EMJ Urology 13 [Supplement 2] 2025 by European Medical Journal

Volume 13 Supplement 2 December 2025 emjreviews.com

Review of the

IURES Congress 2025

Congress Interviews: Exclusive IURES insights from Erdem Canda and Emre Huri Abstract Reviews: A selection of abstract reviews presented at IURES 2025

Urology Supplement

Contents 05

Welcome

Congress Review 06

Review of the International Urologic Research Society (IURES) 2025 Congress, 6th–9th November 2025

Abstract Reviews 10

Robot-Assisted Laparoscopic Radical Prostatectomy in Patients with a History of Transurethral Resection of the Prostate: A Single-Centre Experience Uslu Ö et al.

Risks and Complications of Robotic-Assisted Radical Prostatectomy in Patients Receiving Antiplatelet and/or Anticoagulant Therapy Uslu Ö et al.

Investigation of BRCA1, BRCA2, and RAD51 Gene Expression Levels in Patients with Non-metastatic Prostate Cancer Undergoing Radical Prostatectomy Özcan B et al.

A Rare Vascular Anomaly in a Patient with a Kidney Tumour: Left Common Iliac Vein Draining Into the Left Renal Vein – A Case Report Dogucan Nuri Ugur

Multifactorial Comparison of Flexible Ureterorenoscopy and Mini-Percutaneous Nephrolithotomy Outcomes in the Treatment of Hard Renal Pelvic Stones Measuring 1–2 cm Karkın K et al.

Prospective Assessment of Magnetic Resonance-Cognitive Transperineal Prostate Biopsy Under Local Anaesthesia: Experience From a Single Centre Akdağcık Z et al.

Congress Interviews

Emre Huri

Erdem Canda

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Aims and Scope EMJ Urology is an open access, peer-reviewed eJournal committed to helping elevate the quality of healthcare in urology by publishing content on all aspects of urological function and disease. The journal is six weeks after the International Urologic Research Society (IURES) Congress, and features highlights from this Congress, alongside interviews with experts in the field, and reviews of abstracts presented at the Congress.

We are always keen to hear from healthcare professionals wishing to discuss potential submissions, please email: editorial.assistant@emjreviews.com To submit a paper, use our online submission site: www.editorialmanager.com/e-m-j Submission details can be found through our website: www.emjreviews.com/contributors/authors

EMJ Urology also publishes peer-reviewed research papers, review articles, and case reports in the field. In addition, the journal welcomes the submission of features and opinion pieces intended to create a discussion around key topics in the field and broaden readers’ professional interests. The journal is managed by a dedicated editorial team that adheres to a rigorous doubleblind peer-review process, maintains high standards of copy editing, and ensures timely publication

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Further details on coverage can be found here: www.emjreviews.com

Indexing and Availability EMJ is indexed on DOAJ, the Royal Society of Medicine, and Google Scholar®; selected articles are indexed in PubMed Central®.

Editorial Expertise EMJ is supported by various levels of expertise: • • • •

Guidance from an Editorial Board consisting of leading authorities from a wide variety of disciplines. Invited contributors who are recognised authorities in their respective fields. Peer review, which is conducted by expert reviewers who are invited by the Editorial team and appointed based on their knowledge of a specific topic. An experienced team of editors and technical editors.

Peer Review On submission, all articles are assessed by the editorial team to determine their suitability for the journal and appropriateness for peer review. Editorial staff, following consultation with either a member of the Editorial Board or the author(s) if necessary, identify three appropriate reviewers, who are selected based on their specialist knowledge in the relevant area. All peer review is double blind. Following review, papers are either accepted without modification, returned to the author(s) to incorporate required changes, or rejected. Editorial staff have final discretion over any proposed amendments. Submissions We welcome contributions from professionals, consultants, academics, and industry leaders on relevant and topical subjects. We seek papers with the most current, interesting, and relevant information in each therapeutic area and accept original research, review articles, case reports, and features.

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Distribution and Readership EMJ is distributed through controlled circulation to healthcare professionals in the relevant fields across Europe.

EMJ is available through the websites of our leading partners and collaborating societies. EMJ journals are all available via our website: www.emjreviews.com Open Access This is an open-access journal in accordance with the Creative Commons Attribution-Non Commercial 4.0 (CC BY-NC 4.0) license. Congress Notice Staff members attend medical congresses as reporters when required. This Publication Publication Date: December 2025 Online ISSN: 2053-4213 All information obtained by EMJ and each of the contributions from various sources is as current and accurate as possible. However, due to human or mechanical errors, EMJ and the contributors cannot guarantee the accuracy, adequacy, or completeness of any information, and cannot be held responsible for any errors or omissions. EMJ is completely independent of the review event (IURES 2025) and the use of the organisations does not constitute endorsement or media partnership in any form whatsoever. The cover photo is of Muğla, Türkiye, the location of IURES 2025. Front cover and contents photograph: Muğla, Türkiye © IBRESTER / stock.adobe.com

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We provoke conversation around healthcare trends and innovation - we also create engaging educational content for healthcare professionals. Join us for regular conversations with physician & entrepreneur, Jonathan Sackier.

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Welcome Editorial Director Andrea Charles

Dear Readers,

Managing Editor Darcy Richards

We are pleased to introduce this supplement issue of EMJ Urology, which features coverage of the International Urologic Research Society (IURES) 2025 Congress, which took place in Muğla, Türkiye, between 6th–9th November 2025.

Copy Editors Noémie Fouarge, Sarah Jahncke Editorial Leads Helena Bradbury, Ada Enesco Editorial Co-ordinators Bertie Pearcey, Alena Sofieva Editorial Assistants Niamh Holmes, Katrina Thornber, Aleksandra Zurowska Creative Director Tim Uden Design Manager Stacey White

With a focus on advances achieved in diagnostics and robotics, and a clear commitment to education, collaboration, and progression, the event was a hub of activity and featured a variety of sessions, ranging from live surgeries and training modules to the more traditional scientific presentations and panel discussions. Alongside our review of IURES 2025, you can also find several cutting-edge research abstracts spotlighting the latest developments in robotassisted laparoscopic prostatectomy, magnetic resonancecognitive transperineal prostate biopsy, mini percutaneous nephrolithotomy, and more. Plus, be sure not to miss our exclusive expert interviews with the two Congress Co-Presidents, Erdem Canda and Emre Huri. These interviews provide behind the scenes insights into developing the Congress programme, dive deeper into the aims of IURES, and showcase their personal highlights from the event.

Senior Designers Tamara Kondolomo, Owen Silcox Creative Artworker Dillon Benn Grove Designers Shanjok Gurung, Fabio van Paris

We would like to take this opportunity thank all of the contributors who helped bring this supplement to fruition. In our continued efforts to elevate the quality of healthcare globally, we hope you enjoy reading and discover timely and relevant takeaways for your clinical practice.

