ESGURS at ELUTS19: Recap of GU reconstruction updates

31 October 2019

The meeting of the EAU Section of Genito-Urinary Reconstructive Surgeons (ESGURS) lead with a session on urethral surgery which was chaired by Ass. Prof. Roland Dahlem and Ass. Prof. Luis Alex Kluth. This session covered semi-live surgeries on strictures and presentations such as Prof. Kluth’sImproving results of buccal mucosal graft urethroplasty by standardised perioperative algorithms”. 

According to Prof. Kluth, there is a lack of guidelines and consensus on perioperative algorithms. He emphasised the importance of publishing institutional standards as these are the basis for evidence-based medicine, especially in rare diseases and surgeries. He added that large multi-centre studies could provide sufficient number of patients to allow for statistical power as prospective (randomised controlled) trials are needed. In addition, institutional standardised voiding trial has a high predictive value to identify those patients at high risk for early stricture recurrence.

Thereafter, the session “Radiotherapy reconstruction LUTS”, which was chaired by Ms. Tamsin Greenwell, examined ureteric issues, male stress urinary incontinence, and more. This session was followed by the “Ureteric Reconstruction” session, which included the point-counterpoint deliberations on open versus robotic ureteral reimplantation in children.

Prof. Dr. Mesrur Selçuk Silay stated that open ureteral reimplantation remains the gold standard for correcting vesicoureteric reflux. However, robotic-assisted laparoscopic ureteral re-implant (RALUR) is a valuable alternative and should be performed in experienced centres. According to Prof. Silay, the standardization of the RALUR technique increases the success of the procedure. 

To Dr. Beatriz Bañuelos, open ureteral reimplantation is “safe and sound”. Parents of the young patients chose open surgery 74.9% of the time as the parents perceived no difference in preference for the cosmetic outcome of open versus minimally invasive surgery. Moreover, the length of the submucosal tunnel is an important factor in successful ureteral reimplantation which could explain why extravesical techniques with shorter tunnels have less rate of resolution.

The state-of-the-art lectures by YAU Reconstructive Working Group concluded the ESGURS meeting.

Interested in developments shared during the ESAU meeting? Click here to read the article.