SPECIALTY SOCIETIES The International Neuro-Urology Society Annual Congress
By: Blayne Welk, MD, MSc, Western University, London, Canada; Glenn Werneburg, MD, PhD, Cleveland Clinic Foundation, Ohio | Posted on: 19 Sep 2023
The International Neuro-Urology Society (INUS, www.neuro-uro.org) was established in 2015, and is a medical society with the aim to improve and promote the medical care for patients suffering from neuro-urological disorders worldwide. Its current president, Dr Thomas Kessler, and the scientific committee (Dr Jorge Moreno-Palacios and Dr Apostolos Apostolidis), in partnership with the local organizers (Dr Charalampos Konstantinidis and Dr Michael Samarinas) were honored to host researchers and clinicians from around the world in Athens, Greece, from June 8-10, 2023.
The scientific program started with specialized multidisciplinary workshops (urodynamics, neuromodulation, neurosciences, translational research, and pediatrics) that brought together smaller groups with a shared interest in these focused and in-depth programs (Figure 1). Importantly, a workshop specifically for urological nurses was also hosted, and covered topics such as teaching intermittent catheterization and counselling people with frequent urinary tract infections. The main program included 3 keynote lectures. The first, given by Dr Lori Birder, examined the role of purine nucleoside phosphorylase in age-related changes and detrusor underactivity, and the results of some fascinating preclinical studies that demonstrated these changes can be prevented with 8-aminoguanine. Second, Dr Andrei Krassioukov (physical medicine and rehabilitation specialist) explored the detailed impact of autonomic dysreflexia on people living with spinal cord injury, and how to best manage this condition when it is triggered by urological procedures or complications. Finally, Dr Karl-Dietrich Sievert reviewed clinical targets and unmet needs for neuromodulation in the neurological population.
This congress also represented the first time INUS hosted the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction lecture, which was given by Dr David Ginsberg (Figure 2); Dr Ginsberg discussed the significant economic burden of treatment and rehabilitation for neurogenic lower urinary tract dysfunction, and its associated bladder drainage assistance. Other partner societies were also invited to participate in the program, including the Turkish Association of Urology (Dr Taahra, “Which urodynamic parameters matter in the neurogenic population”), the International Continence Society (Dr Konstantinidis, “Highlights on neurogenic incontinence and sexual dysfunction”), the Pan-Arab Continence Society (Dr al Mousa, “Bladder augmentation and renal transplant in the neurogenic population”), the Iranian Urology Association (“Challenges in the treatment of neuro-urological sexual dysfunction in women in the Islamic world”), the Société Internationale d’Urologie (Dr Principe, “Management of urethral and stoma complications in neuro-urological patients”), and, finally, the Urodynamic, Neurourology & Female Urology section of the Hellenic Urological Association lecture (Dr Apostolidis, “QoL, decision-making for treatment and treatment adherence in patients with multiple sclerosis/NLUTD”). All of these societal partnerships help bring together experts from around the world, and contribute to the rich and highly specialized neuro-urology program.
The program also included a series of nonsociety lectures and panel discussions. For the first time, there was a session dedicated to pediatric neurogenic lower urinary tract dysfunction (NLUTD). Dr Stacy Tanaka discussed the workup and management of neurogenic incontinence in children and adolescent patients. This was followed by an engaging panel for the discussion of challenging cases moderated by Dr Anastasios Karatzaz. Joining Dr Tanaka were panelists Dr Stuart Bauer, Dr Carlos Estrada, Dr Giovanni Mosiello, and Dr Christian Sager. An additional session focused on sexual dysfunction associated with spinal cord injury and other neurogenic pathology and a panel moderated by Dr Desiree Vrijens with panelists Dr Nikolaus Sofikitis, Dr Bertil Blok, Dr Razvan Bardan, Dr Claire Hentzen, and Dr Charalampos Konstantinidis. An additional highlight of the scientific program was a lecture by Dr John Stoffel on the value and utility of the postvoid residual volume in individuals with NLUTD who do not catheterize. He discussed the importance of risk stratification and careful assessment of symptomatology in the clinical decision-making of those with elevated postvoid residual volumes. Neurologist Dr Jalesh Panicker discussed recent research and advances in the understanding of the central control of micturition, and medical physicist Dr Gergely David discussed novel MRI techniques to investigate the pathophysiological mechanisms of spinal cord injury and its relationship to NLUTD. Dr Blayne Welk moderated a Balloon Debate: “Clinical Conundrums in Neuro-Urology.” The premise of the debate is that each panelist presents and supports his or her response to a clinical case question regarding workup or management. The audience then votes for the favorite response, and the panelist with the fewest votes leaves the balloon. The process continues until the balloon only contains the winner. There was robust audience engagement in the session, and multiple votes for all panelists: Drs Emmanuel Braschi, Giulio Del Popolo, Michael Samarinas, and John Stoffel.
Forty-five posters were presented during the Congress. The poster sessions provided a venue for selected abstract submitters to present their latest work. The work ranged from basic science, including a study of a novel reporter-bacteriophage bioluminescent assay to detect bacterial urinary tract infections as presented by Dr Lorenz Leitner, to clinical studies such as the validation of the irritable bowel syndrome quality of life questionnaire in the spinal cord injury population, presented by Dr David Ginsberg.
On the final day of the Congress, the Swiss Continence Foundation selected its 2023 awardee. The Swiss Continence Foundation seeks to support and advance the research and education within the field of neuro-urology and functional urology to improve the quality of care and quality of life with those afflicted with neuro-urological conditions. Its award, which totals 10,000 Swiss francs (approximately $11,200 USD), is awarded annually to the best contribution by a young neuro-urology talent. To select the winner, the Swiss Continence Foundation assembled an independent jury consisting of Drs Martina Liechti, Andrea Sartori, John Stoffel, Jalesh Panicker, and Glenn Werneburg. The jury was moderated by Dr Ulrich Mehnert. The awardee was selected based on the curriculum vitae and a submitted abstract, as well as a research presentation and responses to inquiries of the jury and the general audience. The winner of the 2023 Swiss Continence Foundation Award was Dr Claire Hentzen for her work on the utility of pelvic neurophysiology in the assessment of Tarlov cysts and their relationship with pelvic symptoms (Figure 3).
Finally, the next INUS Annual Congress location was announced. For its 10th anniversary, the INUS Annual Congress will take place back at the location where it was established: Switzerland. The INUS Board (Figure 4) welcomes all those with neuro-urological interest to attend in the winter of 2025.