Presentation Authors: Claire S. Burton*, Gabriela Gonzalez, Yuliya Zektser, Corey Arnold, Christopher V. Almario, Brennan M.R. Spiegal, Jennifer T. Anger, Los Angeles, CA
Introduction: Although pelvic floor disorders are common, women do not feel comfortable discussing their condition with others, including providers. Many turn to online support groups for prevention and treatment recommendations. To date we lack information about the quality of evidence behind recommendations on online forums. We sought to evaluate the level of evidence behind these recommendations.
Methods: We conducted a large-scale digital analysis of anonymous online posts. A total of 97,975 posts from social media sites were collected by Treato, a social media data mining service. 200 posts about Pelvic organ prolapse (POP), stress urinary incontinence (SUI), overactive bladder (OAB), urinary tract infection (UTI), and interstitial cystitis (IC) were randomly selected. We evaluated these posts for recommendations for the prevention of these diseases. Prevention strategies were then compared to current recommendations in available clinical guidelines and analyzed for level of evidence.
Results: A total of 239/1000 posts contained prevention strategies. For POP there were 41 strategies identified, 29 (70%) of which had either Level 4 or no evidence, including changing posture, breathing techniques, and limiting exercise. For UTI there were 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, such as avoiding carbonated beverages and magnesium supplementation. For SUI, 15/34 (44%) of prevention strategies had low or no evidence such as nutmeg supplementation, laser rejuvenation, and bladder training. IC had the highest number of prevention strategies, and most were low or non-evidence based (70/79, 89%), including aloe vera and herbal supplements.
Conclusions: Prevention strategies are common in online discussions of pelvic floor disorders, but at least a third of these recommendations have little to no evidence behind them. To the contrary, some prevention strategies with strong evidence are notably lacking, such as weight loss for POP. The lack of evidence suggests that there is a role for further education of evidence based prevention strategies as well as a need to conduct more research on holistic or natural strategies as there is clearly a high demand and use of these approaches.
Source of Funding: Funded by a pilot grant fromÂ NIDDKÂ Prevention of Lower Urinary Tract SymptomsÂ (PLUS) Research Consortium.