Meet the speakers

Risk prognostication in prolapse and incontinence following childbirth

State of the art lecture - Wednesday 4 September

J Eric Jelovsek, MD, MMEd

Professor Department of Obstetrics, Gynecology and Reproductive Sciences

2nd degree connection2nd/Vice Chair, Education for OBGYN, Associate Professor at Duke University School of Medicine/Durham, North Carolina

Summary: Statistical modeling and machine learning have already transformed online retail, web searching, advertising, finance, politics and more. The prediction modeling vortex continues to attract healthcare into the mix and will likely impact many aspects of day to day patient care ranging from prevention, diagnosis, prognosis, choice of therapy, health care delivery and population health. This talk is for those interested in gaining a broader understanding of how modern statistical and machine learning methods are used for understanding patterns in data and in making clinical predictions. To accomplish this, clinicians should understand answers to a few basic questions: Are their differences between developing prediction models in medicine compared to other industries such as finance or retail? What are the different assumptions when modeling with the primary purpose of understanding patterns in data, performing inference and prediction and how does that primary purpose affect judgment of a model’s performance? Answers to these fundamental questions will be demonstrated using examples of data from women around the time of childbirth and among those with pelvic floor disorders from electronic health records, federal and international datasets. At the end, clinicians should be motivated to recognise that many clinical questions may be accurately addressed by considering a predictive approach and have a better understanding of how modern analytic tools may assist in future research.

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Are there alternative exercises to PFMT for SUI and POP?

State of the art lecture - Thursday 5 September

Kari Bø

Professor Department of Obstetrics, Gynecology and Reproductive Sciences

Professor, Norwegian School of Sport Sciences, Dept of Sports Medicine

Summary: The presentation will discuss the evidence for the two opposing hypotheses on the effect of physical activity and strenuous exercise on the pelvic floor. The first is that general exercise training strengthens the pelvic floor muscles (PFM) and decreases the levator hiatus. This could decrease the risk, or reduce symptoms of, urinary incontinence, faecal incontinence and pelvic organ prolapse, but might have a negative influence on vaginal delivery with prolonged labour and more difficult births. The other hypothesis is that general exercise training overloads, stretches and weakens the pelvic floor. This would have the potential to cause or increase urinary incontinence, faecal incontinence and pelvic organ prolapse, but also potentially make birth easier.

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The Urinary Microbiome

State of the art lecture - Thursday 5 September

Linda Brubaker, MD, MS

Professor Department of Obstetrics, Gynecology and Reproductive Sciences

University of California San Diego

Summary: The recent discovery of the urobiome has stimulated research into a wide variety of urinary tract conditions, including urinary incontinence, overactive bladder and urinary tract infections. Although characteristics of this microbial niche are not yet fully understood, it is clear that the urobiome has bioregulatory functions. The urobiome contains a variety of microbes that had been previously undetected by culture-dependent testing. In health, the microbial members of the urobiome include lactobacillus and has appropriate diversity of microbes which work together to optimise continence and protect against infection. Disturbances in the urobiome, dysbioses, are associated with urinary tract infection, overactive bladder, urgency urinary incontinence and changes in response to oral medical for OAB/UUI treatment. This presentation will review our current understanding of the urobiome and highlight key research initiatives.

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Prostatic controversies

State of the art lecture - Friday 6 September

Andrea Tubaro

Professor Department of Obstetrics, Gynecology and Reproductive Sciences

University of California San Diego

Summary: The lecture will address when how and how prostate surgery is needed in patients with lower urinary tract symptoms due to benign prostatic enlargement and obstruction. The talk will also focus on much debulking is needed to offer long term improvement of symptoms and quality of life. The audience will be certainly aware of the latest data of the peer reviewed literature on minimally and non-minimally invasive surgery of prostatic hypertrophy but a thorough discussion is needed on the external validity of randomised clinical trials particularly when dealing with the non-index patient. Evidence and recommendations of national and international guidelines will be presented filtered through 30 years of experience in the field of functional urology. How indications change when dealing with an index patient, a frail elderly one, your chairman, your dean or your rector? Not just a lecture but food for thoughts for those involved in the management of benign prostatic enlargement.

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