IUGA THE OFFICIAL NEWSLETTER

Volume 14, Issue 3, 2019

Advancing Urogynecological Knowledge Around the World

2019 AUGS/IUGA SCIENTIFIC MEETING

Engaging All Five Senses in Nashville 6

DIFFICULT CASES
In the Shadow of Cancer 8

PHYSIO CORNER
The Physiotherapy Approach to Chronic Urologic Pain
– Interstitial Cystitis and Bladder Pain Syndrome 11
The IUGA Newsletter is TABLE OF CONTENTS
published by the members of
the Publications Committee

LETTER FROM THE PRESIDENT 3

COMMITTEE SPOTLIGHT 4
Editor Research & Development Committee 4
Deborah Karp
Terminology & Standardization Committee 4
Managing Editor 2019 AUGS/IUGA SCIENTIFIC MEETING 6
Missy Render
Engaging All Five Senses in Nashville 6
Editorial Board DIFFICULT CASES 8
Abdelmageed Abdelrahman
In the Shadow of Cancer 8
Amos Adelowo
Manjula Annappa VIDEO SPOTLIGHT 11
Matteo Balzarro Native Tissue Vaginal Apex Repair 11
Elise De
Laura Didomizio PHYSIO CORNER 11
Aparna Hegde The Physiotherapy Approach to Chronic Urologic Pain –
Catherine Hudson
Interstitial Cystitis and Bladder Pain Syndrome 11
Sharif Ismail
Ervin Kocjancic SPECIAL INTEREST GROUPS 13
Helena Luginbuehl New Surgical Database SIG 13
Stewart Pringle
Rebecca Rogers IUJ CORNER 14
Carmen Ortiz Roque Looking Forward to the Joint Meeting in Nashville…
Jane Schulz
And Seeing Your Submissions to the IUJ! 14
Ruben Trochez
Mustafa Ulubay FIUGA AT THE ANNUAL MEETING 15
Help Us Bring Pelvic Floor Health to Nepal! 15
Graphic Designer
Martijn Vosbergen
NOW OPEN – 2019 Silent Auction 15
2019 Fun Walk/Run 16
Join Us 16
UPCOMING EVENTS 17

The views and opinions

expressed by the authors
in this publication do not
necessarily reflect those of
IUGA and/or its editors.

2
 LETTER FROM THE PRESIDENT

Dear Friends and Colleagues,
It’s hard to believe that the 2019 joint AUGS/
IUGA Scientific Meeting is only a month away!
Our annual meeting is always one of the
highlights of the year for me, and this year I have
Ranee Thakar
the additional honor of welcoming you to the
IUGA President
meeting as your president. I am looking forward
to catching up with friends and colleagues and
making new connections. I hope you are too!
IUGA is all about education. The meeting will include the
usual types of high-caliber sessions you’ve come to expect
at our meeting, such as didactic and hands-on workshops,
state of the art lectures, debates, panel discussions,
roundtables and the like. But even better, our collaboration
with AUGS has allowed us to bring you the best educational
features of each society’s annual meeting, allowing all of
our members and attendees to benefit. Basic scientists
can take advantage of a one-day track on Translational
Medicine: Re-thinking the Science of the Pelvic Floor,
while nurses and physiotherapists will appreciate the Allied
Health Track focusing on multidisciplinary assessment and
treatment of chronic pelvic pain and sexual dysfunction.
Fellows and physicians-in-training will find Fellows’ Day to
be a unique educational experience geared to their stage of
career development. Others might be interested in the 1.5-
day CME course, Fundamentals of Urogynecology, in which
some of our specialty’s most renowned experts share their
insights and help physicians improve the quality of patient
care, or you can attend the Surgical Tutorials on Thursday
and Friday.
As practitioners and researchers, we hope that when all is
said and done everything we do on a daily basis improves
the quality of care our patients receive and improves their
lives. While the Annual Meeting allows us to stay abreast of
the latest in urogynecological research and techniques, it’s
also important to stay attuned to our patients’ stories and
make sure we educate them about their pelvic floor and
available treatment options. The media has been flooded
recently with negative stories about mesh, and while we
do have to acknowledge the controversies around mesh
use, we also need to make sure our patients have access
to sound information and a balanced perspective. To that
end, we have added a new feature to our patient website,
www.YourPelvicFloor.org, to allow patients to share their
stories and to read the stories of women just like themselves.
I encourage you to take a look at this new feature and
encourage your patients to share their own story.
I look forward to seeing you all in Nashville. If you are unable
to join us this year, don’t be dismayed! A good portion of
content will be captured during the meeting and made
available in the future on the IUGA Academy.
Best wishes,
Ranee Thakar

It seems now more than ever we are all faced with trying
to do more with less – less money, less staff, less time –
especially in this age of digital multitasking. Learn how to
reduce distractions in order to improve productivity at this
year’s Keynote Lecture by Paul Mohapel. And, be sure to
join us as we look ahead to 2040 with this year’s Ulf Ulmsten
Lecture, Curing Pelvic Floor Disorders in 2040: Measuring Sex
and Other Aspects of Pelvic Floor Function, presented by our
IUJ co-editor-in-chief, Rebecca Rogers.

