New Evidence Report on Treatment of Overactive Bladder in Women
By Rachel Walden — September 3, 2009
AHRQ has posted a new evidence report, Treatment for Overactive Bladder in Women. For these reports, a team of folks reviews and evaluates the quality of the existing evidence on a topic, and looks at how that evidence addresses some key questions – in this case on prevalence and incidence of overactive bladder, treatment outcomes, comparisons of treatments, modifiers of outcomes, and costs.
I am particularly enthused about this one not only because it’s related to women’s health, but because it was done by the Evidence-based Practice Center (EPC) at my larger workplace, and I was actually involved in this topic through input on the search strategy and reviewing abstracts and full-text papers for inclusion/exclusion in the analysis. My colleague Rebecca Jerome was more deeply involved in the process, including some of the write-up, and is listed as one of the investigators.
Here’s the link to the PDF, if you’re interested. OBOS has some related content on urinary urgency and frequency and interstitial cystitis here, which touches on the confusion about treatment/mistreatment of urinary problems in women. Similarly, the AHRQ report notes that while overactive bladder is somewhat common and effectively resolving it may be important for women’s quality of life, the effects of the available treatments (including drug treatment) are considered “modest,” with little high quality literature available on the topic to guide treatment choices. As the Executive Summary concludes: “Women and their care providers deserve better information to guide their choices.”
[Cross-posted from Women’s Health News]
I had my own bladder nightmare several years ago, and spent two years in excruciating pain (I define excruciating as fantasizing about blowing ones brains out to escape form the pain). I saw four different doctors, two of them urologists. It was all very hit or miss. I was on antibiotics fruitlessly for months. The final urologist diagnosed me with IC, and I did have great benefit from following a low-acidity diet and using Prelief. He told me there was a 1% possibility of my having a mycoplasma bacterial infection, but it required a special culture, as it wouldn’t grow using usual methods. I had that bacteria. 6 weeks of doxycycline, and my symptoms were reduced by 80%. We tested for sensitivity (only 2 labs in the country were able to do this, he said) and discovered I had a doxycycline resistant strain. A month of azithromycin later, and I was no longer in pain.
I wonder if I would have had to live like that for 2 years if the first urologist had been more cognizant of the latest research?