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