3 WWW.IUGA.ORG
 COMMITTEE SPOTLIGHT
In each issue this year we will put the spotlight on our Committee Chairs, giving a more personal face to the leaders
behind our committees, and highlighting the great work our committees do. In this issue, we introduce the chairs of the
Research & Development Committee and the Terminology & Standardization Committee.
Research & Development
Committee Chair
How long have you been and IUGA
member?
Pallavi Latthe 14 years
MD, FRCOG
Focus/goals of your committee in 2019:
To work on 2 systematic reviews and 2 opinion papers
Committee accomplishment you wish to highlight:
»» Publication in the IUJ of Management of complications
arising from the use of mesh for stress urinary incontinence
– International Urogynecology Association Research and
Development Committee Opinion (first online March 2019)
»» Submission to the IUJ of Effectiveness of local estrogens
in pelvic floor disorders – International Urogynecological
Association Research and Development Committee
Opinion Paper.
Most rewarding IUGA experience/memory:
Winning the best scientific abstract award as a subspecialty
trainee in 2006 at the Annual Meeting in Cancun, Mexico
Most exotic place you have traveled:
Mexico and South Africa
Favorite food:
Vegetarian fajitas
Last book you read:
International Urogynecology Journal, May 2019
Hobbies:
Cycling and traveling to historic places
4
Terminology &
Standardization
Committee Chair
How long have you been and IUGA
member? Renaud
de Tayrac
Since 2000…20 years!
MD, PhD
Focus/goals of your committee in
2019:
The Terminology & Standardization Committee includes 16
members from 10 countries (Austria, Belgium, China, Czech
Republic, France, Indonesia, Ireland, Philippines, Spain,
USA). In 2018, two documents were published (terminology
for female sexual health - R. Rogers, and French translation
of terminology for female conservative management - R. de
Tayrac). The Spanish translation of terminology for female
PFD (J. Berdichevsky) is at the final draft stage.
In 2019, six working groups are working on the following
documents:
»» IUGA/AUGS SUI Surgical Treatment Terminology
»» IUGA/AUGS POP Surgical Treatment Terminology
»» IUGA/AUGS Joint Clinical Guideline on Mesh
Complications
»» IUGA/AUGS Cosmetic Gynecology Terminology
Read more on page 5
»» ICS/IUGA Female Obstetric Trauma Terminology
»» ICS/IUGA Update to 2010 document on Female UI and
PFD Terminology
Committee accomplishment you wish to highlight:
Various working groups have worked hard this year
to provide, in the coming months, excellent synthesis
documents on stress urinary incontinence and prolapse
surgery, as well as on the management of sling and mesh
complications. These documents will certainly be very useful
to our medical community worldwide.
UPCOMING DEADLINES
Most rewarding IUGA experience/memory:
The fantastic gala dinner at the orangery of the Chateau de Annual Meeting Registration
Versailles during the joint IUGA/ICS congress in Paris in 2004. Advance Fee Deadline:
Most exotic place you have traveled: September 23, 2019
The most exotic place I have traveled to is the island of
Moheli in the Comoros Archipelago, in the Mozambique CLICK HERE!
Channel, where I practiced obstetrics and gynecology for 1
year in 1995.
Call for Nominations
Favorite food: (Secretary, International Advisory Board, Committee Chairs)
French gastronomy!
Deadline: September 1, 2019
Last book you read:
The history of Ambroise Paré, surgeon of the French King CLICK HERE!
François I in 1515 - thanks to whom surgery saw a tremendous
evolution in the 16th century.
Observership Grant Applications
Hobbies: Deadline: September 6, 2019
Diving all over the world & driving a motorcycle.

CLICK HERE!

5 WWW.IUGA.ORG
Engaging All Five Senses in Nashville
Join us this September 24-28, 2019 in Nashville for the joint 2019 AUGS/IUGA Scientific Meeting. In addition
to immersing yourself in the education, research, and networking opportunities provided at the meeting,
you can engage all five senses in the culture, history, landscapes and cuisine of Nashville!

See
There is so much to see in Nashville! Music lovers can visit
the Country Music Hall of Fame. Those more interested
in art can check out the Frist Art Museum, or visit some of
the “I Believe in Nashville” murals throughout the city for
great photo ops while in the States. The Hatch Show Print, a
working letter press print shop in operation since 1879, offers
tours that are part history and part how-to.

Hear
Listen to live music at one of the more than 150 live music
venues in Nashville – free! From country music to blues and
rock ‘n roll, Nashville has it all! Check out some of the many
options at www.visitmusiccity.com/things-to-do/guide-
free-live-music-nashville.

