SPECIALTY SOCIETIES: American Urological Association Participation in the 2023 Urological Society of India National Congress
By: Jaspreet S. Sandhu, MD, Memorial Sloan Kettering Cancer Center, New York, New York | Posted on: 18 May 2023
The Urological Society of India National Congress (USICON) was held February 2-5, 2023, in Gurugram, India, just outside New Delhi. USICON is an annual regional showcase focused primarily on India but also including many other countries from the region. The AUA participated in many meaningful ways and as part of the AUA delegation, I had the opportunity to take part in named lectures, panel discussions, and courses for trainees and attendees which I will highlight below.
The AUA lecture was titled Male Urinary Incontinence: Current State of the Art. This was an overview of the current state of management and prevention of male incontinence and largely sourced from the recent AUA/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction clinical practice guideline titled Incontinence After Prostate Treatment.1 The natural history of urinary function recovery after prostatectomy, risk factors for urinary incontinence, as well as management of persistent stress and urgency urinary incontinence were some of topics addressed. Formal urinary function rehabilitation and prehabilitation as part of prostate cancer treatment programs were also topics that generated interest, as was the impact of adjuvant or salvage radiotherapy—namely, that it arrests urinary function recovery.
A separate AUA/Urological Society of India (USI) session was also held at the meeting, which included a panel of experts that discussed practical evidence-based guidelines for specific urology scenarios. Male and female lower urinary tract symptoms, prostate cancer screening, and urethral strictures were just some of the topics that were presented. Specific differences between the Indian and American populations were also addressed, including the differences in rates of prostate cancer in men with elevated PSA and differences in rates and presentation of urethral stricture between the two populations.
Male Incontinence-Management Issues was also a part of the AUA/USI session. I was asked to give a presentation on incontinence post-transurethral prostatectomy/post-radical prostatectomy—evaluation, imaging, and urodynamics (UDS). This presentation focused on the important role of history and timing and degree of incontinence in the evaluation of patients suffering from urinary incontinence. Imaging plays a minor role and UDS is considered optional, but specific scenarios where it can be helpful such as in radiated patients were illustrated. Another talk on Management—Artificial Urinary Sphincter detailed the preoperative issues, operative technique, and postoperative complications related to implantation of an artificial urinary sphincter. In addition to step-by-step technique, management of device failure via an algorithmic approach was highlighted.
I also took part in multiple other panel discussions and courses. Specifically, the Masterclass in Benign Prostatic Hyperplasia was a case-based panel discussion with panelists from the UK, US, India, and other regional countries. We focused on diagnostic dilemmas within male lower urinary tract symptoms/benign prostatic hyperplasia and differences in patients from various parts of the world. Multiple techniques including transurethral prostatectomy, laser vaporization, laser enucleation, and robotic simple prostatectomy were discussed along with indications and cautions with each of the modalities.
A course on Urodynamics Made Easy was tailored toward trainees, and I spoke about voiding cystometrogram, electromyogram, video UDS, and urethral pressure profile. This was an excellent course that went over basics of a UDS procedure as well as definitions of various UDS parameters. Abnormal values were defined along with corresponding clinical scenarios. Case-based discussion was held at the end of this course and audience questions were answered.
In addition to the scientific sessions, there was a large exhibit hall with local medical device and pharmaceutical companies. Social sessions were also held as part of USICON, including multiple faculty dinners where international faculty were recognized. The USI leadership did a tremendous job in hosting this meeting, and it was an excellent opportunity for the AUA participants to meet old friends and make new ones. I will remember my time at USICON fondly for years to come!
- Sandhu JS, Breyer B, Comiter C, et al. Incontinence after prostate treatment: AUA/SUFU Guideline. J Urol. 2019;202(2):369-378.