Chapter 1 has been completed and published in the IUJ with articles that include the Clinical Definition of POP; the Epidemiology (Incidence/Prevalence and Natural History); the Pathophysiology including Risk Factors, Family History, Genetic Mutations; the Patients' Perception of Disease Burden of POP and the Relationship to Associated Morbidity/Pelvic Floor Dysfunction (Urinary Incontinence/Voiding Dysfunction, Fecal Incontinence, Sexual Dysfunction and Pelvic Pain).

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Introduction to the International Urogynecological Consultation: the new IUGA educational project

Committees

1. Clinical Definition of POP
This will be the first report for this section and will set the tone for this entire report. Defining the disease and how symptoms and physical exam findings play a role in an accurate definition of the disease state of pelvic organ prolapse. This committee should seek to develop a clinically useful definition of this disease based on what is known about normal support vs abnormal support and how the interaction of physical exam findings relates to pelvic organ prolapse specific symptoms.

Steering Committee Advisor : TS Lo (Taiwan)
Committee Chair: Kimberly Kenton (USA)
Committee Members: Tiffany Chih (USA) / Sarah Collins (USA) / Kim van Delft (The Netherlands) / Nicola Dykes (New Zealand) / Autumn Edenfield (USA) / Michele O'Shea (USA) / Olga Ramm (USA) / Clara Shek (Australia)

2. Epidemiology of Pelvic Organ Prolapse: Incidence/Prevalence, Natural History
This report will discuss how the mechanisms of vaginal birth and age predispose women to develop pelvic organ prolapse. The impact of pregnancy, the mechanics of the delivery process and enzymatic and protein alterations or deficiencies will be reviewed and their contribution to the process of developing pelvic organ prolapse will be discussed. What is known about how genetics and family history contribute to these processes will be discussed looking for potential risk factors for developing pelvic organ prolapse.

Steering Committee Advisor : Lynsey Hayward (New Zealand)
Committee Chair: Heidi Brown (USA)         
Committee Members: Aparna Hegde (India) / Markus Huebner (Switzerland) / Ervin Kocjancic (USA)/ Gisele Vissoci Marquini (Brazil)/  Bernard Mbwele (Tanzania)/ 
Hedwig Neels (Belgium) / Visha Tailor (United Kingdom) / Elisa Trowbridge (USA)

3. Pathophysiology of Pelvic Organ Prolapse: Risk Factors, Family History, Genetic Mutations
This report will focus on the how many women are affected with pelvic organ prolapse, the lifetime risk of developing pelvic organ prolapse and how untreated pelvic organ prolapse progresses or regresses. This will set the tone going forward by giving the overall impact of pelvic organ prolapse as a disease in women. There should be discussion of the future need for services, particularly surgical care of prolapse as the population ages. This report can touch on definitions  (symptomatic definitions vs physical exam definitions) and how this relates to the various reports on incidence, prevalence and natural history, but should not express opinions on which definition is most appropriate (that will precede this report in the chapter on the definition). The committee chairs will coordinate their writing so that terminology in this report is consistent with the report on the Definition of Pelvic Organ Prolapse.

Steering Committee Advisor: Maria Bortolini (Brazil)
Committee Chair: Jan Deprest (Belgium)
Committee Members: Kristina Allen-Brady (USA) / Vivian Aguilar (USA) / Luiz Gustavo Oliveira Brito (Brazil)/ Rufus Cartwright (United Kingdom)/ Hans Peter Dietz (Australia)/ Marianne Koch (Austria) / Jittima Manonai (Thailand)/ Adi Weintraub (Israel)

4. Patients' Perception of Disease Burden of POP
This report will focus on how women perceive pelvic organ prolapse and its relationship to body image and poor health.  How the vaginal bulge affects women’s sense of health and wellbeing and how women perceive benefit from treatment will be reviewed. This report will attempt to best define what aspects of pelvic organ prolapse have the greatest impact on women’s sense of wellbeing so that appropriate treatment goals can be established. The cost to society of treating pelvic organ prolapse will be covered in this chapter. The chair of this report will coordinate with the chair of the report on Relationship to Associated Morbidity/Pelvic Floor Dysfunction Prolapse to assure consistency as there will be some overlap of these reports.

Steering Committee Advisor: Chantal Dumoulin (Canada)
Committee Chair: Dudley Robinson (United Kingdom)
Committee Members: Symphorosa Chan (Hong Kong) / Chiara Ghetti (USA) / Suzanne Hagen (United Kingdom) /  Jerry Lowder (USA)/ Svjetlana Lozo (USA)
Kathie Hullfish USA/ Lisa Prodigalidad (Philippines)/ Maurizio Serati (Italy)

5. Relationship to Associated Morbidity/Pelvic Floor Dysfunction (Urinary Incontinence/Voiding Dysfunction, Fecal Incontinence, Sexual Dysfunction and Pelvic Pain)
This report will focus on comorbid conditions that commonly impact women with pelvic organ prolapse. Vaginal/lower abdominal/back pain, sexual dysfunction, lower and upper urinary tract disease and gastrointestinal dysfunction will be discussed and their prevalence in women with pelvic organ prolapse defined. How these comorbid conditions affect health and treatment planning will be briefly reviewed. Treatment of these co-morbid conditions will follow in subsequent reports dedicated to treatment and will not be discussed in depth in this report. The chair of this report will coordinate with the chair of the report on Patients Perception of Disease, Quality of Life and Disease Burden to assure consistency as there will be some overlap of these reports.

Steering Committee Advisor: Bob Freeman (United Kingdom)
Committee Chair: Marie-Andree Harvey (Canada)
Committee Members: Alexandriah Alas (USA) / Baharak Amir (Canada)/ Alka Bhide (United Kingdom)/ Roxana Geoffrion (Canada)/ Pawel Miotla (Poland)/ Ifeoma Offiah (United Kingdom)/ Manidip Pal (India)/ Peter Rosier (The Netherlands)