Application Request to Hold an Add-On ICS Educational Course

Name of ICS Member requesting application: DANIEL GARCIA SANCHEZ Country in which course is to be held: Proposed City GUADALAJARA. Proposed Dates 6, 7 y 8 march 2014 Proposed Venue There will be a teorical-practical course in an hotel of Guadalajara city, it has all the facillites we need Accommodation details for speaker(s) HOTEL: HILTON GUADALAJARA WE ASUME THE HOTEL COST AND HIS MEALS FOR THE SPEAKER Number of expected delegates: 100 (last we had 70) Include degree of training and discipline What event does the ICS course add on to? i.e. a NO ONE national annual meeting Would you like the course to be accredited by the CONSEJO MEXICANO DE UROLOGIA EU-ACME? There is a charge for accreditation so we must ensure that accreditation would be applicable to your delegates. To what local associations are you applying for CPD CONSEJO MEXICANO DE UROLOGIA / recognition? SOCIEDAD MEXICANA DE UROLOGIA Will there be an exhibition? YOU CAN HAVE THE ZONE FREE FOR PROMOTE ICS MEMBERSHIP Other known Urological/Gynaecological meetings in ANY IN SCHEDULLE TO DAY the geographical area occurring 2 months before and 2 months after proposed date Local information: e.g. weather, national holidays in four week period leading up to and including the course date

THIS WAS THE WEATHER FOR THIS YEAR

Need for course: Why is important that the ICS runs a course for this audience? What do you feel the benefit to you will be? What can ICS provide that local providers will be unable to deliver?

There are an spectation for the participation to the ICS in mexico last year many doctors cant came and if you have an point to exhibition you can invite more people to be a member to ICS. The course brings together the most and the majority important doctors in the area. We want to promote RIO in our web side. I ask to Ervin Kocjancic, he is agree to came with us if u are agree too Declaration:

I confirm that the information above is true to the best of my knowledge and that I have read and understood the Course Guidelines.

The proposed programme for the course with detailed speakers/topics and timings is attached to the application.

I acknowledge:  ICS speakers will speak in English. If simultaneous translation or another form of translation required is required then the ICS will not cover the costs for this.  The ICS may wish to attend the meeting and have an exhibition booth and would expect a free booth to promote the benefits of ICS membership.  The host organisation will organise and cover hotel costs for the ICS speaker(s)  The host organisation will organise and cover return transfer costs from the airport to accommodation. If the accommodation is in a different location to the course venue then local ground transport will also be provided  The ICS will cover the costs of flight and related personal expenses for the speaker(s)

Signed

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Dated: México DF a 11 de noviembre de 2014 INITIAL Programme

Incontinence, Urodynamics and Pelvic Organ Prolapse Course

THERSDAY 6 MARCH

Time Activity/Lecture Speaker 8.00-8.45 INSCRIPTION 8:45-9:00 WELLCOME CEREMONY DANIEL GARCIA MD Urodynamics Module coordinador 9.00-9.30 Urodynamics Practice ADRIAN GUTIERREZ MD 9.30-10.10 Urodynamics standarization (ICS) ERVIN KCOJANCIC MD OVERACTIVE BLADDER MODULE COORDINADOR

10.10-10.40 Overactive Bladder physiologic, epidemiologyc DANIEL GARCIA MD 10:40 – 11:10 Overactive Bladder farmacologyc treatment 11:10-11.40 Overactive Bladder / botox / interstim SERGIO DURAN MD 11.40-12.10 Question & Answer Session 12.10-12.30 break 12.00-12.45 ENURESIS UPDATE RAUL PEREZ ORTEGA MD

12:45 – 14:00 lunch 14:00 – 3-30 SLINGS IN FEMALE ALOINJERTOS DERMIS MATRIX SIVIARDO DE LEON FDA TODAY MD VIDEO TECNICS ERVIN KCOJANCIC MD

