Dear professor Falconer

We, the NUGA Board read your letter with keen interest as you are one of the important leaders within our Urogynecology community. It therefore came as a chock to us that you were so displeased with our program. In fact so displeased that you already decided not to attend. The NUGA Board agrees with almost everything in your letter regarding the paradigm shift in SUI treatment and none of us wants to abandon the slings and go back in time to previous inferior methods.

However, we do think you may have misunderstood our reasons for putting these topics on the agenda. We cannot ignore that there is a big international debate regarding slings and our patients use google for information. There is for instance a current moratorium on the procedure in the UK and they have had to re-learn Burch and autologous slings. There are big lawsuits taking place in the UK, US and Australia in which sling-patients make  up more than half of the patients suing the companies due to unexplained pain. Even though this is not the case in the Nordics for which we have good registry data, we cannot close our eyes to what happens around us. We need to be prepared if the industry decides to stop the manufacturing of slings due to their financial settlement payments. If NUGA is to stay relevant as “the conference”  our Nordic colleagues feel they have to attend, we need to discuss the topics that is “hot topics” in the international community whether we like it or not. At the last ICS in Philadelphia there were numerous sessions on the topics “sling removal” and “alternatives to slings”. Your comment on Bulkamid is also a little unfair as you refer to the sponsored lunch-symposium from Contura which  is not part of the official program and has not been decided by the NUGA board. The Board does not think Bulkamid should be first line treatment.

As you have been a major contributor to the development of NUGA and previous NUGA meetings, we were counting on you to come and speak your mind about the success of slings and all the adverse effects of the older discarded methods.

We in the NUGA Board therefore sincerely hope you will reconsider and come join your friends at the NUGA meeting.

Sincerely

NUGA Board 

Rune Svenningsen

Kristin Jonsdottir

Mette Hronum Bing

Antti Valpas

Riffat Cheema