To evaluate the level of evidence behind recommendations on social media for disease prevention in five lower urinary tract symptoms.

We conducted a digital analysis of anonymous online posts on social media sites collected by a social media data mining service. One thousand posts about pelvic organ prolapse (POP), stress urinary incontinence (SUI), overactive bladder (OAB), urinary tract infection (UTI), and interstitial cystitis / bladder pain syndrome (IC/BPS) were randomly selected. We analyzed these posts for recommendations regarding the prevention and treatment of these diseases, which were then compared to recommendations in available clinical guidelines and assessed for level of evidence.

A total of 158/1000 posts contained 239 prevention strategies. For POP there were 41 strategies identified, 25 (61%) of which had no evidence. For UTI 14/58 (29%) had no evidence, including recommendations for dietary modifications and urinary alkalization. For OAB 8/28 (29%) had level 4 or no evidence. For SUI, 12/34 (36%) of prevention strategies had no evidence, such as laser rejuvenation and bladder training. IC had the highest number of prevention strategies, and most were low or non-evidence based (70/79, 89%).

Prevention and treatment strategies are common in online discussions of pelvic floor disorders, but at least one third of these recommendations have no evidential support. There is a role for further online education and social media engagement by health care specialists to promote evidence-based practices.

Urology. 2020 Jul 13 [Epub ahead of print]

Claire Burton, Gabriela Gonzalez, Kristina Vaculik, Carine Khalil, Yuliya Zektser, Corey Arnold, Christopher V Almario, Brennan M R Spiegel, Jennifer T Anger

Department of Urology, David Geffen School of Medicine, UCLA, Los Angeles, CA., David Geffen School of Medicine, University of California, Los Angeles, CA., Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA., Medical Imaging Informatics, Department of Radiology, UCLA, Los Angeles, CA., Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA. Electronic address: .

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