Day 1 :
Keynote: A prospective explorative study regarding efficacy and safety of bilateral pudendal neuromodulation for women with stress urinary incontinence.
Time : 09:00
Prof. van Ophoven received his medical degree from the University of Muenster in 1995 where he became head of the section of Neuro-Urology and Academic Centre for Continence Care in 2004. Earlier from 1998 to 1999 he had become postdoctoral research fellow at the Department of Urology, University of California Los Angeles (UCLA). In July 2008, he was appointed to Head of the Division of Neuro-Urology at the University Hospital Bochum. Prof. van Ophoven is currently lecturing at the University of Bochum. He is a member of many national and international (neuro-) urological societies and has published his research internationally.
Background: Stress urinary incontinence (SUI) occurs in both males, however predominantly in females. The etiology of female SUI is multifaceted and multifactorial (post delivery, aging pelvic floor etc.). After conservative management, e.g. pelvic floor education, has failed surgical implantation of slings or artificial sphincters is currently offered to the refractory patient. To the best of our knowledge we present for the first time the results of a proof of concept case series regarding bilateral pudendal neuromodulation (PNM) for refractory SUI.
Material & Methods: Between June 2015 and June 2016 15 women presenting with SUI of various grades received a bilateral pudendal neuromodulation following STAR technique for implantation of the quadripolar electrodes. Patients rated their treatment satisfaction during a four weeks testing interval comparing bilateral versus a switching unilateral stimulation. Changes in amount of incontinence episodes (IE), amount of pad usage (PU), frequency and micturition volume (MV) were compared with baseline at 2 and 4 weeks following implantation. Additionally, patients were asked to grade the extend of their symptom decrease using a Global Response Assessment questionnaire (GRA).
Results: Mean age of all 7 patients was 58.8 +/- 12.06 years. Mean symptom duration at time of implant was 7.6 +/- 10.8 years. All 7 females had previously undergone pelvic surgery for treatment of SUI (sling implantation and explantation, Burch procedure). At week 4 IE dropped statistically significant from 11.0 to 3.6 (p=0.002) and PU from 9.3 to 3.6 respectively (p=0.002). MV increased statistically significant from 175.3ml to 284.0ml and 298.7 ml at week 2 and 4 respectively (all p=0.005). Daytime frequency decreased statistically significant from 11.6 voids to 7.0 (p=0.010) and nocturia from 2.5 voids to 1.0 voids at week 4 respectively (p=0.003). GRA reflected patients’ subjective general amelioration of 60% at week 2 and of 70% at week 4. IPG implantation rate was 73%, all responders asked for a bilateral stimulation to gain maximum symptom decrease and received 2 IPG implants. No SAEs were noted.
Time : 09:20
Dr Camil Castelo-Branco is full professor of Obstetrics and Gynecology and he is the principal of Ob Gyn at de Surgical Sciences department at Barcelona University. He is currently working at Hospital Clínic in Barcelona as Senior Consultant and Director of the Gynecological Endocrinology Unit. Dr Castelo-Branco is the Chairman of the Council of Affiliated Menopause Societies of the International Menopause Society. Member of the Executive Board of the International Menopause Society-IMS. Past-member of the Executive Board of the Spanish Menopause Society. Founder member of the Spanish Menopause Society. Honorary member of several Ob-Gyn and Menopause Societies abroad including Portuguese, Colombian, Argentine, Peruvian, Chilean… Research Interest: Gynaecological endocrinology in particular metabolic diseases during climacteric and reproductive ages. More than 245 original articles and reviews in national and international peer-reviewed medical journals (70% in journals of the first and second quartile, Impact factor >220, h index: 36).
Turner’s syndrome (TS) is the most common chromosomal abnormality in females, and affects one in 2500 live female births. This condition is more common in utero, affecting 1–2% of all conspectuses. Only 1% of fetuses do not end up in miscarriage .
TS is associated with a wide array of potential abnormalities, most thought to be caused by haploinsufficiency of genes that are normally expressed by both X-chromosomes . The cardinal features of TS are short stature and ovarian failure with insufficient sex steroids. These dysfunctions cause delayed puberty and primary amenorrhoea in most cases. Most medical attention has therefore, been focused on early diagnosis, looking for signs for prenatal diagnosis, or performing paediatric guidelines for treatment with growth hormone and pubertal management .
Nowadays, it has become evident that patients with TS are susceptible to some disorders whose beginning or evolution occurs in adult life, such as osteoporosis, hypothyroidism, diabetes, dyslipemia or non congenital cardiac or nepho-urological changes.
Morbidity and mortality are increased, and life expectancy is reduced mainly by cardiovascular diseases as well as quality of life is affected by clinical manifestations that may appear later in life [1,3–7].
Special care during adulthood is necessary, with coordination among different specialties, in order to develop guidelines for the correct control of sensorineural and endocrine disorders, to seek associated malformations, and for reproductive counselling or sexual health.
Gynaecologists should take primary responsibility for the management of these patients to maintain and control hormone replacement, referring them to other specialties if required. In this lecture, we will describe the complications of patients with Turner’s syndrome in adult life
Sarem Fertility & Infertility Research Center & Sarem Cell Research Center , Sarem Women’s Hospital, Iran
Dr. AboTaleb Saremi born in 1947 received MD degree from Jondishapour and Tehran Universities, Iran in 1975. He trained at the Obstetrics and Gynecology department of Münster University, Germany, and got subspecialty in IVF at Vienna University, Austria from 1981 to 1986 and then participated in complementary assisted reproductive technology (ART) courses in the USA and Australia. His specialization includes laparoscopic surgery and his efforts led to the birth of the ﬁrst Iranian assisted reproduction baby by gamete intra-Fallopian transfer (GIFT) in 1989. He founded his ﬁrst IVF center in Iran in 1993 and received the International Federation of Fertility Societies’ (IFFS) 30th anniversary recognition award in 1998. Currently, He is the president of the Sarem Women’s Hospital, which he founded in 2006, and also the president of the Sarem Cell Research Center (SCRC) & Sarem Fertility and Infertility Research Center (SAFIR).
We want to mention about the Endometriosis management as a female common problem affecting over 14% of female population. The incidence of this disease is significantly on the rise for various reasons. The progression of endometriosis is growing worryingly, as we call it “The Disease of the Century”.
In the case of the world wide problem because of increasing in the rate of endometriosis in all over the world, three following strategies should be put in place; first; Broad etiological studies, second; Developing & planning the preventive health programs for endometriosis as an emerging global health problem and Awareness of the people & health systems are the first steps for this strategy & third; Developing the treatment or management methods for controlling of the endometriosis, its complications and its signs & symptoms.
In this lecture, we want to discuss about the 3rd strategy & focus on the more effective management methods with analyzing the current trend on the developing of the surgical techniques.