session was carried out in Decembre 2024 to test the technical feasibility of ARTUS® implantation in female patients. The procedure was performed by an expert surgeon with extensive experience in AUS implantation and robotic surgery.
Results
One female patient was successfully implanted during the session. The technique has been developed following the principles of the traditional robot-assisted AUS implantation: the patient is placed in gynecological 23° Trendelenburg position. The robot has a 4-arms configuration. The procedure starts with the dissection of the vesicovaginal plane, to approach the bladder neck posteriorly. The lateral surfaces of the bladder neck are developed on both sides. The anterior peritoneum is opened to gain access to the antero-lateral surfaces of the bladder. The separation of the bladder neck from the vagina is performed through dissection of the pre-vaginal fascia bilaterally. The cuff is introduced and it is passed through the antero-lateral peri-vesical spaces, sliding behind the bladder neck from the right side to the left side. The anterior peritoneum is opened to gain access to the anterior surface of the bladder neck. The cuff is closed anteriorly, passing the transmission line inside the hole at the distal part of the cuff. The tightening around the bladder neck is achieved by pulling the transmission cable through. An optimal adjustment of the cuff around the bladder neck is provided tightening the ARTUS cuff clamping notch. Then, a supra-pubic 4 cm skin incision is made to implant the control unit. The tip of the cuff is passed outside through the incision. A lodge is prepared incising along the external oblique muscle aponeurosis. The cuff is connected to the control unit and a test with the remote control is performed to verify the functioning of the system. Finally, the control unit is placed into the lodge, anchored with non-absorbable sutures to the aponeurosis.
Conclusions
Robot-assisted ARTUS® implantation is technically feasible in female patients. This straight-forward technique may reduce operative time. The device has the potential to reduce the pressure and facilitate manipulation in patients with impaired dexterity.
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Yao-Chi ChuangTaiwan
Moderator
Road to Excellent ResearchYao Chi Chuang, Professor of Urology, Kaohsiung Chang Gung Memorial Hospital, and National Sun Yat-sen University Taiwan.
Medical research is what allows doctors to explore unmet medical need and decide how to best treat patients. It is what makes the development of new diagnostic tools, new biomarkers, new medicines, and new procedures. Without medical research, we would not be able to creative new knowledge and decide if new treatments are better than our current treatments.
There are some Tips on what to do about what research is and how to get into it:
1. Ask a good question from your daily practice, what is unmet medical need?
2. Search the old literature of your research interests- what is known? What is unknown?
3. Find a new method to solve your question or an old method but applying to a new field.
4. Start from jointing a pre-planned research project, and join a research collaborative.
5. Try to be an independent researcher from a small project without funding support, retrospective study.
6. Try to get funding support from your institute, national grant, or industry.
As a young doctor, it’s important to look after yourself and maintain a healthy balance between daily practice and research work. There is a range of options for doctors interested in research, from smaller time commitments as a co-investigator to longer-term projects and experience as chief investigator. Research works are all optional activities, so do what you can but don’t overwhelm yourself. Road to Excellent Research
Ching-Pei TsaiTaiwan
Speaker
Robotic/Laparoscopic Sacrocolpopexy and Pelvic Floor ReconstructionAbdominal sacrocolpopexy has been the gold standard operation for POP. Currently, the trend is minimal-invasive surgeries such as laparoscopy(LSC) or robot-assisted laparoscopy(RASC) to promote recovery. However, surgeons hesitated to do it because of longer learning curve and complicated surgical procedures. How to simplify the above operations is the most important issue.
The use of robotic assisted surgery has grown since the advent of better wrist dexterity, a 3D view, and motion scaling, which has great advantages in performing sacrocolpopexy. But the efficacy of RASC and LSC is comparable as indicated in previous studies, and the only difference is less bleeding with the RASC.
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Cheng-Chia LinTaiwan
Speaker
DISS plus FANS used in RIRSNew technologies and techniques are constantly emerging, but the most important part of our discussions is how to use them most effectively. Through this surgical demonstration, we hope to share the procedure and our experience with everyone.健保各領域審查共識及討論－結石
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Yi-Sheng TaiTaiwan
Speaker
Which Laser for RIRS: Thulium Fiber Laser Thulium Fiber Laser (TFL)is a type of fiber laser, distinct from Thulium laser used for prostate surgey. It’ a cutting-edge laser and rapidly gaining traction in urology The machine is compact, portable, quiet with air-cooling, and lower power consumption.It employs a thulium-doped silica fiber powered by diode lasers, emitting light at 1940 nm, matching water absorption peaks. This results in a high absorption coefficient and shallow penetration (~0.1 mm), enabling precise energy delivery and minimizing tissue damage.Compared to Holmium lasers, TFL operates at lower energies (down to 25mJ) and higher frequencies (up to 2000Hz) for delicate tissue ablation and fine stone dusting.
