The session discusses on the cases of incontinence. In a case of a 58-year-old patient presenting with locally recurrent PCa with a single metastatic lesion after initial HDR-brachytherapy, interdisciplinary tumour board recommends systematic treatment with LHRH agonist/antagonist + Enzalutamide or Apulatamide or salvage radical prostatectomy + ePLND. Incontinence at baseline can be considered as an independent risk factor after HoLEP and patients do not spontaneously report incontinence episodes before surgery and should be carefully investigated by the physician. One thing that the surgeon could have done in this case is to ask the patient to go and see oncological colleague who would describe the alternative therapy. After sometime, if there is some iridization of the cavity and catheter were pulled out after 6 weeks, the continence rates were not impaired and catheters were not put back in.

Tumor Board it is an accepted standard of care for the patient to agree to have the case discuss. And then the options presented. And at that point, if systemic therapy was near the top of the list, the patient would be referred to the medical oncologists while the medical oncologists were at the tumor board.

The article demonstrated that incontinence at baseline emerged as an independent risk factor for UC recovery after HoLEP and patients often do not spontaneously report incontinence episodes before surgery and thus they should be carefully investigated by the physician. One year following HoLEP, 10 patients came to attention complaining of persistent urinary incontinence but the symptoms improved significantly, suggesting the fact that HoLEP is a successful operation.

In England, there is a famous story of Corrigan's button. Corrigan was a doctor in Dublin in the 1860s and he had a load of patients who kept on coming back with intractable sciatic pain and he devised the treatment for it, which was that he got a red hot piece of metal on the long wooden handle. He breasted it on a stove till it was glowing hot. The patients were all brought into the room. Trousers pulled down. The button was applied to where he thought the sciatic nerve probably arose, and the results of this treatment were very consistent. The patients all jumped in the air, pulled up their trousers. People who had not been able to walk for years because of their pain ran out of the room and they never came back.

In conclusion, this article stimulates the readers to go back to their own results and study them. Complications are bound to happen so it is best to include them in the consent form.

European Association of Urology (EAU) International Congress 2023, 10th March-13th March 2023, Milan