By Thomas Ellul, Specialist Registrar in Urology, Wales Deanery.
The New Year brings with it the opportunity for urologists in Wales to congregate and discuss the events of the previous year as well as current research, guidelines and hot topics. This year was no different and so the migration took place to the inimitable Metropole Hotel and Spa situated in the beautiful mid-Wales countryside. The proceedings began with a valuable update on the outcomes for radical radiotherapy and radical surgery for prostate cancer. Dr Tanguay (Clinical Oncologist, Velindre Cancer Centre) and Mr Narahari (Consultant Urologist, Cardiff) presented the most recent outcome study data for each treatment modality, respectively. Dr Tanguay also enlightened the (mostly surgical) audience on the feasibility of the use of stereotactic ablative radiotherapy (SABR), a radiotherapy technique which is already being well utilised in other conditions, but shows exciting potential for use in oligometastatic prostate cancer. Following this session, the short paper presentations were undertaken by trainees from around Wales. Given the upcoming changes in National Institute for Health & Care Excellence (NICE) guidelines it is perhaps unsurprising that multi-parametric MRI scanning for the diagnosis of prostate cancer was the theme for several papers, however there was an excellent breadth of variety; from an andrological bibliometric analysis (Nicholas Bullock, Academic Registrar in Cardiff) to frozen section analysis in penile cancer surgery (Thomas Ellul, ST4 in Llantrisant). The Huw Williams prize for best abstract was awarded to Matthew Jefferies (ST7 in Cardiff) for his presentation regarding the histological and patient factors important for predicting response to neo-adjuvant chemotherapy for muscle-invasive bladder cancer. The day concluded with a presentation by Dominic Teichmann (ST6 in Newport) giving us an insight to his Out-of-Programme experience working with Urolink and providing support and training to urologists in Zambia, Ethiopia, and Tanzania. This was a fascinating insight into the incredible work done by Urolink and a poignant reminder that although circumstances may often be challenging in the NHS, we are extremely fortunate to have the resources that are available to us.
The evening dinner and drinks gave a welcome opportunity for colleagues and friends to catch up and reflect on the topics of the day as well as visit the trade exhibits in place from the conference sponsors.
The following day began with an update on the changes expected to NICE prostate cancer guidelines presented by Professor Kynaston (Consultant Urologist, Cardiff). This presentation also gave insight into the vast amount of work and organisation that is required before any changes to guidelines can be completed. It was certainly eye opening to learn that the NICE panel have access to pre-published and even unpublished data which may inform decisions on recommendations.
Following Professor Kynaston’s presentation, we had our first non-Wales based speaker – an extremely informative talk by Mr David Ralph (Consultant Andrologist, UCL hospitals, London) who gave an overview of common andrology scenarios and conditions which was certainly beneficial for all trainees, and allowed for specific questions regarding the management of complicated andrology patients. As a trainee with an interest in andrology, this certainly gave me food for thought.
The meeting closed with a panel discussion chaired by Ms French (Consultant Urologist and Urology lead for Welsh Cancer Network) regarding the proposed changes to pathways for all urological cancers. This was an opportunity for urologists from all over Wales to discuss amendments to the pathways to most benefit patients, as well as allowing for sensible deviations from current pathways as informed by recent evidence. This session certainly led to lively debate and will undoubtedly provide useful information to the cancer-pathway committee.
In conclusion, the meeting was an excellent opportunity for urologists to discuss and debate the management of a variety of conditions and gave ample learning opportunities for trainees. It was also refreshing to see excellent representation from clinical nurse specialists at the meeting, as the backbone of many urological clinical activities it is invaluable to have them present at such events. I would like to thank the consultants at the Royal Glamorgan Hospital who organised this year’s meeting, and give special thanks to Janine Hillier and Mr Fenn (Consultant Urologist, Swansea) without whom the event would never have taken place.