Urology on the Beach Meeting Highlights Innovative Approaches to Multidisciplinary Care

Newswise — Renowned urologists from leading academic centers shared their insights and clinical recommendations at Urology on the Beach, a three-day professional conference hosted by the Desai Sethi Urology Institute (DSUI) at the University of Miami Miller School of Medicine.

The program covered artificial intelligence (AI), translational research and recent findings in virtually every urology subspeciality, including oncology, benign disease processes, male health and female surgery.

“Our conference brought together a who’s-who of urology, along with our own outstanding faculty,” said Dipen J. Parekh, M.D., DSUI’s founding director and chief operating officer, UHealth—the University of Miami Health System.

The second annual Urology on the Beach conference on January 19-21 at the Fontainebleau Hotel, Miami Beach, drew 300 professionals, more than doubling the number of attendees at the inaugural 2023 conference. Sylvester Comprehensive Cancer Center, part of the Miller School, was the lead sponsor, reflecting the importance of collaboration in oncology research and patient care.

Urology’s Leading Specialists

Urology on the Beach gave general urologists a chance to hear from top specialists about diagnosing, treating and managing patient conditions they see frequently, said co-course director Bruno Nahar, M.D., assistant professor of urologic oncology and the Eric and Elizabeth Feder Family Endowed Chair in Urologic Oncology Research at the Miller School.

“I think everyone who attended our conference came away with new knowledge,” added co-course director Raveen Syan, M.D., assistant professor of clinical urology at the Miller School.

Conference attendees applauded the multidisciplinary aspect of the institute’s program.

“Bringing together experts from different fields makes this a great resource for professionals to learn different approaches and procedures,” said Ted Schaeffer, M.D., Ph.D., chair of urology at Northwestern University.

Joel Sheinfeld, M.D., deputy chief of urology at Memorial Sloan Kettering Cancer Center in New York, said the conference offered highly relevant basic, translational and clinical findings.

“With a great program and well-known speakers, this conference has a tremendous impact in providing guidance to the urology community,” he said.

State of Urology Survey

Urology on the Beach attendees received an early look at the institute’s inaugural “State of Urology” survey, with 93 percent of respondents agreeing that working with other medical specialties is crucial for managing complex urological cases. Nearly half of urologists in the survey identified the development of AI as the most impactful trend in the coming years, and 87 percent plan to integrate AI and machine learning into their practices in the next three years.

 “Our survey results underscore the critical role that multidisciplinary collaboration and emerging technology will play in the future of urology, both central elements of our institute’s approach,” said Dr. Parekh, also professor and chair of urology, director of robotic surgery, The Victor A. Politano Endowed Chair in Urology and executive dean, clinical affairs for the Miller School. “Our survey also showed the vital need to improve patient access to urological care. There is a huge demand for our services and we may need a broader focus to accommodate that need.”

AI’s Role in Modern Urology Care

With an overall conference focus on innovation, one of the most popular and engaging sessions was on “AI-Driven Innovations in Surgery,” moderated by Dr. Parekh and Archan Khandekar, M.D., clinical instructor at the Miller School. Noting the explosion of interest in generative AI tools like ChatGPT, Dr. Nahar said these applications can be very effective for patient charting and other back-office work.

“It saves me a lot of time, and can certainly lessen the physician’s burden,” he said. “That’s important because one the big workforce problems we face is physician burnout – not from seeing patients but from the documentation work. This is one area where AI can help.”

Giovanni Cacciamani, M.D., associate professor of research urology at the University of Southern California, agreed, called AI “the perfect copilot” for improving workflow and patient care. But in his presentation, “Current AI Applications in Urology: Clinical and Ethical Perspectives,” Dr. Cacciamani cautioned that clinicians and researchers need to look closely at what data was used to train an AI model and why that information was selected.

Surgical and Innovation Theatre

Another addition to the conference was a surgical and innovation theatre, which allowed exhibitors to provide hands-on workshops as a venue for residents and fellows showcase their work.

“Trainees at a wide range of institutions showcased their interesting cases and relevant research in keeping with our focus on collaboration,” said Dr. Nahar. “We all benefit from learning about research being done at other top urology institutes.”

For instance, Jefferson Hwang, M.D., from Houston Methodist Hospital, covered surgical issues related to aquablation therapy using heat-free, high-velocity water jets to treat benign prostatic hyperplasia (BPH), a noncancerous enlargement of the gland. He added that this relatively new procedure can limit damage to surrounding structures and recommended cauterizing the bladder neck to reduce bleeding.

Urologic Cancers

Chad Ritch, M.D., M.B.A., associate professor of urologic oncology at the Miller School, moderated a session on kidney cancer. 

“Kidney cancer is not one disease, so we need to understand the common subtypes and variants as they respond differently to treatment,” said Ari Hakimi, M.D., associate professor at Memorial Sloan Kettering Cancer Center, in his presentation, “Molecular Characterization of Renal Cell Carcinoma: Implications for Management.”

