The joint session of the EAU Section of Female and Functional Urology (ESFFU) and the EAU Section of Urological Imaging (ESUI) provided state-of-the-art overviews on the current management in female and functional urology.
Prof. Dirk De Ridder (BE) addressed the latest developments in stress urinary incontinence (SUI), focusing on the role of urodynamics and surgical management. On surgical treatment De Ridder was clear: sling procedures are coming of age. Young women under the age of 30 have the greatest risk of complications with slings, but overall the risk is low. Mini-slings show promising results but there is a great need for additional data and randomised trials.
De Ridder further mentioned a recent randomised trial that showed urodynamics can change diagnoses. A randomised trial of over 300 female patients showed that without urodynamics, 41% of patients was diagnosed with OAB but after urodynamics only 28%. On the other hand, only 2% of patients were diagnosed with voiding dysfunction, whereas this increased to 12% with urodynamics. Nonetheless, the debate about the use of urodynamics continues.
Prof. Walter Artibani (IT) presented a new paradigm in pelvic organ prolapse. He advocated to preserve a normal uterus and normal ovaries and perform bilateral salpingectomy. Artibani mentioned that hysterectomy used to be the gold standard but there was no real evidence for it. Current data shows that there are no disadvantages to preserving the uterus. Moreover, it shortens operating time and is in line with most female patients’ wishes.