Organised by the European Association of Urology (EAU) and the International Continence Society (ICS), the 3rd edition of the European Lower Urinary Tract Symptoms (ELUTS19) meeting promises to deliver essentials in LUTS management. The meeting also aims to offer well-rounded treatment approaches collated from urological subspecialties.
In this article, EAU Secretary General Prof. Chris Chapple (GB) and ICS General Secretary Prof. Sherif Mourad (EG) share their valuable insights on current updates and challenges in LUTS management, potential breakthroughs in the field, and what ELUTS19 participants can expect at the meeting.
“ELUTS19 features the first collaboration between the EAU and the ICS, along with the various EAU Sections dealing with aspects of functional and reconstructive urology, and is an important cooperation between the two societies,” stated Prof. Chapple and Prof. Mourad.
Prof. Chapple added, “This will allow a forum for a multidisciplinary approach to this important area of urology. We will examine the latest developments in functional urology, urogenital reconstruction and andrology in this specialist multidisciplinary meeting. Our objective is to provide an overview of what we know, what we don’t know, and what we need to know to improve the quality of care for our patients.”
What to expect at ELUTS19
Participants will congregate in Prague, Czech Republic to receive the best practices in LUTS management from myriad subspecialties. “The ELUTS19 scientific programme is comprised of carefully-selected topics that are relevant and interesting to urologists, urogynaecologists, physiotherapists, and nurses,” said Prof. Mourad.
The meeting is enriched with contributions from the EAU Sections of Female and Functional Urology (ESFFU), Genito-Urinary Reconstructive Surgeons (ESGURS), Urologists in Office (ESUO) and Andrological Urology (ESAU), interspersed with the educational ESU-ESFFU Masterclass on Functional Urology organised by the European School of Urology (ESU).
“ELUTS19 is a truly comprehensive meeting; it offers in-depth coverage and provides plenty of opportunities for participants to discuss and brainstorm with field experts and fellow participants at the meeting,” said Prof. Mourad.
Profs. Chapple and Mourad expounded upon some of the challenges presently encountered in LUTS management.
“Recognising the significance of thorough patient evaluation, particularly the usefulness of a bladder diary, is a major challenge in the management of LUTS. It is imperative to look beyond the terms, for example overactive bladder (OAB), benign prostatic hyperplasia (BPH), and erectile dysfunction, to identify underlying causative problems and issues that are important to patients. It is essential to consider the expectations of patients and their goals to provide the best outcome for them,” stated Prof. Chapple.
Prof. Chapple mentioned that there is a plethora of pharmacotherapeutic agents currently available. In combination therapy, one can augment the benefits of any particular therapeutic agent at a lower dose and combining it with another active agent, as this could improve efficacy and minimise side effects.
“It is also important to bear in mind how to interpret aspects such as post voiding residuals, and to understand when it is appropriate to use urodynamics. Considering that the recent data suggest that pressure flow urodynamics does not necessarily improve outcomes in men prior to transurethral resection of the prostate,” said Prof. Chapple. Prof. Mourad added that urodynamics still needs a global consensus as an investigational tool.
Prof. Mourad shared, “Another challenge is having the right medical and surgical tools that can help ‘underactive bladder’ patient cases. The comorbidities that may present with cases of OAB and neurogenic voiding dysfunction (including multiple sclerosis) is challenging at times because a satisfactory treatment for those cases is yet to be achieved.”
He stated that many new modalities for the minimally invasive treatment of LUTS due to benign prostatic enlargement (BPE) need better assessment for the establishment of usage algorithm.
In addition, he said “A clear cut-off between the medical and surgical treatment of BPH is a true challenge nowadays. With regard to female incontinence, we need to look at the restriction of using meshes +/- slings in treating SUI and POP. Do we give bulking agents injections more chances? Do we go back to the traditional surgeries? This, too, is a challenge as well.”
Prof. Chapple expressed that a critical review of existing knowledge will equip ELUTS19 participants with the latest treatments for their patients, and motivate them to help further boost research in the field.
Possible future breakthroughs
Prof. Chapple foresees a deeper understanding of the mechanisms in how therapeutic agents work. He anticipates a standardised approach in assessing patients with voiding or storage lower urinary tract symptoms. Another forecast is the ratification by the EAU Guidelines with regard to the importance of combination therapy and the most appropriate progression from oral therapy to third-line therapies. Prof. Chapple also predicts the recognition of the true role of urodynamics.
Prof. Mourad foresees further advancement in robotic surgery with a reduction in costs involved; and more innovations with regard to stem cells in the field of tissue engineering and sphincteric deficiency. He predicts introduction of pharmaceutical agents for the treatment of underactive bladder, OAB, BPH, and painful bladder syndrome, with safer biodegradable meshes or slings for the treatment of SUI.
“I anticipate more efficient and easier forms of minimally invasive techniques for BPE. In the coming years, there will be less invasive urodynamic machines and techniques, as well as, neuromodulation techniques,” stated Prof. Mourad.
To know more about ELUTS19 and how to join this comprehensive, multidisciplinary meeting, visit www.eluts.org. We hope to see you there!