Junior Designer Helena Spicer Head of Marketing Stephanie Corbett Project Manager George Graham Chief Executive Officer Justin Levett Chief Commercial Officer Dan Healy Founder and Chairman Spencer Gore

Contact us Editorial enquiries: editor@emjreviews.com Sales opportunities: salesadmin@emjreviews.com Permissions and copyright: accountsreceivable@emjreviews.com

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Congress CongressReview Review GIANT ### 2024 2023 ● ●

IURES 2025 Insights From The Global Innovation and New Technology (GIANT) Health Event 2023

The International Urologic Research Society (IURES) 2025 Congress welcomed more than 500 participants, highlighting the continued growth of IURES as a leading organisation in both Turkish and international urology

IURES 2025

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Congress Review

Congress Review Review of the International Urologic Research Society (IURES) 2025 Congress Location:

Muğla, Türkiye

Date:

6th–9th November 2025

Citation:

EMJ Urol. 2025;13[Suppl 2]:6-8. https://doi.org/10.33590/emjurol/QNBL8541

HOSTED AT the Hilton Dalaman Sarıgerme Hotel, Muğla, Türkiye, from 6th–9th November 2025, the International Urologic Research Society (IURES) Congress welcomed more than 500 participants, highlighting the continued growth of IURES as a leading organisation in both Turkish and international urology. The Congress provided a platform for clinicians, researchers, and healthcare professionals to exchange knowledge and strengthen professional collaboration. The opening ceremony began with talks by IURES President Fatih Atuğ, Istanbul Florence Nightingale Hospital, Türkiye; former President M. Öner Şanlı, Istanbul University, Türkiye; and Congress presidents Emre Huri, Hacettepe University, Ankara, Türkiye, and Erdem Canda, Koç University, Istanbul, Türkiye. Their speeches emphasised the Society’s commitment to scientific progress, renewal of leadership through the inclusion of younger specialists, and the promotion of cooperative practice. They highlighted that over the 4 days, the Congress hosted 165 scientific presentations, 12 panel sessions, 11 workshops, and four handson training modules. In addition, six live surgery sessions were broadcast, providing participants with real-time exposure to advanced operative techniques and decision-making during complex surgical procedures. The Congress adopted the theme ‘Shaping Tomorrow: Emerging Trends in Urology’. Reflecting the Society’s continued year-on-year growth, the 2025 programme also incorporated collaboration with several international institutions, including the Société Internationale d’Urologie (SIU), Montreal, Quebec, CC BY-NC 4.0 Licence

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Canada, and the American Urological Association (AUA), Linthicum, Maryland, USA, among others. On Day 1, the programme opened with a focus on urinary stone disease, covering AI integration, sensor-based diagnostics, robotic applications, and advances in laser technology, followed by complication management and practical case discussions. On this day, video-based courses on laparoscopic and robotic surgery were also offered, addressing both upper and lower urinary tract procedures, including complex pelvic surgeries. Additional sessions covered sacral neuromodulation and penile prosthesis implantation, with hands-on training using 3D models to reinforce procedural techniques. On Day 2, the day began with opening speeches followed by urotechnology discussions and a European Association of Urology (EAU) Robotic Urology Section (ERUS) lecture. A major highlight was the live surgery session broadcast from Koç University Hospital, Istanbul, Türkiye, featuring robotic renal transplantation and nerve-sparing radical prostatectomy. Subsequent sessions focused on urologic

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oncology, with presentations on prostate, kidney, and bladder cancer, followed by case reviews. A dedicated course in paediatric urology was also offered, alongside simulator-based urodynamics training. Interactive booth sessions provided updates on robotic innovation, functional urology, and non-oncological case challenges.

andrology, and focal therapy, supported by practical 3D model training.

On Day 3, educational activities commenced with an informative course on writing scientific articles, followed by a comprehensive functional urology session, including structured debates and videobased discussions. A key highlight of the Congress, and a well-attended session, was the live surgery, which was again featured, this time demonstrating endourologic lithotripsy and robotic prostatectomy. The International Prostate Forum, a specialist panel dedicated to advancing care in prostate diseases, delivered two highly engaging sessions that drew strong interest from attendees. Running alongside these were focused sessions in andrology and sexual health, which explored both current treatment strategies and the next wave of therapeutic advances. The educational programme continued to emphasise innovation, with courses on AI in urology, fusion biopsy, cosmetic

A highlight of the day was the International Societies and Collaborations Joint Meeting, which underscored the Society’s ambition to enhance its global presence. Bringing together representatives from different organisations, including the Balkan Association of Urology (BAU), the Egyptian Urological Association (EUA), and the European Youth School of Robotic Technology (EYouSort), the session strengthened international partnerships and reaffirmed IURES’s commitment to collaborative progress in urology. The final day featured practical laparoscopic nephrectomy training, followed by interactive oncology case discussions led by senior faculty and medical trainees. Further case panels addressed nonurological oncology topics, complemented by oral presentation sessions covering original research. Overall, the IURES 2025 Congress concluded as a highly impactful event that combined scientific depth with structured learning and international collaboration. Its organisation strengthened IURES’s position as a unifying, forwardlooking, and academically driven contributor to the global advancement of urology.

A highlight of the day was the International Societies and Collaborations Joint Meeting, which underscored the Society’s ambition to enhance its global presence

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Abstract Reviews This collection of abstracts from IURES 2025 showcases advances across urologic oncology, diagnostics, and minimally invasive surgery. The studies examine surgical outcomes in complex prostatectomy cases, bleeding risks in patients on antithrombotic therapy, and the prognostic value of BRCArelated gene expression. They also report a rare renal vascular anomaly, compare two key techniques for managing hard renal stones, and evaluate MRI-cognitive transperineal biopsy under local anaesthesia. Together, they highlight ongoing progress in improving precision, safety, and personalisation in urological care.

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Robot-Assisted Laparoscopic Radical Prostatectomy in Patients with a History of Transurethral Resection of the Prostate: A Single-Centre Experience Authors: *Ömer Uslu,1 Mehmet Sefa Altay,1 Fevzi Bedir,1 Hüseyin Kocatürk1

RESULTS

1. Department of Urology, Erzurum City Hospital, Türkiye *Correspondence to dromeruslu1@gmail.com

The mean age was 63.54 years, with a mean pre-operative prostate-specific antigen of 7.17 ng/mL and a mean prostate volume of 142 cc (Table 1). The mean console time was 149 minutes, the mean blood loss was 29 mL, and the mean hospital stay was 5.3 days. No positive surgical margins were observed. Gleason scores were 3+3 in 73% of patients, 3+4 in 9%, and 4+3 in 18%. Perineural invasion was present in 54% of patients, seminal vesicle invasion in 9%, and extraprostatic extension in 9%. Mean follow-up was 50.7 months, during which biochemical recurrence occurred in one patient (9%) at Month 40. At 1-year follow-up, all patients achieved continence. A pre-operative IIEF-5 score >22 was present in 27% of patients, which decreased to 9% postoperatively and improved to 36% after intracavernosal injection therapy.

Disclosure: The authors have declared no conflicts of interest. Keywords: Functional outcomes, oncological outcomes, prostate cancer, robot-assisted laparoscopic radical prostatectomy (RARP), transurethral resection of the prostate (TUR-P). Citation: EMJ Urol. 2025;13[Suppl 2]:10-11. https://doi.org/10.33590/emjurol/LTLA7927

BACKGROUND AND AIMS Radical prostatectomy in patients with a history of transurethral resection of the prostate (TUR-P) can be technically challenging due to altered surgical anatomy. This study aimed to present the outcomes of robot-assisted laparoscopic radical prostatectomy (RARP) in patients with prior TUR-P.1

METHODS A retrospective review was conducted of 11 patients with a history of TUR-P who were diagnosed with prostate cancer via TRU-CUT biopsy due to elevated prostatespecific antigen levels, and who underwent RARP between 2018–2024. Demographic, perioperative, pathological, oncological, and functional data were analysed. Continence was defined as using less than one pad per day, and erectile function was evaluated using the International Index of Erectile Function-5 (IIEF-5) scores.