Smell
Take a deep breath of the great outdoors at Radnor Lake
Read more on page 7

State Park, or smell the flowers at Cheekwood Estate and

Gardens.

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 Taste
Treat your taste buds! From “down-
home southern cooking” to the
Goo Goo Cluster – the world’s first
combination candy bar, to distilleries
(check out the Silent Auction item
from Nelson’s Greenbrier Distillery),
there is plenty to tickle your taste buds in Nashville. If you are spending a few extra days in the area, you can also plan a tour of
the Jack Daniel’s Distillery – home of the top-selling American whiskey (about a 90-minute drive from Nashville).

Touch
Touch American history at The Hermitage, the home of
Andrew Jackson, the 7th President of the United States, or
Riverfront Park, which commemorates Nashville’s river
history.

For more information on what to see and do in Nashville, check out some of these websites:

`` Visit Music City

`` Thrill List

`` The Crazy Tourist

`` The Culture Trip

FOLLOW US ON SOCIAL MEDIA!

@iugaoffice

7 WWW.IUGA.ORG
 DIFFICULT CASES
In the Shadow of Cancer
Case 1:
A 70-year-old patient was referred by the Urology
Department for Bulkamid urethral bulking agent injection
for stress incontinence of urine with negative urodynamics.
She had a radical cystectomy for bladder cancer with neo-
bladder formation. She was Para 2, one normal and 2nd
forceps delivery. She had undergone total abdominal
hysterectomy and bilateral salpingo-oophorectomy. She
was afraid of leaking urine during intercourse and reported
occasional digitation, rectal urgency, and anal incontinence
to loose stools. Her BMI was 28 and examination showed
mobile urethra, with right-sided levator avulsion injury, mild
anterior compartment prolapse, mild vaginal vault prolapse
and moderate posterior compartment prolapse. Pad test
showed 1.4gm increase in pad weight. She was referred for
PFMT and started on low dose antibiotics.  straining/elevated abdominal pressures. Increased urethral
What is the best way to manage stress incontinence in
patients who have had neobladder formation?
SUI, I recommend initially an appropriate trial of pelvic floor
muscle training, ideally with a pelvic physiotherapist. Bladder
training (timed/scheduled voiding) including initiation
of CIC in women with urinary retention can also improve
incontinence. Up to 60% of women with neobladders require
clean intermittent catheterization (CIC) post-procedure (Basu
& Duckett 2009); women may leak with elevated bladder
volumes (overflow incontinence, SUI, or both) and initiating
CIC can resolve incontinence in these women. Ruling out and
managing urinary tract infection may also be beneficial.
If bothersome SUI persists, a trial of a pessary can be
considered with a few caveats. First, the patient may not
have remaining vaginal length to accommodate a pessary.
Second, these patients typically void with abdominal
resistance by the pessary may result in urinary retention and
therefore necessitates repeat post-void residual assessments
with the pessary in place.

Failing this, I generally discuss the options of oral

Expert Response
medication and/or surgical intervention. Duloxetine, an
Stress urinary incontinence (SUI) in women
SNRI antidepressant, can improve female stress urinary
with a history of radical cystectomy and
incontinence (Nyak et al 2018), typically at a dose of 40
orthotopic neobladder urinary diversion
mg PO BID though has side-effects including nausea,
is a challenging issue that has been
constipation, fatigue and loss of appetite. In my practice,
Joseph R. poorly studied to date. The etiology of
initial surgical management options for this cohort include
LaBossiere urinary incontinence in this cohort can be
MD, MSc, FRCSC urethral bulking agents and/or mid-urethral slings using a
multifactorial including traditional risk factors
Urological Surgeon, non-retropubic approach. Avoiding the retropubic space
Specialist in Urodynamics, of advancing age, increased parity, obesity,
is critical as dissection in this space post-neobladder
Reconstructive and etc. with the introduction of new components
Female Urology creation can result in severe and potentially life-threatening
Assistant Professor of
post-surgery including loss of pelvic floor
complications (Quek et al 2004). Urodynamics and physical
Surgery, Division of structures, urethral shortening, denervation
Urology, Department of exam help guide my decision making at this juncture– if the
Surgery, Northern Alberta
of the external sphincter, voiding dysfunction
patient has an abdominal leak point pressure >60cm H20
Urology Centre and development of fistula between the
and urethral hypermobility, I typically recommend a trans-
Read more on page 9

neobladder and vagina (Nyak et al 2018). My

obturator mid-urethral sling (bulking agents are also an
general approach to this complex problem is as follows.
option). If abdominal leak point pressures are <60 cm H20
and/or the patient has a fixed urethra (classically indicative
First, it is important to factor the length of time from
of intrinsic sphincter deficiency) then bulking agents are
surgery, as up to 70-75% of patients will achieve satisfactory
my first recommendation. Using the same logic as for the
continence 1-2 years post-surgery (Zhang et al 2017). It is
pessary, bulking agents can result in urinary retention due
ideal to delay more invasive investigation/management
to increased urethral resistance and the patient should be
until that time. Having identified persistent and bothersome

