European Association of Urology (EAU)

In this first installment of a 2-part interview, guideline chair professor Axel Heidenreich outlines key updates in the management of testicular cancer, with a strong focus on deintensification.

In a controlled silicone kidney model, CVAC 2.0 outperformed a FANS sheath system for moderate-to-larger stone fragments across clearance efficiency, residual volume, and surgeon ergonomics, though the authors note the model was designed to isolate aspiration mechanics rather than replicate full clinical procedures.

Despite promising candidates across tumor, immune, and systemic marker categories, no biomarker yet reliably predicts BCG response or identifies which NMIBC patients would benefit from adding checkpoint inhibitor therapy—a gap that limits informed shared decision-making and broader adoption of IO-BCG combinations despite positive trial data.

Bogdana Schmidt, MD, MPH, identified several subgroups most likely to harbor occult systemic disease and therefore potentially benefit from adding immunotherapy to BCG:

Two new analyses from the ASPIRE trial showed lower health care consumption events and reduced follow-up costs with the SURE procedure vs URS, with RSV emerging as a key predictor of long-term utilization.

The PRIMARY2 phase 3 trial found that PSMA PET-CT in men with normal or equivocal MRI results safely halved the number of prostate biopsies, maintained non-inferior detection of clinically significant cancer, and reduced insignificant cancer diagnosis by more than half.

Sara Coca Membribes, MD, highlights several emerging therapeutic strategies with near-term clinical implications.

At EAU 2026, Adam B. Weiner, MD, spoke with Nikita Bhatt, MD, about the growing interest in prehabilitation to optimize patients ahead of cystectomy.

Enolen implants demonstrated minimal systemic drug exposure and early signals of tumor volume reduction in localized prostate cancer.

64Cu-SAR-bisPSMA demonstrated higher lesion detection rates, improved diagnostic accuracy, and a substantial impact on clinical management.

According to Chew, Break Wave lithotripsy is best suited to renal and ureterovesical junction stones, where ultrasound visualization is most reliable.

A subgroup analysis of the POTOMAC trial showed that durvalumab plus BCG I+M had consistent safety and efficacy in older patients with BCG-naïve high-risk NMIBC.

At 1 year, patients randomized to Rezūm showed a 4.6-point greater improvement on the IPSS symptom score compared with those escalated to combination therapy.

On actionable guidance for community practitioners, Kamat's most emphatic recommendation is early pathology review.

Antoni Vilaseca Cabo, MD, characterizes these results as proof of concept for the local delivery approach, with phase 2 and 3 trials now underway.

Guerrero-Ramos argues that landmark survival data from recent trials justify perioperative immunotherapy in muscle-invasive bladder cancer, while acknowledging that validated tools for individual patient selection remain elusive and that urologists must engage closely with medical oncology to deliver optimal care.

Final results from a phase 1 study of Erda-iDRS provide proof-of-concept for sustained local delivery of erdafitinib into the bladder.

On diagnostic pitfalls, Necchi highlights penile cancer as a particularly common source of delay.

Data showed that the addition of PSMA-PET/CT reduced the need for prostate biopsy by nearly half without compromising the detection of clinically significant prostate cancer.

On counseling patients who want to avoid cystectomy, Bogdana Schmidt, MD, MPH, points to trimodality therapy as the established bladder-preserving option, supported by longer-term data and propensity-matched analyses showing outcomes comparable to cystectomy in selected patients.