3.30- 4:00 QUESTIONS 4.00-5.30 SLINGS IN MALE VICTOR ROMANO MD VIDEO TECNICS AND TIPS REMEX ARGUS

5:30 – 6:00 QUESTIONS 20 00 WELCOME Cocktail

FRIDAY 7 MARCH

Time Activity /Lecture Speaker 9.00-14:00 TALLER INCONTINENCIA FEMENINA (HOSPITAL ) SIVIARDO DE LEON MD 9.00-14:00 TALLER INCONTINENCIA MASCULINA (CEMEFO) VICTOR ROMANO MD 9.00-14:00 TALLER LITIASIS URETERAL (HOSPITAL) WILLY WOLFAIN MD 9.00-14:00 TALLER URODINAMIA (CENTRO DE URODINAMIA DE JALISCO) RAUL PEREZ MD

20 00 PROFESOR DINNER

Saturday 8 MARCH

Time Activity/Lecture Speaker Incontinence in Women Module coordination 9.00-9.30 VALORACION CLINICA DEL PISO DENIA LOPEZ MD PELVICO CLINICA 9.30-10.15 VALORACION PISO PELVICO ULTRASONIDO 10.15-11.00 VIDEO DISCUTION AND TIPS VICTOR ROMANO MD COLPOSUSPENCION CARPIO LAPAROSCOPICA ABIERTA

11.00-11.15 COFFEE BREAK PROFILAXIS URINARY INFECTIONS IN NEUROGENIC BLADDER Module 11.15-12.15 INMUNOLOGIA DANIEL GARCIA MD 12.15-13.00 ANTIBIOTICS ADRIAN GUTIERREZ MD 13.00-13.15 Closing Ceremony SIVIARDO DE LEON MD

DANIEL GARCIA MD

 EX COORDINADOR DEL CAPITULO DE CONTINENCIA DE LA SOCIEDAD MEXICANA DE UROLOGIA

 NEUROUROLOGO

 PROF ASOCIADO DEL CURSO POSTESPECIALIZACION DE NEUROUROLOGIA Y URODINAMIA DE LA UNIVESRSIDAD DE NUEVOLEON

 VOCAL DE LA SINUG

ADRIAN GUTIERREZ MD

 COORDINADOR DEL CAPITULO DE CONTINENCIA DE LA SOCIEDAD MEXICANA DE UROLOGIA

 NEROUROLOGO

 PROF TITULAR DEL CURSO POSTESPECIALIZACION DE NEUROUROLOGIA Y URODINAMIA DE LA UNIVESRSIDAD DE NUEVOLEON

 JEFE DE LA UNIDAD DE UROLOGIA DE LA UNIVERSIDAD DE NUEVOLEON

ERVIN KCOJANCIC MD

SERGIO DURAN MD

 UROLOGO

 JEFE DE LA UNIDAD DE UROLOGIA DEL INSTITUTO DE REHABILITACION DE LA CIUDAD DE MEXICO

RAUL PEREZ ORTEGA MD

 EX COORDINADOR DEL CAPITULO DE CONTINENCIA DE LA SOCIEDAD MEXICANA DE UROLOGIA

 NEUROUROLOGO

 PROF ASOCIADO DEL CURSO POSTESPECIALIZACION DE NEUROUROLOGIA Y URODINAMIA DE LA UNIVESRSIDAD DE NUEVOLEON

SIVIARDO DE LEON MD

 EX COORDINADOR DEL CAPITULO DE CONTINENCIA DE LA SOCIEDAD MEXICANA DE UROLOGIA

 UROLOGO

 GINECOLOGO

 PROF TITULAR DE UROLOGIA DE LA UNIVESRSIDAD AUTONOMA DE GUADALAJARA VICTOR ROMANO MD

 UROLOGO Y CONSULTOR INTERNACIONAL

 JEFE DE LA SECCION DE CONTINENCIA DEL HOSPITAL DURAND

 EX PRESIDENTE DE LA SOCIEDAD ARGENTINA DE UROLOGIA

 PROFESOR DE UROLOGIA DE LA UNIVERSIDAD DE BUENOS AIRES

DENIA LOPEZ MD

 GINECOLOGA

 UROGINECOLOGA

 COLABORADORA EN DIVERSOS CAPITULOS DE LIBROS DE UROGINECOLOGIA