8
counseled on the risk of CIC post-injection. If bothersome
SUI persists at this point, I would recommend referral to a
reconstructive urological surgeon for an opinion. Further
options include insertion of a pubovaginal sling using
autologous rectus fascia (no mesh in the retropubic space)
with careful retropubic dissection and securing of the sling to
Coopers ligaments bilaterally and/or other forms of urinary
diversion (bladder neck closure with continent diversion,
conversion to an incontinent ileal conduit, etc.).
References
01. Nayak AL, Cagiannos I, Lavallee LT, Morash C, et al. Urinary
function following radical cystectomy and orthotopic
neobladder urinary reconstruction. Can Urol Assoc J. 2018 Jun;
12(6): 181–186.
02. Zhang Y, Song Q, Song B, Zhang D, Zhang W, Wang J. Diagnosis
and Treatment of Urinary Incontinence after Orthotopic Ileal
Neobladder in China. Chin Med J (Engl). 2017 Jan 20; 130(2):
231–235.
03. Quek ML, Ginsberg DA, Wilson S, Skinner EC, Stein JP, Skinner
DG. Pubovaginal slings for stress urinary incontinence following
radical cystectomy and orthotopic neobladder reconstruction in
women. J Urol. 2004 Jul;172(1):219-21.
04. Basu M, Duckett JRA. Update on duloxetine for the management
of stress urinary incontinence. Clin Interv Aging. 2009; 4: 25–30.
9 WWW.IUGA.ORG
Expert Response
In a woman with urinary incontinence
and  orthotopic neobladder failing
conservative management,
videourodynamics (VUDS) are essential.
Tamsin
Neobladder overactivity incontinence Greenwell
may be managed by antispasmodics or Consultant Urological
by surgically enlarging the neobladder
Surgeon with a Special
Interest in Female,
with an additional bowel segment. Reconstructive and Neuro-
Urology, University College
London, London, UK
SUI needs to be carefully categorized.
In the majority of cases, intraurethral
bulking agent is a reasonable first line intervention. If
bulking is declined or fails and VUDS reveal significant
hypermobility, an open colposuspension should be
considered. If the patient has intrinsic sphincter deficiency,
then a rectus fascial sling (RFS) is the management of choice.
The patient should be able and willing to perform lifelong
CISC. The RFS should be placed in an open manner (with full
dissection of the retropubic space to allow visualization of
the endopelvic fascia) as blind trochar placement carries a
high risk of neobladder injury. Synthetic mid-urethral tapes
and a bladder neck artificial sphincter have a relatively
high risk of erosion and should be avoided. If all fails, the
neobladder neck can be closed and a supravesical continent
catheterizable Mitrofanoff channel formed.
Case 2:
A 64-year-old patient was found to have a polyp during
cystoscopy surveillance at the time of transobturator tape
(TOT) insertion for urodynamic stress incontinence. The
polyp was removed at the time and sent for histology, which
confirmed grade 2 non-muscle invasive papillary transitional
carcinoma. She was referred to the urologists, who
carried out regular cystoscopy suveillance and the patient
remained asymptomatic and required no further treatment.  Read more on page 10
Six years later, she presented with posterior compartment
prolapse. She already had a vaginal hysterectomy and
anterior repair prior to her tape insertion. She was counseled
about management options and opted for a ring pessary,
which was inserted. Subsequently, she started to experience
stress incontinence of urine. Urodynamics assessment was
carried out. With pessary in situ, urodynamics confirmed
stress incontinence. The patient was counseled about
 management options and opted for autologous sling 02. How comfortable is the surgeon in managing
insertion and cystoscopy at the same time as having complications related to biopsy? Persistent
posterior repair. hematuria, bladder perforation, ureteric injury, etc. are
potential complications of biopsy that urogynecologists
What is the best way for a urogynecologist to deal with may or may not be comfortable managing.
incidental findings of bladder masses or tumors encountered
during cystoscopy? Is biopsy helpful or hazardous for future 03. What are local practice patterns with regards to
work-up and management of bladder tumors? urologic referrals? Bladder masses require emergent
evaluation (seen within 2 weeks at our center). In
Expert Response some centers it may be difficult to obtain a timely
Bladder masses are a common referral to urologic opinion, and as such proceeding with biopsy
urologic surgeons. Management of these of an incidentally detected bladder mass may help to
lesions is complicated by the wide spectrum expedite treatment for the patient in the long run.
of disease processes that manifest as
Urologists are trained to diagnose and manage the entire
Joseph R. ‘bladder masses’ ranging from infectious/
spectrum of bladder pathology and do so on a daily basis.
LaBossiere inflammatory conditions (ex. cystitis cystica),
MD, MSc, FRCSC Further, we are comfortable in dealing with potential
benign neoplastic conditions (ex. papilloma)
Urological Surgeon, complications related to biopsy. Admittedly, biopsy is often
Specialist in Urodynamics, and histopathologic abnormalities (urachal
straightforward, though potential complications can arise
Reconstructive and remnant) to malignancies including urothelial
Female Urology as stated above and some lesions may not require biopsy
Assistant Professor of
and squamous cell carcinoma. Accurate
exposing the patient to unnecessary, albeit low risks of harm.
Surgery, Division of diagnosis is critical to ensuring patients
Urology, Department of Therefore, unless the urogynecologist has the experience/
Surgery, Northern Alberta
receive appropriate and timely treatment.
comfort to determine if and how to biopsy, manage
Urology Centre Arriving at an appropriate diagnosis is
complications if they arise and/or is geographically restricted
predicated on experience in viewing many
with regards to timely urologic access, in my opinion, I would
bladder lesions both in training and in practice and utilizing
recommend avoiding biopsy and referring the patient to a
biopsy when required. For example, cystitis cystica has a
urologic surgeon for an incidental finding of a bladder mass.
classic cystoscopic appearance, does not have malignant
potential and therefore does not require biopsy when
Reference
observed. Urologic surgeons can identify certain pathology
visually and are relatively ‘accurate’ at predicting grade and 01. Mariappan P et al. Predicting Grade and Stage at Cystoscopy in
Newly Presenting Bladder Cancers-a Prospective Double-Blind
stage of urothelial malignancies (Mariappan et al 2017),
Clinical Study. Urology. 2017 Nov;109:134-139.
however, the gold-standard in diagnosis of most bladder
masses is biopsy.

