043IC - Genitourinary Cancer Survivorship: A Practical Master Class

This course will offer learners an outline and model for establishing comprehensive and multidisciplinary genitourinary (GU) survivorship care in the context of modern urologic practice. Increasingly, cancer centers around the world are recognizing the importance of the complex quality of life issues impacting cancer survivors.

• The course will start with an interactive discussion and breakout session on the current state of survivorship care, and identifying knowledge gaps and areas for future research

• Dr. Peterson will discuss his experience establishing a survivorship program at Duke University, a practical “how to” for starting a successful survivorship program and how to apply this to a urology practice. He will also detail the necessary resources and inter-departmental collaboration required for survivorship care, including identifying like-minded physicians and creating a multidisciplinary team to discuss the impact on residency and fellowship training with establishment of a survivorship program

• Dr. Benson will discuss the evaluation and management of the devastated urinary outlet in prostate cancer survivors, which is germane to all urologists. He will detail proposed treatment approaches and practical considerations in management. He will discuss the role of endoscopic treatments, laparoscopy and other reconstructive techniques, including supra-vesical diversions. This presentation will include interactive case presentations with audience participation to reinforce take home messages.

•Dr. Brandes will present his experience and current literature on the management of inter-symphyseal and urorectal fistulas in the cancer survivor, which significantly impact quality of life. He will also discuss important factors to consider before offering reconstruction and shared decision making based on factors such as baseline bladder function, etiology, patient co-morbidities and cancer treatment history. Illustrative cases will be presented on the multidisciplinary medical and surgical management, as well as the reconstructive principles and techniques, with case examples and including interactive audience participation

•Dr. Sukumar will present the long-term issues related to urinary incontinence and continent urinary diversions in cancer survivors. Detailed illustrative cases will be presented as to how to evaluate and manage stomal complications in urinary diversions, and the surgical reconstructive options. He will highlight the outcomes of orthotopic neobladders and management of incontinence/hypercontinence. Evaluation and management of ureteral strictures after urinary diversion, including reconstructive techniques, will be presented along with associated case presentations

•Dr. Alukal will address the consequences of pelvic surgery, radiation, and chemotherapy on male fertility in childhood cancer survivors and testicular cancer survivors. He will review the role of sperm banking, testicular sperm extraction and future roles for germ cell culture in research. Management of retrograde ejaculation and emission issues will be detailed. He will also present the overall schema of shared decision making, taking into account future fertility, when making cancer treatment decisions . Case examples of practical cases will be offered with interactive audience participation
presentations with audience participation to reinforce take home messages.

•Dr. Brandes will present his experience and current literature on the management of inter-symphyseal and urorectal fistulas in the cancer survivor, which significantly impact quality of life. Discussion of important factors to consider before offering reconstruction and shared decision making based on factors such as baseline bladder function, etiology, patient co-morbidities, and cancer treatment history. Illustrative cases will be presented on the multidisciplinary medical and surgical management, as well as the reconstructive principles and techniques, with case examples and including interactive audience participation
•Dr. Sukumar will present on the long-term issues related to urinary incontinence and continent urinary diversions in cancer survivors. Detailed illustrative cases will be presented as to how to evaluate and manage stomal complications in urinary diversions and the surgical reconstructive options. He will highlight the outcomes of orthotopic neobladders and management of incontinence/hypercontinence. evaluation and management of ureteral strictures after urinary diversion, including reconstructive techniques will be presented, along with associated case presentations

•Dr. Alukal will address the consequences of pelvic surgery, radiation and chemotherapy on male fertility in childhood cancer survivors and testicular cancer survivors. He will review the role of sperm banking, testicular sperm extraction and future roles for germ cell culture in research. Management of retrograde ejaculation and emission issues will be detailed. Will also present the overall schema of shared decision making, taking into account future fertility when making cancer treatment decisions . Case examples of practical cases will be offered with interactive audience participation