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CONCLUSION RARP in patients with prior TUR-P can be performed safely, with low blood loss, short hospitalisation, and high rates of negative surgical margins. Continence recovery rates are favourable in the medium-to-long term, although erectile function recovery is limited.

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Table 1: Perioperative, pathological, and functional outcomes.

Parameter

Mean±SD (min–max) or n (%)

Age (years)

63.54±4.63 (51–70)

BMI (kg/m²)

27.00±4.14 (22–35)

Pre-op PSA (ng/mL)

7.17±2.25 (2.46–11.00)

Post-op first month PSA (ng/mL)

0.02±0.01 (0.001–0.040)

Prostate volume (cc)

142.36±76.02 (52–230)

Console time (min)

149.09±27.46 (90–185)

Blood loss (mL)

29.09±13.00 (10–50)

Drain duration (days)

2.36±0.67 (1–3)

Catheter duration (days)

6.63±1.20 (3–7)

Hospital stay (days)

5.36±1.62 (3–7)

ASA score

ASA 1: 1 (9%); ASA 2: 2 (18%); ASA 3: 8 (73%)

Presence of median lobe

5 (45.4%)

NVB preservation

4 (36%)

Bladder neck preservation

2 (18%)

Positive surgical margins

LN dissection

3 (27%); mean: 27.66±2.51 LNN

Gleason score

3+3: 8 (73%); 3+4: 1 (9%); 4+3: 2 (18%)

Perineural invasion

6 (54%)

Seminal vesicle invasion

1 (9%)

Extraprostatic extension

1 (9%)

Apical involvement

1 (9%)

Biochemical recurrence

1 (9%) at Month 40

Continence at 1 year (<1 pad)

100%

IIEF >22 (pre-op)

3 (27%)

IIEF >22 (post-op)

1 (9%)

IIEF >22 (after ICI)

4 (36%)

Follow-up (months)

50.72±4.12 (40–54)

ASA: American Society of Anesthesiologists; ICI: intracavernosal injection; IIEF: Index of Erectile Function; LN: lymph node; LNN: lymph node number; max: maximum; min: minimum; NVB: neurovascular bundle; op: operative; PSA: prostate-specific antigen.

Reference 1.

Uslu Ö et al. Robot-assisted laparoscopic radical prostatectomy in patients with a history of TUR-P:

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a single-center experience. Abstract 0126. IURES Congress, 6-9 November, 2025.

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Risks and Complications of Robotic-Assisted Radical Prostatectomy in Patients Receiving Antiplatelet and/ or Anticoagulant Therapy Authors: *Ömer Uslu,1 Mehmet Sefa Altay,1 Fevzi Bedir,1 Hüseyin Kocatürk1 1. Department of Urology, Erzurum City Hospital, Türkiye *Correspondence to dromeruslu1@gmail.com Disclosure: The authors have declared no conflicts of interest. Keywords: Anticoagulant, prostate cancer, robotic. Citation: EMJ Urol. 2025;13[Suppl 2]:12-13. https://doi.org/10.33590/emjurol/DOUV7515

INTRODUCTION The use of antiplatelet and/or anticoagulant medications has increased due to irregular diets, limited physical activity, and an ageing population. Robot-assisted radical prostatectomy (RARP) has become increasingly common in the treatment of prostate cancer. This study presents a case of post-operative bleeding on the first day following RARP in a patient taking 100 mg of acetylsalicylic acid.1

CASE PRESENTATION A 69-year-old male with a history of cerebrovascular accident was referred to the authors’ clinic due to a prostatespecific antigen level of 7 ng/mL. Transrectal ultrasound-guided biopsy was performed, and pathology confirmed prostate adenocarcinoma. The patient had been using 100 mg of acetylsalicylic acid regularly. Pre-operative biochemical values were within normal limits. On post-operative Day 1, approximately 750 cc of haemorrhagic fluid was drained, and the haemoglobin level was 10.6 g/dL. A contrast-enhanced CT scan revealed a bleeding focus near the anterior abdominal wall adjacent to the bladder (Figure 1). The patient underwent a second robotassisted laparoscopic procedure. Active bleeding was detected in the right pedicle of the prostate. Haemostasis was achieved by cauterising the bleeding sites, and the surgery was completed successfully.

Figure 1: Pre-operative (A) and post-operative (B and C) CT scans.

A) Pre-operative non-contrast CT image. B and C) Post-operative contrast-enhanced CT images.

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Abstract Review

Reference

CONCLUSION

In patients on anticoagulant therapy, postoperative complications such as bleeding may occur more frequently after RARP. Robot-assisted laparoscopy allows for easier surgical access in such cases, and can be an effective option for managing these complications.

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Uslu Ö et al. Risks and complications of roboticassisted radical prostatectomy (RARP) in patients receiving antiplatelet and/or anticoagulant therapy. Abstract 0096. IURES Congress, 6-9 November, 2025.

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Investigation of BRCA1, BRCA2, and RAD51 Gene Expression Levels in Patients with Non-metastatic Prostate Cancer Undergoing Radical Prostatectomy Authors: *Binnaz Özcan,1 Selçuk Erdem,2 Gözde Öztan,1 Meltem Savran Karadeniz,3 Yasemin Özlük,4 Özge Hürdogan,4 Emre Şentürk,3 Öner Şanlı,2 Faruk Özcan,2 Fatma Savran Oğuz,1 Hayriye Şentürk Çiftçi1 1. Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Türkiye 2. Division of Urologic Oncology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Türkiye 3. Department of Anesthesiology and Reanimation, Istanbul Faculty of Medicine, Istanbul University, Türkiye 4. Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Türkiye *Correspondence to binnazozcan364@gmail.com Disclosure: The authors have delcared no conflicts of interest. The authors received approval from the local ethics committee (Clinical Research Ethics Committee of Istanbul University Medical Faculty; approval number: E-29624016050.99-1672458; date: 8th March 2023). Acknowledgements: The authors would like to express their gratitude to the Research Fund of Istanbul University for supporting this work. Project No: 39753. Keywords: Expression, genes, molecular mechanism, prostate cancer (PCa), regulation. Citation: EMJ Urol. 2025;13[Suppl 2]:14-17. https://doi.org/10.33590/emjurol/EWUY7965

Prostate cancer (PCa) is one of the most common malignancies in men and a major cause of cancer-related death worldwide.1 PCa has a heterogeneous clinical course, with some cases exhibiting low-risk disease, while others exhibit aggressive phenotypes that quickly develop metastasis and treatment resistance. While androgen deprivation therapy is the standard treatment for metastatic cases, castrationresistant PCa is common.2 The BRCA1, BRCA2, and RAD51 genes, which are involved in the repair of DNA double-strand breaks, play a critical role in maintaining Urology

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METHODS Fifty patients with non-metastatic PCa who underwent radical prostatectomy between January 2020–March 2023, as well as 20 healthy controls, were included. RNA isolated from peripheral blood was converted to complementary DNA, and BRCA1, BRCA2, and RAD51 expression was measured by quantitative reverse transcription PCR using the GAPDH reference gene. Statistical analyses used parametric and non-parametric tests, Pearson correlation, and receiver operating characteristic analysis (p<0.05 was significant).

