Summary of the 12th Annual ISGE Congress

Professor Hans Brölmann, MD: “We are today, the 4th of April, in Cancun. It is a beautiful venue, at the annual congress of the ISGE. Next to me is Professor Alberto Valero. He is a professor of gynaecological endoscopy, in Mexico City. My name is Hans Brölmann, and I am working at the Free University in Amsterdam also as a professor of endoscopy. Well my first question, Alberto, the weather is wonderful and it’s a beautiful time; it’s a beautiful venue here, how do you think everything is going at the congress?”

Professor Alberto Valero, MD: “First I would like to thank all the speakers who came to Cancun. I have organised this congress for seven years. Now to date we have had 82 speakers from all over the world. This is really very impressive because besides the new data, we have right now it makes me happy to see that the whole team of the ISGE is here. The main headquarters, the executive members of the ISGE, are here and also because the development of the congress is pretty nice. We have 410 delegates from all over the world from 46 countries and Cancun offers all the standards that the ISGE allows to prepare for this type of congress. 

In the beginning we chose Cancun because the people from all over the world can arrive direct from South America, direct flights from the United States, from Canada, from Europe, and the people who come from Asia, they just have to make one stop in the United States and then to Cancun. So it really is a big pleasure to have you right here. 

The main goals of the congress; we divided the congress in four modules. In each module we talk about either the uro-gynaecological problems, about endometriosis, about cancer, and about the reproductive approach for the patients.”

Professor Hans Brölmann, MD: “It’s wonderful. Did you notice any consequence of the problems in the world and the war in Iraq? Do you think this might have had some impact on the number of delegates?”

Professor Alberto Valero, MD: “Obviously I think that all the world is shocked about the world situation, and the impact on this congress was very, very strong. We were expecting over 1000 delegates and we have just 400 so the impact was very, very strong and I think that the world is going to suffer in future months by what is happening in the Middle East. But, besides that, the show must go on. We have to keep working, we have to go ahead, and we can do nothing about the decision of the countries. But in the scientific area we have to keep very tight together and improve all our knowledge with regards to the benefits to the patients.”

Professor Hans Brölmann, MD: “One of the highlights of this congress, I thought, were some beautiful presentations about endometriosis and the controversial medical therapy before and after surgery. My question to you is: could you give your comments on the new developments on endometriosis?”

Professor Alberto Valero, MD: “Well, as everybody knows endometriosis right now has second place in the patients who present with infertility problems. To date, people all over the world start to get pregnant between the late 20s and early 30s and it’s different than it was 50 years ago, the patients started to be pregnant the latest at 19 and early 20s. So it appears right now that the endometriosis occurs more often in our patients, besides the problems that we have with the birth control pills, pelvic inflammatory diseases, various couples, and in this way endometriosis has increased all over the world. I think that these are the same statistics, and it doesn’t matter in the status of the patient, endometriosis is producing these problems very, very strongly. 

One of the main problems that we have is endometriosis in teenagers. The chronic pelvic pain they have when they start their first period at 13, 14 years old and start with the problem, it’s really, really a mess because the patients come to our office and at the age of 16, 17 and they suffer really, very, very strongly with pain every month and sometimes they are crazy, they don’t want to suffer these problems. 

So what we are doing in these instances is we have to make a very, very strong physical examination with complete lab tests, x-rays plus sonography or sometimes MRI to diagnose properly that she is suffering from this illness. After that, our main goal is to establish which type of endometriosis she has. For example, first grade or minimal endometriosis is not the same as severe endometriosis and it depends – on the status of the patient - what we decide we’re going to do with her. For example we can manage, just with a simple medication to avoid the pain, but sometimes we have to offer them a very, very strong medical management. 

The medical management depends on the type of patient. We can tell the patient we have the top end management with GnRH management, that takes between four to six months and it depends on the evolution of the patient if we decide to make some surgery, especially the laparoscopy to check exactly what happened with the endometriosis.”

Professor Hans Brölmann, MD: “Thank you very much. One small subject, there are rumours that you are going to start a training centre for laparoscopy here in Mexico City.”

Professor Alberto Valero, MD: “Yes. As always happens, right now Latin America is having a very strong place in the world with regards to endoscopic procedures. And Mexico has everything to afford this situation. So probably we are going to be one of the worldwide centres for training surgeries and it is where we can offer also to the Latin American people. So we are very happy and probably in less time than a few months we will be working in this field in Mexico City and then to train people from all over Latin America.”

Professor Hans Brölmann, MD: “Professor Valero, thank you very much. It is a pleasure to talk with you.”

Professor Alberto Valero, MD: “Thank you. It was a pleasure.”