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I am writing this blog from The Hague after Day 2 of my visit to IUGA 2023 Conference. It has been so fabulous to be here face-to-face at a conference where we can listen to research, presentations and debates, circulate around the room visiting the trades that support our conferences so willingly, and mostly network with other health professionals whose goal each day when they go to work, is to improve the pelvic health state of women.

It has been a nervous time for me I have to admit  – what with the 25 hour plane trip, attending a conference with 1200 delegates and generally being in closed spaces with many other people, but I am here and gradually feeling more comfortable – albeit with my trusty mask tucked in my bra like a comfort blankey. This is what a pandemic of three and a half years does. 

I have wanted to write another blog forever about how “Words Matter”. This has been sitting in drafts for a few months now, with no time to write for a while. The words we say to patients especially matter. But I was reminded about this half-prepared blog when I listened to a presentation today from a world famous tennis player Esther Vergeer who is one of the most successful Dutch athletes ever. For years Esther has been the world’s undisputed number 1. Her best winning streak was a sequence of 470 winning games. (1)

Did I mention that Esther has been a paraplegic since she was 8 years old? What an inspirational speaker she is. She reminded me about what health professionals say to patients does matter, as does (importantly for Esther) how they say it. She related the story of how at aged 8, she woke up from her anaesthetic lying on her tummy, with a group of doctors talking around her – they were perplexed obviously – because Esther had gone in for back surgery with normal movement and sensation and had come out as a paraplegic. She felt bewildered, confused and worried. 

Esther Vergeer presenting at IUGA 2023 The Hague

After rehabilitation, she embraced life in a wheelchair. Her parents allowed her to be a normal eight year old and as she said, she returned to her school with her friends and lived a ‘normal’ life. She discovered her love of tennis, she has more than excelled at it and she related to us that she has had a wonderful life. Most importantly she has now made it her job in life to assist other people with a disability to realise that sport can be an incredible way to maximise their quality of life as well as their full potential.

She asked the audience today to all individually become an ambassador of change and carry a special message to all the corners of the world. Her dream is to see the Olympic and Paralympic Games to become one merged event to raise the profile of the Paralympic Games and people with a disability.

So here is my Change Message carried from Esther at IUGA2023 to my home state of Queensland, Australia and my home city of Brisbane – the host city for the 2032 Olympics. Why not make it one big spectacular of sport? How inspirational for other 8 year old children with a disability in 2032 to see super athletes in wheelchairs competing on a world stage with athletes without a disability. 

There was also a wonderful keynote address from the President of IUGA and Urogynaecologist, Fred Milani.


He spoke about the importance of diversity, equity and inclusion by relating his own story growing up feeling different and the importance of respecting individual differences whether it be in love, gender diversity or race. It is good to see an organisation like IUGA embracing these principles. May this continue to flourish in all areas of our future conferences.

‘Our stories may be singular, but our destination is shared’: Barack Obama 

Now this blog has turned out to be longer than I intended. So a quick finish to what actually prompted my intention to write a Words Matter blog.

I had a patient recently who came to see me with her husband. She was 12 months post-colorectal repair surgery and was in quite a state. She was convinced her surgery must have failed. When I asked her why she had thought that, she replied because the doctor had said she would probably need to have the surgery 3 or 4 times before it worked. She is 74 and for the last 12 months had been gripping furiously trying to not make it fail. Her pelvic floor muscles (I like to call them ‘the first responders’) were pretty switched on, with tender points on palpation. This was giving her a sensation of heaviness which she naturally translated into “My surgery has failed”. I told her everything was still good. She needed to work on more relaxation of her muscles and belly breathing to calm down her up-regulated state of everything. She was allowed to do some life activities – walk, garden, exercise, be with the grandchildren. I also said it doesn’t necessarily need to fail. It may well last quite a long time.. maybe as long as she needs it to, if she doesn’t strain at stool, manages her lifting of weights well and remembers the knack of bracing. She was incredulous. 

Words matter!

Another patient was told five years ago she had a three compartment prolapse immediately after she had her last child. She was a well-educated woman who believed her O&G. She has spent the last 5 years gripping furiously to fix that prolapse.  Her ‘first responders’ were well and truly talking to her all the time with a sense of heaviness that truly mimicked prolapse. There was no prolapse on assesment. 

Yet again, words matter. 

It has been a long time between blogs because it has been a hectic time, but there is much from the conference to report on, but despite the sky being remarkably light still, it is actually 10.30pm in The Hague. Bed beckons as we have a very early start to get to our next destination when the mountain spam will be flowing. 

There may be no words this time, just pictures…beautiful photos of mountains. I have waited 4 years to get back to Zermatt and see The Matterhorn and my weather app is giving me hope that this time, I will actually get to see it!

(1) Esther Vergeer profile taken directly from the IUGA app.