RESULTS

BACKGROUND AND AIMS

genomic stability through homologous recombination.3 Mutations or changes in expression in these genes are associated with poor prognosis and treatment resistance in many cancers, including PCa.4 The aim of this study was to determine BRCA1, BRCA2, and RAD51 gene expression levels in patients with non-metastatic PCa and to evaluate their association with clinicopathological parameters such as biochemical recurrence (BCR), Gleason score, and age.5

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BRCA1 and RAD51 expressions were decreased, and BRCA2 was increased in patients with PCa compared to controls; the decrease in BRCA1 was significant (p<0.001; Table 1 and Figure 1). BRCA1 and RAD51 were increased in patients with BCR, with the BRCA1 increase demonstrating high significance (p<0.001; Table 2 and Figure 2). In patients with low Gleason scores (6–7), expression of all three genes was found to be elevated, with only the RAD51 increase being significant (p=0.019). In patients aged 60 years and older, BRCA1, BRCA2, and RAD51 levels

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Table 1: Mean BRCA1, BRCA2, and RAD51 expression and evaluation in the patient and control groups.

Genes

AVG Ct

AVG ΔCt

2–AVG ΔCt

Fold change

Fold regulation

Patient

Control

Patient

Control

Patient

Control

BRCA1

33.61

29.72

3.74

1.03

0.074822

0.490220

0.15

–6.55

0.004561

BRCA2

31.79

33.79

2.25

4.82

0.210808

0.035390

5.96

0.222315

RAD51

27.88

26.70

–1.36

–1.99

2.572195

3.970994

0.65

–1.54

0.802367

p<0.05 was considered significant. AVG: average; Ct: cycle threshold.

Figure 1: Fold change ratio and significance values of the genes examined in the patient (N=50) and control (N=20) groups.

Fold change

15 Control Patient

BRCA1

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BRCA2

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RAD51

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Table 2: Mean BRCA1, BRCA2, and RAD51 expression and assessment in patients with and without relapse.

Genes

AVG Ct

AVG ΔCt

Fold change

2–AVG ΔCt

Fold regulation

Relapse group (n=4)

Nonrelapse group (n=46)

Relapse group

Nonrelapse group

Relapse group

Nonrelapse group

BRCA1

33.39

33.63

0.44

4.03

0.734584

0.061343 11.98

11.98

0.000478

BRCA2

31.95

31.78

–0.54

2.49

1.448942

0.178275

8.13

0.695177

RAD51

27.80

27.89

–4.40

–1.10

21.075574

2.142255

9.84

0.368219

The bolded p value indicates that it is significant. AVG: average; Ct: cycle threshold.

Figure 2: Fold change rates and significance values of BRCA1, BRCA2, and RAD51 genes in patient groups with and without relapse.

3.5

Fold change (ΔΔCt; baseline=non‑relapse mean)

3 2.5 2 Non-relapse 1.5

Relapse

1 0.5 0

BRCA1

BRCA2

RAD51

Ct: cycle threshold.

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were significantly lower (p=0.012, p<0.001, and p<0.001, respectively). A positive correlation was found between BRCA1 and RAD51 (r=0.46; p<0.01). Receiver operating characteristic analysis indicated that the combination of BRCA1 and RAD51 exhibited a significant trend in predicting BCR.

Abstract Review

in all three genes with age, support the potential of these genes as diagnostic and prognostic biomarkers. Studies with larger series will provide valuable information for genetic screening strategies and personalised treatments.

References

DISCUSSION The increase in BRCA1 and RAD51 in patients with BCR suggests that these genes may play a role in tumour aggressiveness and recurrence risk.6,7 The high expression of RAD51 in low-grade tumours suggests that DNA repair capacity may be more effective at an early stage, while the differential expression pattern of BRCA2 may reflect its unique function in the homologous recombination mechanism.6 The literature suggests that BRCA2 mutations increase the risk of PCa by two-to-four-fold and are associated with aggressive histology and higher mortality.8,9 This study is one of the few to demonstrate the association of BRCA1 and RAD51 with age, tumour grade, and BCR in non-metastatic PCa in the same cohort.

CONCLUSION BRCA1, BRCA2, and RAD51 genes exhibit clinically significant expression changes in non-metastatic PCa, with a strong association with age, Gleason score, and BCR. In particular, the increase in BRCA1 and RAD51 in BCR cases, and the decrease

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Bray F et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-63.

Tilki D et al. EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer. Part II-2024 update: treatment of relapsing and metastatic prostate cancer. Eur Urol. 2024;86(2):164-82.

Chen CC et al. Homology-directed repair and the role of BRCA1, BRCA2, and related proteins in genome integrity and cancer. Annu Rev Cancer Biol. 2018;2:313-36.

Fan Y et al. Homologous recombination repair gene mutations in prostate cancer: prevalence and clinical value. Adv Ther. 2024;41(6):2196-216.

Özcan B et al. Investigation of BRCA1, BRCA2, and RAD51 gene expression levels in non-metastatic prostate cancer patients undergoing radical prostatectomy. Abstract 0124. IURES Congress, 6-9 November, 2025.

Zhang W et al. Role of the DNA damage response in prostate cancer formation, progression and treatment. Prostate Cancer Prostatic Dis. 2020;23(1):24-37.

Wang Z et al. The emerging roles of Rad51 in cancer and its potential as a therapeutic target. Front Oncol. 2022;12:935593.

Giri VN et al. Genetic testing in prostate cancer management: considerations informing primary care. CA Cancer J Clin. 2022;72(4):360-71.

Page EC et al. Interim results from the IMPACT study: evidence for prostate-specific antigen screening in BRCA2 mutation carriers. Eur Urol. 2019;76(6):831-42.

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A Rare Vascular Anomaly in a Patient with a Kidney Tumour: Left Common Iliac Vein Draining Into the Left Renal Vein – A Case Report Author: *Dogucan Nuri Ugur1 1. Department of Urology, Nigde Training and Research Hospital, Türkiye *Correspondence to dr.dogu@gmail.com Disclosure: The author has declared no conflicts of interest. Keywords: Kidney tumour, renal vein variation, vascular anomaly. Citation: EMJ Urol. 2025;13[Suppl 2]:18-19. https://doi.org/10.33590/emjurol/XBRX7867

INTRODUCTION The classic triad of renal cell carcinoma (flank pain, haematuria, and a palpable abdominal mass) is observed in only 9% of patients. When present, it strongly suggests locally advanced disease.1,2 Further radiological imaging in patients presenting with haematuria and flank pain can improve surgical outcomes. This report presents a nephrectomy case involving a locally invasive kidney mass, thrombus in major vessels, and the rare anomaly of the left common iliac vein draining into the left renal vein.

