The Effectiveness of “Placebo” in Current Medical Research

Diane K. Newman | November 23, 2020

The International Continence Society (ICS) 2020 online meeting opened with a presentation by Dr. Alan Wein, previous Chief of Urology at the University of Pennsylvania, now Director of the Penn Urology Residency Training Program. Dr. Wein presented an informative lecture on the effectiveness of the “placebo” in clinical research. He reviewed the results of the proof of concept study of stress urinary incontinence (SUI) in post-menopausal women with an enobosarm (GTX-024), a synthetic androgen receptor analog, presented previously at the 2017 International Continence Society (ICS) and the 2018 American Urological Association (AUA) annual meetings.

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diane k newman

Diane K. Newman, DNP, ANP-BC, FAAN is an Adjunct Professor of Urology in Surgery, Perelman School of Medicine, University of Pennsylvania and Co-Director of the Penn Center for Continence and Pelvic Health. She is the author of several books. The most recent is as lead editor of the 1st edition of the SUNA Core Curriculum for Urologic Nursing and of Clinical Application of Urologic Catheters, Devices and Products.

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Download Controlling Your Bladder Urges With Bladder Training

CONTROLLING YOUR BLADDER URGES with BLADDER TRAINING is information about overactive bladder symptoms of urgency, frequency and urgency incontinence. This tool detail bladder training strategies including methods for controlling urinary urgency.

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HABITS THAT CAN AFFECT YOUR BLADDER is information about foods and liquids that can irritate the bladder causing urgency, frequency and incontinence. The first page is a list of foods that are known to be bladder irritants, with a list of foods and liquids that contain caffeine. The second page lists other things that can cause bladder symptoms including herbs that have been shown to negatively impact the bladder and information on recommended daily intake of fluids and drinks.

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How to Do Pelvic Floor Muscle Exercises are instructions for performing pelvic muscle exercise. These are commonly referred to as “Kegels”. It details how to perform both quick and slow muscle contractions and provides tips for identifying the muscle, when to do them. These instructions are for men and women.

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Doing the “Knack” to Stop Bladder Leaks reviews the strategy for stopping insentience, bladder leaks. Some refer to these as “stress strategy”. These instructions will assist a person in the use f the pelvic muscle at the time when urine leakage is most apt to occur.

Physician-Scientist Review Articles
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Pelvic Health
October 7, 2021
Overactive bladder (OAB) is a symptom complex of lower urinary tract symptoms of urgency, frequency with or without urinary incontinence. It is prevalent in both men and women (10.8% and 12.8% respectively). According to Irwin and colleagues (2006), women have a higher rate (13.1% vs 5.4%) of urinary incontinence (urgency, stress, or mixed), are more likely (19% vs 12%) to report frequency of more than eight times per day, and are more bothered by urinary frequency than men (66% vs 46%).

September 8, 2021
Summary
A 59 year old gentleman presented to the urology outpatient department, having been referred by his general practitioner (GP) with lower urinary tract symptoms (LUTS). On review of his medications, he was taking a calcium channel blocker for control of his mild hypertension. This was subsequently swapped and his symptoms improved and he was discharged from the urology clinic. It is shown in the literature that there is a clinically significant correlation between use of calcium channel blockers and worsening of LUTS.
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Presented by Sirpi Nackeeran
The study’s aim was to show how frailty affects perioperative complications in women undergoing pelvic organ prolapse (POP) surgery. They sought to determine (1) the role of frailty on postoperative complications and (2) the association of racial and socioeconomic differences between frailty and postoperative complications among women undergoing apical prolapse repair.
Presented by Duane Hickling, MD
Dr. Duane Hickling presented the evidence behind many common urinary tract infections (UTI) treatments: water, methenamine salts, D-Mannose, and lactobacillus. He noted that UTIs are common as 20% of college-aged women had at least one culture-confirmed UTI recurrence within 6 months.
Presented by A Lenore Ackerman, MD Ph.D.
A urinary tract infection (UTI) is defined as microbial infiltration of the normally sterile urinary tract. But there are no accepted definitions of UTI-associated symptoms, cut-offs for culture result, or definitively accepted uropathogens that can guide clinicians in the objective management of a UTI.
Presented by Eric Rovner, MD
Dr Rovner moderated a symposium on Bulkamid, a periurethral injection which was approved by the FDA in 2020 for the treatment of stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD) or in women who have SUI or stress predominant mixed urinary incontinence (UI).
Dr Tamara Bavendam was given the SUFU Lifetime Achievement award in recognition of an outstanding career in urology.  She had previously received SUFU’s Distinguished Service award. In accepting the reward, Dr. Bavendam reflected on what she termed “my unusual career”.
Presented by Jeffrey P. Weiss, MD
Miami, FL (UroToday.com) Dr. Jeffrey Weiss provided an update of the management of nocturia. Patients are oftentimes asked to fill out a 24-hour voiding diary but compliance in completing them is sometimes very difficult to obtain.
Presented by Harris Emilio Foster, MD
Miami, FL (UroToday.com) Dr. Foster leads the audience through the AUA BPH Guidelines briefly emphasizing the new changes /updates that will be seen in the new updated BPH guidelines.
Presented by Alison P Downey, MD
Philadelphia, PA (UroToday.com) Dr. Chapple from Royal Hallamshire Hospital, Sheffield, and his colleagues presented their experience and outcome of surgical intervention in the management of bladder pain syndrome in a tertiary center.
Presented by Mikel Gray, Ph.D., RN
Philadelphia, PA (UroToday.com) Mikel Gray, Ph.D., RN provided an overview of urodynamic procedures, which were defined as a set of tests created to estimate storage and evacuation of urine from the lower urinary tract (LUT).
Presented by Shannon Novosad, MD, MPH
Philadelphia, PA (UroToday.com) Shannon Novosad, MD, medical officer at the Centers for Disease Control and Prevention (CDC) has opened Educational Course on Clinical Directions in Continence care by providing an overview
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