Simultaneous surgical treatment of Pelvic Organ Pro-lapse with uterine leiomyoma: TFS minisling with la-paroscopic myomectomy Short Abstracts (key words underlined) (Full abstracts at page 119)
In the last decades requests for POP surgical correction have been increasing. Hysterectomy for leiomyoma induces a future risk of POP. Myomectomy instead of hysterectomy allows to conserve the 45° vaginal angle and the TFS tape allows to tighten normal pelvic tension and function. Simultaneous laparoscopic myomectomy and TFS surgery for POP with a fibroid represent a good option for all patients with POP and uterus leiomyoma to avoid hysterectomy. If it bleeds we can kill it. BEVAN BROWN
... . BEVAN BROWN (Sydney, Austra lia) Fibroids are a common cause of pelvic symptomatology. Hysterectomy is often used to manage patients with a symptomatic fibroid uterus. Uterine artery embolisation is a safe and highly effective method for treatment of women with symptomatic fibroids and adenomyosis. This approach permits preservation of pelvic structures, facilitating pro-lapse repair. Laparoscopic rectopexy update. IAIN SKINNER (Mel-bourne, Australia) Laparoscopic technique for rectal prolapse repair evolved in the early '90. Today it meets both anatomical and functional indication; the former includes a complete external rectal prolapse while the latter includes rectal intussuscep-tion, obstructed defecation and/or constipation, fecal incontinence and symptomatic rectocele. Ventral laparoscopic rectopexy seems to be efficacious for complete external rectal prolapse, while its role remains uncertain for recto-cele, fecal incontinence, obstructed defecation or intussus-ception. Designer vaginas in the context of the sexual revolution. BERNIE BRENNER (Auckland, New Zealand) This presentation attempts to explain the relatively new phenomenon of cosmetic vaginal surgery. It reviews the history of feminism and the development of the sexual revolution in academic research, the lay literature through magazines and film and television. The types of cosmetic surgery are addressed. Sacral neuromodulation in urology. GERARD TESTA (Sydney, Australia) Sacral nerve stimulation (SNS) is an electric therapy based on a fully implantable system that delivers mild electrical impulses to sacral nerves influencing bladder, bowels, sphincters and pelvic floor muscles. Actual indications for Interstim therapy includes UI, OAB, constipation, fecal incontinence and pelvic pain both in male and female patients. Usually the definitive implant is preceded by a PNE test. Good results have been demonstrated at least in 50% of patients at short and mid term while long term results are uncertain. Modern management of haemorrhoids. DARREN GOLD (Sydney, Australia) Hemorrhoids are very common and symptoms include bleeding, pain and prolapse divided into 4 degrees. Outpatient techniques are based on sclerotherapy or rubber-band ligation. Although the most known procedure remains Milligan Morgan hemorrhoidectomy, in the recent past other notsurgi-cal techniques have been performed. Stapled hemor-rhoidopexy was firstly introduced by Longo in '90s. Recently doppler-guided hemorrhoidal artery ligation (HAL) has gained more and more favor as it allows minimal postopera-tive pain, early return to work and minimal complication rate. Bladder pain-New perspectives. MAREK JANTOS (Ade-laide, Australia) Chronic pelvic pain (CPP) represents an increasing cause for medical visits but in 61% causes are unknown. Female patients make up 95% of these visits. Bladder is a common and important source for this kind of pain but its diagnosis is often based on exclusion criteria. Pelvic floor myofascial trigger points are not only source of pain but also a stimulation for neurogenic bladder via antidromic reflexes. Therapy includes not only medications: normalization of muscle function, postural correction, behavioral management of bladder and bowel function and anxiety management brought good results as well.