CASE REPORT A 48-year-old male patient with a known history of hypertension presented with a 1-week history of flank pain and macroscopic haematuria. Contrastenhanced CT angiography of the abdomen showed a mass approximately 9 cm in size, occupying almost the entire left kidney. The left renal vein was dilated, with a tumour thrombus filling the lumen and extending to the suprarenal level into the inferior vena cava (Figure 1). Additionally, it was noted that the left common iliac vein was draining into the left renal vein, and a thrombus was also found in the iliac vein beyond the level where it joined the renal vein. A cystoscopy was performed to check for bladder involvement, which was negative for a 18

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tumour. Following this, a midline abdominal incision was made. After medialisation of the colon, the retroperitoneal space was accessed. A 9 cm mass was palpated in the left kidney, and dissection began. Due to the mass’s vascularity and surrounding tissue reaction, dissection was challenging. After completing dissection at the posterior kidney, superior dissection was done, and the left renal vein and its connection with the left common iliac vein were exposed and suspended. The cardiac and vascular surgery team was consulted. The renal artery was clamped, transected, and sutured. Both the left common iliac vein and inferior vena cava were clamped, and an incision was made over the common iliac vein. The tumour thrombus filling both the renal and iliac veins was visualised, dissected from the vein wall, and removed. The left common iliac vein was repaired with a 6-0 Prolene (Ethicon Inc, Raritan, New Jersey, USA) suture. After the clamp was released, no further bleeding was observed, and nephrectomy was completed. Lymph node dissection was performed in the paracaval and parailiac regions. A silicone drain was placed in the surgical area, and the incision was closed in layers. The patient was monitored in the ICU for 1 day post-operatively and was discharged on the seventh post-operative day without complications. The patient has been followed by medical oncology for 2 years for lung metastases, which have shown signs of regression since the initial presentation.

DISCUSSION The typical course of the left renal vein is posterior to the superior mesenteric artery, anterior to the aorta, and cranial to the inferior mesenteric artery, where it drains into the inferior vena cava.3 There are several reports of variations in the drainage of the left renal vein. Common variants

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Figure 1: Contrast-enhanced CT angiography of the abdomen.

include retroaortic and circumaortic left renal veins. The incidence of these variants has been reported as 0.5–3.1% and 0.02%, respectively.4 In this case, the left common iliac vein drained into the left renal vein, which in turn drained into the inferior vena cava. A review of the literature revealed no previous reports of a similar vascular anomaly.

CONCLUSION Iliac and renal vascular variants are not uncommon and may pose a risk for injury during retroperitoneal surgery. Failure to recognise these variants can lead to vascular damage and significant

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haemorrhage. In this case, awareness of this rare vascular variation preoperatively and intraoperatively allowed for safe conduct of the surgery.

References 1.

DeKernion JB, “Real numbers,” Walsh PC et al. (eds.), Campbell's Urology (1986), Philadelphia: Saunders, p.1294.

Ugur DN. A rare vascular anomaly in a kidney tumor patient: left common ıliac vein draining into the left renal vein – a case report. Abstract 0127. IURES Congress, 6-9 November, 2025.

Kawai K et al. A rare anomaly of left renal vein drainage into the left common iliac vein: a case report. Int J Surg Case Rep. 2016;20:4-6.

Dilli A et al. Study of the left renal variations by means of magnetic resonance imaging. Surg Radiol Anat. 2012;34(3):267-70.

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Multifactorial Comparison of Flexible Ureterorenoscopy and Mini-Percutaneous Nephrolithotomy Outcomes in the Treatment of Hard Renal Pelvic Stones Measuring 1–2 cm Authors: Kadir Karkın,1 *Buğra Aksay,1 Ediz Vuruşkan,1 Hakan Erçil,1 Adem Altunkol,1 Zafer Gökhan Gürbüz,1 Ergün Alma,1 Mubarız Aydamirov1,2

The following parameters were evaluated: •

1. SBÜ Adana City Training and Research Hospital, Türkiye 2. Başkent University Alanya Hospital, Türkiye *Correspondence to bgraksay@gmail.com Disclosure: The authors have declared no conflicts of interest.

•

Keywords: Complications, flexible ureterorenoscopy (fURS), mini-percutaneous nephrolithotomy (mini-PNL), multifactorial analysis, renal stones. Citation: EMJ Urol. 2025;13[Suppl 2]:20-22. https://doi.org/10.33590/emjurol/LGME9014

BACKGROUND AND AIMS This study aimed to perform a multifactorial comparison of the surgical outcomes of mini-percutaneous nephrolithotomy (miniPNL) and flexible ureterorenoscopy (fURS) in the treatment of patients with solitary renal pelvic stones measuring 1–2 cm and having a stone density of >1,000 Hounsfield units.1

MATERIALS AND METHODS The authors retrospectively analysed 79 patients who underwent either mini-PNL (n=23) or fURS (n=56) between January 2018–December 2023 at the Department of Urology, SBÜ Adana City Training and Research Hospital, Türkiye. All patients had a solitary renal pelvic stone measuring 1–2 cm with a density exceeding 1,000 Hounsfield units, confirmed by preoperative, non-contrast CT. Routine preoperative preparations, including urine culture, laboratory tests, chest X-ray, and ECG, were performed.

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demographics: age, gender, BMI, and American Society of Anesthesiologists (ASA) score; stone characteristics: laterality, size (length, area, and volume), opacity, and density; operative factors: fluoroscopy time, operative time, and hospital stay; laboratory parameters: pre-operative and postoperative Day 1 serum creatinine, estimated glomerular filtration rate, haematocrit, and white blood cell counts; and clinical outcomes: stone-free rates, postoperative Day 1 and 1-month residual stone rates, post-operative Visual Analogue Scale (VAS) scores (1st, 6th, 12th, and 24th hour), and complications classified according to the Clavien-Dindo grading system.

RESULTS Among the 79 patients, 23 underwent mini-PNL and 56 underwent fURS (Table 1). In terms of gender distribution, there were seven females and 16 males in the mini-PNL group compared to 24 females and 32 males in the fURS group (p=0.304). The mean age was 51.0±15.8 years in the mini-PNL group compared to 48.1±14.8 years in the fURS group (p=0.44). The mean BMI was significantly higher in the fURS group (27.5±4.8 kg/m2) compared to the mini-PNL group (25.8±2.5 kg/m2; p=0.04). In terms of stone characteristics, stone size, area, and volume were significantly larger in the mini-PNL group (p<0.05). Fluoroscopy time was significantly longer in the mini-PNL group (75.2±55.2 seconds) compared to the fURS group (12.7±7.9 seconds; p<0.001). The operative time was also significantly longer in the miniPNL group (97.8±27.9 minutes) compared

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Table 1: Comparative analysis of 1–2 cm hard pelvic stones.

Variable

Mini-PNL (n=23)

fURS (n=56)

p value

Age (years)

51.0±15.8

48.1±14.8

0.440

BMI (kg/m2)

25.8±2.5

27.5±4.8

0.040*

Gender (F/M)

7/16

24/32

0.304

Laterality (R/L)

8/15

27/29

0.275

Stone opacity (opaque/nonopaque)

21/2

49/7

0.629

Stone size (mm)

17.4±1.7

14.5±2.9

<0.001*

Stone area (mm2)

211.7±75.2

156.9±68.3

0.002*

Stone volume (mm3)

2,315±1,147.7

1,338±872.7

<0.001*

Fluoroscopy time (s)

75.2±55.2

12.7±7.9

<0.001*

Operative time (min)

97.8±27.9

65.7±23.8

<0.001*

Post-op Hct (%)

36.2±8.7

39.8±5.8

0.033*

ASA score

2 (2–3)

0.422

Hospital stay (days)

3 (2–3)

1 (1–1)

<0.001*

VAS score (1 h)

3 (3–4)

1 (1–2)

<0.001*

VAS score (6 h)

2 (2–3)

1 (1–1)

<0.001*

VAS score (12 h)

2 (1–2)

0 (0–1)

<0.001*

VAS score (24 h)

1 (1–2)

0 (0–1)

<0.001*

Residual stone (%)

4 (17.4%)

5 (8.9%)

0.282

*p<0.05 is statistically significant. ASA: American Society of Anesthesiologists; F: female; fURS: flexible ureterorenoscopy; Hct: haematocrit; L: left; M: male; Mini-PNL: mini-percutaneous nephrolithotomy; post-op: post-operative; R: right; VAS: Visual Analogue Scale.

