ELUTS17 Day 1: Anniversary for ESU-ESFFU Masterclass

12 October 2017

Over 30 participants convened in Berlin on 12 October, taking part in the annual ESU-ESFFU Masterclass on Female and Functional Reconstructive Urology. The masterclass is in its tenth year, making it one of the longest-running courses offered by the European School of Urology (ESU). The masterclass is a collaboration between the ESU and the EAU Section of Female and Functional Urology (ESFFU).

Dr. John Heesakkers (Nijmegen, NL) welcomed the participants, remarking that the successful setup of the Masterclass has remained similar over the past ten years. In recent years, participants are also invited to submit cases for presentation, leading to much discussion between the faculty and the audience.

Heesakkers: “We offer a one-and-a-half-day programme, concentrating on the latest insights, and based on the EAU Guidelines. We also lean heavily on real-life clinical practice, as with surgery, patients don’t always fit to the Guidelines. The faculty will present practical solutions for difficult problems.”

The masterclass will be held over the course of two days, partially overlapping with the scientific programme of the new ELUTS17 meeting, also held in Berlin. ELUTS17 is a new meeting for the EAU this year, offering a two-day programme focused exclusively on the various forms of Lower Urinary Tract Symptoms. With complementary topics, it was decided to combine the masterclass with the regular scientific programme of ELUTS17.

Case discussions

Experienced faculty members Heesakkers, George Kasyan (Moscow, RU), Dirk de Ridder (Leuven, BE), Nikesh Thiruchelvam (Cambridge, GB) and Elisabetta Costantini (Perugia, IT) taught modules on stress incontinence, OAB, female reconstructive surgery, pelvic organ prolapse and the neurogenic bladder. They would also lead discussions with the audience, several members of which were invited to present cases of their own.

“Case presentations always brings up discussion,” Dr. Heesakkers explains. “We’ve always included case discussions in the past, dealing with them in an ad-hoc way. Now they’re integrated into the programme, and we can select the cases based on topic beforehand. Some are demonstrations, in some cases people look to the audience or faculty for answers. Participants are completely free to bring a problematic case that’s still ongoing or something that worked out fine.”

The case presentations raised questions of procedure, the suitable surgical approach, and follow-up. One case, presented by Dr. Elisabeth Pauwels (Antwerp, BE) concerned an 18 year-old patient with mysterious bladder pains and no clear cause or symptoms. After repeat visits and a confession by the patient’s mother, the bladder problems could be attributed to the recreational use of ketamine, which in some cases affects the user’s bladder.

EAU Guidelines

The contents of the Masterclass scientific programme are firmly rooted in the EAU Guidelines. Heesakkers: “You need the EAU Guidelines to take your practice to the next level. On the other hand, by definition the Guidelines based on past experience, and we are living in the present. At some point the Guidelines, particularly in individual cases, won’t give you all the answers that you need.”

“Clinical practice brings certain demands and constraints. It’s easy to recommend expensive treatment but that’s not always an option in every hospital or every country. The guidelines are backbone of your work, but your clinical practice dictates what problems you will encounter.”

Despite being a long-running masterclass that serves new generations of surgeons every year and must therefore cover a certain amount of basics, the actual contents of the scientific programme move with the times. Dr. Heesakkers reflects:

“For a start, we always look at the latest versions of the EAU Guidelines, taking any changes into account. We also try to look at the latest development in a specific topic with respect to new studies, new proof, that gives a focus on what you’re saying. Every year it’s up to date and adapted, and the faculty members are also attuned to what will be coming up.”

“Over the past ten years there we’ve seen big developments in functional urology: the introduction of botulinum toxin, neuromodulation was a new development when we started the masterclass. And of course the whole issue of using foreign material in human body for the treatment of stress incontinence and prolapse being introduced and also causing problems. I like to think that we have also become more patient-oriented in the past ten years.”