Neurourology and Urodynamics 29:21–27 (2010) REVIEW ARTICLE What Was ‘‘Hot’’ at the ICS Annual Meeting San Francisco 2009 Rufus Cartwright, 1 Hashim Hashim, 2 and Christopher Chapple 3 * 1 Institute of Reproductive and Developmental Biology, Hammersmith Hospital, London, United Kingdom 2 Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom 3 Department of Urology, The Royal Hallamshire Hospital, Sheffield, United Kingdom INTRODUCTION The 39th International Continence Society (ICS) meeting was held in San Francisco, California, USA, from September 29 to October 3, 2009. There were 16 educational courses, 38 workshops, 34 oral podium presentations, 18 video podium presentations, 232 oral poster presentations, 309 non-discussion posters, 12 non- discussion videos, 278 read-by-title abstracts, 4 state of the art lectures, and 1 point-counterpoint discussion. This year saw the greatest number of abstracts, workshops, and educational courses accepted for an ICS meeting so far. Some workshops and courses are available for viewing as webcasts (http://webcasts.prous. com/ICS2009/). In this article we summarize what we believe to be the highlights of these sessions, bearing in mind that no doubt there will be an inevitable subjective bias, for which we apologize in advance. Should the reader wish to explore further then this can be done through the ICS website (http://www.icsoffice.org). SESSION 1 (PODIUM)—SURGERY FOR STRESS URINARY INCONTINENCE Kulseng-Hanssen et al. (Abstract 3) 1 presented data comparing tension-free vaginal tape (TVT), tension-free vaginal tape-obtu- rator (TVT-O), and transobturator vaginal tape (TOT), collected from 27 centers in Norway as part of the Norwegian Incontinence Registry between 2004 and 2008. A total of 5,942 patients were recruited, of whom more than 90% completed careful post- operative follow-up investigations at a mean of 9 months. In contrast to previous randomized trials, TVT was demonstrated to provide greater patient satisfaction, and better subjective and objective improvement, than TVT-O or TOT. As expected peri- operative complications such as bladder perforation were com- moner in women selected for TVT. Questions were raised about the possibility of a learning curve effect, or biases introduced by the non-randomized design. Despite high overall cure rates, the study indicates that the introduction of obturator tapes in Norway was associated with a poorer outcome for women undergoing continence surgery. In contrast, Schiener et al. (Abstract 4) 2 presented data from a randomized trial designed to assess the urodynamic effects of the same three techniques. Patients were randomized to TVT, TOT, and TVT-O with a randomization of 4:2:2. The interim analysis presented found no significant differences in efficacy, and similar obstructive effects on voiding. The analysis did however reveal early complications relating to TVT—hemor- rhage and bladder perforation, in contrast to more mid-term complications associated with both obturator tapes, including erosions, thigh pain, and dyspareunia. Lee and colleagues (Abstract 5) 3 reported on 283 women who underwent the ‘‘TVT secur’’ operation in a multicenter study using an ‘‘H’’ or ‘‘U’’ approach. At 1 year they found an 83.9% objective and 76% subjective cure rate. The outcome of mini-sling procedures such as this remain the subject of debate at present and longer term follow-up in a number of studies is awaited with interest before more definitive conclusions can be reached. SESSION 2 (PODIUM)—PELVIC ORGAN PROLAPSE Barber et al. (Abstract 7) 4 presented an analysis of 18 different definitions of success for abdominal sacrocolpopexy, performed with or without Burch colposuspension as part of the CARE trial. Three hundred twenty-two women completing 2-year follow-up were asked to subjectively rate their impression of the success of their surgery. Although only 19% of patients met the NIH definition for optimal anatomical outcome, 71% of patients considered their surgery very successful. Among the definitions examined, those that included the absence of vaginal bulge symptoms had the strongest relationships with patients’ percep- tion of success, and improved health-related quality of life. In contrast, definitions based on anatomical correction had weak or absent association with patient perception of outcome. The authors concluded that the absence of vaginal bulge symptoms should be reported in all prolapse surgery trials as a standard marker of subjective success. de Boer and Vierhout (Abstract 8) 5 reviewed the literature relating to whether storage symptoms improve after surgery for pelvic organ prolapse and found in practically all studies there was an improvement after surgery (see paper in this issue VIERHOUT PAPER NEED TO REFERENCE). Ismail (Abstract 9) 6 highlighted the fact that three mesh techniques (Avaulta, Perigree/Apogee, and Prolift) have each been associated with significant complications, as documented in the FDA MAUDE database; concluding that complications may be a more signifi- cant problem than suggested by the results of clinical trials, conducted by enthusiasts in specialized units. Weincke et al. (Abstract 10) 7 answered an important question about the use of prophylactic antibiotics during prolapse surgery. They randomized 111 women to receive 1.5 g cefuroxime or no prophylaxis at the time of surgery (anterior and/or posterior colporrhaphy, enterocoele repair, or perineorrhaphy). In a planned interim analysis they found that cefuroxime was strongly protective against urinary tract infection (UTI) during the first post- operative week with a reduction as evidenced by an odds ratio of 0.28. This effect was not however maintained out to 30 days. Smoking was associated with an increased risk of infection out to 30 days following surgery. SESSION 3 (PODIUM)—NEUROUROLOGY 1 Kong et al. (Abstract 12) 8 used differential labeling of acetylcho- line receptors, muscle fibers, and neurons to visualize the nature of Disclosures: R.C. has received research funding from UCB Pharma and Astellas, H.H. is a scientific consultant with Astellas and Ferring, C.R.C. is a scientific consultant and researcher with Allergan, Astellas, Novartis, Ono, Pfizer, Record- ati, and Xention. *Correspondence to: Christopher Chapple, MD, FRCS, The Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Glossop Road, Sheffield S10 2 JF, United Kingdom. E-mail: c.r.chapple@sheffield.ac.uk Received 26 October 2009; Accepted 26 October 2009 Published online 15 December 2009 in Wiley InterScience (www.interscience.wiley.com) DOI 10.1002/nau.20859 ß 2009 Wiley-Liss, Inc.