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to fURS (65.7±23.8 minutes; p<0.001). Hospital stay was significantly shorter in the fURS group (1 day) compared to the mini-PNL group (3 days; p<0.001). Postoperative VAS scores were significantly lower in the fURS group at all time points (p<0.001). Post-operative haematocrit decrease was more pronounced in the mini-PNL group (p=0.033). Stone-free rates were comparable between groups; residual stones were found in 17.4% of mini-PNL cases compared to 8.9% of fURS cases (p=0.282). No significant differences were observed in post-operative creatinine, estimated glomerular filtration rate, or white blood cell levels.

mini-PNL and fURS achieve comparable stone-free rates. However, fURS offers significant advantages in terms of shorter operative time, less fluoroscopy exposure, reduced post-operative pain, and a shorter hospital stay, making it a safer and less invasive alternative in appropriately selected cases.

Reference 1.

Aksay B et al. Multifactorial comparison of flexible ureterorenoscopy and mini-percutaneous nephrolithotomy outcomes in the treatment of hard renal pelvic stones measuring 1–2 cm. Abstract 0138. IURES Congress, 6-9 November, 2025.

CONCLUSION For the management of hard and solitary renal pelvic stones measuring 1–2 cm, both

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Abstract Review

Prospective Assessment of Magnetic Resonance-Cognitive Transperineal Prostate Biopsy Under Local Anaesthesia: Experience From a Single Centre Authors: *Zeynep Akdağcık,1 Muhammed Zübeyr Canbolat,1 Abdullah Bolat,1 Erdem Öztürk1

RESULTS

1. Department of Urology, University of Health Sciences, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Türkiye *Correspondence to drerdemoz@gmail.com

A total of 145 patients who underwent TPBx under LA were included in the study. The mean age of the cohort was 65.8±6.9 years, with a mean BMI of 26.1±3.42 kg/ m2. The mean prostate-specific antigen level was 11.69±14.7 ng/mL, the mean prostate volume was 59.2±30.04 mL, and the mean prostate-specific antigen density was 0.22±0.33 ng/mL2. Regarding multiparametric MRI findings, 54 patients (37.3%) had PI-RADS 3 lesions, 65 patients (44.8%) had PI-RADS 4, and 26 patients (17.9%) had PI-RADS 5. The average number of biopsy cores obtained per patient was 15.82±1.56.

Disclosure: The authors have declared no conflicts of interest. Keywords: Cognitive, local anaesthesia, MRI, prostate cancer, targeting. Citation: EMJ Urol. 2025;13[Suppl 2]:23-24. https://doi.org/10.33590/emjurol/XAOR4798

BACKGROUND AND AIMS MRI-cognitive transperineal prostate biopsy (TPBx) performed under local anaesthesia (LA) is increasingly adopted as a minimally invasive, anatomically accessible technique with favourable diagnostic accuracy and low complication rates. This study prospectively evaluated its diagnostic performance and safety profile in a single-institution cohort.1

MATERIALS AND METHODS A total of 145 patients with Prostate Imaging Reporting and Data System (PI-RADS) ≥3 lesions on multiparametric MRI underwent MRI-cognitive TPBx under LA, combined with systematic sampling. For each target lesion, three cores were obtained. Demographic, radiologic, histopathologic, and perioperative outcomes were analysed, with prostate cancer graded using the International Society of Urological Pathology (ISUP) classification. Complications were prospectively recorded.

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Complications were observed in 11 patients (7.58%). The most frequent event was urethral bleeding (n=8), followed by acute urinary retention (n=2) and macroscopic haematuria (n=1). No cases of post-biopsy fever were reported. Histopathological examination revealed malignant pathology in 88 patients (60.7%) and benign findings in 57 patients (39.3%). Distribution of ISUP grades was as follows: ISUP 1 in 14 patients (9.7%), ISUP 2 in 45 patients (31%), ISUP 3 in eight patients (5.5%), ISUP 4 in seven patients (4.8%), and ISUP 5 in 14 patients (9.7%). When comparing biopsy techniques, malignant detection rates were 51% in the cognitive group and 57.2% in the systematic group. Clinically significant prostate cancer was detected in 74 patients (51.0% overall), with 55 cases (37.9%) identified by cognitive biopsy and 52 cases (35.8%) by systematic biopsy. Clinically insignificant prostate cancer was detected in 14 patients (9.7%), including 19 cases (13.1%) in cognitive biopsy and 31 cases (21.4%) in systematic biopsy.

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CONCLUSION

MRI-cognitive TPBx under LA demonstrates high detection rates for clinically significant prostate cancer with a low rate of complications. This technique provides a safe, effective, and patientfriendly alternative for prostate biopsy in contemporary clinical practice.

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Akdağcık Z et al. Prospective assessment of MR-cognitive transperineal prostate biopsy under local anesthesia: experience from a single center. Abstract 0191. IURES Congress, 6-9 November, 2025.

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Congress Interview

Congress Interviews This year, we had the pleasure of sitting down with the International Urologic Research Society (IURES) 2025 Congress presidents, Erdem Canda and Emre Huri. As two distinguished leaders in the field, they highlight the innovative programme planned for this year’s Congress, the rapid growth of the Society, and the promising future of robotic surgery. Read on to gain their expert perspectives.

Citation:

EMJ Urol. 2025;13[Suppl 2]:25-27. https://doi.org/10.33590/emjurol/AAJR5368

As Co-President, what was your specific area of focus for the IURES Congress, and how did your work with Erdem Canda, Koç University, Istanbul, Türkiye, help make the Congress successful?

Emre Huri Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye

In all our sessions, we focused on discussing the future needs of urological science, especially in terms of evidence levels

My specific area of focus for the Congress is functional and reconstructive urology. I work more on preparing for workshops on secondary modulation and developing printed models to help create the best possible equipment. As a co-president, I also worked on every part of the programme because our programme has different subsections like scientific meetings, courses, live surgeries, and interactive international meetings, and we organise all these. Because of this, I was particularly responsible for implementing the Congress and building relationships with international societies such as the Balkan Neurology Society and the Egyptian Neurology Society. In reality, though, we worked together on every part of the process. Canda and I collaborated closely, and I believe that this

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teamwork was the most important factor in the success of the Congress.

