World’s Top Urological Specialists Meet • After testing 492 men in various age brack- in San Diego to Hear Latest Scientific ets ranging from 40 to 73, re s e a rchers con- I n f o rma tion on Genitourinary Disease cluded that, at the same PSA level, older M o r e than 1,800 original re s e a r ch studies men are more likely to have extensive aimed at preventing, diagnosing, and tre a t i n g p ros tate cancer than younger men. adult and childhood diseases of the kidney, ure- H o w e v e r, the investigators did not advo- thra, and genitals, plus dozens of state-of-the-art cate setting higher PSA thresholds for education presentations, highlighted the 93rd older men because such a change might Annual Meeting of the American Uro l o g i c a l c o m p r omise the cure rate. Association® at the San Diego Convention Center, • Working with beagle dogs, medical scien- San Diego, California, May 30-June 4, 1998. tists have reconstructed a bladder from a With an expected overall attendance of 14,000, biodegradable polymer that delivere d m o r e than 7,500 urologists, other physicians, bio- regenerated cells from the interior lining of medical re s e a r chers, and health care pro f e s s i o n a l s the dog’s original bladder. They believe participated in the world’s largest and most com- that their tissue engineering can cre a t e p r ehensive urologic educational and scientific functional, anatomically normal bladder forum. These individuals attended plenary ses- for replacement or augmentation. sions, lectures, panel discussions, point/counter- point debates, poster and podium sessions, video Urinary Incontinence p r esentations, and instructional courses. General According to The National Association For topic areas featured included prostate cancer, Continence, Spartanburg, SC; and the “Clinical benign prostatic hyperplasia (BPH), erectile dys- Practice Guidelines of Urinary Incontinence in function (impotence), urinary tract infection, uri- Adults,” The U.S. Agency for Health Care Policy nary incontinence, kidney stone disease, infertility, and Researc h : bladder cancer, and kidney cancer. • Urinary incontinence — a loss of bladder Some of the important original re s e a r ch find- c o n t rol — is a symptom, not a disease. ings presented at the meeting included: • Causes of incontinence: • In a study involving 909 African American Birth defects men and 2,131 white males, each man Pelvic surg e r y received a prostate specific antigen (PSA) Injuries to the pelvic region or spinal cord test and a digital rectal exam or negative N e u r ological diseases p r ostate biopsy. None had known pro s t a t e Multiple sclero s i s c a n c e r. PSA levels in African American I n f e c t i o n men rose significantly at age 50, compare d Degenerative changes associated with to whites, and continue to escalate consid- a g i n g erably as the men aged. P r egnancy or childbirth • In double-blind, placebo-contro l l e d • 13 million Americans are incontinent — re s e a r ch that involved over 3,100 men 85% of them are women. with severe erectile dysfunction, 46% of • One in four women ages 30-59 have expe- those on oral sildenafil had much higher rienced an episode of urinary stress incon- s c o res for sexual penetration and for main- t i n e n c e . taining an erection than they had at the • 50% or more of elderly persons living at beginning of the study. home or in long-term care facilities are • Fifteen years after diagnosis, cancer mor- i n c o n t i n e n t . tality was dramatically affected by biopsy • Many people affected by loss of bladder grade at diagnosis for men with localized c o n t rol lose self-esteem and isolate them- p r ostate cancer which had been tre a t e d selves for fear of ridicule. conservatively with hormone therapy. Men • A p p r oximately 80% of those affected by with lower grade tumors encountered a incontinence can be cured or impro v e d . modest risk of death while those with high • Treatment options range from simple s c o res faced significant risk. changes in diet or medication to a combi- UROLOGIC NURSING / September 1998 / Volume 18 Number 3 209 Betsy J. Nielsen, BSN, RN (left), was the proud winner of a painting raffled to benefit the Jan LeBouton schol - arship fund. CBUNA President Cathie Green, MSN, A N P, CUNP, presented the award at SUNA’s 29th Annual Conference. and conducted by Louis Harris and Associates, Patricia Bates, BSN, RN, CURN, Urologic Nursing Inc. highlighted this link between health