EAU RF initiates PHOENIX Prospective registry for patients undergoing penile prosthesis implantation for male erectile dysfunction Ass. Prof. Koen Van Renterghem Principal Investigator Hasselt (BE)
koenraad.van. renterghem@ telenet.be
Dr. Federico Deho Principal Investigator Milan (IT)
deho.federico@ gmail.com Erectile dysfunction (ED) is a condition which is often encountered in - especially ageing - men, with an incidence of up to 53,4 % or even higher in men above 60 years1. Oral treatment became available from 1998 when sildenafil was introduced. This resulted in an improvement in accessibility and it made impotence easier to talk about with health care providers2. To date, PDE-5 inhibitors are considered a first-line therapy in men suffering from erectile dysfunction. When oral treatment is not effective or not suitable, more invasive treatments are available, such as intracavernous injections, intra-urethral treatment and vacuum devices3. Notwithstanding the success of the above therapies, a substantial group of patients is not EAU Research Foundation
responding to or not agreeing with these therapeutic modalities. This can be caused by the non-negligible side effects of these treatment modalities. Moreover, in most patients, erectile dysfunction is a lifelong condition that cannot be cured with therapy. In addition we are dealing with an ageing population, consisting of elderly people in an increasingly better general shape. Thus, a penile implant can be a valuable option to treat those patients. High satisfaction rates According to the EAU Guidelines4, a penile prosthesis implant (PPI) is indicated as a third-line option in patients not responding to or refusing other treatments for their ED. Many papers have been published showing a high satisfaction rate in patients as well as their partners5. These high satisfaction rates are related to the excellent mechanical reliability of the available devices on the market. The available implants produce a highquality erection as well as good technical performance. If this is combined with a perfect surgical procedure, the end result is transcending the outcome of the other therapies by far. Unfortunately, PPIs are not always offered to patients with refractory ED despite the excellent results. This can be explained by a lack of good patient information, unfamiliarity among many urologists, implant cost, insufficient high-quality publications on real and unbiased outcome, etc. To date, few prospective registries have been established6-8. Demonstrate effectiveness PPIs Therefore, it was decided to initiate a prospective registry entitled ‘Prospective Registry for Patients Undergoing Penile Prosthesis Implantation for Male Erectile Dysfunction. EAU -RF 2018-01; Acronym: PHOENIX. The aim is to collect prospective data from different European implant surgeons. This will enable us to create a synopsis on patient and partner satisfaction as well as assess the mechanical reliability of the different PPIs on the market. EAU RF will be using validated questionnaires. The final goal
is to demonstrate that this therapeutic option is an excellent treatment in patients with refractory ED who did not respond to previous treatments. Furthermore it should be possible to identify clinical and surgical factors that correlate with patient outcome, surgical complications and mechanical reliability of the devices available on the market. With the results, treatment recommendations and guidelines can be further improved resulting in better care for this group of ED patients. Participating centres and funders for our Registry still needed We aim at including European Centres who offer PPI for their patients with erectile dysfunction. In this survey we will collect pre-defined parameters related to this kind of surgery. All devices on the market that are used as implant in daily urological practice can be included. No extra visits will be required to collect the data, patients are seen on a regular basis according to standard clinical practice. Patient inclusion should be consecutive. The EAU RF has sent invitations to high-volume implant centres and European urologists from Belgium, Italy, Germany, Denmark, Serbia, Spain, the Netherlands, France and the United Kingdom. The centres have already shown interest to set up such a registry and are willing to participate by contributing their patient data after receipt of the patient’s consent. Companies producing PPIs will be approached to ask whether they wish to fund the registry and the first company has already agreed to partially fund this registry. An investigators meeting will be planned shortly, if possible, during the upcoming Annual EAU Congress in Barcelona. Should you be interested in participating in, or fund this registry, please inform the EAU RF by sending a mail to C.Caris@uroweb.org.