The most notable change is pulse modulationHo:YAG lasers has Spike-shaped pulses and indicate greater energy concentration, resulting in higher localized heating, uneven fragmentation, and increased retropulsion.TFL produces pulses with uniform energy distribution and lower peak power, resulting in consistent ablation with less retropulsion and fewer thermal spikes.Higher water absorption rapidly forms a vapor channel, enhancing ablation efficiency.
But, TFL is not as ideal in surgical scenarios. At settings of low pulse energy (0.2 J) and high frequency (100 Hz), it tends to cause troublesome char formation and spark generation, particularly when treating calcium phosphate stones. These phenomena, explosive combustion and carbonization can reduce ablation efficiency and increase the risk of thermal damage and fiber degradation. Optimizing TFL settings is very important for outcome and safety and ongoing evaluation. AI in Medical Imaging – Converting 2D Black & White to 3D and Applications in Mixed Reality (MR) used in RIRS Artificial Intelligence (AI) and Extended Reality (XR) are at the forefront of innovation in modern medicine. In endoscopic surgery, these technologies are increasingly being integrated to enhance procedural precision and intraoperative guidance.
One experimental application involves using AI to convert 2D CT scans into 3D visualizations, offering surgeons a more intuitive understanding of anatomical structures. Devices like the Apple Vision Pro may be used to create fully immersive virtual environments, although it is not currently approved as a medical device.
In clinical practice, Mixed Reality (MR)—which blends real and virtual environments with real-time interaction—has shown promise. MR has been used during Retrograde Intrarenal Surgery (RIRS) to reduce the risk of missed stones, and in Endoscopic Combined Intrarenal Surgery (ECIRS) to overlay anatomical data, improving puncture accuracy during Percutaneous Nephrolithotomy (PCN).
As an emerging field, further advancements will depend on enhanced imaging resolution, improved intrarenal navigation and integration of AI-driven real-time stone detection.
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Hsiang-Ying LeeTaiwan
Moderator
Best Laser for UTUCManagement of Total Ureteral Avulsion during Ureteroscopy
Yi-Yang LiuTaiwan
Speaker
Complex Renal Stone: PCNL or RIRS or Combination?Mini-percutaneous nephrolithotomy (mini-PCNL) provides stone-free rate (SFR) 85 to 95 % in children with complex burdens, and recent systematic reviews report overall complications < 7 % and transfusion requirements ≈3 % when tracts ≤18 Fr are used. Its drawbacks are the need for percutaneous access, risk of bleeding, and potential parenchymal scarring, especially when multiple tracts are required.
Retrograde intrarenal surgery (RIRS) avoids renal puncture and shows the lowest incidence of high-grade complications (<1 %); contemporary series in preschool children describe initial SFRs of 60–78 %, with secondary procedures needed in up to one-third of cases because of narrow, tortuous ureters. Pre-stenting, staged dilation and longer operative time can offset its minimally-invasive appeal for stones ≥2 cm.
Endoscopic combined intrarenal surgery (ECIRS) merges an antegrade mini-PCNL channel with simultaneous flexible ureteroscopy. The first multicenter pediatric series and a 2024 comparative study confirm SFRs of 75–92 %, shorter hospital stay and lower fluoroscopy or transfusion risk than standalone PCNL despite treating more complex stones. Its limitations are the need for two skilled teams, specialized equipment and the Galdakao-modified supine Valdivia position, which lengthen setup and raise costs.
In summary, mini-PCNL remains the most efficient monotherapy for large or staghorn calculi; RIRS is ideal when bleeding risk or unfavorable percutaneous windows predominate; ECIRS offers the best compromise between clearance and morbidity where resources and expertise allow. Individualized, anatomy-based algorithms and further pediatric RCTs are still required.
ECIRSIn this session, we will demonstrate the technique about Totally-X-ray free ultrasound guided endoscopic combind intrarenal surgery in Galdakao modified supine Valdivia position.A Critical Appraisal on Percutaneous NephrolithotripsyPercutaneous nephrolithotripsy (PCNL) has evolved from a uniform prone, fluoroscopy-guided, large-tract technique into a precision endourological platform that emphasizes patient-tailored positioning, radiation-free puncture, miniaturized tracts, energy-efficient lasers and nascent robotic–AI augmentation. Contemporary evidence affirms that stone-free rates now approach a plateau, making safety metrics—bleeding control, infection prevention and intrarenal pressure modulation—the key differentiators among modern approaches. Miniaturized optics, suction-regulated sheaths and thulium-fiber or dual-wavelength laser consoles have collectively reduced hemoglobin loss and postoperative sepsis while preserving clearance efficacy. Future success will hinge on harmonizing technological innovation with rigorous evidence so that every incremental advance translates into measurable gains for both efficacy and safety in stone surgery.Echo guide Puncture in Supine PCNL: Tips and Tricks for an Efficient and Safe ProcedureMastery of ultrasound-guided supine PCNL begins with precise anatomical orientation. Color-Doppler mapping pinpoints the target calyx, which is punctured transpapillary with an echogenic-tip needle after artificial hydronephrosis is produced by retrograde ureteroscopic irrigation. A hydrophilic, floppy-tip yet stiff-shaft guidewire is then advanced through the needle, allowing atraumatic navigation of the collecting system under ureteroscopic visualization. Balloon dilation—used in place of sequential dilators—prevents guidewire dislodgement. When necessary, a through-and-through guidewire from flank skin to urethral meatus may be created to secure renal access. Finally, antegrade nephroscopy along this coaxial tract confirms unobstructed entry, provides panoramic inspection, and optimizes lithotripsy efficiency—all without fluoroscopy. Collectively, these steps deliver reliable access, eliminate radiation, and streamline stone clearance in a single, ergonomically favorable supine position.
