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Politics in the Pelvis

All around the world doctors and allied professionals are holding meetings and organizing educational courses that emphasize a multidisciplinary approach to the problems of the pelvic floor. Unfortunately fragmentation and tribalisation of our specialties have led to rival societies forming that aim to capture the attentions of the many interested specialists. Sometimes these societies are created to promote a particular operation or surgical technique. In Australia AAVIS began life as such a society but quickly realized that the only chance of a good future was to accept all interested practitioners and seek out rather than suppress alternative views and criticism of various techniques.

Societies have been formed based on laparoscopic pelvic floor surgery, urodynamic investigations, the Integral Theory and new classifications of pathophysiology. Other groups are heavily associated with one sponsor or supplier. Controversies have arisen with regard to the financing of meetings and educational courses by commercial interests. Even a prestigious scientific group such as the Internatonal Continence Society has become embroiled in internal disputes and political machinations. These conflicts have caused great personal anxiety for those involved and have rarely achieved the political results that were sought by the protagonists.

Recently this Journal has been criticized for being a “publicity machine” for one specialist with strong views because we published an article that he had submitted. Pelviperineology will not suppress the views of surgeons who are “politically incorrect” as long as they are scientifically sound but we will try to present a balanced position by also publishing alternative views. For example, this issue contains two papers which lead to different conclusions with regard to the STARR procedure.

Pelviperineology is a peer reviewed medical journal that is committed to publishing all opinions as we find them. We will consider the technical matters and language issues that could lead to rejection of an article but our main concern is the medical content and the potential interest of an article to our readers. All submitted articles are reviewed by practicing clinicians with a special interest in the area covered by the article under consideration.

Pelviperineology is also a generic term that refers to the multidisciplinary practice of Pelvic Floor Medicine. It is a term that can mean different things to different people and it has the power to release a clinician from the baggage of his narrow medical classification. Most doctors with an interest in the field of pelviperineology will continue to practice as urologists, colorectal surgeons or gynaecologists but some will seek to increase their skills in specific areas. One such society is Le Groupement Européen de Perinéologie (GEP, the European Perineology Group). We welcome the GEP to our journal and in the future each edition will provide a section for the messages and activities of the GEP to be made available to our readers. The GEP is a French language society of clinicians who have developed an interesting system of diagnosis and treatment, especially with regard to pudendal nerve entrapment and associated conditions. This is an area of great interest to many of our readers and we look forward to an ongoing contribution from this group.


The Editors