Christopher Chapple | Consultant Urological Surgeon, Sheffield Teaching Hospitals NHS Foundation Trust; University of Sheffield; and Sheffield Hallam University, UK; Secretary General, European Association of Urology (EAU)
Citation: EMJ Urol. 2022; DOI/10.33590/emjurol/10064659. https://doi.org/10.33590/emjurol/10064659.
Over the past several years you have served as the Secretary General of the European Association of Urology (EAU). What has been your proudest achievement in the role over the last 12 months?
It is the 50th anniversary of the EAU, and I have been proud to see how the organisation has reached such a strategic level in the field of international urology. This includes having accredited guidelines that are the most comprehensive and up-to-date in the world of urology; the highest ranked journal in the field of urology; and a very comprehensive educational and training programme, combined with very successful supraspecialist Section Offices covering the whole field of urology.
Personally, I have achieved nothing more than to be working closely with my colleagues on the Executive and Board of the EAU. We are consolidating our position as an organisation after the difficult times of COVID-19. A major achievement for our organisation has been the strength and dedication of our Central Office, and it is through their efforts that we are where we stand today, coupled with superb input from the many members of all our committees and faculty groups within the association.
Can you name a particular presentation or piece of research that stood out to you at the EAU22, and can you explain why it resonated with you so much?
In my field of interest, there was an excellent randomised controlled trial presented by Mohammed Abdel-Fattah, Professor and Clinical Chair in Gynaecology at the University of Aberdeen, UK, demonstrating the efficacy of mini-slings for the treatment of stress incontinence with long-term follow-up.
You currently have more than 700 international publications to your name for your research on various topics in the field of urology. What do you believe to be the current gaps in the literature and what topics merit greater attention?
At this stage in functional urology, there are very few new developments. Personally, I do feel that we need to look closely at the potential for greater insights into the functioning of the urinary tract and its innervation. Albeit not being a specialised onco-urologist, it is very clear that there are major developments on the horizon as applied to urology. This is the area where I see the greatest gaps in the literature and knowledge, especially in terms of how we best individualise therapy for patients. Ultimately, this is the key to understanding more effective treatment of oncological conditions.
At EMJ Urology throughout 2022 we published a lot of articles on prostate cancer, covering tumour staging, patient care, imaging, and treatment. Can you speak to why this has become such an important aspect of contemporary urology research and clinical practice?
As noted above, it is very clear that there are enormous developments in the field of oncology in terms of personalising treatment (i.e., individualised therapy), with the intention of producing effective and better-tolerated treatments for patients and improving cure rates compared with surgery alone. It is these and other aspects dealing with holistic care of patients with better imaging and targeting of therapy that will lead to the greatest advances in the future. In particular, it is important to emphasise the important outcome of an initiative started by the EAU looking at the early detection of prostate cancer as part of the European Union’s (EU’s) Beating Cancer Plan.
This year’s EAU focused a great deal on robotic surgery and its various applications in the field of urology. Why do you think this has become such an area of focus in this field?
I have no doubt that the use of robotic technology has had a major impact on allowing us to carry out many surgical procedures in a minimally invasive fashion. A great deal of innovation has taken place in this area, and there is no doubt that this is a technology that has made a significant impact on clinical practice, particularly relating to pelvic surgery. It is very clear that we need to train the next generation very effectively in the use of this technology. As with all surgery, it is not a robot that is carrying out the surgery but a surgeon. Therefore, surgeons need to be appropriately skilled in terms of knowledge and understanding of the conditions they are treating, as well as the surgical procedures being undertaken. The robot allows this to be carried out in a minimally invasive fashion. Nevertheless, the surgery carried out internally in the body is of the same magnitude as that carried out at the time of open surgery; however, the technology allows very precise dissection and visualisation of the operative field. With this in mind, it is very clear that there has been a great focus on this area of urological surgery. This will likely continue into the future as we refine our techniques and identify the best modality and approach to use for any individual procedure.
Do you feel that any areas of urology specialism were overlooked in the last year due to the COVID-19 pandemic and if so, can you explain why this may have been the case?
Most healthcare systems in the world, not only in urology, have been overwhelmed by the volume of work that needs to be accommodated following the COVID-19 pandemic. This particularly applies to many so-called non-urgent conditions and is having a major impact on the working practice of all urologists at present.
This year the EAU celebrated its 50th year anniversary, where do you expect the main focus of EAU to lie in the coming year? Have you set specific goals or identified any key areas of interest moving into 2023?
As we celebrate our 50th year at the EAU, we can look back with pride on what has been achieved; however, in accordance with our mission statement, we must continue striving to provide the best quality of care for our patients. This is accomplished through careful evaluation of the appropriate knowledge and the training and dissemination of that knowledge for its effective implementation into surgical practice. It is with this in mind that we move forward into our next 50 years, and certainly, this will be the focus of our activities from 2023 onwards. One particular initiative that emphasises our commitment to patient care is the European Reference Network on rare urogenital diseases and complex conditions (ERN eUROGEN), a pan-European expert reference network that has gone from strength to strength. In addition, our programme on big data, PIONEER and subsequently OPTIMA, are key initiatives that we feel are going to have a significant impact on clinical practice within these areas.
Finally, as a Consultant Urological Surgeon and an Honorary Professor, where can we expect to see your focus lie in the coming years?
There is no doubt that the focus of therapy in future years will be more minimally invasive surgical procedures wherever possible; the individualisation of therapy to patients, in particular if it is possible to identify specific targets within oncology; and personalising therapy across the whole field of urology to take account of patient-reported outcomes and to do our best to help our patients achieve good outcomes.