Dr. Wim Witjes Scientific and Clinical Research Director EAU Research Foundation Arnhem (NL) w.witjes@ uroweb.org References 1. Eardley I et al. The incidence, prevalence and natural history of Erectile Dysfunction. Sex Med Rev. 2013; 1: 3-16 2. Hartmann et al. Erectile dysfunctions in patient-physician communication: optimized strategies for addressing sexual issues and the benefit of using a patient questionnaire. J Sex Med 2007; 4: 38-46 3. Virag R. Intracavernous injection of papaverine for erectile failure. Lancet 1982; 2: 938 4. European Association of Urology. Guidelines on male sexual dysfunction. 2017. 5. Brinkman et al. A survey of patients with inflatable penile prostheses for satisfaction. J Urol 2005; 174: 253-7 6. Pescatori et al. INSIST-ED: Italian society of andrology society registry on penile prosthesis surgery. Arch Ital Urol Androl. 2016; 88: 122-7 7. Henry et al. The who, how and what of real world penile implantation in 2015: the PROPPER registry baseline data. J Urol. 2016; 195: 427-33. 8. Capogrosso P, Pescatori E, Caraceni E, Mondaini N, Utizi L, Cai T, Salonia A, Palmieri A, Deho F. Satisfaction rate at 1-year follow-up in patients treated with penile implants: data from the multicentre prospective registry INSIST-ED. BJU Int. 2018 Jun 29. doi: 10.1111/bju.14462. [Epub ahead of print]
Principal Investigators: Dr. Koen Van Renterghem, Hasselt, Belgium Dr. Federico Deho, Milano, Italy Organisation: EAU Research Foundation
BCa19: Turin welcomes second EAU Update on Bladder Cancer “Thorough and updated overview of BCa for any clinician involved in multidisciplinary care” After a successful inaugural meeting last year in Munich, the EAU is continuing to offer a two-day educational update on the topic of bladder cancer. The meeting is specifically designed to give participants a practical, high-quality and comprehensive update on bladder cancer, using highly interactive group-based case discussions to illustrate the latest treatment options. BCa19 is coming to the North of Italy, to the historic and cultural city of Turin on 17-18 May, 2019. We spoke to Prof. Paolo Gontero (Turin, IT), member of the BCa19 Scientific Committee. An interactive meeting “We’ve designed the BCa19 scientific programme to appeal to any clinician involved in the multidisciplinary care of bladder cancer who wants to have a thorough and updated overview of the disease,” Gontero explains. “The format is designed to provide high quality, comprehensive information with a constant view to the clinical applicability of the contents.” Aside from state of the art lectures that address all the meeting’s participants, the programme features three case discussion sessions. During these sessions, participants are assigned to a session room and they are joined in turn by three faculty groups, each addressing different aspects of bladder cancer.
Visit bca19.org to register for BCa19! Registration includes accommodation and is heavily discounted if you sign up before February 15. For example, the first case discussion session offers the following three topics: Open vs robotic radical cystectomy, the possible benefit of extended lymphadenectomy in BCa, and a multidisciplinary look at the choice of urinary diversion. Participants can therefore enjoy the educational benefits of a smaller group, as well voting during the case discussions. 6
European Urology Today
BCA19 features pre- and post-meeting testing. Prof. Gontero: “The mission of the meeting is thus to provide a high educational content, always oriented to clinical practice in order to fulfil the interest of clinicians that might have different levels of expertise.” “This year the scientific committee has worked very hard to identify contents, titles of presentations and an outstanding faculty able to fulfil the interest of a multidisciplinary audience. The aim is to foster a high level of interest for all different topics among oncologists, radiotherapists and urologists. We believe that the methodology to conduct a high-standard TURBT is no less interesting for an oncologist or a radiotherapist than systemic immunotherapy is for a urologist.” The character of the meeting BCa19 is hardly the only oncology-related meeting that the EAU has to offer in 2019. It joins PCa19 and RCC19 in the onco-urology update series, as well as the ESOU’s annual section meeting and EMUC19. Prof. Gontero makes the distinction between BCa19 and its ‘cousins’: “ESOU and EMUC are both outstanding meetings addressing the whole spectrum of uro-oncology, the latter with a special view to multidisciplinarity. However, the growing complexity and rapid progress in diagnostics and treatment of oncological diseases is generating the need of specialists devoted to a specific disease and this has translated into the dissemination of so-called bladder cancer clinics worldwide. BCa19 is the EAU meeting entirely devoted to train or to provide an annual update to bladder cancer specialists.” In terms of topics addressed, Gontero pointed out some highlights: “Genetics and, chiefly, molecular staging are changing the landscape of bladder cancer and Eva Prof. Eva Compérat (Paris, FR) and Prof. James Catto (Sheffield, GB) will have the task to explain how these new developments will soon affect clinical practice.”
Optional Live Surgery Session In addition to the full BCa19 scientific programme, Prof. Gontero is offering visitors to Turin the option to attend a special live surgery session, held on May 16, the day before BCa19 starts. Registering for the live surgery session is free of charge for BCa19 delegates, although any extra night in Turin will be at delegates’ own expense. Location: “Molinette Incontra” Congress Centre Città della Salute e della Scienza Corso Bramante, 88 Turin, Italy
17 -18 May 2019 Turin, Italy
The Live Surgery Session “Standard and Innovative Procedures for Bladder Cancer in 2019” is broadcasted on 16 May, 12.00 - 19.00 hrs, from Molinette Hospital, Turin, Italy For more information on the Live Surgery Session, including the programme, visit www.bca19.org/ livesurgery
“Another important issue is represented by the variant hystologies with Dr. Ashish Kamat (Houston, USA) and Dr. Shahrokh Shariat (Vienna, AT) translating these complex cases into practical management. Bladder cancer has recently witnessed technological advances in diagnostics as well as the consolidations and expansion of novel
EAU Update on Bladder Cancer
What to expect: • Three operating theatres broadcasting simultaneous bladder procedures • Comparison of open and robotic cystectomy with neobladder • Demonstration of new technologies like Cellvizio
treatment options. These will be thoroughly covered.” “The surgical topics will be devoted to a thorough discussion of controversial topics such as robotic and open cystectomy, the extent of lympadenectomy and the difficult choice of urine diversion.”
EAU onco-urology series
www.bca19.org
January/February 2019