It’s an honor to collaborate with the AUA to bring you the Society of Genitourinary Reconstructive Surgeons (GURS) session at the Annual Meeting in San Antonio. Reconstructive urology has continued to evolve and expand as a discipline both in training and scope of practice. The GURS session during AUA2024 will focus on a broad range of challenging topics that reconstructive urologists face on a regular basis, including patients with complex male sexual dysfunction, genitourinary injury, incontinence after prostate cancer treatment, phalloplasty for gender-affirming surgery, and urethral stricture.

The first session will begin with the honorary F. Brantley Scott Lecture. This lecture is named after the late Professor Scott, an eminent trailblazer in the treatment of incontinence and sexual dysfunction through his remarkable and now standard of care prosthetic devices. This annual lectureship is given by distinguished speakers who have made substantial impacts in the field of reconstructive urology. This year the presenter will be Dr Allen Morey, a highly accomplished innovator in the field of reconstructive urology. His lecture, titled “Contemporary Management of Priapism,” will focus on new developments for this often challenging condition. Successfully treating refractory priapism requires striking the correct balance between efficiently achieving detumescence and preserving sexual function.¹ This lecture will be moderated by past GURS president Dr Francisco Martins and is guaranteed to be informative and riveting.

Next up will be a session addressing “Complex Issues in Genitourinary Prosthetics: Male Sexual Health,” moderated by Dr Jay Simhan. While implantation of an inflatable penile prosthesis is an effective treatment for refractory erectile dysfunction, the optimal methods to meet patient expectations in difficult scenarios remain elusive.² This panel discussion will focus on achieving improved outcomes of penile prosthesis for those patients with prior infection, severe Peyronie’s disease, corporal fibrosis, or loss of penile length. This session is certain to be worth your while.

The next session will focus on “Reconstructive Urology and War Zone Trauma.” War extracts a toll in many ways, but complex genitourinary injuries have become a devastating aspect of modern warfare.³ These traumas are often associated with concurrent injuries and negatively impact a patient’s sense of self with profound identity loss. This panel is composed of surgeons who have treated patients impacted by the Ukraine-Russian war on the front lines. Drs Damian Lopez, Artem Kobirnichenko, Volodymyr Bondarchuk, and Aditya Bagrodia will share their insights gathered from reconstruction of genitourinary injuries from the ongoing war in Ukraine.

Despite recent trends with respect to declining PSA screening, increased active surveillance, and refinements in curative therapies, incontinence remains a profound issue after prostate cancer treatment.⁴ The increasing use of radical prostatectomy in patients with high-risk cancer and salvage local therapies has resulted in increased complexity and complication risk in patients presenting with urinary incontinence after prostate treatment.⁵ The best way to optimize the lower urinary tract prior to surgical intervention warrants further attention. For example, when is it safe to offer treatment for incontinence to patients with evolving comorbidities, concurrent urethral stenosis, detrusor dysfunction, or previous cuff erosion? Determining the limits of surgical intervention, setting expectations, and deciding when “enough is enough” is a delicate issue. The panel titled “State of the Art: Treatment of Incontinence After Prostate Cancer Treatment” led by Dr O. Lenaine Westney and composed of key opinion leaders will tackle these critical questions.

For the patient undergoing masculinizing gender affirmation surgery, creation of the ideal phallus remains in many ways the “Mount Everest” of reconstructive urology. The “State of the Art Phalloplasty Techniques and Current Challenges” session moderated by Dr Rajveer Purohit will discuss critical modifications and interactively discuss the best approach to build an ideally functional and aesthetically appealing phallus.

Urethral stricture is a common condition that causes a broad spectrum of symptoms, signs, and complications with an associated reduction in patient-reported quality of life.⁶ While urethral reconstruction is broadly considered the most efficacious treatment of recurrent stricture, there are instances where the best approach is unclear.⁷ The session, “Challenges in Urethral Reconstruction,” moderated by Dr Lindsay Hampson will tackle scenarios involving unique treatment considerations such as revision urethroplasty, complete urethral loss, recurrent fossa navicularis strictures, and where to begin in patients with panurethral stricture and buried penis.

As always, the sessions will have plenty of time for interaction and discussion. Additionally, we will provide updates on GURS initiatives such as the clinical trials initiative, women of GURS, the Young Reconstructive Urologist Committee, and the Global-GURS meeting that we are co-planning, which is scheduled for October 9 to 11, 2024, in Antwerp, Belgium. This meeting will bring the world’s reconstructive urology experts together for the first time to share innovations and enhance worldwide collaboration in our field.

Please join us at AUA 2024 as we delve into the unique challenges facing reconstructive urologists today. Everyone is welcome!