With this in mind and returning to the question of how our

urogynecology colleagues deal with an incidental finding of
a bladder mass, the answer, in my opinion, depends on the
response to the following questions:

01. How comfortable is the surgeon in assessing lesions

visually and determining if biopsy is warranted?
As a urologic surgeon I see bladder pathology daily
in practice and I am comfortable in deciding what
lesions to biopsy and how to appropriately biopsy the
lesion (cold cup at the time of cystoscopy vs a formal
transurethral resection of bladder tumor procedure).

10
 VIDEO SPOTLIGHT
Recognizing that the IUGA membership is a global audience
and different resources are available depending on
geographic location, the Video Spotlight highlights video
resources from various sources, such as the International
Urogynecology Journal* and IUGA Academy*, on a single
topic. This quarter we focus on native tissue vaginal apex
repair.
*IUGA Membership is required to access the IUJ and IUGA Academy.
Not a member? Join today at: www.iuga.org/membership/apply-now.
PHYSIO CORNER
The Physiotherapy Approach
to Chronic Urologic Pain –
Interstitial Cystitis and Bladder
Pain Syndrome
A staggering number of women and men’s
Nelly Faghani
quality of life is significantly affected with
PT, Owner and Instructor,
Pelvic Health Solutions, symptoms of urinary urgency, frequency and
Ontario, Canada
bladder/pelvic pain. Chronic urologic pain
(IC: Interstitial Cystitis; BPS: Bladder Pain
Syndrome) is much more prevalent than previously thought
and patients often present with multiple comorbidities.
Physiotherapy is an integral part of the interdisciplinary team
that treats within a biopsychosocial framework to address
the blend of tissue issues and a sensitized nervous system
that is common in these persistent pain states.
The subjective physiotherapy assessment includes a
thorough past medical history and appropriate questions
pertaining not only to the patient’s pain, but also to their
11
Uterosacral Ligament Colpopexy: The Way We Do It
(2018)
Tonya N. Thomas, Lauren N. Stiff & Mark D. Walters
Watch Now!
bladder, bowel, sexual function and possible history of
trauma. A three-day bladder and bowel diary will evaluate
a base line of the patient’s micturition and bowel habits
and fluid intake/type. It is important to use validated and
reliable outcome measures as part of the assessment to
help evaluate symptoms of depression, anxiety, stress, pain
catastrophization and to learn more about the patient’s
behaviors, attitudes, and beliefs.
The objective physiotherapy assessment includes global
assessment of respiratory function, posture and alignment,
movement patterns, the lumbar and thoracic spine,
connective tissue, neural involvement, and overall strength
Read more on page 12
and conditioning. Overactive pelvic floor muscles can be
a significant contributor to patients’ symptoms, and it
is important to improve the proprioception of the pelvic
floor muscles and focus on eccentric lengthening (Cox et al
2016; Fitzgerald et al 2013). Gentle non-nociceptive manual
techniques, such as myofascial release (Fitzgerald et al 2013)
can help improve these muscle imbalances.
WWW.IUGA.ORG
Breathing techniques are essential because of the
diaphragm’s direct relationship with the pelvic floor. Think
about the diaphragm and the pelvic floor on opposite sides
of a piston (Julie Wiebe): when you breathe in, the diaphragm
descends, and so does the pelvic floor. If we are stressed, in
a constant fight/flight state, we will physiologically breathe
in a shallow manner. Shallow breathing does not allow for
good diaphragmatic excursion and can contribute to the
pelvic floor becoming overactive. Overactivity of the pelvic
