JU Open Plus: Section Meetings—Science, Practice Improvement, and Networking

Abstract

SEPTEMBER 2023 ISSUE REVIEW We start our September issue review with the research communication from Takahara et al from Japan.1 The article reviews the needs for minimally invasive surgeons to offer partial nephrectomy, when indicated, and to achieve a trifecta of warm ischemia time <25 minutes, negative surgical margins, and no complications. They report on an early experience with a 3D workstation product called Atrena. I am sure you have to see it in person to appreciate its contribution. From the article's figure, the surgeon can have this program on a tablet nearby and rotate, zoom, and make some structures translucent. Images can then be pushed into the daVinci console with TilePro. They present an early experience of 15 cases, with 14 achieving the “trifecta.” Intraoperative navigation will certainly be a hot topic for the foreseeable future to augment the improvements realized thus far in surgical vision and ergonomics. JU Open Plus will have several articles types to publish research including reviews, hypothesis-generating study, clinical trials, and videos as manuscripts. We have 2 interesting case reports. Cohen et al2 report on a rare case of metastatic clear cell renal cell carcinoma within Birt-Hogg-Dube syndrome. The interests in the case are the genetic mutations identified that were common to bilateral renal lesions and a brain metastasis. The discussion emphasizes germline testing for multifocal or bilateral renal cell carcinoma and the possibility of clear cell histology with Birt-Hogg-Dube syndrome. Faber et al3 report on primary renal neuroendocrine tumor causing Zollinger-Ellison syndrome. Primary renal neuroendocrine tumors are very rare and generally treated surgically. The gastrin-secreting tumors will have gastrointestinal symptoms as described. With early detection, this lesion was amenable for partial nephrectomy. If you are in board review mode, see their figure 2 with an octreotide scan–positive lesion due to somatostatin receptor avidity. For original articles, Rasheed et al4 studied the emerging field of telemedicine: What are the barriers to successful connections? For our system, I see patients mostly struggling with how to turn on their camera or microphone. In this study, a volunteer medical student group was working with groups including geriatric and pediatric patients. They break it down into 4 themes: completing registration, familiarity and access to video conference software, proxy access for pediatric patients, and various technical questions. They present an algorithm and discussion on pathways to success. As a sign of the times, my institution is not only expanding telemedicine visits and access but also starting to credential the staff in multiple states to expand our reach. Norman et al5 pose a long-standing question in prostate cancer diagnostics—What to do with results that are not cancer but are not “not” cancer either. The tracked patients had high-grade prostatic intraepithelial neoplasm, atypical small acinar proliferation, or both. With available follow-up biopsies form a large Veterans Affairs Medical Center cohort, they observed a 3 to 9 years of interval in finding clinically significant cancer depending on these risk factors in primary biopsy. They conclude that immediate repeat biopsy might not be necessary, and modern practice updates, such as MRI and secondary biomarkers, may give clinicians additional risk classification tools. Gabrielson et al6 performed a health services research study on the focused question as to whether testosterone replacement therapy in hypogonadal men affects artificial urinary sphincter complications. They propensity matched 504 eugonadal and 504 hypogonadal patients. They found no differences in the key areas of complications—all-cause revision, mechanical failure, erosion, infection, or surgical site infections. Their data come from the TriNetX LLC Research Network which provides electronic medical records for more than 111 million patients from 92 health care organizations. There are different findings in the literature, and they discuss these variations and methodology topics. SEPTEMBER 2023: PEOPLE PLACES AND THINGS The American Urological Association has 7 unique sections that divide up the United States, Canada, Mexico, and Central America. Many sections meet during the Fall Season. I grew up in the Mid-Atlantic section, and my residency program at Eastern Virginia Medical School has always been supportive of the section and has had several past presidents including Michael Fabrizio (2018), Paul Schellhammer (1994), Patrick Devine (1974), and current AUA Board of Directors Representative Kurt McCammon. I have been in the South Central Section (SCS) since 2006 and recently completed the executive leadership tract as immediate past president. Of interest, I am the first MD Anderson Cancer Center faculty to be an SCS president. However, I am not the first John Davis—no relation to my namesake—who served 1940 to 1941! AUA sections serve a number of key purposes. The science and practice building content is important to all practicing and academic urologists. Many urology residents present their first research at a section meeting. The networking is highly rewarding—both among the attending urologists and the many spouses/significant others who attend every year. For this issue, I will highlight some people/places/things pictures from our recent 102nd meeting in Austin, Texas, under the leadership of President Chad LaGrange (Nebraska) and Fernando Kim (Colorado—also our JU Open Plus Associate Editor). For the featured people, there were so many pictures to choose from at a meeting like this. Figures 1 and 2 are from the board of directors/past presidents' dinner. Figure 3 highlights the popular plenary formats of debates and challenging case discussions. Figures 4-6 highlight notable meeting events such as the Society of Mexican Urology breakfast, morning yoga, and guest speakers. For places, Figure 7 highlights some Austin sights such as the downtown skyline and the University of Texas at Austin. Figure 8 highlights some fun “things” that added to the meeting experience.Figure 1.: PEOPLE. The 2023 South Central Section of the AUA kicked off with a Board of Directors/Past Presidents Dinner. The event features a “fun” topic presentation by a past president. This year Arturo Mendoza-Valdes (president 2004-2005) from Mexico gave us a primer on Tequila—complete with history, production, and tasting.Figure 2.: PEOPLE. SCS Past Presidents attending the 2023 Austin Meeting: Left to Right John Davis (2022), Mike Cookson (2021), Tim Langford (2018), Tomas Griebling (2019), Dmara Kaplan (2015), James Wendelken (2002), Arturo Mendoza-Valdes (2005), Brian Flynn (2017), Allen Morey (2013), and James Cummings (2020).Figure 3.: PEOPLE. Functional Urology Block: Oluwarotimi Nettey (Houston) discusses how to fix radiated fistula.Figure 4.: PEOPLE. The Society of Mexican Urology always brings a large group of faculty, residents, and abstracts. They have their own breakfast meeting as pictured. Their featured plenary speaker was Dr Grisel Hernandez (seated left).Figure 5.: PEOPLE. Morning yoga overlooking downtown Austin. Wellness has been a focal point of the SCS program.Figure 6.: PEOPLE. Visitors! A highlight of all section meetings is to learn from out of section experts. 6a: John Mulhall (New York). 6b: Jeff Karnes (Minnesota). 6c: Inderbir Gill (California). 6d: President Chad LaGrange with Guest Speaker Lou Kavoussi (New York).Figure 7.: PLACES. Austin, Texas, makes a great venue for a section meeting—a growing city featuring outdoor activities, BBQ, the Capitol of Texas, and the University of Texas at Austin. Figure 7a: The Austin skyline and Lady Bird Lake. Figure 7b: The Littlefield Fountain—a World War I memorial at the South Mall leading to the University of Texas at Austin Tower. The tower is lit burnt orange on days of celebration—a mix of academic and athletic celebrations.Figure 8.: THINGS. Interesting “things” from the 2023 SCS meeting: Figure 8a: Tequila tasting. Figure 8b: Dr. Damara Kaplan wins an SCS branded Yeti Tumbler. Figure 8c: Themed night entertainment included armadillo races.