Monday and Tuesday, Winston-Salem is the site for a global conference with more than 130 international experts in female pelvic floor disorders. Up to fifty percent of women will have symptoms of vaginal prolapse in their lifetime, and one in five will require surgery for prolapse or urinary incontinence.
With the number of women over 65 expected to double by 2050, the need for more resources and better prolapse management will continue to rise.
Wake Forest University School of Medicine Professor of Urology and OBGYN, Dr. Catherine Matthews, is chairing the conference. She recently spoke with WFDD’s David Ford about the conference and its significance.
Interview Highlights:
On Matthews' goals for the conference:
"So, this conference is designed to improve the care of women who present the first time with uterine prolapse, because what we know currently is depending on what practice that patient walks into, in what part of the world, she'll be offered extremely different surgical management. And so the aim of this conference is to systematically review the literature regarding the evidence that we currently have for the surgical management of primary uterine prolapse and apply that evidence to different phenotypes of disease."
On why now in 2026?
"There are probably multiple reasons. Number one, gynecologic surgical research is dramatically underfunded. It's never been a prioritized research agenda. Many women who present with uterine prolapse unfortunately undergo a hysterectomy as an intervention, which has never actually been found to be effective, because it's not the uterus's fault that it's falling; it's the support around the uterus. And so simply removing the uterus does not fix the problem of prolapse. And so in some measure, it's really because women have been surgically mismanaged for a long period of time with simple hysterectomy, which is still ongoing today."
On specific hopes for the conference:
"We've been fortunate to have contributions from really a global panel of experts who are internationally known, big names in the field, who've made contributions to the collection of evidence to inform the discussions. The consensus statements that I'm most excited about is defining the risk factors for failure of surgery, so we can start categorizing patients into low risk versus high risk, much like breast cancer. When you're treated for breast cancer, not all breast cancer is created equally. They're women with high risk for recurrence versus low risk, and your treatments should be different for those different populations.
So we're going to try to define clearly the risk factors for recurrence, the differential impact of different surgical interventions, specific techniques that may impact on success versus failure and complications, and then, importantly, how to evaluate and manage concomitant urinary symptoms. When you're operating on one problem, you don't want to create another, and so we want to really carefully assess, how should we be dealing with urinary symptoms in the context of uterine prolapse."