floor is not simply an isolated dysfunction, but a physical
manifestation of the patient’s emotional state. The mind-
body connection plays a significant role in the patient’s
presentation. Breathing is the only autonomic function of
which we have voluntary control, and it is a fantastic and
simple gateway into the autonomic system and allows us
to turn on the parasympathetic system to calm down the
powerful fight/flight systems. Controlled breathing can help
to modify pain and autonomic responses (Busch et al 2012).
Pain science research has evolved globally and now provides
us credible evidence that we can treat and change the pain
system through pain neuroscience education (PNE) and
hence should be a first-line treatment (Louw et al 2016).
We must strive to find the driver of our patients’ symptoms
and provide a multifaceted treatment approach that
12
addresses pain education, diet, behavior modification,
breathing, mindfulness, improved sleep hygiene, cognitive
behavioral therapy, manual therapy techniques and patient
centered exercises. We must provide hope and self-efficacy to
our patients so they can play an active role in their treatment.
References
01. Cox A, Golda N, Nadeau G, Curtis Nickel J, Carr L, Corcos
J, Teichman J. CUA guideline: Diagnosis and treatment of
interstitial cystitis/bladder pain syndrome. Can Urol Assoc J.
2016 May-Jun;10(5-6):E136-E155.
02. Fitzgerald MP, Anderson RU, Potts J, Payne CK, Peters KM,
Clemens JQ, Kotarinos R, Fraser L, Cosby A, Fortman C, Neville
C, Badillo S, Odabachian L, Sanfield A, O’Dougherty B, Halle-
Podell R, Cen L, Chuai S, Landis JR, Mickelberg K, Barrell T, Kusek
JW, Nyberg LM; Urological Pelvic Pain Collaborative Research
Network. Randomized multicenter feasibility trial of myofascial
physical therapy for the treatment of urological chronic pelvic
pain syndromes. J Urol. 2013 Jan;189(1 Suppl):S75-85.
03. Busch V, Magerl W, Kern U, Hass J, Hajak G, Eichhammer P. The
effect of deep breathing on pain perception, autonomic activity
and mood processing. 2012 Feb:13(2):215-28.
04. Louw A, Zimney K, O’Hotto C, Hilton S. The clinical application
of teaching people about pain. Physiother Theory Pract. 2016
Jul;32(5):385-95.
 SPECIAL INTEREST GROUPS

New Surgical Database SIG
Knowing surgical outcomes is critical in planning treatment
and forms the cornerstone of surgical practice. For members
who are interested in how to best assess outcomes, we’ve
got a new Special Interest Group (SIG) that aims to increase
awareness of the importance of measuring outcomes,
developing strategies around the world to help implement
data capture, and in the longer term, influencing the
development of tools to improve both data capture and
data usage to assess clinical practice and drive program
improvement. SIGs are open to all IUGA members. Login via
the IUGA website and join this new SIG today!
If you haven’t already set up your free database account,
be sure to do so and get ready for our 2nd Annual Database
Challenge, October 6-13, 2019. Our goal is to have all
members who perform surgery enter all of their data during
the Challenge week in order to better understand world-wide
pelvic floor surgery outcomes.
Interested in helping on a regional level? We are still looking
to identify regional leaders for the Database Challenge in
North and South America, Africa, and Asia. If interested in
learning more, contact office@iuga.org.

LEARN MORE ABOUT SIGS

Whether or not you are a member of the Surgical Database
SIG, all IUGA members can use the IUGA Surgical Database.

Surgical Database

Data Speaks Volumes!

2nd Annual IUGA Database Challenge
October 6-13, 2019

Use the IUGA Surgical Database to collect pre-, intra-, and post-operative data on your patients to inform your practice.

