AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program

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The Pelvis in Pain Endometriosis and Beyond Program Abstracts - Friday 8 March A overview of the current pharmacological drugs in development will be provided in this lecture. There is an exciting variety of new agents in the pipeline, including new GnRH-antagonists, immune-modulators, angiogenesis inhibitors, selective progesterone receptor modulators, antioxidants and new classes of pain-killers. The challenge for many of these drugs will be to show that the promising results in animal models translate to the clinic. Many have already failed this test in the past and many more will follow, but even one new effective drug would be a welcome addition to our arsenal. AUTHOR AFFILIATION: Associate Professor Luk Rombauts; Department of Obstetrics & Gynaecology, Monash University, Melbourne, Victoria, Australia. Director of Clinical Research, Monash IVF, Hawthorn, Victoria, Australia. SESSION 8 / 1645-1705 Robotics and endometriosis Abrão M Complete excision of deep infiltrating endometriosis poses a surgical challenge. Robotics provides features such 3D imaging and articulation of instruments that may overcome many of the limitations of conventional laparoscopy. The role of robotics in benign gynecology particularly in endometriosis as evidenced in the current literature will be discussed. Surgical videos will be presented. AUTHOR AFFILIATION: Professor Mauricio Abrão; Director of Endometriosis Division, Ob/Gyn, Department, Sao Paulo University, Brazil. President, SBE - the Brazilian Endometriosis and Minimally Invasive Gynecology Association. Director, Reproductive Clinic, Sirio Libanes Hospital, Sao Paulo, Brazil. THUNDERBEAT Thunderbeat THUNDERBEAT THUNDERBEAT THUNDERBEAT SYNERGISTIC TECHNOLOGY. ADVANCEMENT BEYOND JUST TWO Visit the Olympus stand at AGES ASM to find out more! Customer Service 1300 132 992 www.olympusaustralia.com.au
AGES XXIII Annual Scientific Meeting 2013 Program Abstracts - Saturday 9 March SESSION 9 / 0815-0845 Why is classification of endometriosis such a struggle Abrão M Endometriosis is a prevalent disease that is one of the most important causes of pelvic pain. This enigmatic disease can behave like a malignant tumor, causing adhesions, distortion of pelvic anatomy and invasion of adjacent organs. Deep endometriosis was first described by Cornillie in 1990. Since then, it has been shown to be highly associated with significant pain and infertility. The current classification systems, of which the ASRM (1997) is the most commonly utilized, do not, however, include the concept of deep endometriosis and its significant implications. In order to address deep endometriosis and other clinically relevant aspects of this disease, the AAGL SIG on Reproductive Surgery and Endometriosis has determined that it is imperative and timely to develop a new classification system. Recently, AAGL created a new endometriosis classification system. Thirty internationally-recognized experts in endometriosis surgery have been approached to contribute to the initial phase of this project. Ultimately, our goal would be that this new classification system be utilized to further our understanding of this still perplexing disease, including the frequent symptom of pain. AUTHOR AFFILIATION: Professor Mauricio Abrão; Director of Endometriosis Division, Ob/Gyn, Department, Sao Paulo University, Brazil. President, SBE - the Brazilian Endometriosis and Minimally Invasive Gynecology Association. Director, Reproductive Clinic, Sirio Libanes Hospital, Sao Paulo, Brazil. SESSION 9 / 0845-0905 Interstitial cystitis Rosamilia A Your doctor may have made the diagnosis of interstitial cystitis; this leaflet may help you to understand your condition INTERSTITIAL CYSTITIS/PAINFUL BLADDER SYNDROME/BLADDER PAIN SYNDROME • What is interstitial cystitis • What causes interstitial cystitis • How does my doctor know that I have interstitial cystitis • How interstitial cystitis is treated What is interstitial cystitis Interstitial cystitis (IC) is a term used to describe the condition of bladder pain or discomfort, with a frequent and often urgent need to pass urine. Nine in ten people with IC are women. People with interstitial cystitis may have a bladder wall that is inflamed and irritated (red and painful). In severe cases, the bladder wall inflammation may make the bladder wall less flexible and stiffer inflammation can scar and stiffen the bladder so it can’t easily expand as urine fills it that may lead to pain and frequency and urgency. Some women get pin point bleeding of the bladder wall when it is stretched or have ulcers or fissures of the bladder lining. Painful Bladder Syndrome (PBS) is another name for the condition when there is no abnormality visible in the bladder. Bladder Pain Syndrome is the name suggested to include both IC and PBS. People with interstitial cystitis may have many of the following symptoms: • An urgent need to urinate, both in the daytime and during the night • Frequent need to urinate. Women with severe cases of IC may urinate as many as 20 times a day or more. • Pressure, pain and tenderness around the bladder, pelvis and perineum (the area between the anus and vagina). This pain and pressure may increase as the bladder fills and decrease as the bladder empties. • A bladder that won’t hold as much urine as it did before • Pain during sexual intercourse The symptoms of IC vary greatly from person to person and even in the same individual. Treatment depends on the severity of the symptoms. In many women, the symptoms get worse before their menstrual period. Stress may also make the symptoms worse, but it doesn’t cause them. What causes interstitial cystitis We don’t yet know what causes interstitial cystitis. We do know that infections with bacteria or viruses don’t cause it. It might be caused by a defect in the lining of the bladder. Normally, the lining protects the bladder wall from the toxic effects of urine. In about 70 percent of people with interstitial cystitis, the protective layer lining the bladder is “leaky.” This may let urine irritate the bladder wall, causing interstitial cystitis. Other changes seen include an increase of histamine (produced due to the inflammation process)-producing cells and increased nerve cells in the bladder wall. An autoimmune response (when antibodies are made that act against a part of the body such as rheumatoid arthritis) may also be the cause in some people. How does my doctor know I have interstitial cystitis You may have interstitial cystitis if any of the following occur: • You have to urinate often or urgently • You have persistent pelvic or bladder pain 17
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AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program

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