How does the IURES Congress help with the important need to create clear, standard rules for treatment for different hospitals in both Türkiye and Europe? This Congress helped our participants, or maybe not ‘helped’, but guided our colleagues, from many different cities and various types of hospitals. Some came from education and training hospitals, others from state hospitals, and we also had many urology residents participating. The Congress attracted participants not only from Türkiye but also internationally. In all our sessions, we focused on discussing the future needs of urological science, especially in terms of evidence levels. For that reason, the Congress promoted treatment policies and provided detailed, evidencebased information about urological diseases. So, I can honestly say that this Congress reached a

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high scientific level, not only for Türkiye or Europe, but on a worldwide scale.

surgical procedures for this purpose. This is one of our research-based European projects. The most important issue is to follow research and implement it in clinical practice. It’s not something that happens in a single day, but we continue working, and new ideas are still emerging.

Your work connects research and the clinic. How did you make sure that the sessions at IURES focused on research findings that doctors can actually use right away with their patients? Our society was established 3 years ago, and inside the society, we had the research section. Research is not easy to deal with; it's a long-term commitment. But we are working to strengthen scientific research, especially in areas where evidence is lacking in the urological field. I would also like to mention our new collaboration with an EU project. We are a collaborator in the EU Erasmus Youth Project called the European Youth School of Robotic Technology. IURES is a partner of the project. Within the project, we are responsible for dissemination. We help promote and spread knowledge of robotic technology among young people, residents, and young urologists. We are also preparing 3D-printed models for robotic training programs, and we have selected several robotic reconstructive

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What new and innovative teaching methods, beyond traditional lectures, did IURES implement this year to ensure doctors effectively retained the updated knowledge? We had many hands-on training courses. In these courses, we first performed secondary neuromodulation on a 3D-printed customised model. We performed penile prosthesis surgery courses with the printed model castings. In addition, we used printed prostate and kidney models for robotic and laparoscopic surgery. In the Congress, we had a special guest, Ignacio T. Castillón Vela, Hospital Universitario Nuestra Señora del Rosario, Madrid, Spain, and I think he did a great job. We also organised laparoscopic ureteroneocystostomy courses as part of our EURO Lab sessions. These were examples

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of new, innovative technologies implemented in our handson training. This Congress provided valuable opportunities for our colleagues, especially the younger generation who represent the future of urology in Türkiye, although it benefited our international guests as well. We had more than 500 participants, and more than 60 or 70 international colleagues who were truly interested in our programme. When you look at the Congress, it is not only ‘international’ in name; the scientific programme itself reflects this. We started at 8 a.m. and continued until 7 p.m., without overlapping sessions. In the main hall, we focused on discussions about the needs and the future of urology across different subsections, while in the other halls we provided hands-on training and updated practical knowledge.

New technology has ethical questions. Did IURES include any sessions to discuss the responsible use of new tools like AI, or questions about patient data privacy? We also had a course on AI, specifically the usefulness

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IURES 2025

of AI in urology. I participated in that session as well. It was a theoretical course, and we invited speakers from different disciplines, not only urologists, but also engineers. We discussed AI as a broad concept, and under that, we focused on deep learning, machine learning, and AI-based diagnostic tools, including applications for prostate cancer evaluation. This is one of our main goals for the future: to use AI for training purposes and possibly for our next meetings. For example, AI could help us analyse our data to identify which topics are most popular and which ones may not need as much focus. Regarding patient data privacy, we always stress its importance in all our theoretical lectures. We also emphasise the role of AI in protecting patient data. We don’t have a specific dedicated course on data privacy yet, but we incorporate this topic within the AI course.

What goals did you set for IURES to help with public health issues, such as improving screening for cancer or treating widespread diseases like kidney stones in the region? When you look at the Congress, and even apart from the Congress, we have a policy, our policy to teach our colleagues. On the other hand, we also have a responsibility to the public, because we have a responsibility to give the right information about the urological disease, diagnosis, management, follow-up, and treatment, including which surgical approaches are appropriate, whether robotic, open, or laparoscopic. We are aware of the importance of this condition, especially in

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We had several highlights, especially in neurotechnology. Our main highlight was, and still is, robotic technology

improving cancer screening and managing widespread conditions like kidney stones. We have a subspecialty group focused on stone disease, and they are working actively in this area. We also have a group for uro-oncology addressing these problems. I personally work on functional urological issues, such as voiding dysfunction. So we are continually developing new ideas, projects, and researchbased studies. On the other hand, today we had an interview with the Turkish National Agency and national TV channels. We provided information about prostate cancer, bladder cancer, urinary incontinence, bladder dysfunction, urinary retention, and also about the robotic surgical era in Türkiye and in the region. I think this is another way the Congress benefits public health.

Looking back at the Congress this year, what has been a particular highlight, or standout moment for you, and why? We had several highlights, especially in neurotechnology. Our main highlight was, and still is, robotic technology. We used different robotic systems during the live surgeries. Another major achievement was organising 15 different handson training courses. We also introduced a ‘live lunch session’

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during the coffee break. This meant we didn’t stop the scientific programme even during social time, because we believe that social activities can also serve scientific purposes. So, the live lunch session became one of the unique highlights of this Congress. We also made very effective use of social media to share our goals with the world. This is not marketing; it is the true visualisation of our ideas and our vision. And our vision is ‘the future together’, because we believe that when you are together, you achieve success in science and reach your main goals in urology. It’s not only me and Canda, our entire executive committee also worked together on these goals. This Congress highlighted the importance of unity and collaboration in creating such a unique event. Finally, although we are a regional society, we have strong collaboration with the Balkan Urological Association, which includes five to seven national societies. The Egyptian Urology Association was also represented, as well as the European Association of Urology (EAU), Société Internationale d'Urologie (SIU), and American Urological Association (AUA). This is one of the elements that truly stands out: it is a Turkish Congress, but at an international level.

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EMJ Urol. 2025;13[Suppl 2]:28-31. https://doi.org/10.33590/emjurol/QCAS5168

Citation:

As Co-President, what was your main goal for the International Urologic Research Society (IURES) Congress this year, and what part of the scientific programme are you most proud to have brought to the delegates?

Erdem Canda

When we were establishing IURES, our aim was to be not only a national society but an international one. Our main goal has been to organise events on a global scale.

Department of Urology, School of Medicine, Koç University, Istanbul, Türkiye

This Congress is the first in our country where major international societies, including the American Urological Association (AUA), the European Association of Urology (EAU), and the third major society, the Société Internationale d'Urologie (SIU), have all had representatives. All three of the leading international societies supported this event. In addition, the European Robotic Urology Society, as well as the Balkan and Egyptian societies, also joined us.

This Congress is the first in our country where major international societies, including the AUA, EAU, and the third major society, the SIU, have all had representatives

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This means that we succeeded in reaching a truly global setting. That is my proudest moment, being able to attract the attention and support of almost all the leading societies in the world.

