Dear IUGA Family,
Happy New Year! May 2023 bring you peace, good health, happiness, and immense professional contentment. As we breathe a sigh of relief at seeing the pandemic recede, we are all hopefully going back to regular life with renewed optimism and hope and a recalibrated approach that prioritizes our health and happiness over worldly pursuits.
We begin the new year with another dedicated theme-based newsletter throwing light on the posterior compartment. Our focus in recent times has been to include short articles that incite thought, encourage lateral thinking, and allow teasing out nuances in our understanding of our field. Our hope is to make the Spotlight more relevant to your clinical practice and teaching. Hopefully this special issue achieves this goal as well as our previous theme-based one on female voiding dysfunction did.
Since the topic is such a huge one, this iteration can be considered as part one of our focus on the ‘Posterior compartment and the Urogynecologist’. We have several international experts deliberating on the topics perplex them as much as us, including renowned colorectal surgeons and physiotherapists. It is always interesting for us Urogynecologists to understand how our colorectal and physical therapy colleagues tackle the posterior compartment.
We start off with an enlightening piece by Dr. Prajesh Bhuta on the colorectal surgeon’s perspective on the management of rectocele in patients with obstructed defecation syndrome. We follow that up with amazing insight from Dr. Peige Zhou and Dr. Dana Sands on how to avoid posterior pitfalls in rectocele repair. We have all been confounded by the impact of concomitant pelvic floor dysfunction, including paradoxical contraction, hypertonic pelvic floor, and levator spasm on the management of rectocele. Hopefully these two articles will help us improve our management protocols for rectocele. Then, Dr. Dana Sands helps us understand whether to rely on fluoro-defecography or MR-defecography while investigating the underlying causes for posterior compartment problems. The ongoing debate regarding which of these two modalities is superior needed an opinion from a colorectal surgeon of her stature. We follow with the physiotherapist’s approach to ‘Obstructed Defecation Syndrome in young women’ and we are grateful that Dr. Barry Berghman and Dr. Silvana Ochoa have both provided their learned opinion on such a difficult clinical issue.
Next up, Dr. Lucia Oliveira offers a colorectal surgeon’s perspective on a situation that can prove nightmarish for any obstetrician: the conundrum of a young female with a repaired OASI who still has symptoms of anal incontinence. We end part one of the focus on the posterior compartment with a considered view on the management of complex rectovaginal fistula by both a Urogynecologist, Dr. Judith Goh and a colorectal surgeon, Dr. Chris Gillespie.
Lastly, we have a swansong piece by the outgoing Editor of the International Urogynecology Journal, Dr. Becky Rogers in the IUJ Corner. We are grateful to both Dr. Rogers and Dr. Swift for their incomparable contribution to the journal. We also would like to take this opportunity to thank our outgoing President, Dr. Jorge Haddad, for his immense contribution to our IUGA family. We will miss his wonderful and uplifting Presidential notes informing us on all the successes of our organization.
2023 has rung in changes in our Publications Committee too. We thank our outgoing members, Dr. Jane Schulz and Dr. Carmen Ortiz Roque, for their hard work and good spirit. We also welcome our new members, Temesgen Tilahun Bekabil, Kazibe Koyuncu, and Kaven Baessler. Thank you for your willingness to contribute to the committee and IUGA.
Happy New Year once again! And thank you for your support, our dear readers! Hope you find this issue as enlightening as we did in producing it!