TICC - 3F Plenary Hall
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Advancing Urologic Care Through Technology and Minimally Invasive Innovation
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Hann-Chorng KuoTaiwan
Moderator
ACU Lecture: Videourodynamic Study for Precision Diagnosis and Management of Lower Urinary Tract DysfunctionVideourodynamic Study in the Precision Diagnosis and Management of Lower Urinary Tract Dysfunctions
Hann-Chorng Kuo, M.D.
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
As a urologist, we are dealing with patients with lower urinary tract symptoms everyday. We did transurethral resection of the prostate (TURP) for elderly men with bothersome lower urinary tract symptoms (LUTS). We put a suburethral sling for women with stress urinary incontinence (SUI). We prescribed alpha-blocker for those who had difficulty in urination. We add antimuscarinics for patients with urgency urinary incontinence. Our seniors always told us these treatments are effective in treating patients with LUTS. However, patients still had LUTS after TURP, women still complained of urgency and dysuria after anti-incontinence surgery. Medication based on storage or emptying LUTS do not work all the time. Why? Because symptoms are not reliable, a large prostate does not indicate bladder outlet obstruction (BOO), and SUI is not solely a result of urethral incompetence. Therefore, in diagnosis and management of LUTS, we need precision medicine to direct an accurate pathophysiology of LUTS, and to guide an appropriate management based on the bladder and bladder outlet dysfunction. When we encounter patients who have LUTS refractory to the treatment based on our initial diagnosis, when we are treating patients who have complicated storage and emptying LUTS, when we are not sure patients could benefit from the invasive procedures for their LUTS, or patients who had both lower and upper urinary tract dysfunctions, videourodynamic study (VUDS) is an essential investigation for diagnosis and management of LUTS. In additional to benign prostate hyperplasia (BPH) and BOO, male patients with emptying LUTS might result from detrusor underactivity (DU), bladder neck dysfunction (BND), urethral sphincter dysfunction, or a hypersensitive bladder, which is not related with the prostate. Patients with BPH and LUTS might have latent neurogenic lesion, such as minor stroke, Parkinson's disease, or early dementia, causing LUTS. TURP without known the neurological disease might exacerbate LUTS after surgery. Mixed SUI comprises intrinsic sphincter deficiency (ISD) and detrusor overactivity (DO). The overactive bladder (OAB) symptoms may also result from an incompetent bladder outlet. Without comprehensive VUDS, we might cure the SUI, but OAB remains after placing a mid-urethral sling. Bladder pain is the cardinal symptoms of interstitial cystitis. However, bladder pain perceived by the patient might also originate from BOO or pelvic floor fascitis. VUDS can help in discrimination. DU and low compliant bladder and ISD could result in complicated storage and emptying LUTS. Large post-void residual (PVR) should alert us to investigate whether it is originated from low compliance or ISD. Dysfunctional voiding (DV) and BND in women with emptying LUTS. OAB symptoms are not always coming from the DO. BOO such as BND, DV, or urethral stricture might exist in men and women without voiding symptoms. Urinary difficulty in women is usually a result from low detrusor contractility, due to DU, or through inhibitory effect from a poorly relaxed pelvic floor or urethral sphincter. A simple bladder neck incision can effectively restore spontaneous voiding in men or women with dysuria due to DU or BND. However, a tight BN is necessary to predict a successful treatment outcome. Patients with central nervous system (CNS) disorders or spinal cord injury usually have complicated LUTD, including DO, BND, DV, detrusor sphincter dyssynergia (DSD), and vesicoureteral reflux (VUR). Management of LUTS in CNS disorders or SCI patients should know the current bladder and bladder outlet dysfunctions. Pediatric incontinence, children with myelomeningocele, DV, or recurrent urinary tract infection are complicated and need precision diagnosis before treatment. Especially when surgery is planned. Lower urinary tract dysfunctions is a dynamic condition. The bladder and bladder outlet dysfunction might change with time. Although VUDS is considered as an invasive investigation with radiation exposure, the advantages in accurate diagnosis and guiding management outweigh these disadvantages.
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Simone CrivellaroUnited States
Speaker
Single-Port vs. Multi-Port Robotic Prostatectomy: Balancing Innovation, Precision, and OutcomesThe Application & Limitation of Urological SP SurgerySingle Port Retroperitoneal Partial NephrectomySingle Port Prostate Surgery
TICC - 1F 101B
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