care and Editor from 1982 to 1998, received the Outstanding embarrassment. More than 90% of physicians sur- Contribution to SUNA award at SUNA’s 29th Annual veyed agreed that serious medical problems could Conference in San Diego. Accepting the award for Ms. be averted if patients were more willing to talk Bates was journal editor Catherine-Ann Lawrence, MA, RN (left). The award was presented by SUNA President about their pro b l e m s . Jan Giroux, MSN, RN,C, CURN. Embarrassment was the primary re a s o n patients were reluctant to talk with their doctors about health problems, garnering a rating of 25%. Embarrassment far out paced other leading factors nation of drugs, behavioral modification, such as thinking symptoms are unimportant pelvic muscle exercise, absorbent pro d- (11%), fear of bad news (8%), not wanting to ucts, surgery, and collagen injections. waste the doctor’s time (8%), and fear of tre a t m e n t • Despite the high success rates in tre a t i n g options (7%). incontinence, only one out of every 12 Loss of bladder control is one of those condi- people affected seeks medical help. tions that often causes people embarrassment. The Harris survey revealed that of those re s p o n d e n t s Incontinence Embarrassment Can Have who avoided talking to their physician about med- Serious Health Implications ical control, 52% said they would feel embarrassed As teenagers it seemed everything made us if their doctor asked them about bladder contro l . cringe in embarrassment. As adults, there are still Many people with bladder control pro b l e m s embarrassing subjects that even the most open- cope in silence because they fear ridicule. They try minded adults find difficult to broach with family, to change their lives to cope as best they can, self- friends, and even physicians. t reating or ignoring the problem rather than facing Undue embarrassment becomes a pro b l e m their doctor. However, not seeking treatment for when it affects our health and enjoyment of life. If bladder control problems can drastically re d u c e patients are unable to talk about bladder contro l quality of life, according to Dr. Leroy Nyberg , p r oblems with their health care pro v i d e r, they may d i rector of Urology and Women’s Health at the try to ignore or self-manage the problem, but they National Institutes of Health. “Many people with a re very unlikely to solve it independently. incontinence experience adverse psychosocial A recent survey on patient-physician commu- e ffects ranging from embarrassment to depre s s i o n nication issues sponsored by Pharmacia & Upjohn and social withdrawal,” said Dr. Nyberg. “Often, 210 UROLOGIC NURSING / September 1998 / Volume 18 Number 3 they stop exercising, traveling, or working because they live in fear that they will have ‘an accident’ in public.” By conquering embarrassment and seeking help, these problems often can be effectively tre a t- ed. Patients need to realize that they will not be the first or the last person to have this common p r o b l e m . Study Examines Patterns of Exercise and Fatigue in Physically Active Cancer S u r v i v o r s The April 1998 issue of the Oncology Nursing F o r u m has published the results of the study “Pattern s SUNA’s 29th Annual Conference offered many valuable of Exercise and Fatigue in Physically Active Cancer opportunities to network and reunite with friends and colleagues. Don’t miss SUNA’s 30th Anniversary Survivors.” The project provides support for exerc i s e Convention April 30-May 4, 1999 in Dallas. as an intervention for cancer- r elated fatigue (CRF). As the most common side effect of cancer, CRF has been reported to affect 40% to 90% of patients. The impact of CRF on patients’ quality of life and physical and emotional; and various psychosocial ability to carry out activities of daily living has sig- i n t e r v e n t i o n s . nificant implications for patients who experience a The text also covers several special topics, notable decline in functional ability during cancer such as psychosocial implications of genetic test- t r eatment. Exercise has been one of the few inter- ing and susceptibility, experimental therapy, alter- ventions suggested to prevent or decrease CRF. This native and complementary therapies, and physi- particular re s e a r ch describes how CRF affects the cian-assisted suicide. e x e r cise patterns of physically active individuals The book is $29.95 for ONS members and who received cancer tre a t m e n t .