May, 2018

This year I had the privilege of attending the 113th American Urology Association Annual meeting – the largest gathering of urologists in the world with more than 20,000 participants.

The meetings are a chance for the world’s urology specialists to gather and discuss their work and ideas, expand their professional network, and review the latest research.  It is also an opportunity to expand education with 80 Instructional Courses held over the 5 days, spanning the full spectrum of urology.

The course on urologic chronic pelvic pain (IC/BPS, chronic prostatitis, vulvodynia) was one of the best. Taught by Robert Evans MD, Robert Moldwin MP and Jennifer Fariello CRNP, they presented actual, successful patient case studies from their clinics. Doctors were given new and far more effective approaches for diagnosing and treating pelvic and bladder pain.

Here are few of the main key points from their presentation:

• Flares during allergy season are common. They reported that many patients struggle with a two month seasonal flare and suggested that patients increase their antihistamine dose. They suggested Zyrtec or Xyzal – non sedating antihistamines.
• Pelvic floor muscles can cause and/or exacerbate our bladder, prostate and vulvar symptoms and “flares.”
• Kegel exercises should not be done. They make patients pelvic floor dysfunction worse.
• Basic therapy for Pelvic Floor Dysfunction: No pushing or straining, treat constipation, warm bathes twice a day with Aveeno Soothing Bath Treatment, no squats, using muscle relaxants and physical therapy.
• Treat constipation promptly! A new FDA approved medication can help!
• Marijuana suppositories and CBD (Cannabidiol) oil were suggested for pelvic floor spasms and pain.
• Men with “prostate problems” who have not responded to any oral medications should be tested for pelvic floor dysfunction, especially if they have a tender rectum.
• Dr. Robert Moldwin specifically discouraged ANY use of chlorpactin, or Silver Nitrate bladder instillations. He said “they don’t work.”
• Rescue Instillations (aka anesthetic instillation) can give patients empowerment and control during potential flares. These can be done at home.
• Nurse Practitioner said that to remove all vulvar chemical irritants: scented feminine products, no douching, scented soaps, dryer sheets and products which contain a variety of chemical irritants.
• Patients who struggle with vulvar pain can get relief by using ice packs, or warm bathes with Aveeno Soothing Bath Treatment, white Crisco, coconut oil or natural Vitamin E oils were suggest for topical application. It was recommended aloe gel with lidocaine to help reduce vulvar pain and suggested putting it in the fridge first.

All sessions were generated from qualitative research with IC/BPS patients in many countries to ensure that new targeted treatment was included.

The meetings were also a chance for private medical companies to showcase their latest technology and research in urological medicine.

I had the pleasure of meeting Mr.Rick Martin, the CEO of MicroGen – a company that specializes in Next Generation DNA sequencing for microbial identification. I discussed our research into IC/BPS and he is very supportive of what we plan to accomplish. In fact, he has generously offered the use of Microgen’s services free of charge to our research team.

This will undoubtedly be very important to us in the next stage of our research – “Validation of High Frequency Ultrasound applications and urinary microbiome diversity in patients with Interstitial Cystitis/Bladder Pain Syndrome”. We will be looking to start this phase as soon as we receive the approval from Sir Charles Gairdner Hospital Human Research Ethics Committee.

Dr. Antonina Volikova