Lower urinary tract symptoms and functional urology are receiving less attention from traditional industry partners, and so it is vital that the European Association of Urology fills this void with a dedicated meeting, according to Prof. Francisco Cruz (Porto, PT) Chairman of the ELUTS17 Organising Committee. Prof. Cruz is also the chairman of the EAU Section of Female and Functional Urology, ESFFU.
“At the moment, functional urology lags behind other topics within our field, topics like uro-oncology. The purpose of our meeting is two-fold: firstly to draw urologists’ attention to functional urology, particularly as LUTS are extremely common in the ageing European population.”
“Secondly, we want to convince younger urologists who have not yet specialised in a particular area that functional urology is attractive and can provide an interesting and competitive future for them.
The European Lower Urinary Tract Symptoms Meeting will be taking place on 13-14 October, in Germany’s capital, Berlin. It will be taking place in conjunction with the 10th ESU-ESFFU Masterclass on Female and Functional Reconstructive Urology, a seven-module course held on 12-13 October. Together with PCa17 in Vienna, ELUTS17 marks the beginning of a new direction for EAU Meetings: topic-oriented and with a strong educational component.
Importance of functional urology and LUTS
Lower urinary tract symptoms may not be an immediate, acute killer for the patients that suffer them, but they can be a (first) indicator of larger problems and have a large impact on the quality of life of the sufferer. Therefore, a continuing familiarity of urologists with LUTS and functional urology is vital for patient welfare. Prof. Cruz:
“Of course we don’t expect patients to die because they have urgency or frequency incontinence, but they will be extremely bothered. Their sleep patterns will be affected and daily activities will be much more difficult. Eventually LUTS can cause co-morbidity, for example if elderly patients have to get out of bed multiple times during the night. They are vulnerable for falls and fractures, especially the femur.”
“The treatment of LUTS must be understood in conjunction with all the treatments of co-morbidities that these patients usually have. There are serious concerns about the use of antimuscarinic drugs and common medications with antimuscarinic effect over long periods of time. Also, many functional changes in the lower urinary tract can be a consequence of oncological treatment, so as urologists we can make a bridge between the two. Urologists deal with oncological problems and cannot simply abandon patients with, for example, urinary incontinence following radical prostatectomy.”
If urologists are no longer the prime carers for LUTS patients, the closest specialty to deal with these symptoms are gynaecologists. “Some countries have specialists in between both fields, uro-gynaecologists. We understand the importance of gynaecologists and their experience in the treatment of LUTS, hence our collaboration with EUGA, the European Urogynaecological Association for this meeting. This brings gynaecologists to the EAU, allows us to exchange information and experience and ultimately lets us improve the quality of the meeting.”
The ELUTS17 scientific programme takes place over the course of two days, and features state-of-the- art lectures, in-depth sessions with multiple discussants, semi-live surgery sessions and a lot of specific, practical and clinically applicable advice for delegates. Prof. Cruz on some of the more pressing topics that delegates can look forward to:
“First, we must examine LUTS and in particular storage LUTS. These symptoms are difficult to treat, and occur widely, particularly in elderly people. The cause of these symptoms is not always clear, but for the patient they are extremely bothersome. Correct management of these symptoms is essential in my opinion.”
“These kinds of storage LUTS will affect women, but not exclusively. This gender ‘problem’ is the result of most regulatory trials by industry dealing in the past with women only. It has almost become assumed that this was exclusively a women’s problem while men suffer from BPH and bladder outlet obstruction. So it’s important to know that these symptoms can exist in both genders and should be recognised by treating urologists.”
Nocturia is the most prevalent LUTS, and it too is associated with mortality. The aforementioned risk of falling during nightly voiding is one aspect, but nocturia can often be an indicator of bigger problems:
“Nocturia is multifactorial, and heart disease, sleep apnoea, and diabetes, all might contribute to nocturia. Here education is again very important for young urologists, and those dedicated to functional urology: nocturia is not the same as a sign of prostate problems. It’s in fact a symptom that can be caused by a huge number of different conditions. Urologists are in the ‘front line’ when these patients look for help, so urologists need to be well aware of the related conditions that patients may be suffering from.”
Other key topics and sessions at ELUTS17:
- Why do clinical trials not correlate with real life clinical practice?
- Female stress urinary incontinence
- POP and the use of mesh
- My BPH patient needs treatment
- Male incontinence after radical prostatectomy
- NDO and incontinence