LEARN MORE AT WWW.IUGA.ORG/DATABASE-CHALLENGE

13 WWW.IUGA.ORG
13
 IUJ CORNER
Looking Forward to the Joint
Meeting in Nashville…And
Seeing Your Submissions to the
IUJ !
I have had an opportunity to peek into the
Rebecca Rogers
scientific offerings of our upcoming meeting
MD
Editor-in-Chief in Nashville, TN, USA. As always, the program
is jam-packed with interesting abstracts, state
of the art lectures and opportunities to meet
with colleagues and friends. I am looking forward to our
time together. Because I know that many of you are working
feverishly on presentations and posters, I was curious to
know how many presented abstracts wend their way to
published manuscripts in our field. Unfortunately, I could not
find a specific article that determined the publication rate of
abstracts presented at IUGA. Elsewhere, publishing rates for
urologic and gynecologic meetings range from 30-50% (Muffly
et al 2016; Yoon et al 2012). Why does so much great work
go unpublished? First, it takes hard work to bring research
to publication. After the novelty of presenting an abstract at
our international meeting, slogging through a submission
process may not be entertaining. Few manuscripts sail
through the peer review process without revision, which
can require authors to write/rewrite/reanalyze their data
and sections of their paper. The benefits of peer review and
The IUGA Academy app
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publication are obvious – the finished work is very nearly
always improved over the submitted version, and the rest
of the scientific community, and ultimately patients, benefit
from your discoveries. So is this a big deal? Should we
bring our work to publication? Sir Iain Chalmers, MD, one
of the founders of the Cochrane Review, stated that failure
to publish research is a form of scientific misconduct. Many
journals, including ours, have worked to improve submission
processes so that they are more streamlined, and authors
receive prompt and useful reviews of their work. Whether
you are a seasoned researcher who has published extensively
in the IUJ or this is your first meeting with a presentation, I
wanted to take the opportunity, on the behalf of both Steve
and I, to invite all of you to submit your work to the IUJ. We’ll
be looking for it!
References
01. Muffly TM, Webster K, Conageski C, Gujahi M. Predictors of
Manuscript Publication: A Review of Obstetrics and Gynecology
Society Meeting Abstracts. Female Pelvic Med Reconstr Surg.
2016 Mar-Apr;22(2):83-7. doi: 10.1097/SPV.0000000000000212.
02. Yoon PD, Chalasani V, Woo HH. Conversion rates of abstracts
presented at the Urological Society of Australia and New
Zealand (USANZ) Annual Scientific Meeting into full-text journal
articles. BJU Int. 2012 Aug;110(4):485-9. doi: 10.1111/j.1464-
410X.2011.10879.x. Epub 2012 Feb 2.
More than
500
Presentations
Available!
FIUGA AT THE ANNUAL MEETING

FIUGA
Foundation for International Urogynecological Assistance

Help Us Bring Pelvic Floor Health to Nepal!

The primary focus of the Foundation for International Urogynecological Assistance (FIUGA – IUGA’s Foundation) is its
International Assistance Program, which has supported the successful establishment of an FPMRS/urogynecology fellowship in
Ghana and is now supporting the establishment of a similar fellowship program in Nepal.

At this year’s Annual Meeting, our focus is raising funds to cover the surgical costs for women in Nepal. At $285 USD as the
expected cost per surgery, the need is great. You can help us bring pelvic floor health to this under-served region of the world
when you:

`` Donate an item to the 2019 Silent Auction

`` Bid on an item in the 2019 Silent Auction

`` Participate in the 2019 Fun Walk/Run

`` Support a 2019 Fun Walk/Run participant

`` Donate to FIUGA online or at our booth at the Annual Meeting

NOW OPEN – 2019 Silent Auction
The 2019 Silent Auction is open for online bidding! Be sure to
check out www.32auctions.com/FIUGA2019 for an overview
of all items, and to bid on two Nashville-specific items that are
only available for online bidding through August 29.* These
2 items will be awarded to the highest bidder after that date
so that the recipients can plan to make use of their purchase
while in Nashville for the Annual Meeting.
*All other items will transition to a silent auction taking
place at the AUGS/IUGA Joint Scientific Meeting in Nashville,
September 24-28, 2019. Be sure to stop by the IUGA/FIUGA
ONLINE BIDDING ONLY FOR THESE 2
ITEMS:
`` Music City Star Card: Get up close and personal with all
Nashville has to offer with the Music City Star Card. This
card is not available for purchase by the general public
and is worth over $1,000 USD! The Music City Star Card is
good for two people to gain free admission once to all the
venues and attractions listed inside the card (33 venues/
activities) plus entitles the cardholder to discounts at 32
additional restaurants, bars, shops, and activities!
`` Nelson’s Greenbrier Distillery: Tour & Tasting for 4 people
Read more on page 16

booth to place your bid!

BID NOW

15 WWW.IUGA.ORG
 3K WALK & 5K RUN
Thursday, September 26, 2019
06:30 a.m. - 07:30 a.m.

2019 Fun Walk/Run Join Us

This year’s Fun Walk/Run is sure to be just that…FUN! Join
us for a breath of fresh air and see a bit of Nashville outside
of the convention center! Your entry fee this year includes
a T-shirt. All proceeds support the foundations of both
IUGA (Foundation for International Urogynecological
Assistance) and AUGS (PFD Research Foundation).
We are always looking to identify those who are passionate
about bringing urogynecology access to all corners of
the globe to fill periodic openings on the FIUGA Board of
Directors. If the mission and work of FIUGA interests you, we
want to know who you are! Learn more at www.iuga.org/
news/fiuga-call-for-interest and contact us today!

