Very good. Your question is excellent. The reason is, if we miss or don't find those subtle atypical lesions one would think it is recurrence, but it is not recurrence, it is missed diagnosis, or this is under treatment. That is why a systematic evaluation is important; it finds those small subtle lesions allowing us to take care of them because if the lesion is left behind, it will grow.
Yes, especially in the younger individuals. I see a lot of young individuals, who have pain and bleeding, and it’s been ignored. And then, when you look at it and you catch it at the early stage, it makes them understand they have a condition that could stay with them. They no longer think it is in their head. The patient I showed you had small lesions in the inguinal area, she had cyclic pain on her groin and a CAT scan revealed she did not have a hernia but endometriosis caused irritation and inflammation.
The staging of endometriosis, unfortunately, does not truly describe the invasiveness of the disease, specifically when it comes to pain. Current staging is for infertility assessment even though infertility does not always describe the severity of the disease. For example, an ovarian endometrioma is automatically staged higher than a 25px obstructed lesion on the ureter although the obstructed ureter, if left untreated, can result in irreversible kidney damage. We have yet to come up with appropriate classifications to address the extent of the disease correlating it to the patient’s symptoms. Hopefully this will change.
So, American Society of Reproductive Medicine was initially established as American Fertility Society. During the past 75 years, they have made significant progress in not only fertility, but in all aspects of reproductive health in women and men. The society is based on a very close collaboration between the gynecologist and urologist to address female and male fertility problems; for example, we’ve had children born with congenital abnormalities and this collaboration has helped surgical improvement. From the fertility point of view, we have accomplished a lot regarding hormonal problems, not only in the young aged individuals like persons with polycystic ovarian syndrome but also in the older people like postmenopausal women. So it covers all aspects of the reproductive part of the female, mainly, and some men.
Yes. The annual meeting is going to be another successful meeting not only from the scientific value, but internationally. American Society of Reproductive Medicine has the largest international participation. And we anticipate finding it very very productive with of course, a lot of learning opportunities like postgraduate courses. From the Society of Reproductive Surgeon, we have a very good didactic part covering different surgical aspects of reproductive surgery. We also have a hands-on course with training, and of course other areas like urology, will have hands-on courses also.
Absolutely. As I mentioned, the Chinese surgical society in all specialties have progressed significantly and, from the technical point, they are doing a very good job. I have seen a lot of research coming out from the PhD levels on the scientific part, specifically, I have seen it on endometriosis and also on cancer, a lot of research coming up. So, this collaboration we are anticipating being in more putting courses, hands on courses, and working. Personally, I always have at least one or two visiting Chinese fellows in my center each year. Of course Professor Duan has come for a visit. This year so far, I have had three from China, and they stay anywhere between three to six months.
Very good, and I am very pleased to see our collaboration is improving and progressing very rapidly.
Thank you very much, it has been a pleasure.