Your expertise includes robotic and laparoscopic surgery. How did the IURES programme make sure that the newest surgical techniques were taught in a practical, useful way to all attendees? The number of robotic systems is increasing in the world. We have the da Vinci Robotic Surgical System (Intuitive Surgical,

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Sunnyvale, California, USA), and we have new upcoming robotic systems like the Hugo™ Robotic-Assisted Surgery System (Medtronic, Dublin Ireland) and the Toumai® Laparoscopic Surgical Robot (Shanghai MicroPort MedBot (Group) Co.,Ltd, Shanghai, China). For the very first time, our Congress featured live surgeries performed using more than one robotic system. I personally performed a live robotic prostate cancer surgery with the Medtronic Hugo™ system. I flew back to Istanbul, Türkiye, and did a live case at my hospital, which was broadcasted live at the meeting venue. We had a friend from Oklahoma, USA, who performed a single-port da Vinci robotic kidney cancer surgery; it was the second live broadcast. Another board member of our Society, Uğur Boylu, Liv Hospital Ulus, Istanbul, Türkiye, returned to Istanbul to perform a robotic prostate cancer surgery using the MicroPort Toumai® system at his hospital. This was the third live surgery with a robotic system. We also had a colleague sharing his experience with robotic renal transplantation. This Congress heavily included robotic surgeries. We also included many courses covering both laparoscopy and robotics. Trainees had the opportunity to work with 3D-printed materials, such as prostate models and kidneys with tumours, which we produced in our own 3D printing facilities. All trainees were residents, and these models allowed them to improve their skills in both laparoscopic and robotic procedures.

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What is one new technology or surgical tool that you believe will change urology practice the most in the next 3–5 years, and how did IURES highlight this? The answer is telesurgery, or more specifically, robotic telesurgery, because this can only be done using robotic systems. There have been several examples, particularly over the last 1 or 2 years. For instance, imagine a surgeon living in London, UK, and a patient in Istanbul, Türkiye. Both locations have robotic systems, but there is no surgeon in Türkiye who can perform that specific procedure. By connecting the robotic system to the patient in Istanbul, the surgeon in London can control the robotic arms remotely, performing the surgery as if they were physically there.

we can expect robotic telesurgery to become increasingly feasible and widespread in the near future.

The Congress covers many topics. How did you work with the committee to ensure a good balance between teaching the essential urology topics and showing new areas like genomics? We have, for example, a Basic Research and Basic Science group that identify the most interesting subjects, like genomics, and invite the appropriate speakers. This is how we ensure that the basic science and research content of the Congress is comprehensive.

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We call these groups ‘special interest’ groups. We have a special interest group in uro-oncology, of which I am a member, and this group decides which topics to include and who to invite, ensuring that there is a dedicated and appropriate focus on oncology. Similarly, we have a special interest group in functional urology, where Emre Huri, Hacettepe University, Ankara, Türkiye, is a member. They work to create the most up-to-date programme in that field. We also have special interest groups for andrology, neuro-urology, paediatric urology, and renal transplantation. Each expert group works independently on their

This is called robotic telesurgery, and over the past year, it has been done transcontinentally. For example, a surgeon in Florida, USA, operated on a patient in China; a surgeon in Barcelona, Spain also performed surgery on a patient in China; and a surgeon in Kuwait operated remotely on a patient elsewhere. Now it's possible. We have witnesses. I have witnessed at least 10 examples in the last year by attending robotics meetings. The question is, why was it possible in the last year? Why was it not possible before? The reason is the availability of fast 5G technology, especially in the last year, which allows high-volume, live data transmission with minimal delay (there is a slight delay of 0.035 milliseconds, which the human eye cannot identify). So, it has no negative impact on the surgeon or the patient. That's why it's possible. With the development of 5G technology, CC BY-NC 4.0 Licence

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specific field to develop the most current and high-quality content. Through the collaboration of all these groups, we can deliver the best possible programme for the Congress, ensuring that no important topic is missed.

We also included many live surgeries, in addition to the robotic cases

What new session or teaching format did you create this year to help excite residents and young specialists at the Congress?

surgical specialty. To truly teach surgery, videos and lectures alone are not enough. Handson practice is essential, and we provided many such opportunities.

This significantly increases the financial burden on governments and creates a wider negative impact on both the healthcare system and the nation.

The answer is that we offered a lot of courses. Most of the time, other congresses also arrange many courses, but they are primarily video presentations and lectures. Here, though we did have lectures and video presentations, we also had a lot of hands-on sessions. These included laparoscopy, simulator training, robotic surgery, and even procedures such as neurostimulator implantation.

All the trainees and participants were residents, and they were very pleased. We believe this strategy will increase participation in the coming years, as it will encourage their colleagues to attend the IURES Congress because of the extensive handson training. We hope to attract an even larger number of young urologists to our future meetings.

So, in my view, this is the most important technical challenge that urology and our patients face. That is why we included talks on the early diagnosis of prostate cancer, kidney cancer, bladder cancer, benign prostatic hyperplasia, and kidney failure in our Congress.

We also offered hands-on training in open and laparoscopic ureteroneocystostomy, where the ureter, the tube that carries urine to the bladder, must be surgically reconnected due to certain diseases. For this, we created special models specifically designed for training. In addition, we organised a prostate biopsy course and several other hands-on sessions. The ureteroneocystostomy course was organised by Ignacio T. Castillón Vela, Hospital Universitario Nuestra Señora del Rosario, Madrid, Spain, who is a well-known person in this field, in addition to laparoscopy and robotics This was one of the strongest aspects of the Congress. Trainees appreciate videos and lectures, but they ultimately want and need to perform procedures themselves, because urology is a 30

Urology

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What is the biggest technical problem or patient care need that urology faces globally right now, and how did the IURES Congress try to find a solution for it? It's the early detection of cancer and non-cancer diseases, including kidney failure, prostate cancer, kidney cancer, and bladder cancer. So, if we are able to identify these conditions at an early stage, we can prevent their progression. Once these diseases advance, it becomes difficult for the patient, difficult for the doctor, and difficult for the government. If we diagnose them early, we can stop or slow progression, and we can treat effectively. But if we miss that opportunity and only detect these diseases at an advanced stage, then most of the time we cannot cure them. We can treat them, but treatment does not necessarily lead to a cure.

December 2025

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When you look back at the Congress this year, how do you think it was different from last year, and what was your favourite moment? It is definitely much more global. We managed to gain the support of all the major societies. We contacted the authorities of the AUA, and they approved their involvement. The AUA logo appears in our meeting, and John Davis, MD Anderson Cancer Center, Houston, Texas, USA, joined our Congress to give an AUA talk. We also had Derya Tilki, Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Germany, giving the EAU lecture, and Jean de la Rosette, Medipol University Hospital, Istanbul, Türkiye, delivering the SIU talk. So, this year, we had all three major international societies represented. This means that this year’s Congress is clearly superior to

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IURES 2025

previous years in terms of being fully global; we have truly achieved that. We also included many live surgeries, in addition to the robotic cases. For example, we had a live kidney stone laser surgery performed today by one of my colleagues at my hospital. We also performed a penile prosthesis implantation for erectile dysfunction, again from my hospital, broadcast live yesterday evening. Live surgery is always valuable because surgeons sometimes encounter difficulties,

bleeding, or other challenges, and the audience is interested in how these problems are managed in real time. It is exciting and attractive, and including multiple live surgeries increases attention and engagement. We featured a live surgery every day, and this was a key strength of this year’s meeting. We definitely offered more courses, especially hands-on courses, compared to previous years. We originally expected around 300 participants, but thanks to this very strong

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Congress Interview

programme, we reached more than 500. This clearly shows how well supported the event has been. In addition, Alan McNeill, Western General Hospital, Edinburgh, UK, gave a lecture as a representative of a medical journal. So, we now have excellent collaborations not only with major societies, but also with leading scientific journals, including EMJ. When you bring all these forces together, you create a truly outstanding meeting.

December 2025

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Urology

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