Participants can go the extra mile for their foundation by

becoming an individual fundraiser or creating a fundraising
team. Simply create your fundraising profile here and ask
everybody you know to support you!

Too early for you? Sports not your thing? That’s OK! You can
still support our Foundation by being a Sleeper Supporter!
Simply select the Sleeper Supporter option with your
meeting registration. You get the T-shirt and get to sleep in
while still supporting the Foundation to achieve our goals.
SHARE YOUR NEWS

Have news to share?

News, meeting announcements,
and article suggestions may all
be submitted to the Publications
Committee at office@iuga.org.

16
UPCOMING EVENTS
For a full calendar of events, visit www.iuga.org/events/event-calendar.

International Continence Society (ICS) 

™™ September 3-6, 2019 AGES Pelvic Floor Symposium 2019 
™™ November 1-2, 2019
33rd Annual Conference of AICC RCOG 
™™ September 5-8, 2019 NVOG 56th Biannual Gynaecology Meeting 
™™ November 7-8, 2019
Understanding Urodynamics 
™™ September 11, 2019 3rd Annual PUGA Conference
™™ November 9-10, 2019
ISSVD XXV World Congress & Postgraduate Course 
™™ September 16-20, 2019 26th Asia and Oceania Federation of Obstetrics and
Gynecology Congress 

European Society of Coloproctology  ™™ November 10-14, 2019

™™ September 25-27, 2019

British Association of Urological Nurses Annual
Conference 
Annual Scientific Update in Urogynaecology 
™™ November 11-12, 2019
™™ October 3, 2019
2019 Australian National Conference on Incontinence 
International Society of Pelvi-Perineology 
™™ November 13-16, 2019
™™ October 6-8, 2019
Federação Brasileira das Associações de Ginecologia e
Associação Brasileira de uroginecologia e assoalho pélvico Obstetrícia (FEBRASGO) 
(UROGINAP)
™™ November 13-16, 2019
™™ October 10-12, 2019
Advances in Urogynecology 2019 
ISUOG World Congress 
™™ November 14-16, 2019
™™ October 12-16, 2019
27th World Congress on Controversies in Obstetrics,
RANZCOG Annual Scientific Meeting  Gynecology & Infertility 
™™ October 13-16, 2019 ™™ November 21-23, 2019

European Urogynaecological Association  AGES Laparoscopic Anatomy Pelvic Dissection Workshop 

™™ October 16-18, 2019 ™™ November 30, 2019

1st International Conference on Clinical Practice in

Obstetrics, Gynaecology and Neonatology 
™™ October 24-26, 2019

17 WWW.IUGA.ORG
CONTACT DETAILS

IUGA Board of Directors

Ranee Thakar Lynsey Hayward Roy Ng

President Past President Secretary
ranee@iuga.org lynseyhayward@iuga.org royng@iuga.org

Jorge Milhem Haddad Sylvia Botros-Brey

Vice-President Treasurer
jorgemilhemhaddad@iuga.org sylviabotros-brey@iuga.org

IUGA International Advisory Board

–– Africa –– Europe –– Southern Asia

Zeelha Abdool, South Africa Kaven Baessler, Germany Natarajan Rajamaheswari, India

–– Northern America –– Oceania –– Southeastern Asia

Holly Richter, USA Lore Schierlitz, Australia Sivakumar Balakrishnan, Malaysia

–– Latin America & the Caribbean –– Western Asia –– Central & Eastern Asia
Carlos Rondini, Chile Tony Bazi, Lebanon Masayoshi “Jimmy” Nomura, Japan

IUGA Committees

Education Committee Chair Nominating Committee Chair Research & Development Committee Chair
Catherine Matthews, USA Lynsey Hayward, New Zealand Pallavi Latthe, United Kingdom

Fellows Committee Chair Public Relations Committee Chair Scientific Committee Chair
Svjetlana Lozo, USA Olanrewaju Sorinola, United Kingdom Maria Augusta Bortolini, Brazil

Membership Committee Publications Committee Chair Terminology & Standardization

Abdul Sultan, United Kingdom Deborah Karp, USA Committee Chair
Renaud de Tayrac, France

IUGA Office - office@iuga.org

IUGA Office - North America IUGA Office - Europe

Office: +1 (952) 683 9037 Fax: +1 (952) 314 8212 Office: +31 (0)75-647 63 65 Fax: +31 (0)75-647 63 71
Address: 14305 Southcross Dr., Suite 100 Address: Zaanweg 119A, 1521 DS Wormerveer, The Netherlands
Burnsville MN, 55306, USA Mail: PO Box 94, 1520 AB Wormerveer, The Netherlands

18