Mr William M A Kuteesa MBBS MRCOG
Consultant Obsetrician and Gynaecologist Subspecialty interest: Urogynaecology.
William Kuteesa graduated from Guys and St Thomas’s Hospital, University of London in 1994. He undertook postgraduate training in sexual health medicine, obstetrics and gynaecology in London, and went on to practice in township hospitals in the Eastern Cape province of South Africa. He returned to the UK to enter the Oxford Deanery Specialist Training Programme and took a special interest in urogynaecology. He was then appointed as a Senior Fellow at the St George Hospital Pelvic Floor Unit, Sydney Australia. There he gained experience in minimal access surgery and undertook clinical research into detrusor overactivity, and continence surgery. He has presented original research at national and international urogynaecology meetings and has contributed articles to peer reviewed journals relating to this area. He currently practices obstetrics and gynaecology with special interests in pelvic floor reconstruction, continence, and minimal access surgery.
- Ageing and Pelvic Organ Prolapse. A View of Treatment: Past, Present, and Future.
Female pelvic organ prolapse (POP) has challenged physicians since the time of Hippocrates. The sheer weight of numbers affected by this condition makes it a major world healthcare problem that is compounded by ageing western populations.
Parturition commonly traumatises the pelvic floor musculature and fascial attachments that support the pelvic organs. Menopause and ageing magnify the effects of this initial injury, resulting in descent of the pelvic organs into the vaginal canal, or through the vaginal opening.
Over millennia, medical texts have described every conceivable material from pomegranates to gold to mechanically support prolapsing pelvic organs. The history of surgical intervention is equally rich, with one of the first authenticated case reports of successful vaginal hysterectomy being described as early as the 1500s. Despite this, surgical techniques have altered very little in almost 100 years. This is until recent advances have been made in the understanding of biomechanics and synthetic materials. Contemporary surgery uses a combination of time-honoured techniques with these new materials and novel ways of inserting them. The objectives of surgical intervention are not only to abolish symptoms by re-establishing correct anatomy, but also to minimise failures, maintain sexual function and improve quality of life.
Future advances in this field might include the widespread implementation of robotic assisted surgery, and perfecting the synthetic materials used to reinforce the weakened facia and ligamental attachments, that are essential to pelvic organ support.