Support provided by independent educational grants from AbbVie, Amgen, Astellas, AstraZeneca, Bristol-Myers Squibb, Genomic Health, Genentech, Merck, Pfizer, Inc. and Sanofi Genzyme 

CME Available: https://auau.auanet.org/content/aua-castration-resistant-prostate-cancer-crpc-guidelines-and-therapeutic-advances-metastatic

Instructional Course Director(s)
Michael Cookson, MD, MMHC
Professor and Chair
University of Oklahoma

Instructional Course Faculty(s)
David Jarrard, MD
University of Wisconsin


Adam Kibel, MD
Brigham Health, Harvard University


William Lowrance, MD
University of Utah, Huntsman Cancer Institute

This course will review the important and newly updated 2018 AUA Guidelines on Castration-Resistant Prostate Cancer. This includes a thorough discussion of new trials and approval of agents for MO non-metastatic nmCRPC. In addition, we will review therapeutic breakthroughs in the management of advanced and metastatic hormone naïve prostate cancer (mHSPPC). Faculty will highlight the management of patients with advanced prostate cancer, including mHSPC, nmCRPC, and CRPC, and how therapeutic options have been incorporated into evidence-based guidelines. Also, the role of genomic classifiers and genetic testing in the evaluation of CRPC, as well as discuss new developments and future research needs for this topic. The course will showcase clinical scenarios in urological practice and the correct application of the new AUA CRPC guidelines in those instances. This course will be a benefit to practicing urologists, oncologists, advanced practice providers, and residents/fellows preparing for their certification exam and physicians preparing for their re-certification exam.


 

Learning Objectives:
Identify the active agents and their mechanism of action in the management of nmCRPC and mCRPC
Understand the sequencing and indications for active treatment with approved agents in the management of nmCRPC
Analyze the evidence and outcomes on the treatment of MO and M1 CRPC as outlined in the newly updated AUA CRPC guidelines
Improve diagnostic and therapeutic decision making processes by illustrating the application of these guidelines in urological practice
Understand and analyze breakthrough treatments in the management of advanced and metastatic hormone naïve prostate cancer

AUA2019 027IC AUA CRPC Guidelines And Therapeutic Advances In Metastatic Prostate Cancer

Co-Host: Dr. Rena Malik, Assistant Professor of Surgery, Division of Urology and Director of Female Pelvic Medicine & Reconstructive Surgery at University of Maryland School of Medicine

Increasing Workplace Diversity - Attracting And Retaining Women And Minority Urologists

South America
Panelist: Marcio A. Averbeck, MD, MSc, PhD
UK
Panelist: Tamsin J. Greenwell, MBChB, MD FRCS(Urol)
Canada
Panelist: Blayne K. Welk, MD
Continental Europe
Panelist: Matteo Balzarro, MD

Blayne K. Welk, MD
St. Josephs Hospital
London, ON
Consistent with many other societies, the Canadian Urology Association supports the use of midurethral synthetic slings for the treatment of stress incontinence. However, these procedures have decreased substantial over the last 10 years in Canada in response to public awareness of the legal cases and the North American regulatory warnings. 

Marcio A. Averbeck, MD, MSc, PhD
Moinhos de Vento Hospital
Porto Alegre, Brazil
According to a cross-sectional study, which used a 37-item internet-based survey applied to members of urologic and gynecologic associations from 18 countries in Latin America, most participants (75.2%) indicated that the use of mesh has declined after FDA warnings, and 41.9% considered this has had a negative effect in the use of midurethral synthetic slings (MUS) as well (1). One of the largest series of MUS in Southern Brazil has been presented during the 2014 ICS Annual Congress in Rio de Janeiro (2). From January 2008 to December 2013, 315 patients underwent TOT implantation at a single terciary hospital. Mean age was 58.66±11.87 years. Postoperative continence rate was 78% at a mean follow-up of 33.83±20.67 months (6 to 72 months). Surgical complications were found in 17.4% of patients. Most frequent complications were dyspareunia (16 cases), groin pain (12 cases), new
onset of recurrent urinary tract infections (5 cases), de novo urgency (5 cases), vaginal erosion (3 cases) and persistent urinary retention requiring urethrolysis (3 cases). 90.3% of patients stated that they did not regret undergoing TOT implantion and were happy with their surgical outcomes.
Consistent with many other international medical societies, the Brazilian Society of Urology (SBU) still supports the use of midurethral synthetic slings for the treatment of stress urinary incontinence in women. However, public hospitals usually have budget restrictions and the ‘mesh controversy’ has been perceived as an excuse to postpone regular acquisition of surgical materials (eg. synthetic sling kits). Curiously, the decision-making process for surgical interventions is mostly surgeon-centered in most South-American countries.

References
1. Plata M, Bravo-Balado A, Robledo D, Castaño JC, Averbeck MA, Plata MA, Cataño JG, Caicedo JI, Trujillo CG. Trends in pelvic
organ prolapse management in Latin America. Neurourol Urodyn. 2018 Mar;37(3):1039-1045. doi: 10.1002/nau.23392. Epub 2017 Sep 6.
2. Averbeck MA, Wachter L, Dörr D, Schneider N, Ramos J, Ledesma AG, Prado Schmidt A, Camargo SF. Long-term outcomes of
transobturator tension-free midurethral slings for the surgical treatment of stress urinary incontinence in women. Podium presentation
during ICS Congress in Rio de Janeiro (2014). Session 16; abstract 271.

SUFU20: International Perspectives on the Use of Synthetic Mesh Slings

The official podcast of the Society of Urodynamics, Female Pelvic Medicine &  Urogenital Reconstruction. Listen here monthly for member spotlights, helpful information for physicians and providers practicing Female Pelvic Medicine & Reconstructive Surgery (FPMRS) and residents interested in FPMRS. Also find patient-centered podcasts on topics such as overactive bladder, urinary incontinence, pelvic organ prolapse, neurogenic bladder, benign prostatic hyperplasia and more! 
Views expressed by hosts or interviewees on the podcast do not directly reflect the views of the SUFU organization.

SUFU20: International Perspectives on the Use of Synthetic Mesh Slings

SUFU podcast

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