Concluding ELUTS19: Advances in POP, SUI, and neuro-urology with the best of ICS

02 November 2019

The 3rd edition of the European Lower Urinary Tract Symptoms (ELUTS19) meeting, which was organised in collaboration with the International Continence Society (ICS), concluded today and imparted delegates with developments on Pelvic Organ Prolapse (POP), female stress urinary incontinence, neuro-urology insights, applications of laparoscopy and robotic laparoscopy, and the best of the ICS. 

One of the notable sessions of today’s programme was the “POP Update”  which was chaired by Prof. Elisabetta Costantini and Prof. Sherif Mourad. In his presentation “Pelvic pains after vaginal repair of POP“, Dr. Alex Disgesu underscored the importance of specialised training for clinicians who would opt for surgical mesh in treating POP or Stress Urinary Incontinence (SUI). Dr. Disgesu added that in most cases, POP can be treated successfully without mesh. If mesh it so be used for POP repair, transabdominal mesh placement may result in lower rates of mesh complications.

He emphasised the significance of informing patients that transplantation of surgical mesh is permanent. The patients should be informed that some mesh-related complications may require additional surgery that may or may not correct the complication.

In the following session, “Female stress urinary incontinence” chaired by Prof. Tufan Tarcan and Dr. Nikolaus Veit-Rubin, Prof. Dr. Karl Dietrich Sievert stated that after appropriate counseling on lack of long-term durability, bulking therapy is an option for selected individuals with SUI such as poor candidates for anti-incontinence surgery or those desiring an office-based, minimally-invasive procedure.

He added that bulking agents may be offered to female patients as therapy for recurrent or persistent SUI following anti-incontinence surgery. However the outcomes are likely inferior to repeat anti-incontinence surgery in the long term.

During the session on practical neuro-urology, Prof. Mourad stated that enterocystoplasty continues to be an effective tool in decreasing bladder pressure, preventing or reversing upper-tract deterioration, and managing socially unacceptable incontinence in some patients.

According to Prof. Mourad, complications following cystoplasty are frequent and related to the use of intestinal segments. He added that overall reported outcomes are remarkable for a high-continence rate and acceptable patient satisfaction; however, complications are evident in approximately a third of the patients.

“One of the primary challenges of surgical management for neurogenic bladder is still identifying methods to avoid or prevent the complications of augmentation cystoplasty,” said Prof. Mourad. 

The session was chaired by Prof. Rizwan Hamid and Prof. Sievert.

The “Best of ICS 2019” session marked the completion of ELUTS19. Session Chairs Prof. Francisco Cruz and Prof. Dr. David Castro Díaz presented selected abstracts such as Abstract 50: “Tension-free Vaginal Tape Obturator (TVT-O) for the Treatment of Female Urinary Incontinence – Efficacy and Patient Satisfaction in the Long-term Follow Up” (Warro A. et al). TVT-O operation is effective and safe in women who suffer from SUI having 89% objective and 92% subjective cure rate a mean of 9 years after surgery.

Another noteworthy abstract was “The Associations Between Nocturia, Health, Wellbeing and Workplace Productivity in a Working-Age Population” (Hafner M. et al) which stated that the strongest predictors of nocturia include poor sleep quality, kidney disease, cardiovascular disease or cancer, high glucose levels/diabetes, obesity, depression, hypertension.

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To all the participants of ELUTS19, thank you very much! See you in the next edition!