AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
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The Pelvis in Pain<br />
<strong>Program</strong> <strong>Abstracts</strong> - Thursday 7 March<br />
Endometriosis and Beyond<br />
SESSION 1 / 0840-0900<br />
Images of pain - the library of lesions<br />
Cooper M<br />
This presentation will attempt to display the myriad range of<br />
appearances that endometriosis can appear in.<br />
AUTHOR AFFILIATION: Clinical Associate Professor<br />
Michael Cooper; Department of Obstetrics and Gynaecology<br />
at Sydney University, Royal Prince Alfred Hospital, St Luke’s<br />
Hospital, St Vincent’s Private Hospital, Sydney IVF Sydney<br />
New South Wales, Australia.<br />
SESSION 1 / 0900-0920<br />
Macro to micro – The host of heinous histology<br />
Law K<br />
Endometriosis is defined histologically as the presence<br />
of endometrial glands and stroma at extrauterine sites.<br />
It has a myriad of gross appearances, and can vary from<br />
‘powder burn’ lesions, white or yellow lesions/nodules,<br />
clear vesicles to flame-like red lesions. To the trained eye,<br />
endometriosis can usually be macroscopically recognised,<br />
but some studies have reported the correlation between<br />
laparoscopic diagnosis and histological diagnosis can be<br />
as low as 65%, and may be affected by operator experience<br />
and sampling problems.<br />
Despite ongoing research, it is unclear as to the exact<br />
mechanisms by which pain is generated by endometriotic<br />
lesions. It has been reported that deep endometriotic lesions<br />
may be neurotrophic, with higher expression of nerve growth<br />
factor in comparison with peritoneal and ovarian implants.<br />
In particular, histological studies have shown a proliferation<br />
of nerve fibres associated with rectovaginal nodules.<br />
However a correlation between the type of lesion and the<br />
severity of pain has not been consistently demonstrated.<br />
Ultimately the location of disease may be a more important<br />
predictor of the nature and degree of symptoms.<br />
AUTHOR AFFILIATION; Dr Kenneth Law; Greenslopes<br />
Private Hospital, Brisbane, Queensland, Australia.<br />
Another issue which needs to addressed at the highest<br />
level, i.e. College is who should do this surgery. Too many<br />
inexperienced gynaecologists are setting themselves up in<br />
practice and trumpeting to the unsuspecting public their<br />
“expertise” in this and many other branches of gynaecology.<br />
The approach to each group of patients will be discussed<br />
taking into account age, symptoms and lifestyle impact.<br />
The effect of chronic pelvic pain on treatment will be<br />
discussed according to three age groups of patient that the<br />
author has arbitrarily selected.<br />
Empiric, drug and surgical treatment will be discussed also<br />
according to these groups and the impact of the “first cut”<br />
will be discussed.<br />
At the completion of the presentation the author will revisit<br />
who should do what and to whom.<br />
The first cut is not necessarily the deepest!!<br />
AUTHOR AFFILIATION: Professor Peter Maher; Head,<br />
Department of Endosurger, Mercy Hospital for Women,<br />
Melbourne, Victoria, Australia.<br />
SESSION 1 – Keynote lecture / 1000-1030<br />
Imaging and endometriosis: A match made in<br />
surgical heaven<br />
Abrão M<br />
Endometriosis poses a challenging clinical and surgical<br />
dilemma for many gynecologists. Realizing the depth<br />
and extent of disease prior to surgery can be the key to<br />
pre-operative surgical planning and patient counselling.<br />
This presentation provides a discussion of the role of preoperative<br />
imaging (with a defined protocol in ultrasound)<br />
and a description of the technique. Imaging findings will be<br />
correlated to those in surgery.<br />
AUTHOR AFFILIATION: Professor Mauricio Abrão;<br />
Director of Endometriosis Division, Ob/Gyn, Department,<br />
Sao Paulo University, Brazil. President, SBE - the Brazilian<br />
Endometriosis and Minimally Invasive Gynecology<br />
Association. Director, Reproductive Clinic, Sirio Libanes<br />
Hospital, Sao Paulo, Brazil.<br />
SESSION 1 / 0920-0940<br />
The first cut is the deepest<br />
Maher P<br />
An interesting title but what does it mean. As we know<br />
endometriosis strikes all ages even the pre-menarchal patient.<br />
There is naturally a reluctance to operate on the very<br />
young patient.<br />
SESSION 2 / 1100-1120<br />
Mechanisms of pain<br />
Bajzak K<br />
Chronic pelvic pain (CPP) is responsible for one in ten<br />
gynaecologic outpatient visits and the indication for 15-50%<br />
of gynaecologic laparoscopies and 12% of hysterectomies.<br />
Limited data is available on the prevalence of CPP it is