A Joint Meeting in the City of Inspiration
The 2010 ICS-IUGA annual scientific meeting held 23-27 August at the Metro Convention Center in Toronto was a memorable record-breaking event. The all-time record attendance of 3,528 registrations from no fewer than 74 different countries was an amazing achievement, particularly bearing in mind the current economic climate. The 2010 meeting co-chairs Sender Herschorn (ICS) and Harold Drutz (IUGA), the ICS Office and our congress organisers Kenes should be heartily congratulated on this fine result which may go down in history as a collaborative, multidisciplinary and multicultural global event par excellence.
Abstract submission was another record with 1374 submitted, 1253 accepted and 298 presented orally in 30 sessions. All members of the scientific committee reviewed abstracts in their field of expertise and all abstracts were reviewed by at least 3 reviewers. Many thanks are due to them for their incredibly hard work. For the first time video reviewing was also done online by the video subcommittee allowing the committee to review the video programme scores during the meeting. Since 44 videos were accepted, reviewing this number during the Scientific Committee meeting itself would have been logistically impossible. The online video review system allowed more time for discussion during the meeting. All 2010 accepted abstracts can still be read in full on the ICS website, while abstracts 1-298 can be found in Neurourology & Urodynamics, volume 29, issue 6, 2010.
There was also tremendous competition for the ever popular workshops, with 108 applications to hold workshops and 48 accepted. Following ICS tradition, the workshops and courses were held on the two days preceding the official opening of the scientific programme. They were attended by a total of 3070 delegates. The top three workshops with the highest attendances in 2010 were:
- Pelvic Floor Anatomy & Function: Agreements & Disagreements – 191
- Pelvic Organ Prolapse Repairs With or Without Mesh- Choices and Outcome –163
- Vaginal Surgery. Is apical support always necessary at the time of anterior repair? – 146
Scientific programme: an update on research and best practices
Being a joint ICS and IUGA event, this 2010 annual meeting presented the scientific knowledge, research and special interests of both societies. However, the collaboration by the ICS with other societies went even further this year. The state-of-the-art lectures included an innovative presentation on Recent Advances in Childhood and Adolescent LUT Dysfunction jointly chaired by Wendy Bower, chair of the ICS Children’s Committee, and Stuart Bauer, president of the International Children’s Continence Society (ICCS) with which the ICS is endeavouring to forge closer relationships. Their presentations covered standardisation of terminology documents, findings from the recent World Congress on Pediatric Urology in relation to advances in understanding noctural enuresis and the evaluation of daytime incontinence, dysfunctional voiding and elimination, use of botulinum toxin in children and spina bifida issues. This state-of-theart joint venture was particularly valuable in the light of following patients from early childhood through to adulthood and onwards.
Further scientific highlights
A randomised controlled trial showed that women with urinary stress incontinence (USI) and intrinsic sphincter deficiency (ISD) are significantly less likely to require further stress incontinence surgery with the retropubic transvaginal tape (TVT) sling than the transobturator sling. A systematic review of mini-slings showed an overall cure rates for stress incontinence from 70% to 81% using subjective and objective outcome data which are lower than the reported rates for the retropubic and transobturator tapes. The complication rates, however, appear to be reduced (less than 1%). A functional role for the M2 receptors of the bladder urothelium was demonstrated for the first time. Furthermore, a new system has been identified which might be involved in detecting ‘danger’ in the bladder and triggering early inflammatory responses. A new breakthrough was presented on the anatomy of the female pelvis studied by 3D MRI. The cardinal ligament is relatively vertical in a standing position, while the uterosacral is more dorsally directed. There is considerable variation in the angles for the cardinal and uterosacral ligaments in normal women and these angles affect ligament tension for any given load. The load supported by each ligament can be expected to vary depending on the angle between ligaments. Regarding the continence mechanism, it was shown that urethral closure pressure can be augmented voluntarily by symptomatic patients, on average by about 8 cm H2O which equates to about 20%. However, this effect seems to be limited. A randomised controlled trial showed that the morbidity of anterior colporraphy and anterior repair mesh kit (ARMK) is similar, although patients treated with ARMK report more pain. ARMK results in a better anatomical outcome of the anterior compartment. However, functional outcome is similar following both surgical techniques. The authors conclude that the anterior colporraphy is still a viable option for primary anterior compartment repair. No general consensus has been found on what to do after a failed sling. When questioned, most of the people in the audience suggested doing nothing! Other options included re-doing a retropubic sling. An interesting new option is the adjustable continence therapy device (ACT) for the treatment of female stress urinary incontinence.
While social events are always an attraction for delegates and their partners, this year the Gala Dinner was so popular that tickets were sold out before the meeting even started! The welcome reception typified the multicultural nature of Toronto, reflected here by highly diverse cuisines that were much appreciated by the delegates. Pelvic floor exercise classes organised by the physiotherapists were an innovation this year and proved a great attraction, even at the crack of dawn! In the exhibition area, the well-designed and versatile ICS booth was manned by the ICS Office Staff on one side and IUGA staff on another. It attracted many delegates all day long for the three exhibition days and was a valuable source of information and assistance. Many thanks are due to all the ICS Office Staff for their hard work to make this annual scientific meeting a success, also to all members of the various organising and scientific committees without whom these events could not happen.