ICA @ AUA
Tuesday, May 17
A day
hasn’t gone by here at the American Urological Association’s (AUA’s) annual
meeting without IC education or research that could spell insight into and help
for IC—even when there were no scientific sessions devoted to IC.
Unprecedented
third course on IC at AUA
ICA
Medical Advisory Board Co-Chair Philip Hanno, MD, led a two-hour course on IC,
the third at this meeting. There, urologists who will be treating you in the
future, learned about the new IC clinical guidelines and more that should bring
you better treatment. Read about the new guidelines in our Spring 2011 ICA Update, which will be arriving in
your mailbox shortly.
Many of
the clinicians and researchers we know well also treat chronic
prostatitis/chronic pelvic pain syndrome (CP/CPPS) and were presenting research
at a scientific session devoted mostly to that condition.
Do-it-yourself
physical therapy
Can’t
afford to go to physical therapy the way you’d like? Well, you can learn to
work out your own pelvic floor trigger points at home so that the process can
be more affordable for you and so you can get more regular treatment. In fact,
many physical therapists are already having their patients use wands made of
plastic or medical-grade glass that can be used internally to massage pelvic
muscle trigger points through the vagina or rectum.
Now,
urologist Rodney Anderson, MD, and psychologist David Wise, PhD, have done a
study using a wand they developed. They mapped their patients’ trigger points
and taught them to use this j-shaped wand to work them out. The patients used
the device two to three times a week for 5 to 10 minutes. Patients rated their
pelvic floor tenderness at about 7.5 at the start of the study and got it down
to an average of 4 six months later.
New
alpha blocker helps men with chronic
prostatitis
Clinical
trials of alpha blockers for CP/CPPS haven’t really shown them to be very
effective, but a new alpha blocker, silodosin (Rapaflo), showed better results than others have in
the past for men who have significant urinary problems as part of their
condition. It remains to be seen whether this alpha blocker might help urinary
symptoms in IC. There’s a spectrum of symptoms from CP/CPPS to IC in men, noted
Curtis Nickel, MD, who presented the study. Plus, he said, men can have both.
So, for men with IC, this alpha blocker might also help, but they will also
need more IC-specific therapy.
These
studies and a number of IC studies we told you about yesterday were highlighted
in a press conference on pelvic pain, which should help put the medical and
public spotlight on IC.
In an
afternoon session on female urology, hormones, nerve growth factor, and the
relationship of childhood urinary trouble to adult urinary symptoms and pelvic
pain got a look.
Could
birth control pills worsen urinary symptoms?
New York
University researchers surveyed young women (18 to 39) at two universities
about their urinary symptoms and their use of oral contraceptives. (It was not
clear whether any of the young women had IC.) Urinary symptoms were not very
common, but there were some differences among the groups. Users of low-dose contraceptives
were more likely to wake up at night to urinate and more likely to have uncontrollable
urge than women who didn’t take oral contraceptives. Women who took normal-dose
pills were less likely to have uncomfortable urge than controls. This doesn’t
necessarily match the experience of clinicians who take care of IC patients,
but it might mean that some pills may be better than others at easing cyclic IC
flares, and more research needs to be done.
Women
with pelvic floor symptoms had trouble as kids
A study
from Vanderbilt University showed that nearly 40 percent of women with pelvic
floor-related problems, such as incontinence and pelvic pain, had voiding
problems when they were children. Those problems included bedwetting,
frequency, incontinence, constipation, and fecal soiling. A history of
childhood symptoms seems to spell an increased prevalence of symptoms in adulthood.
The study didn’t identify IC specifically, but we know that many IC patients
say they had symptoms when they were children. This study should help increase
awareness that IC may start in childhood and even that kids can have IC.
Posted May 18, 2011