Robert Uzzo, M.D., M.B.A., president and CEO, Fox Chase Cancer Center in Philadelphia, focused on the right treatments for metastatic kidney cancer in his talk, “Immediate Versus Deferred Cytoreductive Nephrectomy: Timing and Indications.” He noted that the recent CARMENA (Cancer du Rein Metastatique Nephrectomie et Antiangiogéniques) clinical trial showed that upfront therapy is equivalent to surgical treatment.

Dr. Nahar and Sanoj Punnen, M.D., associate professor of urologic oncology at the Miller School and DSUI vice chair of research, moderated a session on prostate and testicular cancer that included a panel discussion, “Balancing Functional Outcomes and Cancer Control in High-Risk Cases.”

Looking at the follow-up findings of the ProtecT (Prostate Testing for Cancer and Treatment) prostate cancer trial, Ian Thompson, M.D., professor emeritus, University of Texas in San Antonio, said, “We have more effective therapies for those who develop metastatic disease. However, we tend to overtreat and we need to be sure patients are fully informed about screening benefits and risks.”

Mark Gonzalgo, M.D, Ph.D., professor and vice chair of urology, led a session on bladder cancer. Within that session, Cheryl T. Lee, M.D., chair of urology, The Ohio State University, addressed non-muscle invasive bladder cancer recurrence. Sima Porten, M.D., M.P.H., associate professor of urology at University of California, San Francisco, spoke on management of complete response after neoadjuvant chemotherapy before panelists took a deeper dive in the discussion of challenging cases.

Translational Research in Urology

Nima Sharifi, M.D., Miller School professor and DSUI scientific director, moderated a session on translational research that featured a presentation on the cancer-driving MYC oncogene by Sarki Abdulkadir, M.D., Ph.D., the John T. Grayhack Professor of Urological Research at Northwestern University.

“MYC is the most over-expressed oncogene in human cancer, and is critical in many late-stage, therapy-resistant cancers,” he said. “Tumors are more dependent on MYC than normal cells and reducing MYC levels impairs tumor genesis.”

In the session, Dr. Sharifi presented his work on “Intraoperative Studies on Androgen Physiology in Prostate Cancer,” looking at the impact of local testosterone levels on outcomes of men undergoing radical prostatectomy. He said a better understanding of andogren processes could help identify cancer treatment targets.

Later in the session, Atish Choudhury, M.D., Ph.D., co-director of the Prostate Cancer Center at Dana-Farber Cancer Institute in Boston, discussed how cancer cells release DNA to the bloodstream.

Session on Male and Female Health 

Ranjith Ramasamy, M.D., associate professor of urology at the Miller School and DSUI’s director of reproductive urology, moderated a Friday session on men’s health that covered issues like erectile dysfunction and survivorship after prostate cancer.

“Our presenters, including two women physicians, discussed the latest research, reflecting our institute’s position at the forefront of this field,” he said.

Denise Asafu-Adjei, M.D., M.P.H., director of male reproductive medicine, Loyola University in Chicago, focused on the linkage between erectile dysfunction, cardiovascular disease and prostate cancer.

“This conference is a great venue to learn from each other,” she said. “Seeing what others are doing will help me provide better care to my patients and I encourage more urologists to attend next year.”

Dr. Syan and Katherine Amin, M.D., assistant professor of clinical urology at the Miller School, moderated a session on female urology.

“Our topics included the emergence of mini-invasive, office-based procedures for stress-related incontinence, as well as the management of complex cases,” said Dr. Syan.

Other presentations included novel therapies in neuromodulation using implantable devices placed in the ankle.

Wide Variety of Contemporary Urology Issues

Robert Marcovich, M.D., associate professor of urology and director of the urology residency program at the Miller School, moderated a session on endourology and BPH that included a talk by Hemendra Shah, M.D., professor of clinical urology, on minimally invasive surgical therapies for BPH.

In her keynote presentation, “Management of the Asymptomatic Stone,” Margaret Pearle, M.D., Ph.D., professor of urology at University of Texas Southwestern Medical Center in Dallas, discussed the pros and cons of treating kidney stones before they create problems, noting “it’s hard to make an asymptomatic patient feel better.”

Later in the session, Janak Desai, M.S., M.Ch, Samved Urology Hospital in Ahmedabad, India, discussed the birth of the ultra-mini-percutaneous nephrolitotomy and its widespread global adoption.

Dr. Syan was joined by Laura Horodyski, M.D., assistant professor of urology at the Miller School, for Sunday’s closing session on genitourinary reconstructive surgery.

“Our goal was to raise awareness of treatment options for transgender patients and how community urologists can provide gender-affirming care,” said Dr. Syan. “That might include prostate cancer screening in a transgender woman or treatment protocols for hormonally suppressed patients.”

Reflecting on the conference, Dr. Parekh said he expects Urology on the Beach to continue growing in the future.

“Our attendees were very enthusiastic about the topics and presenters,” he said, noting the importance of sharing knowledge throughout the urology community in improving patient outcomes.

“The success of this conference is testimony to Dr. Parekh’s leadership,” said Paul Russo, M.D., a urologic oncology surgeon at the Sidney Kimmel Center for Prostate and Urologic Cancers in New York. “The Desai Sethi Urology Institute is enjoying impressive growth and it was a privilege to be invited to join the faculty for ‘Urology on the Beach.’”