The next International Continence Society (ICS) meeting will be held in Philadelphia at the end of this month. This year’s program, comprising a strong conservative management track, will certainly please the physiotherapy audience. As the physiotherapy representative on the ICS Scientific Committee, I had the opportunity to review the submitted abstracts ahead of time and was very impressed by the scientific quality. The findings of highly relevant studies, including large multicentre randomised clinical trials, will be presented. These studies not only comply with the highest standard and rigor in research, but their results will undeniably be a vector of change for clinical practice.
For instance, the ESTEEM trial conducted by Sung et al, received the Conservative Management Award sponsored by Essity. This study investigated whether combined midurethral sling (retropubic or transobturator) and behavioural/pelvic floor therapy is superior to sling alone for improving urinary incontinence in women electing surgery. A total of 464 women with mixed urinary incontinence participated in this multicentre study. Their results showed that the midurethral sling is associated with improvements in incontinence symptoms at 12 months. Most interestingly, the addition of behavioural and pelvic floor therapy was associated with greater improvements in urinary symptoms (UDI scores, number of total and urge episodes, urinary frequency, pad use) and quality of life compared to sling alone.
The COBALT randomised clinical trial also received the Conservative Management Award. The study evaluated drug and behavioural therapy in men with lower urinary tract symptoms. The goal of this multi-centre study was to assess whether combining behavioural and drug therapy improves outcomes compared to each treatment alone for LUTS in men. They also investigated different models for implementing combined therapy. Behavioural treatment comprised pelvic floor muscle training with urge suppression strategies and delayed voiding. The two-drug therapy consisted of an anti-muscarinic (sustained-release Tolterodine 4mg) + an alpha blocker (Tamsulosin 0.4mg). Based on their findings, the authors suggested to begin with behavioural therapy alone, as it yielded fewer side effects and better outcomes at 6 weeks. Overall, improvement is achieved more quickly when starting with behavioural therapy alone than when starting with drug therapy alone.
Furthermore, this year’s meeting entails a large number of abstracts focusing on e-technologies and innovative treatments to address various pelvic floor disorders. A complete session will hence be dedicated to this topic of interest. Several studies investigating Web apps will be presented including the feasibility, acceptance and efficacy of these e-technology modalities for anal incontinence, postpartum health, and male urinary incontinence.
In addition to the diversified scientific program, several workshops will be offered including a free workshop updating the evidence for conservative management of female pelvic floor dysfunction. Also, physiotherapists should not miss the yearly, well-attended, Physio Forum. It is an amazing opportunity to converse and share ideas with other physiotherapists worldwide on clinical and research topics. The ICS Annual Meeting will undeniably meet your expectations for learning more about the most up-to-date evidences, and to network with pelvic floor experts of all disciplines.
Article by Melanie Morin on behalf of the Physiotherapy Committee